Stressful events that involve both grief and humiliation, such as messy romantic breakups, are linked to a higher risk of major depression than "merely" painful events, such as the death of a loved one, according to a study.
Researchers at Virginia Commonwealth University in Richmond, Virginia, interviewed some 7,000 male and female twins as part of the university's Mid-Atlantic Twin Registry. The subjects ranged in age from 20 to 60 years old.
Scientists analyzed subjects' stressful life events to determine which were linked to episodes of depression and anxiety.
Researchers found losses that involved lower self-esteem were twice as likely to trigger depression as ones that involved loss alone. This was particularly true of breakups that were initiated by the other partner or that involved infidelity or violence.
"The most toxic combination was loss and humiliation that in some way directly devalued the individual," says Kenneth S. Kendler, professor of psychiatry and lead author of the study.
The study was published in the Archives of General Psychiatry.