WHAT IS A RISK FACTOR?
‘Risk factors’ are variables affecting groups of people which increase the likelihood of developing depression. Uncovering and understanding risk factors not only provides insight into the sources of depression, but also is important for identifying at-risk children and teens before they develop depression, and developing preventative care interventions.
DO RISK FACTORS CAUSE DEPRESSION?
While researchers have identified many key variables that correlate with the development of depression, no singular causal pathway has been identified. Mental illness, in the vast majority of cases, is influenced by many factors which interact in unique ways for every individual. In all likelihood, depression has no universal cause, and is instead a common product of an individual’s various characteristics and experiences.
WHAT ARE COMMON RISK FACTORS FOR DEPRESSION?
Stress
Stress is rampant amongst teenagers. Not only are their bodies and brains changing rapidly, they are under pressure to conform to new social expectations. During this time, stressful life events have increased negative impact on teen’s mental health. Teens with higher stress levels, such as when under-going academic pressure, dealing with parental divorce, or being bullied by peers, are more likely to develop depression. Stress is also experienced more by social minority groups, such as LGBTQ+ teens and racial/ethnic minorities. For marginalized people, stressors are usually more common and combinations of stressors may amplify effects. Most of the risk factors examined in this section related to increased stress levels.
Children who have family members with depression have an increased risk of having depressive episodes, showing that depression has a genetic component, and is somewhat heritable. The greater the genetic relationship between the family member(s) with depression and the child, the greater the risk of the child developing depression.
However, genes do not predetermine who develops depression and who does not. Someone genetically predisposed towards depression may not develop depression if they are supported by their environment.
​Having a family member with depression affects children in more ways than the simple transmission of genes. Depressed parents may create environments which elevate the risk of depression in their child, such as not being able to adequately respond to their child’s emotional needs. Children may also internalize their parents' problems and blame themselves.
Family Members with Depression
Financial distress is a risk factor for many forms of mental illness, particularly depression. Poverty is related to increased parental stress, greater exposure to stressful life events (like divorce, abuse, relocation), less access to resources (especially mental health resources), and exposure to bad neighborhoods and violence.
Poverty
Unsurprisingly, children and teens that have experienced trauma, especially abuse or neglected at any point in their lives are at an increased risk for depression, as well as many other forms of mental illness. Special resources are available to teens who have undergone trauma.
Trauma
Temperament is an innate and stable pattern of behavior which forms the building blocks of personality. Temperament appears in early infancy, and certain temperaments predict higher risk for depression.
Low positive emotionality: Children with low Positive emotionality tend to be less receptive to reward, less sociable, and involved with their environment.
​High negative emotionality: children with high negative emotionality tend to have more negative emotions, like fear, anger, and sadness. They also tend to be more anxious and responsive to threat.
Temperament
Relationships with peers are incredibly important during adolescents, when teens’ identity, self-image, and place in the world are being shaped and explored. Teens who experience loneliness, rejection, victimization, and negative friendships are at higher risk of becoming depressed. Moreover, teens with poorer social skills, and socially marginalized teens are more likely to have these issues.
Peer Relationships
Past Depressive Episodes
One of the greatest predictors of future depressive episodes is experiencing past depressive episodes. In adolescents, depressive episodes tend to be brief, but are highly recurrent, and predict depression later in life. The more episodes of depression that are experienced, the more at risk one is to later depressive episodes.
Although all teens experience significant stress and heightened risk of depression, girls and trans teens are at higher risk. During childhood, rates of depression are equal across sex and gender, however, at puberty, girls and females are twice as likely to become depressed. Transgender adolescents are also more at risk than their cisgender peers. Not only are bodies changing, but gender intensification is occurring as society stresses conformity to gender stereotypes.
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​Hormones: Changes in sex hormones, especially estrogen, are related to heightened depression.
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Early puberty: girls who experience early puberty are less developmentally ready to deal with the stresses of related changes.
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​Body dissatisfaction: Girls are becoming increasingly aware of the value placed on their physical bodies by society, and may feel that they do not conform to this ideal. Trans teens may also begin experiencing higher rates of gender dysphoria (distress resulting from feeling that one’s assigned gender does not match their internal feeling of one’s own gender). As their bodies begin to differentiate, and gendered social expectations increase, trans teens may feel a greater sense of insecurity.
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​Changing peer relationships: Girls are expected to have closer interpersonal bonds, such that peer relationships have a strong effect on girls’ self-perceptions. Negative peer relationships are particularly salient. During this time, trans teens may be subjected to increased victimization by peers due to non-conformity to gender expectations.
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​Changing social expectations: Expectations to conform to particular gender stereotypes. In girls, expectations to conform to impossible idealized model of womanhood creates negative self-image. In trans teens, expectations to conform to a gender that they do not identify with creates heightened stress.
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​Negative life experiences: Girls and trans teens are more likely to experience negative life experiences, resulting in increased stress.
Sex and Gender
LGBTQ+ teens are particularly at risk for developing depression, given pervasive negative social beliefs. During adolescence, teens are becoming more aware of their sexual orientation and gender identities, and diverging from social norms around attraction and gender, especially in unsupportive environments, can be stressful and, in some cases, dangerous. Concealment of identity, rejection by family (and potential subsequent abuse and/or homelessness), and rejection from community (peer groups, religious organizations) are major stressors that heighten the risk of depression.
Identifying as LGBTQ+
RISK FACTORS
Sources
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Cyranowski, J. M., Frank, E., & Young, E. (2005). Adolescent Onset of the Gender Difference in Lifetime Rates of Major Depression. Arch Gen Psychiatry, 57(1), 21-27
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