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Breaking Up Is Really Hard (on You?)

Combination of Loss and Humiliation May Trigger Depression
WebMD Health News

Aug. 13, 2003 -- Breaking up is not only hard to do, but a romantic split may also be especially hard to handle and possibly trigger a bout of depression.

A new study shows romantic breakups can literally add insult to injury by piling humiliation on top of loss, dramatically increasing the risk of depression.

In the largest study to date to rate the role that stressful life events play in triggering depression, anxiety, or a combination of both, researchers found the risk of depression doubled in months when an episode of humiliation occurred along with a serious loss.

"For example, if your marriage breaks up, that's a loss, and it's reasonable to expect that you will experience aspects of grief, including sadness and loss of appetite," says researcher Kenneth S. Kendler, MD, professor of psychiatry at Virginia Commonwealth University, in a news release.

"If your marriage breaks up and your husband moves into a house a few doors away with a woman half his age, and he shows off his new girlfriend to your friends and family -- that's grief combined with humiliation. Most cases of combined loss and humiliation involved romantic breakups."

Rating Depression Risks

Using a five-point scale, researchers rated the impact of various stressful life events based on interviews with a group of 7,322 male and female twins that were divided into four broad categories:

  • Humiliation (such as a breakup sparked by infidelity)
  • Entrapment (an event that makes a person feel trapped in a bad or worsening situation)
  • Loss (death of a loved one)
  • Danger (fear that a traumatic event will occur)

They then matched the event ratings against episodes of depression, anxiety, and mixed depression/anxiety reported by the participants in the previous year.

The study found the risk of depression or mixed anxiety/depression was significantly higher in months in which there were high ratings for both loss and humiliation, especially if a romantic breakup was involved.

For example, the risk of depression in a month in which there was a breakup that was initiated by the other person or prompted by an infidelity or violence was about 22% compared with a 10% risk of depression in a month when a loved one died but no humiliation occurred.

"Love can make our life wonderful, but it also can make us miserable," says Kendler.

Other findings of the study, which appears in the Archives of General Psychiatry, include:

  • An episode of anxiety was much more likely to occur in the month following a month with high scores for loss and danger.
  • High ratings of entrapment, in contrast, were only predictive of mixed bouts of depression and anxiety within the month that the event occurred.
  • Although the effects of loss and humiliation in increasing the risk of depression were limited to the month in which the events occurred, the impact of danger on the risk of triggering mental illness was more prolonged.

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