I was diagnosed at age 18 with bipolar disorder and still have the same struggles at 52. I also have PTSD. Is there evidence that adverse childhood experiences prevail as a factor in mood disorders?

It’s certainly well established that adverse childhood experiences increase risk for mood disorders (especially chronic depression) and anxiety disorders (especially PTSD). The evidence is clearest for adverse experiences that are well defined and easier to measure―like losing a parent to death as a child or experiencing childhood physical or sexual abuse. But this may just be science catching up to what people have known for a long time―that traumatic experiences early in life can increase risk for a wide range of mental health and chronic physical conditions.

I want to focus, though, on your use of the word “prevail”. If you have experienced abuse, trauma, or other negative experiences early in life, there’s a difference between saying “It makes sense that I experience depression and anxiety” and saying “It’s inevitable that I experience depression and anxiety.” The first statement can lead you away from self-blame.  But the second one can lead you into hopelessness.  And recovery from bipolar disorder, depression, or anxiety is certainly possible―even if it’s been with you for 34 years.

One other factor to consider: there is at least some evidence that people with chronic depression following childhood trauma benefit more from psychotherapy with medication than medication alone. If your treatment has been mostly or completely focused on medication, you should certainly ask about seeing a therapist knowledgeable about specific treatments for chronic depression and PTSD.

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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