Women take more antidepressants after divorce than men but that doesn’t mean they’re more depressed
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Research out today from Finland suggests women may find it harder to adjust to later-life divorce and break-ups than men.
The study used population data from 229,000 Finns aged 50 to 70 who had undergone divorce, relationship break-up or bereavement and tracked their use of antidepressants before and after their relationship ended.
They found antidepressant use increased in the four years leading to the relationship dissolution in both genders, with women experiencing a more significant increase.
But it’s too simplistic to say women experience poorer mental health or tend to be less happy after divorce than men.
Remind me, how common is divorce?
Just under 50,000 divorces are granted each year in Australia. This has slowly declined since the 1990s.
More couple are choosing to co-habitate, instead of marry, and the majority of couples live together prior to marriage. Divorce statistics don’t include separations of cohabiting couples, even though they are more likely than married couples to separate.
Those who divorce are doing so later in life, often after their children grow up. The median age of divorce increased from 45.9 in 2021 to 46.7 in 2022 for men and from 43.0 to 43.7 for women.
The trend of late divorces also reflects people deciding to marry later in life. The median duration from marriage to divorce in 2022 was around 12.8 years and has remained fairly constant over the past decade.
Why do couples get divorced?
Changes in social attitudes towards marriage and relationships mean divorce is now more accepted. People are opting not to be in unhappy marriages, even if there are children involved.
Instead, they’re turning the focus on marriage quality. This is particularly true for women who have established a career and are financially autonomous.
Similarly, my research shows it’s particularly important for people to feel their relationship expectations can be fulfilled long term. In addition to relationship quality, participants reported needing trust, open communication, safety and acceptance from their partners.
“Grey divorce” (divorce at age 50 and older) is becoming increasingly common in Western countries, particularly among high-income populations. While factors such as an empty nest, retirement, or poor health are commonly cited predictors of later-in-life divorce, research shows older couples divorce for the same reasons as younger couples.
What did the new study find?
The study tracked antidepressant use in Finns aged 50 to 70 for four years before their relationship breakdown and four years after.
They found antidepressant use increased in the four years leading to the relationship break-up in both genders. The proportion of women taking antidepressants in the lead up to divorce increased by 7%, compared with 5% for men. For de facto separation antidepressant use increased by 6% for women and 3.2% for men.
Within a year of the break-up, antidepressant use fell back to the level it was 12 months before the break-up. It subsequently remained at that level among the men.
But it was a different story for women. Their use tailed off only slightly immediately after the relationship breakdown but increased again from the first year onwards.
sk/Unsplash
The researchers also looked at antidepressant use after re-partnering. There was a decline in the use of antidepressants for men and women after starting a new relationship. But this decline was short-lived for women.
But there’s more to the story
Although this data alone suggest women may find it harder to adjust to later-life divorce and break-ups than men, it’s important to note some nuances in the interpretation of this data.
For instance, data suggesting women experience depression more often than men is generally based on the rate of diagnoses and antidepressant use, which does not account for undiagnosed and unmedicated people.
Women are generally more likely to access medical services and thus receive treatment. This is also the case in Australia, where in 2020–2022, 21.6% of women saw a health professional for their mental health, compared with only 12.9% of men.
Why women might struggle more after separating
Nevertheless, relationship dissolution can have a significant impact on people’s mental health. This is particularly the case for women with young children and older women.
So what factors might explain why women might experience greater difficulties after divorce later in life?
Research investigating the financial consequences of grey divorce in men and women showed women experienced a 45% decline in their standard of living (measured by an income-to-needs ratio), whereas men’s dropped by just 21%. These declines persisted over time for men, and only reversed for women following re-partnering.
Another qualitative study investigating the lived experiences of heterosexual couples post-grey divorce identified financial worries as a common theme between female participants.
A female research participant (age 68) said:
[I am most worried about] the money, [and] what I’m going to do when the little bit of money I have runs out […] I have just enough money to live. And, that’s it, [and if] anything happens I’m up a creek. And Medicare is incredibly expensive […] My biggest expense is medicine.
Another factor was loneliness. One male research participant (age 54) described he preferred living with his ex-wife, despite not getting along with her, than being by himself:
It was still [good] knowing that [the] person was there, and now that’s gone.
Other major complications of later-life divorce are possible issues with inheritance rights and next-of-kin relationships for medical decision-making.
Separation can be positive
For some people, divorce or separation can lead to increased happiness and feeling more independent.
And the mental health impact and emotional distress of a relationship dissolution is something that can be counterattacked with resilience. Resilience to dramatic events built from life experience means older adults often do respond better to emotional distress and might be able to adjust better to divorce than their younger counterparts.
Raquel Peel, Adjunct Senior Lecturer, University of Southern Queensland and Senior Lecturer, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Fast Exercise – by Dr. Michael Mosley & Peta Bee
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We’ve written before about the benefits of High-Intensity Interval Training (HIIT), but there’s more to say than we can fit in a short article!
Dr. Michael Mosley, who hates exercise but knows his stuff when it comes to the benefits, teamed up with Peta Bee, who loves exercise and is a science journalist with degrees in sports science and nutrition, to bring us this book.
In it, we learn a lot about:
- the science of HIIT
- what makes it so different from most kinds of exercise
- exactly what benefits one can expect
…in a very detailed clinical fashion (while still remaining very readable).
By “very detailed clinical fashion”, here we mean “one minute of this kind of exercise this many times per week over this period of time will give this many extra healthy life-years”, for example, along with lots of research to back numbers, and explanations of the mechanisms of action (e.g. reducing inflammatory biomarkers of aging, increasing cellular apoptosis, improving cardiometabolic stats for reduced CVD risk, and many things)
There’s also time/space given over to exactly what to do and how to do it, giving enough options to suit personal tastes/circumstances.
Bottom line: if you’d like to make your exercise work a lot harder for you while you spend a lot less time working out, then this book will help you do just that!
Click here to check out Fast Exercise, and enjoy the benefits!
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Where to Get Turmeric?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
“I liked the info on Turmeric. The problem for me is that I do not like black pepper which should be ingested with the turmeric for best results. Is black pepper sold in capsule form?”
Better than just black pepper being sold in capsule form, it’s usually available in the same capsules as the turmeric. As in: if you buy turmeric capsules, there is often black pepper in them as well, for precisely that reason. Check labels, of course, but here’s an example on Amazon.
“I would like to read more on loneliness, meetup group’s for seniors. Thank you”
Well, 10almonds is an international newsletter, so it’s hard for us to advise about (necessarily: local) meetup groups!
But a very popular resource for connecting to your local community is Nextdoor, which operates throughout the US, Canada, Australia, and large parts of Europe including the UK.
In their own words:
Get the most out of your neighborhood with Nextdoor
It’s where communities come together to greet newcomers, exchange recommendations, and read the latest local news. Where neighbors support local businesses and get updates from public agencies. Where neighbors borrow tools and sell couches. It’s how to get the most out of everything nearby. Welcome, neighbor.
Curious? Click here to check it out and see if it’s of interest to you
“It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!!”
We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:
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Freekeh Tomato Feast
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Fiber-dense freekeh stars in this traditional Palestinian dish, and the whole recipe is very gut-healthy, not to mention delicious and filling, as well as boasting generous amounts of lycopene and other phytonutrients:
You will need
- 1 cup dried freekeh (if avoiding gluten, substitute a gluten-free grain, or pseudograin such as buckwheat; if making such a substitution, then also add 1 tbsp nutritional yeast—for the flavor as well as the nutrients)
- 1 medium onion, thinly sliced
- 1 2oz can anchovies (if vegan/vegetarian, substitute 1 can kimchi)
- 1 14oz can cherry tomatoes
- 1 cup halved cherry tomatoes, fresh
- ½ cup black olives, pitted
- 1 5oz jar roasted peppers, chopped
- ½ bulb garlic, thinly sliced
- 2 tsp black pepper
- 1 tsp chili flakes
- 1 sprig fresh thyme
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Place a heavy-based (cast iron, if you have it) sauté pan over a medium heat. Add some olive oil, then the onion, stirring for about 5 minutes.
2) Add the anchovies, herbs and spices (including the garlic), and stir well to combine. The anchovies will probably soon melt into the onion; that’s fine.
3) Add the canned tomatoes (but not the fresh), followed by the freekeh, stirring well again to combine.
4) Add 2 cups boiling water, and simmer with the lid on for about 40 minutes. Stir occasionally and check the water isn’t getting too low; top it up if it’s getting dry and the freekeh isn’t tender yet.
5) Add the fresh chopped cherry tomatoes and the chopped peppers from the jar, as well as the olives. Stir for just another 2 minutes, enough to let the latest ingredients warm through.
6) Serve, adding a garnish if you wish:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Eat More (Of This) For Lower Blood Pressure
- Making Friends With Your Gut (You Can Thank Us Later)
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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Zuranolone: What to know about the pill for postpartum depression
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In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed.
Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same.
The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available.
On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting.
Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more.
What is zuranolone?
Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days.
How does zuranolone work?
Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.
“Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”
How is it different from other antidepressants?
“What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility.
“It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.”
What are Zurzuvae’s side effects?
According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.
“Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”
She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief.
Can someone breastfeed while taking zuranolone?
It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials).
A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”
Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication.
“A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says.
How much does Zurzuvae cost?
Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind.
Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance.
The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Coconut & Lemongrass Protein Soup
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The main protein here is pea protein, but the soup’s health benefits don’t stop there. With healthy MCTs from the coconut, as well as phytochemical benefits from the ginger and chili, this wonderfully refreshing soup has a lot to offer.
You will need
- 1 can coconut milk
- 1 cup vegetable stock (making your own, or buying a low-sodium option)
- 1 cup frozen petits pois
- 1 oz fresh ginger, roughly chopped
- ½ oz lemongrass stalk, crumpled without being broken into multiple pieces
- 1 red chili, roughly chopped
- 1 tbsp white miso paste
- zest and juice of 1 lime
- Optional: garnish of your choice
Method
(we suggest you read everything at least once before doing anything)
1) Mix the coconut milk, vegetable stock, ginger, and chili in a saucepan, and simmer for 15 minutes
2) Remove the lemongrass and ginger (and the chili if you don’t want more heat), and add the petit pois. Bring back to a simmer for about 2 minutes more, stir in the miso paste and lime, then take off the heat.
3) Blend the soup to a smooth purée. Since it is hot, you will need to either use a stick blender, or else a food processor that is ok with blending hot liquids (many are not, so don’t use yours unless you’re sure, as it might explode if it’s not made for that). Alternatively, you can let it cool, blend it, and then reheat it.
4) Serve, adding a garnish if you so wish:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Can Saturated Fats Be Healthy?
- Ginger Does A Lot More Than You Think
- Capsaicin For Weight Loss And Against Inflammation
Take care!
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You can now order all kinds of medical tests online. Our research shows this is (mostly) a bad idea
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Elena.Katkova/Shutterstock Many of us have done countless rapid antigen tests (RATs) over the course of the pandemic. Testing ourselves at home has become second nature.
But there’s also a growing worldwide market in medical tests sold online directly to the public. These are “direct-to-consumer” tests, and you can access them without seeing a doctor.
While this might sound convenient, the benefits to most consumers are questionable, as we discovered in a recent study.
What are direct-to-consumer tests?
Let’s start with what they’re not. We’re not talking about patients who are diagnosed with a condition, and use tests to monitor themselves (for example, finger-prick testing to monitor blood sugar levels for people with diabetes).
We’re also not talking about home testing kits used for population screening, such as RATs for COVID, or the “poo tests” sent to people aged 50 and over for bowel cancer screening.
Direct-to-consumer tests are products marketed to anyone who is willing to pay, without going through their GP. They can include hormone profiling tests, tests for thyroid disease and food sensitivity tests, among many others.
Some direct-to-consumer tests allow you to complete the test at home, while self-collected lab tests give you the equipment to collect a sample, which you then send to a lab. You can now also buy pathology requests for a lab directly from a company without seeing a doctor.
We’ve all become accustomed to RATs during the pandemic.
Ground Picture/ShutterstockWhat we did in our study
We searched (via Google) for direct-to-consumer products advertised for sale online in Australia between June and December 2021. We then assessed whether each test was likely to provide benefits to those who use them based on scientific literature published about the tests, and any recommendations either for or against their use from professional medical organisations.
We identified 103 types of tests and 484 individual products ranging in price from A$12.99 to A$1,947.
We concluded only 11% of these tests were likely to benefit most consumers. These included tests for STIs, where social stigma can sometimes discourage people from testing at a clinic.
A further 31% could possibly benefit a person, if they were at higher risk. For example, if a person had symptoms of thyroid disease, a test may benefit them. But the Royal Australian College of General Practitioners does not recommend testing for thyroid disease in people without symptoms because evidence showing benefits of identifying and treating people with early thyroid disease is lacking.
Some 42% were commercial “health checks” such as hormone and nutritional status tests. Although these are legitimate tests – they may be ordered by a doctor in certain circumstances, or be used in research – they have limited usefulness for consumers.
A test of your hormone or vitamin levels at a particular time can’t do much to help you improve your health, especially because test results change depending on the time of day, month or season you test.
Most worryingly, 17% of the tests were outright “quackery” that wouldn’t be recommended by any mainstream health practitioner. For example, hair analysis for assessing food allergies is unproven and can lead to misdiagnosis and ineffective treatments.
More than half of the tests we looked at didn’t state they offered a pre- or post-test consultation.
Ordering medical tests online probably isn’t a good idea.
fizkes/ShutterstockProducts available may change outside the time frame of our study, and direct-to-consumer tests not promoted or directly purchasable online, such as those offered in pharmacies or by commercial health clinics, were not included.
But in Australia, ours is the first and only study we know of mapping the scale and variety of direct-to-consumer tests sold online.
Research from other countries has similarly found a lack of evidence to support the majority of direct-to-consumer tests.
4 questions to ask before you buy a test online
Many direct-to-consumer tests offer limited benefits, and could even lead to harms. Here are four questions you should ask yourself if you’re considering buying a medical test online.
1. If I do this test, could I end up with extra medical appointments or treatments I don’t need?
Doing a test yourself might seem harmless (it’s just information, after all), but unnecessary tests often find issues that would never have caused you problems.
For example, someone taking a diabetes test may find moderately high blood sugar levels see them labelled as “pre-diabetic”. However, this diagnosis has been controversial, regarded by many as making patients out of healthy people, a large number of whom won’t go on to develop diabetes.
2. Would my GP recommend this test?
If you have worrying symptoms or risk factors, your GP can recommend the best tests for you. Tests your GP orders are more likely to be covered by Medicare, so will cost you a lot less than a direct-to-consumer test.
3. Is this a good quality test?
A good quality home self-testing kit should indicate high sensitivity (the proportion of true cases that will be accurately detected) and high specificity (the proportion of people who don’t have the disease who will be accurately ruled out). These figures should ideally be in the high 90s, and clearly printed on the product packaging.
For tests analysed in a lab, check if the lab is accredited by the National Association of Testing Authorities. Avoid tests sent to overseas labs, where Australian regulators can’t control the quality, or the protection of your sample or personal health information.
4. Do I really need this test?
There are lots of reasons to want information from a test, like peace of mind, or just curiosity. But unless you have clear symptoms and risk factors, you’re probably testing yourself unnecessarily and wasting your money.
Direct-to-consumer tests might seem like a good idea, but in most cases, you’d be better off letting sleeping dogs lie if you feel well, or going to your GP if you have concerns.
Patti Shih, Senior Lecturer, Australian Centre for Health Engagement, Evidence and Values, University of Wollongong; Fiona Stanaway, Associate Professor in Clinical Epidemiology, University of Sydney; Katy Bell, Associate Professor in Clinical Epidemiology, Sydney School of Public Health, University of Sydney, and Stacy Carter, Professor and Director, Australian Centre for Health Engagement, Evidence and Values, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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