The Role of Chronic Stress in Anxious Depression

Abstract

Depression is a heterogeneous disease with many different subtypes. Patients with the anxious depression-a common subtype of major depression-are at an increased risk for treatment-resistance to standard antidepressants, with resultant increases in morbidity. However, the underlying pathophysiology of anxious depression remains unknown. Without such knowledge, the development of targeted treatments towards this specific depression subtype will likely remain elusive. One method by which research into the neurobiology of anxious depression may prove fruitful is with the research domain criteria (RDoC). RDoC provides a framework for investigation into the underlying pathophysiology of mental illness. By studying disorders in terms of RDoC constructs-such as the sustained threat construct of the negative valence systemnew insights may be gained into neurobiological mechanisms of disease. These mechanisms may be useful for the development of novel antidepressants that are based on specific brain targets. Specifically, we review the impact that sustained threat-or chronic stress-has on the eventual development of depression (especially anxious depression) through pathological changes to molecules, cells, neurocircuitry, physiology, and behavior.

Transdiagnostic trauma severity in anxiety and mood disorders: Functional brain activity during emotional scene processing

“…Moreover, the current data suggest that a deficit in visual sensory processing—a failure to discriminate motivational cues—is not limited to PTSD but, instead, is present across the spectrum of internalizing disorders and is not limited to aversive stimuli but is also found for appetitive cues. Given the strong covariation between functional activation in the amygdala and ventral visual cortex observed here, together with data supporting re‐entrant amygdala‐visual processing (Sabatinelli et al, ), the deficits in visual cortical processing found for those exposed to trauma could reflect effects of chronic stress on amygdala circuitry or function (McEwen, ; Vyas, Miltra, Shankaranarayana Rao, & Chattarji, ) or, alternatively or in addition to, HPA axis dysfunction (Ross, Foster, & Ionescu, ).…”

Effects of a Healing Rhythm System Based on ECG Waveform Simulation on Stress, EEG, Heart Rate, and Anxiety in University Students; A Randomized Controlled Trial

“…지속적으로 스트레스에 노출되면 생리적으로 심박동수 증가와 혈압 상승을 포함한 심혈관계 증상이 나타날 뿐만 아니라, 소화기계의 변화나 근 긴장도의 증가가 발생하기 도 하고 심리적으로는 우울감과 분노, 흥분, 정서 불안정 및 초조 등과 관련이 있다 (Gorman et al, 2000). 이러 한 스트레스원에 노출되었을 때 즉각적으로 해소되지 않 고 만성적으로 이어지거나 부적절한 방식으로 대처하였을 시 불안의 증가와 우울증으로 이어질 수 있으며 (Ross, 2017), 이는 국가의 의료비 지출 증가 및 국민의 삶의 질 저하 뿐만 아니라 질병이환율에도 영향을 줄 수 있기 때문 에 스트레스를 완화할 수 있는 적합한 중재가 필요하다.…”

Disorganized Diseases: Are they a Simple Explosion of Random Energy and therefore Meaningless? A Cases Series Study in Family Medicine

“…[38] The impact that sustained threat -or chronic stress -has on the eventual development of depression through pathological changes to molecules, cells, neurocircuitry, physiology, and behavior. [39] Trauma is considered any stressful event extreme, something outside the realm of normal human experience, at least for the social group to which the individual belongs, and produces negative consequences on behavior and emotions of the individual, causing problems or symptoms seen as due to anxiety disorders or caused by stress. [40,41] The term stress refers to any requirement or encouragement that we produce a state of tension and that it requests an adaptive change on our part.…”