Psychoneuroendocrinological and Cognitive Interactions in the Interface Between Chronic Stress and Depression
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The role of chronic stress in the origin and development of depression may be conceived as the result of different factors, including the impact of current environmental stressors and the cumulative effects of stressful experiences during early periods of life. It has been shown that chronic stressful experiences, including current and early-life events, may lead to increased activation of the hypothalamicpituitaryadrenal axis. These changes, including increased synthesis and release of Corticotrophin Releasing Hormone (CRH) and cortisol, have been also associated with functional changes in certain limbic structures, including increased reactivity of the amygdala and decreased activity of the hippocampus, and changes in different monoaminergic systems, including decreased serotonergic activity, therefore resulting in increased vulnerability to stress. Upon exposure to chronic stressful events, as well as stressful conditions in early life, other biological factors may also contribute to this process, including genetic polymorphisms and epigenetic mechanisms, altered immunological responses, and psychological factors, including negatively biased cognitive processing, with the resulting cognitive distortions and learned helplessness. This chapter aims to understand the role of these converging factors, the potential interactions between them, and the role they play in the interface between chronic stress and the development of depression.
