Depression - age of onset

Professor Wayne Drevets explains that depression most commonly arises after puberty. There are exceptions, where it arises in childhood or in relatively late adulthood.

The age of onset for depression usually arises after puberty. There is something about going through the hormonal changes associated with puberty that seems to trigger the depression in the largest number of patients. There are exceptions; sometimes it can begin in childhood and sometimes it can arise in early 20’s and 30’s. There are also late onset forms of depression, where you typically see depression arising after 45-50, and those late onset forms are often associated with structural brain abnormalities like cerebral vascular lesions. The locations of those lesions end up affecting the same areas of the brain that we see affected in the early onset forms of depression, but the type of pathophysiology is different. So in the late onset depression it’s like getting a cerebral vascular disease lesion that seems to interfere with the function of some of the prefrontal cortex regions or striatal regions that are modulating areas that get involved in regulating emotions like the amygdala, whereas in young individuals where they get an early onset depression. There, instead, we see structural brain imaging abnormalities and post mortem cellular changes that suggest that those regions of the prefrontal cortex and striatum also aren’t functioning right in modulating the emotional expression.