Antidepressant Use Peaks Just Before Divorce

By Neuroskeptic | August 15, 2013 4:07 pm

People are almost twice as likely to be taking antidepressants or other psychotropic medication just before getting a divorce.

Use of psychotropic medication over time (in months)

This striking graph, from a new paper out of Finland, shows the data.

The vertical bar represents the divorce date. The solid curve is the divorcees, and the other two are comparison individuals who were either married throughout the period, or not married at all.

In both the male and the female divorcees, rates of psychotropic use began to climb about four years before the divorce date, peaking a few months before the event.

Afterwards, usage declined – does this mean that divorce is, more often than not, a positive turning point?

Even five years before the eventual split, the divorcees-to-be used slightly more psychotropics than those whose marriages lasted.

These trends were driven by antidepressants, with sedatives, anxiety and sleeping pills also contributing. Use of antipsychotics didn’t change before divorce.

So what? Well, many say that antidepressants (and the rest) are often prescribed as a result of ‘medicalizing’ normal emotional problems that arise in life.

This argument is often made as a lazy generalization with no supporting evidence, but, while these data don’t prove it, they’re consistent with the theory.

However, it is important to remember that if antidepressants are sometimes prescribed inappropriately, this doesn’t tell us anything about antidepressants, but rather about our prescribing habits. Antibiotics are used inappropriately too, but you can’t blame the antibiotics for it.

ResearchBlogging.orgMetsä-Simola N, & Martikainen P (2013). Divorce and changes in the prevalence of psychotropic medication use: A register-based longitudinal study among middle-aged Finns. Social science & medicine (1982), 94, 71-80 PMID: 23931947

  • AlisonCummins

    Another explanation is that antidepressants enable some people who would be otherwise too incapacitated by depression to leave a bad relationship to do what they want to do (but can’t).

    • http://blogs.discovermagazine.com/neuroskeptic/ Neuroskeptic

      Interesting idea. The way to check would be to look at whether the antidepressant spike was bigger in the initiators of the divorce than in the ‘receivers’ (although it’s often a joint decision so might be hard.)

      • bettyrose

        Some people may get strength to get up and leave from the antidepressant … others may find themselves deprived of the ability to care enough to keep struggling with the marriage. “Comfortably numb” is a very common side effect and in the long term it ain’t so comfortable.
        And still others may be using the antidepressant in a vain attempt to relieve the pain that can only be relieved by walking out…

      • thecellularscale

        Another thing to check would be people prescribed antidepressants for things other than depression. (such as chronic pain) I know of someone who was in this situation and got divorced shortly thereafter (n=1).

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  • Julie A Mars

    I couldn’t find the time units for the horizontal axis. Are these months? Weeks? Days?

    • http://blogs.discovermagazine.com/neuroskeptic/ Neuroskeptic

      Oops, I thought that was on there. It’s in months – so the whole horizontal axis spans 10 years. Medication use (or rather dispensing – no-one knows if they actually swallowed the pills, but they bought them) was assessed every 3 months.

  • Kara Eidsvik

    I wonder if yhe type of antidepressant matters, since some affect libido.

    • bettyrose

      Good point Kara! Indeed they do … and a couple of divorced friends have told me the sex was actually the last thing to go sour in their marriage. A lot of fussing & fighting could be lived with as long as they could kiss & make up etc. but once that was gone, it was all over. Some people never get their libido back even once they quit SSRI’s — came across a whole community of them here http://wp.rxisk.org/treating-pssd/ in a lot of distress and searching for possible cures.

    • andrew oh-willeke

      This was my first thought upon looking at the result too. Also, antidepressants suppress not just sexual responsiveness in the narrow sense but the entire sexual dimension of response to a partner far beyond bedroom performance. Anecdotes of antidepressant impact on relationship health are numerous.

    • Sarah Toenin

      Most do affect libido but they also increase mania. It’s not unusual for someone to lose the ability to achieve an erection or even climax, yet they will be consumed with porn (while taking these drugs.). It’s also not unusual for rx users to associate their rather sudden lack of love for their spouse with the loss of libido. That’s when the rx user will stray from the marriage. They are craving that intense feeling which has been suppressed by the ssri/ssni. These drugs essentially remove the body’s ability to self regulate inhibitions. They compromise our ability to remain morally centered.

  • Daniel

    Another possibility is that partners leave people who are being treated for chronic depression (which I have seen very often in my practice) and the drop in prescriptions after the divorce is a coincidence.

  • Eric Charles

    But they lack the most interesting control group… which would be very hard to get… What you really want to compare with are people who are potentially headed towards divorce, but then don’t get divorced. That is, we would really like to know if a comparable group of people at the 4-years-ago point might not have had their marriages saved by EVEN MORE anti-depressants, or if a comparable group of people at the 4-year-ago point might be more likely to stay married with no drugs at all.

    Frankly, at this point, it just says that people who are likely to be in a depressing situation take more anti-depressants, and when they get out of that particular depressing situation their use drops to near normal levels. Not that exciting (or surprising).

    • Sebastian

      Perhaps people try to save their marriages, therefore taking more drugs leading to the peak, and than reduce when it is not working. Maybe the participants look for help but don’t find it? A control group could be people using other treatments, such as psychotherapy, meditation, or a combination of treatments.

  • http://neuroautomaton.com/ Zachary Stansfield

    As per usual, it is very difficult to draw any firm conclusions from these correlational data. Perhaps over-prescription of anti-depressants is causing an increase in divorce rates, only to be followed by a immediate cessation of drug-taking as these woeful divorcees realize their mistakes!

    All kidding aside, it’s important to notice that the sharp peak at 9 months pre-divorce is set against a back-drop of high and steadily increasing anti-depressant use among this same group of people. Is this much larger group of people “over-medicating” normalcy or are they “truly” depressed?

    This question cannot be adequately answered using the above data set.

  • thecellularscale

    So is the 2%, 3% on the x axis is % of people taking meds? Was there any data about increase in dosage per person or anything? If someone already on meds started taking more, that wouldn’t influence this curve?

  • http://www.nevadadivorce.org/ Nevada divorce

    interesting article. I really enjoyed the comments, some really interesting ideas, thanks guys

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  • Sarah Toenin

    Antidepressants have been a silent marriage killer for years. Check out the “Marriages Destroyed By SSRI/SSNI’s thread on Topix, or research Helen Fisher’s work re: the impact these drugs have on interpersonal relationships. SSRIS can indeed make people fall out of love with their spouse. They blunt emotions & increase dopamine seeking behaviors. It’s actually not rocket science and the notion that psychotropic mediation alters brain chemistry but has little to no impact on relationships is absurd. Far too much anecdotal evidence exists to the contrary. These drugs have contributed to the mental health crisis in America. They are 90% responsible for all media reported crime (or rather the common link, if you prefer) including all school shootings & premeditated homicide. I know first hand the impact they have on marriages as I came within inches of having lost my 20 year marriage because of them. No question about it. The Numbing Down of America continues.

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About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.

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