Which of the following is a risk factor for depression in midlife women during menopause?

• A. Prior depression
• B. Age over 50
• C. Regular exercise
• D. Vitamin D deficiency

Answer: (A)

Prior depressive episodes increase the risk of depression during menopause because history of mood problems marks a vulnerability in mood regulation that menopause can unmask. The menopausal transition brings hormonal fluctuations, sleep disruption, and stressors that can trigger mood symptoms, but if someone has had depression before, their brain may be more prone to relapse due to lasting changes in neural circuits, stress response systems, and cognitive patterns. In practice, this history is the strongest predictor that a depressive episode may occur during midlife.

Being over 50 by itself isn’t a strong independent risk factor. Regular exercise tends to protect against depression rather than increase risk, and vitamin D deficiency, while it can be linked to mood changes in some individuals, isn’t as robust a predictor in this specific scenario.