The Role of Cortisol in Depression

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People with depression tend to have reduced amounts of serotonin in their brain and elevated levels of cortisol in their bloodstream. Because cortisol is related to stress, implementing a stress-management lifestyle may be an important aspect of coping with your depression.

Understanding Cortisol

Cortisol is a hormone produced by the adrenal glands, which are the small endocrine glands that sit on top of our kidneys. It is secreted by the body in response to stress and one of the hormones involved in the fight or flight response.

Cortisol plays an important role in everything from how the body uses glucose (sugar) to the regulation of blood pressure to the function of the immune system.

In the short run, cortisol release has many benefits. It prepares you for physical and emotional challenges, generates bursts of energy in the face of trauma, and triggers surges of immune activity when you're confronted with infectious diseases.

Following this cortisol-induced activation state, your body goes through a necessary relaxation response. However, cortisol production becomes problematic when you're exposed to prolonged stress, which results in the continuous production of cortisol.

Prolonged elevated levels of cortisol can result in high blood sugar, high blood pressure, a reduced ability to fight infections, and increased fat storage in the body. Over time, this can lead to serious conditions like diabetes, heart disease, and stroke.

In other words, in the short term, an increase in cortisol secretion may aid in survival, but long-term elevations can do the opposite.

Stress, the Brain, and Depression

When you experience ongoing stress, your stress hormones are active all day long. This is exhausting to the body and may cause the neurotransmitters in your brain—like serotonin, the "feel good" chemical that influences mood, appetite, and sleep, among other things—to stop functioning correctly, potentially leading to depression.

In people who are not depressed, the level of cortisol in the bloodstream peaks in the morning then decreases as the day progresses. However, research reveals that, in people who live with depression, cortisol tends to peak earlier in the morning and does not level off or decrease in the afternoon or evening.

Instead, repeated surges of cortisol are experienced throughout the day. This is sometimes referred to as cortisol dysfunction. It can make you become resistant to cortisol (and all of its positive effects), increase your stress-induced inflammation, and might even cause or worsen pain.

It has been found that people with elevated cortisol levels are less responsive to psychotherapy treatments, implying that techniques that may reduce cortisol levels, such as stress management, may be an important part of a depression treatment regimen for these patients.

Signs of Stress-Induced Cortisol Dysfunction

How do you know if your body's cortisol may not be functioning properly? Only a blood test can say for sure. But you may also notice some changes in how you feel. Here are a few signs to watch for:

If you have any of these symptoms, you may want to contact your doctor and ask about your cortisol levels. A blood test might be ordered to find out if any dysfunction exists.

Stress-Reduction Strategies

Reducing your stress may be a useful way to temper chronically elevated cortisol levels, which may help mellow out the effects of depression. Here are a few stress-relieving options to consider.

Do Something You Love Every Day

Research indicates that cortisol levels appear to be tied to long-term happiness and inner peace. So, doing something that you enjoy regularly can be a great way to positively affect your cortisol, potentially decreasing your depression. Even if it's just for 10 minutes, take some time to read the next chapter of that novel you're absorbed in or play your guitar.

Get a Massage

Many people use massage as a way to relieve stress, anxiety, and tension. Massage also decreases your cortisol while increasing your serotonin and dopamine. In easier-to-understand terms, this means that it makes you feel better on a biological level in addition to making you feel better physically.

Keep a Journal

Giving yourself a place to let it all out can be not only freeing, but the act of writing about the things in your life that haven't gone as planned also reduces your cortisol. If you're new to journaling, make it a point to take a few minutes every evening and write your thoughts down. You might notice that you feel better simply by getting your emotions out.

Meditate

Meditation has been proven to reduce stress and anxiety, boost your mood, and even help physical ailments like headaches. All of this can be helpful when you live with depression. This stress-relieving option works in part by keeping you focused on the here and now. But it also reduces your blood cortisol levels, providing biological benefits too.

Try Art Therapy

One study found that people's cortisol levels were reduced 45 minutes after making art. Color, paint, draw, or do photography. All of these art therapy options can engage your inner creative side, making them a fun way to distract you from stress.

Exercise

Studies have shown that aerobic activity has positive effects on your cortisol levels. Go for a walk or run, take a bike ride, or dance around the house. It doesn't matter so much what you do, just that you engage in some type of physical exercise.

Increase Your Light Exposure 

Have you ever spent some time outdoors and noticed that you felt better after? This may be partially due to the way the sun's rays are able to decrease your cortisol, more so during the summer and spring months. Light therapy can also potentially help, and it's available all year long.

Sleep Well

When you are sleep deprived, your cortisol levels will likely go up, as does your level of stress. Getting enough sleep and keeping a regular sleep pattern (getting up and going to bed at the same time) helps stave off depression and improve mood.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

There are many ways cortisol may contribute to the development of depression or make it harder to treat. That's why finding a way to lower your stress, and your cortisol, is so important. Taking actions such as these can help you feel better faster and make your path to recovery an easier journey.

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