At the recent National Prayer Breakfast, President Trump called the United States a “nation of believers.” The highly Christian language of his speech—focused on the Bible and being “created in Jesus Christ”—underscored for some the president’s focus on Christian nationalism and the exclusionary nature of his vision for America.

Of course, there can be real problems when a nation circumscribes who belongs and who doesn’t by whether they are people of faith. That type of social duress can be culturally and personally unhealthy. In fact, according to a recent study in the journal, Society and Mental Health, individuals who consider leaving a faith, but do not, tend to experience more depression than those who decide to leave.

The research, done by Matthew May, assistant professor of sociology at Oakland University, analyzed the still data-wealthy Portrait of American Life Study (PALS), which (through 1300 interviews) focused on the religious life of 2,610 participants from 2006-2012.

“PALS,” says May, “is the only data set that asks people if they have seriously considered dropping out of religion.”

May looked at those who left a religion altogether (“leavers”), those who considered dropping out of religion, but did not (“stayers”), those who never considered leaving (“stable affiliates”), and the nonreligious (“stable nones”). Tracking responses from the Portrait of American Life Study, he was able to show a correlation between depressive feelings and remaining in a faith for “stayers.”

“Although most people never think about dropping out of religion,” May tells The Daily Beast , “a growing number of people are leaving the pews. Social scientists tend to give a lot of attention to these ‘leavers.’” These are “the Nones”—the spiritual, but not religious, atheists, and agnostics—and, according to the Public Religion Research Institute, they are roughly 24% of Americans.

But, as May points out, “we haven’t given much attention to the people who think about leaving and decide to stay.” This group intrigues him the most, and he sees room for more research into what drives their struggle.

“We all have many identities that reflect the different roles we occupy,” says May. “Each of these identities comes with certain expectations, and we tend to look to others to see if we are meeting these expectations.” Distress occurs when our identities do not match what we believe others expect of us—and this instability can be especially true for those considering leaving religion.

Caleb Lack agrees with the results of May’s study, seeing a strong player in doubt. He serves as associate professor of psychology and practicum coordinator at the University of Central Oklahoma, and director of the Secular Therapy Project. The Secular Therapy Project connects the non-religious who need mental health services with mental health professionals.

“I’d say it both matches our experience and isn’t unexpected based on what we know about how uncertainty impacts us,” says Lack. “If we exist in a state of uncertainty, such as what exists if I am not sure about, or wavering back and forth between, religious belief and doubt, then people are naturally more vulnerable to developing anxiety and depression.”

There are good reasons to not underestimate the instability of doubt, says Lack.

“Doubt is often framed in religious communities as showing that you aren’t a ‘good’ Christian or that the devil is tempting you and you are too weak to resist,” Lack explains. “Given that, many people who have doubts either get shamed by their communities when they express doubt or feel shame at their ‘weakness.’”

This may, he says, lead individuals to withdraw from their social support groups, such as friends or family.

Kevin (last name is withheld to protect his privacy), a 40-year-old seminary graduate, knows the difficulty of extricating oneself from a faith tied to family.

“There are definitely times where I get the feeling of being trapped and unable to express my true thoughts, which does lead to moments of depression,” says Kevin.

“I have opened up to only a couple friends and somewhat to my wife to provide some outlet,” he says, “but having to avoid or hide from certain topics often weighs heavy on my mind. I would not say that I have a feeling of worthlessness, but definitely can get a feeling of hopelessness.”

Raised in an independent Baptist church, which he considers fundamentalist in nature, Kevin has yet to fully leave and embrace all aspects of his new identity.

“From a private perspective, I no longer identify as a Christian. From a public perspective, I have let others draw their own conclusions,” he tells me. He’s not in church or affiliated with a faith organization of any kind, but it gets complicated with family.

“I believe that it is family relationships that prevent me from leaving fully. I am concerned that disclosing that I have left Christianity to my parents and my wife’s parents will lead to greater every day strife for both me and my wife. I am constantly weighing this decision in my mind to see if, and when, I am ready to take on this challenge.”

A similar struggle in that middle-place of identity can also be found for Muslims who have considered leaving Islam.

May’s research “matches my experience, both personal and professional,” says Sarah Haider, co-founder of Ex-Muslims of North America (EXMNA), an organization that “advocates for acceptance of religious dissent, promotes secular values, and aims to reduce discrimination faced by those who leave Islam.”

As with Kevin in Christianity, ex-Muslims may never disaffiliate from Islam completely.

“I would say a majority of those who join our communities, and no longer believe in the faith, continue to be affiliated with the religion publicly and do not ‘come out’ due to fear of persecution,” explains Haider. “They routinely express frustration with the life they are living and the choices denied to them.”

This struggle with authenticity, she says, is a source of distress. “It doesn’t seem natural or easy to force yourself into living a lifestyle you don’t believe in.” This, she adds, brings in “elements of isolation, negative self-views, a sense of hopelessness, and even suicidal thoughts. They may feel as if they have surrendered their future, as their choice to stay often has far-reaching consequences.”

Being caught between two worlds, she says, means individuals are culturally expected to marry someone who does not share their perspective on the world. Parents may be frustrated with expectations on how they will raise their children, or even—should those parents choose to leave Islam later—find themselves ostracized by their children.

May says that the act of leaving enables a person to embrace a new identity and to “alleviate this distress.” But what is really considered “leaving?” As with Kevin’s situation, or in the case of former Muslims, considering dropping out of a faith, or even the very notion of having left, falls along a spectrum.

Still, for those who manage to find their path out entirely, this acceptance of a new identity can mean an entirely new life.

“[My] faith background growing up was mostly non-denominational,” says 26-year-old Jordan Harper from Albuquerque, New Mexico, and “that most closely aligned with Reformed Baptists.”

Reformed Baptists are “very conservative,” Harper adds, meaning there are “no women in leadership, no women teaching except for young (usually middle school age and below) children. [This meant] no drinking, [and] no dancing when we lived in the Midwest, but [the rules were] more lax on those points on the East coast and the Rocky Mountain region when I was older.”

Homeschooled, Harper eventually left that world and went to college at Moody Bible Institute in Chicago, Illinois.

“I joined the Lutheran church as I searched for something I could better tolerate. [I] started in the Missouri Synod, which is extremely conservative, and the last church I attended before I finally left Christianity was an extremely liberal...ELCA church [Evangelical Lutheran Church in America].”

That all ended in 2017, when Harper left religion entirely.

No longer a Christian, Harper now identifies as spiritual and settled on “eclectic paganism, with a dash of Chaos Magick thrown in.” Additionally, that journey also involved a new public gender identification.

“I am ambigender,” says Harper, “both male and female simultaneously without much if any fluidity or switching.” Being ambigender means foregoing the gender binary terms of “he” and “she” for “they” and “them.” In that process, they took on the new name of Jordan Harper—a choice that represents a new life.

Harper already struggles with a depressive disorder, but says being in the church stoked that strong cognitive dissonance. This new freedom allowed that to dissipate.

“Changing my name became very symbolic of that time in my life, and an appropriate memorial to a time when so many charades and secrets were allowed to end, and the emotional chaos finally found some peace.”

So how should one go from being a “stayer” to a “leaver?”

Secular Therapy Project’s Lack sees these transitions out of a faith, which for his group frequently involves secularity, as a journey one should never take alone.

“I would recommend finding someone nonjudgmental and supportive to discuss this with,” he says. “That could be a friend or a family member, or it could be a mental health professional, such as those in the Secular Therapy Project.”

EXMNA’s Haider urges careful forethought in leaving.

“Some of these negative feelings can be alleviated by leaving religion,” she says, “however the chances of success appear to be higher the earlier one gathers the courage to be open and honest about themselves.”

She adds that getting an education and a good job can provide the independence one needs to be free to be themselves. “Distance and independence can do wonders for [one’s] psychological well-being,” she says, particularly, “for those who feel as if they are being coerced into a faith they have doubts about.”

In the end, stayers and leavers want to be understood and respected for being true to themselves.

“Others should know that, at least in my case, dropping out of my religion is not a decision made lightly,” says Kevin, adding that “it is not the result of some tragedy, nor a momentary lapse of reason,” rather, “one cannot simply believe something one no longer believes.”

But this, he insists, should be a chance for openness, not boxing someone into a religion.

“I would want for others to have open, true dialog with me about my positions. I would want for others to be willing to accept individuals regardless if they share the same beliefs or not.”