Impact on Chronic stress on the HPA Axis and its Link to Depression

Abstract

Prolonged exposure to stress is a major risk factor for depression and dysregulation of the HPA axis due to chronic stress may lead to depression. The study investigated the association among chronic stress, cortisol regulation, functioning of the HPA axis, and depressive symptomatology within the Indian context. A cross sectional mixed method design was used with a sample of 150 adults aged 18 to 45 years of 75 high stress individuals and 75 low stress individuals. Depressive symptoms and perceived stress were measured by the Perceived Stress Scale, Beck Depression Inventory and Hamilton Rating Scale for Depression. Functioning of the HPA axis was measured using salivary cortisol and the Dexamethasone Suppression Test (DST). Twenty high stress subjects were interviewed. High stress individuals had significantly higher stress and depressive symptomology and cortisol.  Morning cortisol was positively correlated with BDi-II and afternoon cortisol was correlated with HAM-D. Results enhance an integrated biosocial model of stress related depression which informs culturally sensitive mental health care.