Boys and girls have the same rate of depression until they reach adolescence. Between the ages of 11-13, the rate rises sharply for girls. By age 15, girls are twice as likely as boys to have depression, a trend that continues throughout adulthood.
Adolescence is a stressful time involving physical, hormonal and intellectual changes. Stresses include identity, sexuality, separation from parents and independence. Girls experience these stresses differently from boys, which may be a risk factor for developing depression. Parents may not recognize depression in adolescents, viewing withdrawal from the family as a "normal" part of being a teenager. However, parents should watch closely for confusing signs between teenage rebellion and clinical depression.
In general, stress can contribute to depression in people who are biologically vulnerable to the illness. Some professionals think that the greatest contributor to the higher rates of depression in women isn't their greater vulnerability, but the number of stresses they face, including major responsibilities at home and at work, single parenthood and caring for children and aging parents. How these factors uniquely affect women is not yet fully understood.
The rates of depression are highest for people who are separated or divorced and lowest among the married, although the rates remain higher for women than men regardless of marital status. Reasons for the higher rates of depression in women who were unhappily married were that they lacked an intimate, confiding relationship or they frequently and openly argued.
As with younger women, elderly women are at a greater risk of major depression than elderly men are. Similarly, being single-including widowhood-is also a risk factor. About 800,000 men and women are widowed each year. Most of them are older females who experience different degrees of depressive symptoms. One-third of widows/widowers met the criteria for major depression in the first month after the spouse's death and half of them continued to be depressed one year later.
In a study of elderly, mostly white women, stress earlier in life increased their risk for major depression. Greater childhood adversity, higher levels of negative life events and marital stress earlier in adulthood were also associated with later major depression.
Bereavement can look similar to clinical depression. Grief may resolve without medical intervention as the loss is metabolized and with the support of family, faith and friends. In some cases, though, a true depression originating in grief requires more active intervention to help a person move forward.
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