Nearly half of marriages end in divorce. For patients, divorce is a critical stressor, but how it affects their mental health can vary widely. This article looks at factors that mitigate the effects of divorce on men, women, and children. 

Gender

Men are about two times more likely than women to have a depressive episode after a divorce. Women tend to have larger circles of family and friends, while men tend to rely on their partner and nuclear family for emotional connection. The dissolution of a marriage can leave men isolated, particularly younger men (Affleck W et al, Can J Psychiatry 2018;63(9):581–589). 

Custody also plays a role in the vulnerability of men’s mental health after divorce. In the US, primary custody is held by the woman in four out of five divorces. Custody litigation is one of the most stressful aspects of divorce for men and raises the risk of both substance use disorders and suicide.

The higher rate of depression in men is compounded by the fact that men are 50% less likely to seek mental health services. Fears that a psychiatric diagnosis could interfere with custody only adds to the problem. 

For both men and women, the partner who initiates the divorce is less likely to develop depression, as is the partner who finds a new relationship after the breakup. Each gender also has unique protective factors. Men who have had prior experience with divorce, or who have a lot of children, were less likely to develop post-divorce depression in a 2020 Danish study. For women, higher income is a unique protective factor (Sander S et al, Front Psychol 2020;11:578083).

Poverty

Women are particularly vulnerable to the economic consequences of divorce. In an Australian study, economic loss—rather than the loss of the partner—was the most significant factor in the decline of women’s mental health (Ervin JL et al, Soc Psychiatry Psychiatr Epidemiol 2021;56(6):1059–1068).

The “gray divorce”

Divorce is rising in the older generation, sparking the term “gray divorce” for marital dissolutions after age 50. A UK study found that divorce has similar effects on men as women in this demographic. Children are a factor here. Older couples without children recover from depressive symptoms after a divorce faster than couples with children.

Surprisingly, older men may fare better after divorce than younger men. In a study from Europe, older men experienced less loneliness and social isolation after a divorce than younger men. Older men were more likely to find support outside of the marriage, while younger men sought emotional support from their partner (Tosi M and van Den Brock T, Soc Sci Med 2020;256:113030).

Overall, older adults are more likely to lose a partner through death rather than divorce. It is the widowhood that leads to depressive symptoms in people over 50.

Children and divorce

Patients going through divorce often ask us “How will this affect my children?” It might seem counterintuitive, but divorce itself is not what harms a child’s mental health. Rather, it is conflict within the couple that has a negative impact, particularly when the children witness verbal or physical aggression.Exposure to that kind of conflict predicts poor outcomes whether the parents are married or divorced, and if divorce reduces contentious exposure, the child’s mental health will improve.

After a divorce, parents often have to make decisions together around custody, education, and healthcare, and they can protect their child’s mental health by reducing conflict around coparenting. Triangulation—in which the parents involve the child in the conflict—also worsens outcomes for the child (Lange AMC et al, J Child Adolesc Trauma 2021;15(3):615–625).

Practical strategies

When your patient is facing a divorce, ask how the loss of the marriage might influence them. Social isolation, loss of economic status, and custody disputes are particularly relevant. Parents who stay in a high-conflict marriage out of fear that divorce will harm their children can be reassured that the evidence suggests the opposite. Divorce brings unique challenges, but evidence-based programs can help parents improve their skills. These include Triple-P Parenting (www.triplep-parenting.com) and Love and Logic (www.loveandlogic.com), which offer online courses and books. 

Taking time to listen to children is also critical—gauging their understanding, thoughts, and feelings about what is happening. When talking to children, it is important to make it age appropriate and transparent. The details of the marital conflict do not have to be shared, but what is happening to the family is important to communicate. Listening to how children understand the situation and to their feelings will strengthen trust and communication. It is common for younger children to blame themselves for the conflict or divorce; teenagers will easily blame their parents. If parents do not feel comfortable having an open conversation with their children about the divorce, they can reach out to a mental health professional to mediate the dialogue (see the Q&A with Marie Yap, PhD, in the March 2019 issue of The Carlat Psychiatry Report).

CARLAT VERDICT