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-HT and the stress hormones, this question was answered in the affirmative, based on the following two considerations: (1) 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; (2) 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
Herman M
HM
Department of Psychiatry and Neuropsychology, Academic Hospital Maastricht, and the Brain and Behavior Research Institute, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. h.m.van.praag@vanpraag.com
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000374:Aggression / Q000502:physiology; D000818:Animals; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000502:physiology; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012701:Serotonin / Q000097:blood; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology
D012701:Serotonin; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone