When Mental Illness Discriminates: Experiential Risk Factors for Major Depression

Women are twice as likely as men to experience major depression in their lifetime. The reasons for this are not entirely understood, but researchers believe that biological, psychological, and sociocultural components play a role in predisposing women to depression. In addition to potential genetic and hormonal factors, women as a group are paid less money, take on a larger proportion of unpaid labor in the home, are more deeply involved in raising children, are more likely to be victims of sexual violence or intimate partner violence, and are more likely to outlive their partners. As a result, women may be more likely to be exposed to overwhelming stresses that can trigger major depression.

Despite the great gains that the LGBTQ community has made in recent decades, discrimination against and othering of LGBTQ people continues to persist, sometimes with devastating results. The bullying, violence, harassment, and alienation many have experienced – and continue to experience – as result of their sexual orientation or gender expression can create serious stress, trauma, and social isolation that fuel the emergence of major depression. Parental rejection, in particular, is strongly associated with depression and suicide attempts. The most severely affected group within the LGBTQ community is transgender people; a 2013 study found that an astounding 50% of trans people experienced depression and that the level of available social support was inversely proportional to the severity of depression. Additionally, gay and bisexual men are “3.0 more likely to meet criteria for major depression.” One factor that may contribute to this is the prevalence of HIV in the gay community, along with widespread social stigma against HIV+ positive people. As Matthew Hodson, Chief Executive of the Gay Men’s Health Charity says, “Rates of depression among gay men with HIV are twice as high as they are among other gay men, affecting about one in every four men.” Interestingly enough, lesbians do not appear to be at increased risk for depression due to sexual orientation and experience depression at about the same rate as heterosexual woman.

If you’ve never had depression in the past, your chances of experiencing depression following divorce remain relatively low – about 10%. However, if you have a history of depression, that risk jumps to 60%. Since women are more likely to have a history of depression, it would be logical to assume that women are more likely to experience post-divorce depression. According to Statistics Canada, however, that assumption would be false; in fact, men are twice as likely as women to report an episode of depression in the two years following divorce. Researchers believe that this heightened depression risk is due to decreased contact with children, social isolation, lifestyle changes such as increased alcohol and drug use that were previously tempered by their social role as a husband, and the fact that men are less likely to initiate divorce. Additionally, men are less likely to have a strong social support network outside of their marriage and may be “less accustomed to seeking or receiving non-spousal emotional support.” In contrast to women, who tend to report positive growth, confidence, and independence following divorce, men are less likely to report any benefits of divorce.

While a surge of media attention has put the spotlight on postpartum depression, many mistakenly believe that the phenomenon is largely random, biologically-based, and affects only women. Although it is true that any woman can experience postpartum depression and there may be a biological component for many, large numbers of both men and women – 26% and 42% respectively – report significant depressive symptoms in the early years of parenthood, suggesting that this form of psychological distress is rooted in something other than the chemical workings of the body. As Dr. Eli J. Finkel says, “The fact that postpartum depression rates are much higher among the poor than among the wealthy, who can purchase peace of mind through hired child care, supports the idea that the phenomenon is, in most cases, more circumstantial than biological.” Social isolation, financial stress, changing interpersonal dynamics and conflict with your partner, loss of autonomy, impaired ability to engage in healthy self-care practices, and disruption of your sense of self may combine to trigger overwhelming distress that manifests as depression. Depression also isn’t limited to new parents; parents – both men and women – are more likely to experience major depression than adults without children across the board and symptoms may become more severe when children leave home.

The idea that people come to the United States for a better life is part of the very foundation of the country’s genesis story and contemporaneous self-identity. Often, however, the immigration experience is far more complicated and many immigrants find themselves in serious psychological distress even when established in their new country. A study published in the Archives of General Psychiatry found that Mexicans who immigrate to the United States are significantly more likely to experience depression than their peers who stayed in Mexico. The effect was particularly pronounced in younger people; depression risk amongst immigrants between 18 and 25 was 4.5 times that of same-age non-immigrants. In Canada, which has one of the highest immigration rates in the world, researchers have probed the causes of immigrant depression and believe that the roots can be found in a complex network of social and economic factors such as social isolation, language difficulties, unemployment and under-employment, rejection, and discrimination. Skilled immigrants forced to take jobs below their level of education may be particularly prone to depression. “They are demoralized,” says Normal Sanchez, a coordinator at Vancouver Community Mental Health Services. “Their socioeconomic status really comes down, and that creates a lot of distress.”

For some, living alone is ideal; you can have all the solitude and autonomy you want while never having to negotiate what to watch on TV or coming home to find that someone has eaten the leftover Chinese food you’ve been thinking about all day. For others, however, solitary living can drastically increase the risk of major depression. According to a study on 3,500 Finnish people between the ages of 30 and 65, people who live alone were 80% more likely to receive a prescription for antidepressants than those who lived with spouses, family, or roommates. Because the study only examined diagnosed and treated cases of depression, the true number may be even greater. It has long been known that social integration, particularly face-to-face social encounters, can have profound protective benefits against psychological distress and living alone decreases the likelihood of experiencing those advantages. As Beth Murphy of the mental health charity, Mind, says, “Loneliness and isolation results in people having fewer outlets to talk about how they are feeling, which we know can really help to manage and recover from a mental health problem.”