The Role of Spirituality, Meaning in Life, and Existential Well-Being in Depression, Anxiety, and Suicidality: A Systematic Review
DOI:
https://doi.org/10.66687/jebmr.2.03.2026.38Keywords:
Meaning in life, spirtuality, depressionAbstract
Background: Spirituality, meaning in life (MiL), and existential well-being (EWB) have increasingly been investigated as psychological and existential resources relevant to depression, anxiety, and suicidal thoughts and behaviours. However, these constructs are frequently conflated with religiosity, despite evidence that their associations with mental health may differ.
Objective: To systematically synthesize empirical evidence concerning associations of spirituality, spiritual well-being, EWB, and MiL with depression, anxiety, suicidal ideation, suicide attempts, and related suicide risk, and to evaluate evidence from interventions explicitly targeting meaning or spiritual/existential well-being.
Methods: Searches were conducted on 19 August 2026 across PubMed-indexed literature, Europe PMC, and Semantic Scholar using combinations of terms for spirituality, spiritual well-being, existential well-being, meaning/purpose in life, depression, anxiety, and suicidality. The auditable retrieved screening corpus contained 95 records: 39 PubMed-indexed records, 30 Europe PMC records, and 26 Semantic Scholar records. Three duplicate title/DOI records were removed, 92 records were screened, and 35 primary studies met eligibility criteria. Screening, extraction, and design-specific risk-of-bias appraisal were conducted by one reviewer. Owing to substantial clinical, methodological, and construct heterogeneity, meta-analysis was not considered appropriate and narrative synthesis was performed.
Results: Across clinical, community, student, oncology, renal, psychiatric, military/veteran, and older-adult populations, higher EWB and presence of MiL showed the most consistent inverse associations with depression, anxiety, and suicidality. EWB was frequently more strongly associated with mental health than religious well-being. Presence of MiL predicted lower subsequent suicidal ideation in several longitudinal studies, whereas searching for meaning showed heterogeneous and context-dependent associations. General spirituality was usually associated with favourable outcomes but was less consistent after adjustment for social support and other psychosocial factors. Randomized trials of meaning-centered and spiritually oriented interventions demonstrated improvements in meaning/spiritual well-being and selected depressive, anxiety, hopelessness, or desire-for-hastened-death outcomes, although effects were not uniform.
Conclusions: Existential meaning, coherence, peace, and purpose appear to constitute clinically relevant protective resources across depression, anxiety, and suicidality. Evidence is strongest for EWB and the presence of MiL rather than for religiosity per se. Nevertheless, causal interpretation is limited by the predominance of observational studies, self-report measurement, cultural heterogeneity, and potential reverse causality. Future longitudinal and mechanism-focused trials should distinguish spiritual, religious, existential, and meaning-related constructs rather than treating them interchangeably.
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