The Shadowlands of Stress and Depression: How to find your way into the light
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A lens brought to you by Stress: Beyond Coping, an international provider of stress management seminars and education tools
Stress is a world-wide problem that contributes to heart disease, cancer, high blood pressure, diabetes, asthma, ulcers, the common cold...and Depression. This lens, written by a neuroscientist & stress researcher, explains the brain link between stress and depression.
There's some good news and bad news about stress and depression. The bad news is that chronic stress can slowly erode brain structure and function, leaving us more vulnerable to depression. But the good news is that exercising good stress management, a skill we ALL can learn, can also help us recover from stress-induced depression.
Want to learn more? Read on!
Table of Contents
What is Stress?
Simply put, STRESS is our physical and mental response to potential danger in our environment.
We usually think and talk about stress in a negative way. But stress can actually be a very good thing. It's like an emergency system that kicks in when there is any sort of threat in our environment (i.e. STRESSOR) that needs to be taken care of.
This emergency system speeds up our heart rate, raises our blood pressure, and makes us breathe faster. These changes are helpful under emergency conditions because they speed up the delivery of oxygen and nutrients to the areas in the body that need them: our muscles (so we either fight the threat or get away from it fast) and our brains (to keep us alert and thinking straight).
The stress response also releases stress hormones into the bloodstream. These hormones do important jobs like releasing energy from storage and also raising our alertness levels.
But major problems can occur if the stress response gets turned on and stays on for a long time. When this happens, everything that was initially helpful in preparing our body for an emergency can actually do us harm. Chronic elevations in our heart rate and blood pressure put us at risk for cardiovasular problems, hypertension, stroke, etc. When stress hormones stay high over a long time, they can actually contribute to energy-related problems (e.g. weight gain, diabetes). And stress can even damage our brains.
What is Depression?
According to the American Psychological Association, Major Depressive Disorder (a type of depression linked to high stress) occurs when you have at least 5 of the following 9 symptoms at the same time:
- A depressed mood during most of the day, particularly in the morning
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Impaired concentration, indeciveness
- Insomnia (unable to sleep) or hypersomnia (sleeping too much)
- Decreased interest or pleasure in work, hobbies, family, and relationships
- Recurring thoughts of death or suicide
- Feeling restless, agitated, or slowed down
- Significant weight loss or gain (more than 5% in a month)
How Does Stress Lead to Depression?
Step 1: Pre-Conditioning Factors
First, some live with chronic, adverse conditions that constantly erode their ability to deal with stress. Think of these conditions as "the ROAD" we travel in life. Examples of rough roads include poverty, social disadvantage, abusive relationships or family problems, medical disability, or caring for loved one with a terminal illness.
Second, some have genetic or biological factors that increase the likelihood that stress will cause depression. Because these factors shape who we are, you can think of them as the "VEHICLE" we drive through life. Vulnerable vehicles are caused by:
- Gender (Women are much more likely to suffer from stress-induced depression than men);
- Genetic factors that affect how "happy" chemicals, like Serotonin, travel around the brain;
- Biological factors that affect how well stress hormone systems function;
- But most importantly: psychological and personality factors that affect we interpret stress. If we tend to be pessimistic, we're more likely to suffer from stress-induced depression. Being a perfectionist also adds more strain and may make stress-induced depression more likely.
These factors can make us see and interpret the stress in our lives in a very negative way. This leads to the second step in the process of stress-induced depression...(see below)
How Does Stress Lead to Depression?
Step 2: We Experience an Uncontrollable Loss
- Loss of a loved one through divorce or death
- Loss of self-esteem
- Loss of role: maybe an important position at work, or if you've lost your job, the loss of the role of "breadwinner"
- Loss of cherished ideas
- Loss of safety (such as a natural disaster, terrorism, or war)
Stressors are much more likely to result in depression if we don't have a sense of CONTROL over them. This was first discovered in experiments where researchers exposed laboratory animals to an unpredictable form of stress, like an electric shock. If the animal had no control over when the stress occured and was powerless to stop it, it would exhibit some very specific behaviors:
- It became withdrawn from other animals, more passive and less social
- It became "moody" and anxious
- It develped stress-related health problems, like ulcers
- It could not learn how to escape a stressor in another situation
- If exposed to addictive drugs, it responded quite readily and quickly became dependent on them
Sound familiar? These sound like some of the symptoms experienced with depression. Now, here is the really interesting part: if the researcher gave the animal any sense of control over the stressor, even if was not real control, then the animal did not develop any of these pathological behaviors. The same thing happens in humans - an uncontrollable stressor is much more likely to result in depression than something we feel we have some control over.
How Does Stress Lead to Depression?
Step 3: Chronic imbalance in Brain Areas that Control Stress
When we experience uncontrollable stress, this can lead to a chronic imbalance in the way the brain interprets and trys to control any other stress we encounter. The more emotional, "knee-jerk reaction" part of the brain has much more influence than would normally be the case. This is quite dramatically illustrated when someone with Post Traumatic Stress Disorder (PTSD) is exposed to an environmental trigger that reminds them of their original trauma. Many PTSD patients lose touch with current reality and become frozen into a flashback of the original event. They also become paralyzed with fear.But even everyday life becomes more stressful for these individuals. Why? Because the brain systems that interpret the environment are permanently skewed and therefore interpret almost everything as potentially stressful. When everything seems dangerous and threatening, then the stress response is permanently turned on.
How Does Stress Lead to Depression?
Step 4: Brain Damage that impairs control over stress, leading to depression
Here's the fascinating thing: The same pattern of brain damage occurs with depression. Brain changes associated with early-onset major depression have been reported in the hippocampus, amygdala, caudate nucleus, putamen, and frontal cortex (Sheline 2000). Magnetic resonance imaging (MRI) studies report losses of left and right hippocampal and frontal cortex volumes in subjects with a history of severe recurrent depression. (Sheline 2000).
Some researchers believe that this is the biological link between stress and depression: when we experience chronic stress, this causes chronic changes in brain structure and function that are the neurological basis of depression.
How to Avoid Stress-Induced Depression, Part I
The Key is RESILIENCE
RESILIENT individuals have been studied in relation to many forms of traumatic stress, including natural disasters, terrorism, rape, assault, torture, war and the holocaust.
But what is different about RESILIENT people?
Do they experience less stress than the rest of us? No, because RESILIENT people have been found even in the most severe forms of stress.
Do they have an easier "road" to travel than the rest of us? No - research has shown that many of these individuals come from extremely disadvantaged circumstances.
So is RESILIENCE ingrained in their psychology or personality? In other words, do RESILIENT people drive a different "vehicle" than others? Yes, compared to some, it seems that RESILIENT people drive an armored car that can help them get through the most challenging circumstances unscathed.
How to Avoid Stress-induced Depression, Part II
Characteristics of RESILIENCE
What personality or character traits do RESILIENT people have that create this armored car? In a recent article, one researcher* looked through the past 20-30 years of data to compile the following list:
- RESILIENT people have an Internal locus of control. In other words, they believe that they, not other people or circumstances, control how they feel.
- RESILIENT people have high self-esteem and self-efficiency
- RESILIENT people have personal goals that they are constantly working toward
- RESILIENT people are able to find some sort of meaning in all circumstances in life
- RESILIENT people can use past successes to confront current challenges
- RESILIENT people can view stress as a challenge/way to get stronger
- RESILIENT people can use humor, patience, tolerance, and optimism in the face of a crisis
- RESILIENT people can adapt to change
- RESILIENT people take an action-oriented approach. They don't bury their head in the sand when trouble comes; they face it and conquer it.
- RESILIENT people have strong relationships and ask for help
- RESILIENT people have spiritual faith
Take a good look at this list. Do you have to be born with these characteristics, or can you learn them? The great news is that we can ALL learn to be resilient by developing this qualities in our lives.
*Connor, KM (2006) Assessment of Resilience in the Aftermath of Trauma. J Clin Psychiatry 67 (suppl2):46-49
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Stress: Beyond Coping wishes you the best of health!
by stressbeyondcoping
Dr. Pamela Coburn-Litvak has published research articles on stress in Neuroscience, Neurophysiology, and Neurobiology of Learning and Behavior. After... more »
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