The Role of Cortisol in Depression

Depression is linked to borderline personality disorder.
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People with depression tend to have reduced levels of serotonin in the brain and elevated levels of cortisol in their bloodstream. Since cortisol is related to stress, implementing a stress-management lifestyle can help alleviate your depression.

Understanding Cortisol

Cortisol is an important hormone produced by the adrenal glands, the small endocrine glands that sit on top of our kidneys. It is secreted by the body in response to stress and is 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 small doses, cortisol secretion has many benefits. It prepares you for physical and emotional challenges, generates bursts of energy in the face of trauma, and provides 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.

Cortisol production becomes problematic when you're exposed to continuous or 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.

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

Stress, the Brain, and Depression

Ongoing stress means that stress hormones are operating throughout the day for most of the day. This is exhausting to the body and may cause the neurotransmitters in your brain like serotonin—the "feel good" chemical that appears to influence 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, in roughly half of the people who live with depression, cortisol peaks earlier in the morning and does not level off or decrease in the afternoon or evening.

While it is still unknown if and how cortisol affects serotonin levels or other aspects of depression, cortisol is important in another way for people with depression. 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, would be an important part of a depression treatment regimen for these patients.

Strategies

Reducing your stress is, of course, the best way to temper chronically elevated cortisol levels, which may help mellow out the effects of depression. Consider these options:

  • Relax: Make sure you take some time every day, even if it's just a few minutes, to completely relax your body and your mind.
  • Meditation: Using meditation has been proven to reduce stress and anxiety, boost your mood, and even help physical ailments like headaches.
  • Get a massage: Massage has proven benefits to relieve stress, anxiety, and tension.
  • Try art therapy: Coloring, painting, drawing, or photography—whatever your pick, engaging your inner artist can help drive away stress.
  • Keep a journal: Giving yourself a place to let it all out can be not only freeing, but it can also help you deal with stress you may not have even realized you had.
  • Do something you love every day: Even if it's just for 10 minutes, being able to read the next chapter of that novel you're absorbed in or playing your guitar will help you unwind.

You can also engage in some natural solutions that may help boost your serotonin levels, including:

  • Exercise: While it has been clearly demonstrated that physical exercise boosts mood, many studies have also shown that it increases serotonin levels in the brain.
  • Sleep well: Getting enough sleep and keeping a regular sleep pattern (getting up and going to bed at the same time) also helps stave off depression and improve mood.
  • Increase light exposure: Sunlight is preferable, though getting light by way of a therapy light can also help.
  • Curb caffeine: Caffeine may lower serotonin levels, so consider decreasing or even stopping your intake.

A Word From Verywell

There are many ways cortisol may contribute to the development of depression, either by affecting serotonin levels or through other endocrine pathways. What's most important to understand is that elevated cortisol levels can make depression therapy less effective, and the best way to lower cortisol levels is by adopting a stress-management lifestyle.

Regardless of whether or not cortisol has a direct role in depression, we know that chronic stress can lead to elevated cortisol levels, which in turn is connected with other serious conditions such as metabolic syndrome, which can lead to diabetes, heart disease, or stroke.

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