Depression and life events

Life events and depression

Reviewed by Dr Ciaran Mulholland, MRC clinical scientist, senior lecturer and honorary consultant psychiatrist

What are life events?

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These are changes that occur suddenly in someone's life. They don't necessarily have to be bad, and so can be viewed as being either desirable or undesirable.

Life events have been classified according to how stressful they are, as Holmes and Rahe^[1] attempted to do in 1967. This consists of over 40 classes of life events.

Another scale used is the Life Events and Difficulties Schedule by Brown and Harris ^[2].

Particularly stressful life events include death of a spouse, divorce and marital separation. Examples of other events that are rated include redundancy and retirement.

Why are life events important?

There's good evidence to link life events with the onset of both psychiatric illness and physical illness.

Examples of such a link are when someone presents to their doctor with abdominal pain after a life event and a healthy appendix is then unnecessarily removed ^[3]. Psychiatric illnesses, which can be associated with life events, include anxiety, depression and deliberate self-harm.

It is, however, often difficult to decide whether life events are dependent or independent.

Dependent life events may be secondary to depression – eg someone may lose their job because they are not working as efficiently due to a deterioration in their attention and concentration as a result of depression.

Independent life events, on the other hand, do not occur as a result of symptoms of an illness – eg losing your job as a result of cost saving measures and then becoming depressed as a consequence.

Depression and life events

In different research studies, an excess of life events has been shown to occur in the three months prior to an episode of depression – and it has also been found that the risk of depression can increase six-fold in the six months after experiencing markedly threatening life events.

After studying women in London, Brown and Harris divided circumstances that can increase the vulnerability of a person to life events into two kinds.

· Long-term difficulties such as ongoing, stressful circumstances. These include things like long-standing difficult relationships. These can cause depression and can make the effects of life events worse.

· Vulnerability factors. Again, these can make the effects of life events worse, although they can't in themselves cause depression. These include having three children under the age of 14 years, not working outside the home, having no one to confide in and loss of one's mother by death or separation before the age of 11 years.

However, further studies made after Brown and Harris's research have not always supported their findings.

Дата добавления: 2015-10-26