While depression can strike anyone at any time, research has identified several factors associated with an increased risk for depression:
- Family History—Having an immediate family member with depression increases the risk of developing depression. Other mental illnesses, such as alcoholism in family members, also can increase the risk for depression.
- Early Childhood Experience—Early childhood trauma, such as loss of a parent before adolescence, child neglect, physical, emotional or sexual abuse, and parental divorce are all linked to increased risk for adult depression.
- Stress—Negative life events, such as divorce, loss of a loved one or loss of employment are associated with increased depression. Research shows that chronic stresses (such as illness, lack of social support and numerous “daily hassles”) also are linked to depression.
- Alcohol—Depression and alcoholism often is seen in the same patient at the same time. Alcohol is a depressant and its presence in a depressed person has serious implications on treatment outcome (see Alcohol and Depression).
- Residence—Depression seems to be higher in urban residents than in rural residents. In fact, one study found that depression was twice as common among city dwellers than among those who lived in rural settings.
- Marital Status—Depression is highest among divorced, separated, or cohabiting persons. It is lowest among single and married persons. People living alone have higher rates of depression than those living with others do.
- Work Status—Research shows that people unemployed for six months or more in the last five years had a rate of depression three times that of the general population.
- Physical Illness —Certain physical illnesses, such as thyroid disorder, hormonal imbalances, chronic viral infections, cancer and heart disease, are associated with depression.
- Medications—Many medications can cause depression-like symptoms, including sedatives such as Valium (diazepam) and pain medications such as Percocet™ and Demerol (meperidine).
- Gender—Recent research by the National Institute of Mental Health estimates that one in four women and one in 10 men experience some type of depression during their lifetime. While women suffer from depression more often and attempt suicide more frequently, men are more successful in their suicide attempts. Women also suffer from unique forms of depression related to their unique biology and life experiences.
- Age—Most people experience their first episode of depression between the ages of 20 and 40. In fact, the average age of onset for depression is the mid-20s. Alarmingly, recent research shows that the average age of onset is decreasing with each generation. Children, adolescents and elderly persons often display unique symptoms of depression and have specific stressful events that predispose them to depression.
- Ethnic and Cultural Groups —The World Health Organization named depression the fourth most devastating illness in the world today and predicts that it will become the second ranked illness by 2020. No ethnic or cultural group is immune. While depression occurs at about the same rate in different groups, ethnic and cultural differences often affect the ways in which people express their feelings and their willingness to seek treatment.
Tobacco—Increased tobacco use has been noted in depressed persons and individuals with underlying or current depressive symptoms are likely to experience mood disturbances when they attempt to quit.
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Michael Herkov, Ph.D., and Wayne Goodman, M.D. also contributed to this article.