Thanks for writing to JA.
Your question is a tricky one... in that it sounds like you might be doing some self-diagnosis and that you've had a history of treatment for unipolar depression over the years. Your history (hellish childhood) is certainly an important part of that mix.
All that is to say, it is inappropriate and unethical for a Licensed Mental Health Professional (LMHP) to diagnose over the internet (and across the Atlantic Ocean). That being the case, I can provide some insight into Bipolar Depression:
Generally speaking, Bipolar Depression is considered a brain-based disorder that may be exacerbated by environmental factors. That is, there may be a strong biological (genetic or otherwise) component to the disorder, but it can become worse with environmental stress and/or ameliorated when the environment is stable and supportive.
Those with Bipolar Depression often manifest symptoms in adolescence. Rarely would an individual be a seasoned adult and only begin to manifest symptoms of the disorder. Furthermore, there is some evidence to suggest that medications used for Unipolar depression might exacerbate manic or manic-like symptoms for Bipolar individuals.
In sum, to answer your question directly, most LMHP believe that folks with Bipolar are likely to have been born with it. It can be made better or worse by the environment in which they live - but the manifestation of the disorder would be more immediate than delayed.
I hope that helps.
Thanks for writing back.
That is useful information to know that you had some "hypomanic episodes" as a result of the medications. Of course, you've shared this with your psychiatrist/GP, I hope.
It is possible that you may have Bipolar Disorder or Bipolar II... this can only be confirmed with a LMHP working directly with you.
Your specific question: "Could my physical and sexually abusive childhood be the underlined reason for my depression?" It is entirely possible that the abuse you suffered in childhood contributed mightily to your depression. I believe it is unlikely that it *caused* you to have Bipolar Disorder (I or II), but may have exacerbated underlying symptoms that might have remained dormant had you experienced a more typical, stable home environment.
If your question is whether or not you should get into therapy, the answer is ABSOLUTELY. Why?
Research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for depression. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with mood and/or anxiety disorders (like depression).
A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."
Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of mood and/or anxiety disturbance... it actually exacerbates the condition(s) [This is especially true with OCD]. So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.
Your psychiatrist *may* know of a CBT licensed mental health professional. Please make certain, however, that they employ CBT practices.
If $$ is a super-big issue, you might want to consider contacting your local Community Mental Health Center. These tend to offer free or greatly reduced cost mental health services, including therapy and/or med management, depending upon your ability to pay.
Thanks. I hope you're well and that this was helpful.
* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.
Thank you for explaining about the cbt. I left you the other day to go to my first appointment with a Mental Health Team in my area. They have been very helpful so far. They are going to continue their help and have arranged for me to see a Counsellor called 'Family matters'. They deal with sexual/physical abuse.
I will mention about cbt at some point as I feel that could be very helpful to me.
The M.H.T. are calling my illness 'a reoccurring depressive episode' as I have had many over the years.
Thank you again for all your information. I have taken it onboard.
Kind regards & the best of health to you 'across the waters'.