Hormones play a major role in our mood. Cortisol — also known as the stress hormone — may affect some mood disorders, including depression.

When faced with stress, your body releases cortisol and other hormones to trigger a fight-or-flight response. This is an important survival mechanism. When the stress goes away, your cortisol levels return to baseline.

But in the face of chronic stress, you might have consistently elevated levels of cortisol.

We know that long-term stress can have a negative impact on health, both mental and physical. But what role does cortisol play, and can it affect depression?

While people often associate cortisol with stress, the hormone also helps regulate metabolism, inflammation, blood sugar, and more.

Experts still don’t know exactly what causes depression, but a combination of factors may be involved, including:

  • environmental factors, such as stressful or traumatic events
  • genetic factors, which are largely inherited from your parents
  • biological factors, such as hormone levels

According to a 2015 review, chronic stress can lead to mental health conditions like depression and anxiety. Some researchers believe that this is because chronic stress leads to consistently high cortisol levels, which can affect the brain.

Another 2015 review says that stressful events may cause psychological changes and brain changes, specifically in the hypothalamic pituitary adrenal (HPA) axis. The HPA axis is the region of the brain that produces cortisol. This review also notes that many people with depression have high cortisol levels.

Does that mean that high levels of cortisol are the main cause of depression? Not necessarily.

Experiencing chronic stress doesn’t always mean that you’ll develop depression. Certain people may be more prone to developing depression in the face of stress.

A small 2020 study found no significant difference in cortisol levels before and after treatment in participants with major depressive disorder (MDD), even when treatment was successful and symptoms decreased.

However, other studies, including a 2012 study, have found the opposite to be true. Researchers from the 2020 study suggested that variations in results may exist because of factors like weather and sample timing.

The same study also found that participants with MDD had higher cortisol levels in the evening compared with control participants without depression.

This suggests some link between cortisol and depression, but it may not be as simple as saying that high levels of cortisol equal depression.

A 2019 review looked at studies in both mice and humans. The research suggests that an elevated cortisol response may be linked with more severe MDD symptoms.

The review concludes that baseline cortisol isn’t a good way to diagnose MDD. Instead, variability in stress response is probably a more accurate way to measure things.

Cortisol and chronic health conditions

Atypical levels of cortisol can cause health problems linked to depression.

According to the Endocrine Society, high levels of cortisol can contribute to the development of chronic diseases like Cushing’s syndrome. Cushing’s syndrome is a condition that causes weight gain, high blood pressure, and mood changes.

Chronically low cortisol levels can cause Addison’s disease. This is another chronic condition that also causes mood changes, including depressive symptoms.

Having a chronic illness may lead to depression, according to the National Institute of Mental Health (NIMH).

Stress-induced depression can have the same symptoms as other types of depression. You might notice that your symptoms become worse at times of stress.

The symptoms of depression include:

  • being withdrawn
  • sadness and hopelessness
  • low energy and loss of motivation
  • changes in appetite
  • changes in sleep habits
  • restlessness, agitation, and irritability
  • difficulty with concentration and memory
  • anger
  • feelings of guilt
  • feeling bad about yourself
  • suicidal ideation

If stress-related depression is affecting your life, various treatment options may help. A combination of therapy and antidepressant medications is a common treatment plan for people with depression.

Talking with a mental health professional about your symptoms is a great first step. They can help you figure out the best course of treatment.

Looking for a therapist, but not sure where to start? Psych Central’s How to Find Mental Health Support resource can help.

You can’t completely eliminate stress from your life, but you can try to prevent some of it and manage the stress that does come your way.

Strategies for reducing and managing stress include the following:

Make plans

You can plan ahead to avoid anxiety and stress.

Do you find yourself fretting over preparing meals after work? Trying meal prep or writing out a meal plan can help. With plans in place, you won’t be mulling over what to eat at the last minute when your stomach is growling.

Prioritize what’s most important

Not every task needs to be at the top of your to-do list. Focusing on those that need to get done pronto can help you stress less over those that are less pressing.

You might even consider delegating less critical tasks to other people.

Recognize your stress

If you can pinpoint when you’re feeling stressed, you’ll be in a better position to address it directly.

Take a breather

It’s important to find time to relax and recharge when possible. Practicing deep breathing can help.

Maintain healthy habits

If you’re tired, run down, and constantly running on little sleep, your body will find it harder to cope with stress.

Healthy habits like good sleep hygiene and exercise, which releases feel-good endorphins, make it easier to manage stress.

Get support from others

Whether you’re talking about what’s stressing you out or leaning on others for a helping hand, the people around you can play a role in stress reduction and management.

Chronic stress can make it hard to cope with everyday life, especially when it leads to depression.

Learning ways to cope with stress can help. But if symptoms don’t let up, or you don’t feel equipped to deal with high stress levels on your own, you may want to consider seeking out professional help.

A mental health professional can help you manage your depression symptoms and introduce you to strategies for coping with long-term stress.