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The Stress-Depression Link


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In the last few articles in my series on antidepressants and depression, I have presented evidence demonstrating that – despite popular belief – depression is not caused by a deficiency of serotonin in the brain.

However, this of course does not suggest that depression is completely divorced from biochemical processes in the body.

The brain is a “living orchestra” of complex, interconnected systems that are in continuous relationship with one another. Everything from the food that we eat to the chemicals we’re exposed to in our environment to the hormones we produce effects the functioning of the brain. This will likely come as no surprise to you. It’s simply common sense. But as you may have noticed, in the world of scientific research common sense must first be proven according to the established standards of scientific proof before it is accepted.

Such has been the case with the link between stress and depression. I’ll wager that if I asked ten people on the street whether chronic stress caused depression, probably all ten of them would say “yes”. However, scientific proof of the causal link between chronic stress and depression has only begun to emerge over the past few years. It has been known for much longer that depressed people have elevated levels of cortisol (an indicator of chronic stress), but it was not known whether those elevated levels were the result or cause of depression.

In 2006 Ardyfio & Kim published a study indicating that chronic hypercortisolemia (elevated cortisol levels in the blood) causes anxiety-related behavior in mice. These results suggest that elevated cortisol levels may contribute to the symptom profile of depression rather than simply being a consequence of it.

Ardyfio & Kim’s study also confirmed the results of other studies which suggest that while acute stress is adaptive (helps us adjust to our changing circumstances), chronic stress has detrimental effects on the brain and behavior. Indeed, chronic stress has been linked to a wide variety of modern diseases, including (but not limited to) heart disease, cancer, diabetes, autoimmune disease, irritable bowel syndrome and fibromyalgia.

In a more recent study published in 2007, work stress was demonstrated to precipitate diagnosable depression and anxiety-related disorders in previously healthy, young individuals. The authors point out that stressful work conditions predict poor mental health, and that currently as many as 40% of people are exposed to work stress. (That’s funny, I would have thought the number to be closer to 100%).

The relationship between psychological job demands and the risk of depression and anxiety was graded; in study members exposed to high psychological job demands the risk was two times higher than in those with low demands. The combination of multiple work stressors conferred an even higher risk, especially in men.

Once again, this probably does not come as a surprise to you. It makes sense that high stress at work may cause depression and anxiety. But, believe it or not, this is relatively recent news to the mainstream scientific establishment.

Finally, in a study published today, researchers have shown how cortisol (one of the stress hormones) regulates brain neurotransmission in both the short and long term and enables neuronal connections to adapt.

In the short term, cortisol increases the mobility of receptors found on the surface of neurons, thus allowing synaptic connections to adapt more effectively to the demands of brain activity. The stress hormone might be considered as an “alarm” that mobilizes the receptors for action.

This behavior is adaptive, as it helps the organism (us) prepare and mobilize for action when faced with stress (a threat).

However, in the case of prolonged stress (which is the type of stress most prevalent in modern life) cortisol actually reduces synaptic plasticity. Lack of receptor mobility contributes to a lack of adaptation, which of course, is bad news for us.

The relevance to all of these studies to our recent discussion about depression and its treatment is this: stress is likely a significant contributing factor to depression for most people, and stress-management should play an important role in the treatment of depression.

Stress-management strategies are drug-free, non-invasive, cost-effective and have a wide range of beneficial “side effects” such as happiness, relaxation, improved sleep, more energy, improved libido, increased productivity, and protection from the legion of diseases that have been linked to stress.

In short, there is absolutely no reason not to include stress management in your treatment regimen for depression, or in your daily life even if you are currently healthy and free of disease.

There are many ways to reduce stress, including meditation, prayer, gentle movement (yoga, tai chi, Feldenkrais), exercise, deep relaxation techniques, spending time in nature, listening to music. What’s most important is that you find something that works for you and stick with it.

Mindfullness-Based Stress Reduction (MBSR), created by Dr. Jon Kabat-Zinn, is a very successful approach that has been clinically proven in well-designed studies to reduce pain and stress and improve health. I recommend his book Full Catastrophe Living, as well as the CD recordings of the techniques.

I also recommend a system of gentle movement and breathing exercises called “mini-moves”. Although they are marketed as a treatment for insomnia, the creator (Michael Krugman) of the system believes (quite correctly) that the best way to cure insomnia is to manage daytime stress successfully. You can download the “Secrets of Sounder Sleep” audio here. They are very simple and can be performed in as little as 5-15 minutes at a time.

I’ve used both of these systems myself with great success.

Next week will be the final article in the depression series (for now): drug-free alternatives to treating depression. Until then…

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  1. I think it’s interesting that the management of stress–giving yourself ways to recover from stress throughout the day using music, yoga, or mindfulness meditation–is more important than removing stressors from your life. I used to think that I had to work to be less stressed, which is stressful in and of itself!

  2. Since
    Feb 15, 2011 I started to take a drink of ground pumpkin seeds, ground almonds, ground flax seed, wheat germ, Brewers Yeast and ground dulce. I mix it in soy milk and molasses.

    I noticed that I started not to be so hungry after I drink the protein drink. I now take a hot drink of water and molasses. The molasses perks me up. Now I feel like I could improve my nutirition some more and so help my depression.

    Is there anything else I could try? Also what do you take to fall asleep and stay asleep?
    P.s. what other improvements did you notice as a result of changing your diet?

  3. Hi redcatbiker,

    Thanks for your comment and welcome to the blog. If you take a peek around you’ll see that the diet you follow (Weston A. Price inspired?) is very close to what I recommend for everyone.

    The only place we may not be in full sync is regarding the omega-3 fatty acids. I wrote an article a while back explaining why I think we need to moderate our intake of these polyunsaturated fatty acids. What is most important, I believe, in promoting general health and treating conditions like heart disease and depression is dramatically reducing our intake of omega-6 fatty acids. Since omega-6 fatty acids interfere with the absorption of omega-3s, if we significantly reduce our intake of omega-6 we will simultaneously begin absorbing more of the omega-3 we eat.

    Too much of any polyunsaturated fat, including omega-3s, can promote oxidative damage – which is a primary contributor to many conditions including heart disease and cancer.

    Nevertheless, I’m very glad you were able to successfully treat your depression through diet. I follow a very similar diet myself and have also been more or less “depression-proof” since I’ve eaten such nutrient-dense, traditional whole foods.

    As you point out, your diet has not only relieved depression it is also contributing greatly to your physical health and longevity.

    The timing of your post is serendipitous. Tomorrow I will publish the first in a two-part series on drug-free treatments for depression. I will cover diet in the second part, though I won’t be able to go into as much detail as I wish for this particular series. Perhaps in the future I’ll write an article focused on nutritional treatment of depression.

    Thanks again for sharing your valuable experience.

  4. I suffered from depression, for many years–it was so bad that often I thought that the only answer for my life would be to end it. Thoughts of suicide danced through my mind frequently.

    Early March 2008 I changed my diet completely:

    –eliminated all processed foods

    –eliminated all white foods; most important, eliminated sugar, which is the “white devil”

    –eliminated all foods containing soy and corn; so I don’t eat the meat of animals that have been fed grains

    –two years prior to March 2008 I stopped drinking sodas/soft drinks

    –only meats that have been traditionally raised; meat from ruminants that have been grass fed; chickens that have been pastured (I get them with the head and feet); meat from pigs that have not been raised in confinement (I know the people who “produce” the pork that I eat–they feed their pigs food that is in season and local, and they allow their pigs to be pigs, and never slaughter them before their time)

    –eliminated all the bad fats

    –added good fats: coconut oil, palm kernel oil, [raw] butter from grass fed cows, lard (from the pigs described above), beef bone marrow fat (from grass fed and pastured cows), olive oil

    –eat a tin of sardines (with the skin and bones) weekly

    –eat wild Alaskan salmon weekly

    –cut out grains; although, occassionally, I have a jones for those carbs, so I’ll eat some brown rice; sometimes I’ll have a bowl of steel-cut oats, which I have soaked overnight, and when I eat it, I add lots of butter and raw cream to it

    –stopped eating out; I cook all of the meals that I eat

    –only eat raw milk cheeses

    –eggs from hens that have been pastured

    –drink this mixture daily: raw milk, raw cream, 4-6 raw egg yolks, some unsulphured organic blackstrap molasses

    –daily supplements of: cod liver oil, evening primrose oil, wheat germ oil, kelp powder, dessicated liver

    –vegetables and fruit

    –drink only when thirsty

    –stopped wearing sunblock/sunscreen lotions; get out in the sun daily for 20-plus minutes

    –exercise daily; I ride my bike everywhere (I live in San Francisco) or I walk

    I have written the above to let you know, that I conciously increased my intake of omega-3 fats, which has totally eliminated depression from my life. There are times when I try to be depressed–through the years I have relied upon it to disenable me from “living” or to run away from problems that I did/do not want to face. With these dietary changes (and let me tell you that I do not miss the way I used to eat, which was the Standard American Diet) I am unable to go to being in a depressed state. Also, my physical health has improved, quite dramatically, too.

    Thank you for posting my comment.

    To website owner: If you wish to speak with me, to learn more what I have done to eliminate depression from my mind, feel free to email me.