Although no one is invulnerable to depression, statistically, depression does play favorites. Here, for example, are some of the high-risk groups:

• Women. Women are twice as vulnerable to depression as men. Research has never produced an explanation for this phenomenon.
• People from families with a history of mood disorders. Research indicates that children with one depressed parent are two to three times more likely to suffer from depression by the time they reach the age of 18 than children of nondepressed parents. If both parents are depressed, the risk doubles.
• Anyone in the 25 - 44 age range. These are the ages in which rates of depression peak. Although depression can occur at any age, including infancy, for most people it begins in the late 20s and 30s.
• Married women who are not getting along with their husbands. According to a study by the National Institute of Mental Health, nearly half of all such women are clinically depressed. Whether the depression caused the marital problems or vice versa remains unknown.
• Anyone who has experienced a recent loss or misfortune. In the past, clinicians regularly differentiated between endogenous depression, arising from within the individual with no apparent provocation and believed to be a biological form of illness, and reactive depression, occurring in response to a life event or stressor and believed to be psychological and thus not responsive to somatic treatment. Today, however, it is recognized that an unfortunate life event triggers treatment-responsive depression in many people, whether they are predisposed biologically or psychologically to the illness.
• Individuals who suffer from borderline personality disorder. Although depression occurs in a wide range of mental disorders, borderline personality disorder is highly associated with depression and mood swings. Indeed, depression is so common in this disorder that some experts speculate that the two share the same biological underpinnings.
• People dependent on alcohol, cocaine, and other substances of abuse. Problems with drugs are known to be predisposing factors in many people.

  Frederick M. Quitkin, M.D., D.M.Sc.
  Professor of Clinical Psychiatry
  Columbia University, College of Physicians and Surgeons
  Jean Endicott, Ph. D.
  Professor of Clinical Psychology in Psychiatry
  Chief, Department of Research Assessment and Training,
  New York State Psychiatric Institute

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