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Who Gets Major Depressive Disorder (MDD)?

Reviewed by: HU Medical Review Board | Last reviewed: September 2023

Feelings of depression are widespread. Nearly everyone will experience a low or depressed mood every once in a while. Stress, grief, and more all can lead to feeling down. However, major depressive disorder (MDD) happens when these feelings last for a long time and affect daily functioning. These longer-term symptoms are considered a major depressive episode.1

MDD is common in the United States. In a 1-year period, roughly 2 in 10 people have an episode of MDD. This is more than 20 million adults each year in the United States. About half of these people have an episode that severely impacts their ability to carry out their daily tasks.2,3

Depression across the lifespan

There is about a 1 in 5 chance that a person will develop MDD at some point in their lifetime. The highest rate of depression is diagnosed in 18 to 25-year-olds. In addition, many people will experience mild symptoms earlier in life before being diagnosed.2,3

Although symptoms are most commonly noticed in young adulthood, MDD also can affect kids, teenagers, and older adults. But it can be challenging to diagnose MDD in these age groups. Symptoms may look different than expected.4,5

In older adults, trouble with thinking or memory may be common signs of depression. These problems can be misdiagnosed as dementia and go untreated. Kids may have a hard time communicating their feelings. Signs of depression in kids may include acting out at school, irritability, or changes in eating.4,5

Kids who have higher rates of depression than their peers include those who:4

  • Are exposed to significant stress or trauma
  • Have other medical issues
  • Have academic challenges

Sex-based differences in depression rates

People assigned female at birth are more likely to be diagnosed with major depressive episodes than those assigned male at birth. Data show that the rate of major depression is higher in women than it is in men.2-4

However, these sex-related differences are actually reversed in kids. Before puberty, boys are more likely to have major depression than girls. This trend switches once puberty occurs. This may point to a link between hormones and depressive episodes.2-4

Certain forms of depression are also specific to certain biological traits. One example is premenstrual dysphoric disorder (PMDD). In PMDD, depressive symptoms occur around the time of the menstrual cycle. This condition may occur in as many as 5 percent of people who have a menstrual period.6

People who are pregnant or who have just given birth also commonly experience feelings of depression. As many as 70 percent of women report a depressed mood within the first few weeks after giving birth (called “baby blues”). This typically goes away within 2 weeks.7,8

Full episodes of major depression that last longer than 2 weeks during pregnancy or after birth are called perinatal depression or postpartum depression. As many as 1 in 7 pregnant women develop these conditions.7,8

Depression across different gender and sexuality identities

Rates of depression are also higher in the LGBTQ+ community. Research suggests that people who identify as lesbian, gay, bisexual, or queer are more than twice as likely to have depression than those who do not.9

More studies are needed about the experience of transgender, genderqueer, or nonbinary people. But, in general, rates of depression are higher for this group. Some research suggests that gender-affirming medical care decreases the rates of depression and suicidal thoughts or behaviors among people in this community.9-11

Depression alongside other medical conditions

People with other health conditions are more likely to be diagnosed with depression. Estimates vary, but the risk of depression may be as much as 2 to 5 times higher for people with multiple medical issues than for those with no other conditions. This risk is especially high for older adults in assisted living facilities, in skilled nursing facilities, or receiving home healthcare.2,3

Other factors that increase depression risk

Current research suggests that the risk of a major depressive episode is similar across most races and ethnicities. However, those who identify as American Indian or Alaskan Native often report having higher rates of MDD symptoms. The risk of an episode is highest for those who identify as more than 1 race.2,3

Income and marital status may also impact rates of depression. For example, people with lower incomes seem to be more likely to have a depressive episode than those with higher incomes. People who are divorced, widowed, or separated also seem to have greater rates of MDD than those who are married or living with a partner.2

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