Women experience larger increase in antidepressant use after break-up than men, study suggests

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Although both divorce and remarriage are becoming more frequent later in life, there is insufficient research on their effects on mental health. A new study Journal of Epidemiology and Community Health Divorce, separation from cohabitation, or bereavement, trends in use before and after subsequent partnerships, as well as patterns of antidepressant use were explored among Finnish adults aged 50–70 years.

Study: Trajectories of antidepressant use before and after union dissolution and repartnership in later life: a prospective population register-based cohort study.  Image credit: Antonio Guillem/Shutterstock.com
Study: Trajectories of antidepressant use before and after union dissolution and repartnership in later life: a prospective total population registry-based cohort study.. Image credit: Antonio Guillem/Shutterstock.com

Background

Unlike previous generations, older people today are more likely to divorce and remarry or take on new partners. However, such relationships usually do not last as long as marital unions and repeated re-partnerships are common in this subgroup.

About 10-15% of people over the age of 55 have symptoms of clinical depression. Correlations with poor mental health have been identified, including divorce, nonmarital separation, and death of a partner, but little research has been done with these factors in this population.

Existing studies indicate that older adults show increased symptoms of depression, clinical or otherwise, after divorce. However, a US study found that depressive symptoms began before divorce, peaked with divorce, and gradually declined to pre-divorce levels over the next four years.

Other studies indicate similar trends, although recovery in the UK study appears to be significantly faster than in several US studies. However, none of these separately examined depression and antidepressant use among couples who broke up during cohabitation. The effect of new relationships is also evident, although some studies in the United States indicate that depression symptoms decrease in most men with the formation of new partnerships.

The study is based on Finnish population registry data from 1996 to 2018. It included about 230,000 people aged 50 to 70 in 2000-2014. The focus was on use of antidepressants during the four years prior to the end of any relationship, including death and subsequent formation of a new relationship.

What does the study show?

Among the large group, about one-third were bereaved, divorced or separated from cohabiting partners aged 50 to 70. Separation may occur at an earlier age than bereavement, leading to differences in socio-economic characteristics between these categories.

That is, bereaved individuals were more often employed, had higher incomes, and lived with children than bereaved individuals. The latter were more likely to own their homes.

After bereavement, less than 8% formed new relationships, vs. One in five divorce. In contrast, about half of those who left their cohabiting partners found new partners. Men were more likely to find a new partner after bereavement or the loss of their live-in partner, a difference not marked by divorce. A greater income was correlated with a higher rate of finding new partners.

Both men and women had the same average age at the time of divorce or forming a new relationship.

After adjusting for potential confounders, the scientists found that both men and women used antidepressants significantly more in the four years before and after the breakup.

Calculated as percentage points, the increase in divorce was five for men versus seven for women. With non-marital relationships, it was smaller by three and four, respectively. Men who lost their partners increased antidepressant use by five percentage points and women by six percentage points.

People are likely to increase their use of antidepressants just before a relationship ends, followed by a gradual decline. Final levels of use were, however, at a sustained higher level than before the event.

Even after making the new relationship, antidepressant use failed to return to baseline, with declines of 0.1–1.5 percentage points being temporary. Women showed a greater increase in their antidepressant use than men and a more transient partial recovery after finding a new partner.

While there was a slight increase in men’s use four years after separation from live-in partners, it declined and stabilized at levels recorded the year before the event. Women show greater increases, but hardly any recovery after such separation, and rates of use begin to rise gradually after one year.

After a live-in partner breakup, antidepressant use decreased slightly in the four years before repartnering for both sexes. It starts to rise again a year after repartnering, for men, but within 6 months, for women.

Among bereaved couples, antidepressant use began to increase in the four years preceding the event, but particularly rapidly among women. Men and women showed greater increases in antidepressant use three months after their partner’s death than 3 months earlier. A small decline in use occurred later, but it never returned to baseline.

After finding a new partner post-bereavement, both sexes had a reduction in antidepressant use from 6 months before the event to 6 months after. For women, it continues to increase after that.

With divorce, men and women began using antidepressants more often over the previous four years, peaking in the previous six months. This was followed by a decline associated with divorce, although usage rates were higher than before divorce. By re-partnering, the trend increased before and after eight years, with a one-year break just before re-partnering for women. For men, this hiatus lasts for a year before and after repartnering (“the honeymoon effect”).

What are the effects?

Both men and women suffer from depression at equal rates, as reflected by antidepressant use after bereavement later in life. However, when separated from live-in partners, women showed twice as much increase in antidepressant use as men.

The authors suggest that losing one’s life partner can trigger a cascade of harmful effects, including loss of income and social support that builds up over time, and this appears to be particularly relevant for women who separate from their live-in partners compared to men. feels Same situation.

Greater growth in [antidepressant] The use associated with union dissolution among women in our study may actually be related to the fact that the costs of union dissolution on mental health fall more heavily on women than on men.

More research is needed to understand why new partnership formation is helpful in reducing antidepressant use only among bereaved and separated live-in couples but not divorce.



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