Can stress cause depression?
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.
van Praag
H M
HM
Department of Psychiatry and Neuropsychology, Academic Hospital Maastricht, and the Brain and Behavior Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. h.m.van.praag@vanpraag.com
D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use; D001921:Brain / Q000378:metabolism; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D003863:Depression / Q000145:classification / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D010554:Personality Disorders / Q000209:etiology / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism*; D013312:Stress, Physiological / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism
D000928:Antidepressive Agents; D006728:Hormones; D012701:Serotonin; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone