|Low morning cortisol associated with depression and anxiety: possible adrenal fatigue|
|Written by Matthew Hogg|
|Tuesday, 22 January 2013 13:18|
Specifically the team from the Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, examined whether salivary cortisol indicators predict the 2-year course of depression and anxiety disorders.
Information spanning a period of two years from 837 participants of the Netherlands Study of Depression and Anxiety was used in this analysis. Each participant had a depressive and/or anxiety disorder diagnosis based on standard DSM-IV criteria at the start of the study period.
Initially, seven saliva samples were obtained from each of the participants, including the one-hour cortisol awakening response (CAR), evening cortisol level and a 0.5mg dexamethasone suppression test. At follow-up, DSM-IV based diagnostic interviews and Life Chart Interviews that integrate diagnostic and symptom trajectories over 2 years were given to participants to determine if their depression/anxiety had worsened over that time.
The CAR is important as in most people a significant rise in cortisol is seen in the first hour after awakening in the morning. The increased levels of cortisol help to prepare individuals for expected stress (e.g. morning traffic, a day at work etc) and motivate them and help them cope accordingly. Learn more about the CAR here.
The Dutch researchers discovered that 41.5% of the participants had a worsening of their depressive or anxiety disorder over the two year period studied without a remission lasting longer than 3 months.
Analyses of the data showed that a lower CAR value (i.e. lower morning cortisol level) was associated with an unfavorable illness course to a high degree of statistical significance; so much so that a low CAR value translated to an 83% chance of a participant experiencing a worsening of their depression and/or anxiety.
No associations were found between evening cortisol or cortisol suppression after dexamethasone ingestion and the course of participants' depression or anxiety.
The findings are extremely interesting from a scientific and medical point of view and if confirmed may lead to depressive and anxiety disorders being treated on an individual basis according to a patient's cortisol test results.
The researchers suggest that the low morning cortisol may be the result of a condition known as adrenal fatigue (or adrenal exhaustion) in which chronic stress and other factors (genetic susceptibility, toxic exposure, nutritional status) eventually leads to dysfunction of the HPA-axis and suboptimal output of cortisol and other adrenal hormones. Learn more about this condition here.
Reference: Vreeburg SA Hoogendijk WJ Derijk RH van Dyck R Smit JH Zitman FG Penninx BW (2013) Salivary cortisol levels and the 2-year course of depressive and anxiety disorders Psychoneuroendocrinology doi: 10.1016/j.psyneuen.2012.12.017. [Epub ahead of print]
|Last Updated on Tuesday, 22 January 2013 15:07|