The links between childhood stressors and adult behaviors, moods and anxiety are becoming clearer and clearer with each passing study. The things we go through as kids often stay with us over the years—especially if we don’t get treated along the way. A new study in Journal of Clinical Psychiatry finds that the stresses and traumas that a woman goes through in her teen years are linked to a greater risk of depression in peri-menopause, even if she didn't experience depression before that. It’s not totally clear where the link lies, but it’s very likely at the level of the molecules—the stress and reproductive hormones and the markers of inflammation.
The new study from the University of Pennsylvania followed 243 women from the time they were premenopausal (aged 35 to 47) for the next 16 years. They were tested regularly for mood and cognitive problems, and their hormones measured from time to time; the women also reported when they went through menopause. Toward the end of the study period, the women filled out questionnaires about the kinds of stresses and traumas they’d been through in their childhoods and teenage years.
Most of the women’s traumas had occurred before they went through puberty, and involved emotional abuse, living with someone with addiction, and parental separation or divorce. It turned out that women who’d been through two or more traumatic events were over twice as likely to experience major depression during peri-menopause and menopause. But interestingly, they weren’t any more likely to have experienced depression earlier in life.
Earlier work has linked both external stuff (recent life stress, for instance) and internal stuff (hormone changes, or interpersonal conflicts) to depression during menopause. The connection between very early life trauma, as seen in the current study, may have several mechanisms to explain it. But more work will be needed to really grasp all the potential links.
“Early life stress is linked to increases in markers of inflammation and an unhealthy hormonal response to current stressors,” says lead author C. Neill Epperson. “Pro-inflammatory substances such as cytokines are linked to metabolic disorders, cardiovascular disease, depression and poor cognitive aging. Now that we know that childhood adversity is a risk factor for a first episode of depression during the menopause transition, it is important for us to determine how childhood adversity ‘gets under the skin’ to have an enduring effect on women’s behavioral health during this period of unique hormonal change.”
So it may be that subtle changes to the stress response and reproductive hormones lurk in ways that aren’t fully felt until menopause triggers more substantial shifts to these systems. As far as what can be done to sever the tie between early life stress and mid-life depression, treating the early stuff as soon as possible is probably the key. While waiting till later may not be ineffective, it’s generally more effective to deal with the trauma and re-regulate the stress response earlier on.
“As a psychiatrist, I care deeply about preventing behavioral health conditions, not just treating them after the fact, when a woman may have been suffering for months to years before seeking treatment,” says Epperson. “We know from preclinical studies as well as brain imaging studies in humans that the brain is changed by early life stress. In addition to changing the brain and its developmental trajectory at the time the adversity occurs, we know that the experience of significant early-life adversity increases the risk of behaviors and lifestyle choices that lead to sub-optimal health later in life.”
She adds that meditation, medication, therapy, exercise and a healthy diet can all help psychologically and with regulating the stress and inflammatory responses. And again, the earlier the treatment for the trauma, the more effective it will be. “Intervening early in childhood or adolescence,” says Epperson, “to address post-traumatic stress, depression and anxiety and to promote healthy behaviors may be one method to reduce illness risk later in life.”
