What are the prevention and risk factors associated with depression?
The concept of risk is a modern one. The word derives from the Italian riscare, meaning “to dare.” Before such a concept, the future could only be predicted by consulting the gods, prophets, or astrologers, and when bad things happened, they were attributed to fate. The concept of risk was born out of a simple yet practical question regarding games of chance when money was at stake. Given certain known events that just occurred in the game, what are the odds for winning the game? From there, everything about predicting the future grew and forecasting with degrees of certainty for future events of all kinds developed. Knowledge of risk gives one some power over future events so as to make the odds more favorable to one’s goals. For example, although wearing seat belts does not change the odds of getting into an accident, it does change the odds of surviving one.
In medicine, the knowledge of risk factors helps to understand the odds of developing certain diseases. It is important, however, to remember that odds, no matter how favorable or unfavorable, are still just odds with the outcome for any particular event still unknown. Just because the odds of developing lung cancer are greater for one who smokes a pack of cigarettes a day than one who does not, does not mean that the outcomes are certain.
There are risk factors that one can change and risk factors that one cannot. One cannot change the genes inherited from one’s parents, but one can use the knowledge of one’s family history to help make choices in life to reduce other risk factors contributing to the probability of developing a particular disease. Thus, recommendations for various diagnostic tests for breast cancer, colon cancer, and heart disease vary depending on whether someone has a family history for a particular condition. With all of this in mind;
The risk factors for depression are as follows:
- Gender: Depression is two times more likely in females.
- Age: The peak age of onset is 20-40 years.
- Family history: A person is at one and a half to three times higher risk when he or she has a positive family history for mood disorders.
- Marital status: Separated and divorced persons report higher rates. Married males have lower rates than unmarried males, and married females have higher rates than unmarried females.
- Postpartum: There is an increased risk for the 6-month period after childbirth.
- Negative life events: A possible association exists.
- Early parental death: A possible association exists.
- Premorbid personality factors: A possible association exists.
- Co-morbid psychiatric illnesses: A clear association exists.
- Substance abuse or alcoholism history: A clear association exists.
- Socioeconomic status: A possible association exists.
- Childhood conduct and behavior problems: There is a 20% increase at the age of 21 years.
The risk factors of developing recurrent depression are as follows:
- Multiple prior episodes
- Incomplete recoveries from prior episodes
- A severe episode
- A chronic episode
- Bipolar or psychotic features
Controlling the depression risk factor
In depression, the risk factors that one has control over are very limited when compared with diseases such as heart disease that has opportunities for lowering cholesterol, blood pressure, and weight, through various options, including diet, exercise, smoking cessation, and prescription medications. It is often difficult, if not impossible, to change exposure to any of the risk factors for depression mentioned previously here, except for substance abuse and alcoholism, and yet the perceived level of control over developing depression is much greater than other diseases, another paradox of mental illness! Regarding the risk of recurrence, some control over risk factors can be taken by ensuring aggressive treatment with a competent clinician or team of clinicians and sticking to the treatment plan, with frequent follow-up visits to ensure that the symptoms are controlled effectively with all available therapies.
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