Stress, Mood, and Pathways to Depression

Mood disorders are very common. More than 10-20% of the population suffers from mood disorders at one time or another. These disorders are heterogeneous and multifactorial. The most common form of mood dysregulation is depression. At least four intersecting vulnerability factors contribute to the development of depression. One is through the vulnerability characteristics of the individual that include neuroticism, low self-esteem, and early-onset anxiety symptoms. The second path is through the events that happen to the individual beginning with stress of the mother during pregnancy trailed by childhood events including troubled family environment, childhood abuse, and death or divorce of parents. As individuals mature, this could be exacerbated by other life events such as job loss, divorce, trauma, and low social support. The third factor is through drug and alcohol abuse. The fourth path is through vascular disease. These trails lead to a state characterized by features that make the individual vulnerable to the development of depression. The features that constitute this state include negative bias in information processing (affecting perception and decision making) and the liability to experience negative affect in response to stress. The factors are not specific to the vulnerability to depression and can lead to other expressions such as anxiety disorders. In this chapter, we outline the neurobiological underpinnings of these factors that lead to risk for depression and the neurobiology underlying the expression of depression.

Duke Scholars

Author K. Ranga Rama Krishnan Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...