Many Midlife Traumas Can Cause Depression-like Symptoms, Says New Study

LifeTwo has long argued that what many people call their "midlife crisis" is really their normal reaction to a crisis that could occur at any time, but happened to them in midlife. Their "crisis" could be their emotional response to divorce, death in the family, job loss, serious illness, or other trauma. We've held that one such type of "midlife crisis" is actually depression.

Now a new study shows just how blurry the line is between feeling down after negative life events and clinical depression. Publishing in the journal "Archives of General Psychiatry," a team of researchers found that about one-quarter of people who appear to be depressed are actually dealing with a recent emotional blow. The symptoms are virtually identical, except that clinical depression generally does not have a triggering loss.

Simple depression diagnosis checklists used by some school districts and clinics probably won't correctly distinguish depression-like grief, leading to false positives for depression. One such test asks whether, over the last two weeks, the patient has had little interest in doing things, had little energy, had trouble concentrating, and the like; the responses for people suffering a loss would be similar to those for people with major depressive disorder.

Grief can morph into depression, but such an evolution is rare.

Treatment for people undergoing grief reactions after a loss, no matter how depression-like their symptoms, would differ from treatment for major depressive disorder. Antidepressants, for instance, might not be used at all.

---
You can find a NPR report on the proposed change here. A San Francisco Chronicle reprint of a New York Times story on the subject is here.