Can stress cause depression?

Prog Neuropsychopharmacol Biol Psychiatry. 2004 Aug;28(5):891-907. doi: 10.1016/j.pnpbp.2004.05.031.

Abstract

The central issue raised in this paper is: can stress cause depression? Phrased more precisely: can stress cause brain disturbances thought to underlie (certain forms of) depression or particular components of the depressive syndrome. Focussing on 5-hydroxytryptamine (5-HT) and the stress hormones, this question was answered in the affirmative, based on the following two considerations: changes in the 5-HT and stress hormone systems produced by sustained stress mimic to a substantial extent the disturbances in these systems that may be observed in depression. Substantial evidence indicates that the 5-HT and stress hormone disturbances in depression are of pathophysiological significance and not merely a consequence of the depressed state or a product of stress generated by the depressed state. Furthermore, the question was raised whether a depression type could be identified particularly stress-inducible. This question, too, was answered in the affirmative. The depression type in question was named anxiety/aggression-driven depression and characterized on three levels: psychopathologically, biologically and psychologically. Preferential treatment of this depression type was discussed. In studying stress-inducible depression, biological depression research should shift focus from depression per se to the neurobiological sequelae of stress. Treatment of stress-inducible depressions and particularly its prevention should be geared towards reduction of stress and stress sensitiveness, utilising both biological and psychological means.

Publication types

  • Review

MeSH terms

  • Animals
  • Antidepressive Agents / therapeutic use
  • Brain / metabolism
  • Corticotropin-Releasing Hormone / metabolism
  • Depression / classification
  • Depression / drug therapy
  • Depression / etiology*
  • Depression / metabolism
  • Hormones / metabolism*
  • Humans
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / metabolism
  • Personality Disorders / etiology
  • Personality Disorders / metabolism
  • Serotonin / metabolism*
  • Stress, Physiological / complications*
  • Stress, Physiological / drug therapy
  • Stress, Physiological / metabolism

Substances

  • Antidepressive Agents
  • Hormones
  • Serotonin
  • Corticotropin-Releasing Hormone
  • Hydrocortisone