During the sensitive period of social development, depression can affect mental health well into adulthood, according to a report published by the science journal Nature.
The study compared the social functioning of adults that had suffered from depression since their young age (10-20 years) to depression in adulthood (ages 21+). Over 3,300 individuals who had experienced severe depression participated in the study.
The study analyzed a diverse set of practical aftermaths of depression in the participating individuals, including marital status, divorce, number of children, years of education, employment status, household income, dependency on welfare, and obesity.
The study concluded that “depression during adolescence were less likely to get married, have children, and more likely to have lower household incomes.”
Furthermore, the World Health Organization (WHO) said that about a billion people, or one in 8 people globally, were living with mental health issues.
Depression at a young age has a severe negative impact on individual well-being and society. The researchers suggested effective mitigation through timely intervention and effective policy.
Depression can be devastating to multiple facets of an individual’s life, extending beyond sheer emotional distress. Compared to healthy controls, individuals who are currently depressed have diminished academic achievement and occupational functioning, experience more interpersonal conflict, and are more likely to be afflicted with comorbid conditions.
The concurrence of multiple stressful life events with depression is termed stress generation, which expounds how the cycle of stress and depression affects an individual’s life and social world in a disruptive, reverberating fashion8. The present study explored whether onset of MDD during adolescence, a sensitive period of social development, is associated with poorer adulthood functioning in ways that extend beyond health.
During sensitive periods of psychosocial development9, the harmful effects of depression and other psychiatric disorders may be amplified. Adolescence is a sensitive and transitional period of development during which individuals undergo dramatic biological, cognitive, and social changes.
It typically starts with pubertal maturation (beginning around age 10) and ends when individuals take on independent social roles and adult responsibilities12. During this time, adolescents are learning to navigate an increasingly complex social world while more sensitive to social stimuli, social deprivation, and peer rejection.
Superimposing a syndrome that involves social withdrawal, amotivation, and profound changes to weight and sleep that have both visible and cognitive consequences may have lifelong sequelae. This possibility has extraordinary scope given that the prevalence of depression more than doubles during the transition from childhood (2–4%) to adolescence (4% to 14%) and at least half of the individuals who develop depression in their lifetimes experience their first depressive episode by age 14, and three-fourths by age 24.
Early adolescence may be a more stressful time for females than males due to the cooccurrence of multiple stressors. Early maturing girls are especially vulnerable because of shifts in body image and the increased likelihood of being sexualized or harassed.
Symptom presentation differs between adolescent females and males, with females being more likely to display internalizing problems (e.g., self-blame, social withdrawal) while males typically show more externalizing behaviours (eg aggression, substance abuse).
Females are more likely to attempt suicide, while males are more likely to complete suicide due to the lethality of the methods used. These differences in symptom presentation may lead to differential sequelae in adulthood.
For effective policy and intervention, there remains much to know about the adulthood functioning of individuals who experienced depression during adolescence. One recent seminal study followed a sample of 1420 youth from age 9 to age 30 and assessed for psychiatric disorders up to 8 times between the ages of 9 and 16 years.
They found that depression during childhood or adolescence was associated with higher risk of anxiety, illicit substance use disorders, worse health, and poorer social functioning in adulthood. Further, a meta-analysis published in 2019 reviewed 31 articles of 24 different cohorts and reported consistent associations between depression during adolescence and a wide range of negative functional outcomes an average of 9 years later, notably lower academic achievement and higher rates of unemployment.
Taken together, there is clear evidence that experiencing depression during adolescence has broad implications for adulthood functioning, though no studies to our knowledge have examined this association beyond age 35, or addressed the potential modifiability of these long-term sequelae.
Indeed, efforts to develop effective depression programs in adolescence have been promising, though their effects have seldom been followed for as long as 1 year. Therefore, we have little evidence to inform whether effective treatment for depression during adolescence would also confer benefits for functioning in adulthood.
The present study sought to extend these gaps in our knowledge by leveraging data from the National Comorbidity Survey Replication (NCS-R), and compared adulthood functioning in nine domains between individuals with a history of depression that began during adolescence (between the ages of 10 to 20) to those whose first episode occurred in adulthood (age 21 and older).
Consistent with theoretical models of adolescence as a sensitive period of development, we hypothesized that adolescent-onset participants would be less likely to reach social milestones (eg marriage, children), more likely to have poorer occupational outcomes (e.g., income, education), and more likely to have poorer health (e.g., obesity). We further hypothesized these patterns would differ when looking at females and males separately, and would be less robust among participants who received treatment for their depression during adolescence.
