Depression is a common aftereffect of abuse and violence. The Commonwealth Fund Adolescent Health Survey found that physically and sexually abused girls were five times more likely to report depressive symptoms than nonabused girls. In a primary-care sample, 65% of sexually abused women reported feeling blue or depressed compared with 35% of nonabused women. And in a study of chronic pain in primary-care patients, women with a history of child or domestic abuse were significantly more likely to be depressed than a matched group of nonabused women. Unfortunately, depression can lead to poor health in abuse survivors.
Immune Dysfunction In Depression
For several years, researchers considered depression to be primarily immunosuppressive. More recent studies indicate that depression causes an immune dysfunction, meaning that some aspects of immunity are suppressed, while others are elevated. For example, depressed people have fewer lymphocytes, making them more vulnerable to infection. However, depressed people also have elevated levels of inflammation—and this increases the risk of disease.
How Depression Influences Health
A number of significant health problems have been associated with depression, including coronary heart disease, chronic pain syndromes, premature aging, impaired wound healing, and Alzheimer’s disease. The National Comorbidity Study found that childhood physical abuse, sexual abuse, and neglect increased the risk of cardiovascular disease ninefold. In this study, however, it was trauma history, rather than depression, that accounted for the increased risk of cardiovascular disease.
Although these findings are still preliminary, depression is something that must be identified and treated in abuse survivors to effect a positive impact on their health.
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