The rates of major depression are highest in New Haven and Los Angeles. The rates of bipolar is disorder are highest in New Haven and St. Louis, and that of dysthymia are highest in St. Louis and Los Angeles. Increased life time prevalence appears to be that the age of onset of major depression is declining. The separated and divorced men and women have the highest rates of both disorders. Among adults over age 45, who are the group most likely to be widowed, widows have a risk of a bipolar episode as high as the separated or divorced do.
Major depression is twice as common among people living alone as among others.
It is the disruption of marital bonds that leads to living alone, which appears to increase the risk of an affective episode. They can suggest both that men and women with a history of affective disorders have greater difficulty obtaining and maintaining employment, and that unemployed people are at greater risk of depressive episodes because they lack the sense of accomplishment, social bonds, time structure, and financial security provided by employment. According to ECA study Socioeconomic factors have little effect on the likelihood of experiencing an affective disorder. The exception is a higher rate of bipolar disorder among adults with fewer years of education. A longer duration of symptoms in the lower social classes due to poorer access to treatment, rather than more episodes.