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Divorce Found to Increase Antidepressant Use, Especially in Women

Divorce later in life, sometimes referred to as “grey divorce,” was found to lead to an increase in antidepressant (AD) use, particularly in women, according to results from an observational study published in the Journal of Epidemiology & Community Health.

“The partial recovery and the continuous increase in [antidepressant] use appear to support the marital resource model which…suggests that losing the partner may bring stressful changes in life circumstances (decreased household income, loss of social support) that persist or accumulate over time,” noted lead author Yaoyue Hu, Chongqing Medical University, Chongqing, China, and co-authors. “Our findings underscore the challenges of adapting to union dissolution in later life and the associated need for support.”

Related: Adults Living Alone at Higher Depression Risk Than Those Living With Others

Fixed-effects (FE) linear probability models were used in combination with Finnish registry data from 1996 to 2018 on 228,644 individuals aged 50 to 70 in 2000 to 2014 to examine the trajectories of AD use 4 years before and 4 years after divorce, non-marital separation, bereavement, and subsequent re-partnering. 

In the adjusted FE models, AD use increased for both genders studied in the 4 years prior to divorce (men: 5.00 percentage points [95% CI 4.50 to 5.50]; women: 6.96 [95% CI 6.34 to 7.59]), non-marital separation (men: 3.20 [95% CI 2.72 to 3.69]; women: 5.98 [95% CI 5.30 to 6.66]) and bereavement (men: 4.53 [95% CI 3.97 to 5.09]; women: 5.64 [95% CI 5.25 to 6.04]). Re-partnering only showed a minor reduction in AD use (0.1–1.5 percentage points) and was particularly short-lived in women. 

For the men studied, within a year antidepressant use fell back to the level it was 12 months before the break-up and remained at that level. Conversely, in their use tailed off only slightly immediately afterwards then quickly increased again from the first year onwards.

Researchers noted that women had greater increases in AD use than men following the dissolution of the relationship and hypothesized that it could be because “the costs of union dissolution on mental health fall more heavily on women than men.” 

They also noted that the lack of benefit in re-partnering could be due to the fact that “marriage benefits men’s mental health to a greater extent than women’s, and older men are more likely than women to seek emotional support from re-partnering…in addition, women may take greater responsibilities to manage interpersonal relationships between the blended families, such as those with the partner’s children, which could undermine their mental health,” authors concluded.

This being an observational study, there are several limitations, one being the researchers cannot establish a cause. Study authors noted they were unable to account for the number and length of partnerships. Additionally, they did not fully examine family support networks and living arrangements which may have had an impact on antidepressant use.

 

References 
Hu Y, Metsä-Simola N, Malmberg S, et al. Trajectories of antidepressant use before and after union dissolution and re-partnering in later life: a prospective total population register-based cohort study. J Epidemiol Community Health. Published online: February 6, 2024. doi: 10.1136/jech-2023-221529.

Women may find it harder to adjust to later life divorce and break-ups than men. News release. EurekAlert. February 6, 2024. Accessed March 18, 2024.