Morning Cortisol Levels Predict First Episode and Recurrence of Depression

Chronic and acute stress can lead to many physical and mental health problems. Cortisol, the stress hormone, is often measured as a way to determine how much stress someone is experiencing and how their body reacts to that stress. Many studies have shown that elevated cortisol levels can indicate specific mental health issues, and some individuals who are sensitive to cortisol peaks may be more vulnerable to specific mental and physical conditions. In the study of depression, cortisol has been linked to symptomology. One of the ways to gauge cortisol levels is by measuring waking cortisol levels and comparing them to levels gathered 30 to 40 minutes after waking. This is called the cortisol awakening response (CAR) and is recognized as an effective assessment of baseline cortisol and cortisol sensitivity.

In a recent study, Suzanne Vrshek-Schallhorn examined CAR to determine if it could predict the onset of major depressive episode (MDE) in individuals with a history of depression and without. In a previous study, Vrshek-Schallhorn had shown that CAR was successful at predicting MDEs in the year following assessment. But in this most recent study, Vrshek-Schallhorn extended her existing findings by looking at the predictive value of CARs over a 4 year period in a sample of 270 older teenagers. She found that CAR was a strong predictor of first MDE, regardless of whether the teens experienced major life stressors or not. When looking at those with a history of MDE, Vrshek-Schallhorn discovered that their CAR was even more accurate at predicting future episodes than it was initial MDEs. However, this was only the case in the first two-and-a-half years of the study period.

Essentially, after the 30th month of the study, the levels of CAR were not directly linked with future MDEs or initial MDEs. Upon further investigation, Vrshek-Schallhorn also noticed that elevated CAR did not make the participants more vulnerable to stress reactions. However, stressful life events by themselves were predictive of depression. The findings of this study support the theory that CAR can be used to predict MDEs, but with limitations. Vrshek-Schallhorn said, “These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events.”

Vrshek-Schallhorn, S., et al. The cortisol awakening response predicts major depression: Predictive stability over a 4-year follow-up and effect of depression history. Psychological Medicine 43.3 (2013): 483-93. ProQuest Research Library.Web. 3 Feb. 2013.

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  • Vale

    February 12th, 2013 at 11:15 AM

    Even with the predictor limitations, this would still be something that medical doctors could check for to know if your risk could be higher for developing an MDE

  • DEAN M

    February 13th, 2013 at 3:11 PM

    I would have thought long term levels of cortisol would predict depression rather than short term..But it seems like there is no quick change in cortisol levels in the short run so this study does answer the required question..Now just hope that these can help us predict and prevent such episodes.

  • Cayden f

    February 14th, 2013 at 1:44 PM

    I agree with Dean. Thought that looking at something over the course of hours or days would make more of a difference than one specific time of day as it would give you more variation and help to establish more of a pattern.

  • ED

    February 15th, 2013 at 10:10 AM

    Please don’t see this as my way of dicounting what I am sure is probably valid research. But often I think that we are grasping at straws, trying to make sense of things that may or may not have a rhyme or reason. Maybe there are things in life that have nothing behind it- they are what they are so to speak. Could this be true of this too?

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