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Dr. Bob is Robert Hsiung, MD,
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Posted by mogger on April 16, 2012, at 12:58:32
Does anyone have any insight as to whether those who have clinical unipolar depression and OCD can have high levels of cortisol? It seems as if cortisol is a fight or flight hormone so theoretically as clinical depression is constantly in overdrive as well as OCD, perhaps there is a correlation with elevated cortisol levels? I know that glutamate hyperactivity seems to be an issue as well.
Posted by Tomatheus on April 16, 2012, at 13:58:40
In reply to Cortisol Levels in Depression and OCD, posted by mogger on April 16, 2012, at 12:58:32
Mogger,
I don't know about OCD, but there is some evidence that activity of the hypothalamic-pituitary-adrenal axis (which regulates cortisol) tends to be elevated in patients with melancholic depression and diminished in patients with atypical depression:
http://www.ncbi.nlm.nih.gov/pubmed/11920153
I'm not sure exactly how conclusive the findings of the above study are in the grand scheme of things, but the findings seem to indicate that different subtypes of unipolar clinical depression look different on the neuroendocrine level.
Perhaps others will be able to expand on what I've written here and provide more information.
Tomatheus
Posted by mogger on April 16, 2012, at 14:02:58
In reply to Re: Cortisol Levels in Depression and OCD, posted by Tomatheus on April 16, 2012, at 13:58:40
Thanks Tomatheus,
How does melancholic depression differ from atypical? What would unipolar fall under?
Posted by Tomatheus on April 16, 2012, at 14:17:00
In reply to Re: Cortisol Levels in Depression and OCD » Tomatheus, posted by mogger on April 16, 2012, at 14:02:58
Mogger,
Melancholic depression and atypical depression are considered to be subtypes of unipolar depression.
The following quote from the abstract that I linked to describes the differences between melancholic depression and atypical depression:
"In melancholia, the stress response seems hyperactive, and patients are anxious, dread the future, lose responsiveness to the environment, have insomnia, lose their appetite, and a diurnal variation with depression at its worst in the morning. They also have an activated CRH system and may have diminished activities of the growth hormone and reproductive axes. Patients with atypical depression present with a syndrome that seems the antithesis of melancholia. They are lethargic, fatigued, hyperphagic, hypersomnic, reactive to the environment, and show diurnal variation of depression that is at its best in the morning. In contrast to melancholia, we have advanced several lines of evidence of a down-regulated hypothalamic-pituitary adrenal axis and CRH deficiency in atypical depression, and our data show us that these are of central origin."
Tomatheus
Posted by mogger on April 16, 2012, at 14:26:23
In reply to Re: Cortisol Levels in Depression and OCD » mogger, posted by Tomatheus on April 16, 2012, at 14:17:00
Excellent description Tomatheus thank you!
Posted by Phillipa on April 16, 2012, at 18:09:46
In reply to Re: Cortisol Levels in Depression and OCD » Tomatheus, posted by mogger on April 16, 2012, at 14:26:23
I found an article that focuses on the Ocd component. Albeit it sells supplements the info thoughout the alticle does say that cortisol fits into the picture. Phillipa
http://www.lef.org/protocols/emotional_health/obsessive_compulsive_disorder_01.htm
Posted by mogger on April 16, 2012, at 21:57:22
In reply to Re: Cortisol Levels in Depression and OCD » mogger, posted by Phillipa on April 16, 2012, at 18:09:46
Thank you Phillipa for sharing that link that is very interesting.
Posted by Phillipa on April 17, 2012, at 19:16:04
In reply to Re: Cortisol Levels in Depression and OCD, posted by mogger on April 16, 2012, at 21:57:22
You're welcome I also found it helpful. Wasn't what I expected til got to the bottom. Phillipa
Posted by phidippus on April 18, 2012, at 22:11:01
In reply to Cortisol Levels in Depression and OCD, posted by mogger on April 16, 2012, at 12:58:32
Increased nocturnal secretion of ACTH and cortisol in obsessive compulsive disorder.
Kluge M, Schüssler P, Künzel HE, Dresler M, Yassouridis A, Steiger A.
SourceMax-Planck Institute of Psychiatry, Munich, Kraepelinstrasse 2-10, 80804 Munich, Germany. kluge@mpipsykl.mpg.de
AbstractInformation on the function of the hypothalamic-pituitary-adrenal (HPA) axis, the main mammalian system of stress response, in obsessive compulsive disorder (OCD) is inconsistent. In this study, nine inpatients with a DSM-IV diagnosis of OCD without comorbid major depression (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score >15; HAMD-21 total score 16) and nine healthy matched controls were included. Blood of patients (seven males; 31.8 +/- 9.3 years, Y-BOCS: 27.3 +/- 4.3, HAMD-21: 13.3 +/-1.9) and controls (seven males, 31.6 +/- 9.1 years) was drawn every 20 min between 23:00 and 7:00 h during sleep using a long catheter for later ACTH and cortisol analysis. Secretion patterns of cortisol and ACTH were similar in both groups, in OCD, however, at a higher level. Area under the curve plasma concentrations of both ACTH (p<0.05) and cortisol (p<0.005) were significantly greater in patients with OCD (ACTH: 674.3 +/- 57.4; cortisol: 2148.4 +/-271.7) than in controls (ACTH: 460.2 +/- 61.0; cortisol: 1191.2 +/- 124.1). In conclusion, our findings suggest that the activity of the HPA axis in patients with OCD is increased compared to healthy controls.
Abstract
Plasma levels of melatonin and cortisol were measured over a 24-hour period in seven patients with primary obsessive-compulsive disorder (OCD) and seven matched healthy control subjects. In OCD patients, the 24-hour secretion of melatonin was reduced as compared with that in healthy control subjects, whereas its circadian rhythm was preserved. In addition, in OCD patients, the overall secretion of cortisol was higher than that in control subjects, but there was no change in the circadian pattern of cortisol secretion. No correlation was found between clinical parameters and hormone levels.
Eric
Posted by mogger on April 18, 2012, at 22:19:48
In reply to Re: Cortisol Levels in Depression and OCD » mogger, posted by phidippus on April 18, 2012, at 22:11:01
Eric so is it more noteworthy that OCD individuals have low levels of melatonin hence supplementation of melatonin could be effective?
Posted by creepy on April 19, 2012, at 12:35:38
In reply to Cortisol Levels in Depression and OCD, posted by mogger on April 16, 2012, at 12:58:32
If you ever want to experiment, supposedly licorice root raises cortisol. Holy basil supposedly lowers it.
I think its a lot more complex than just cortisol. There are changes in brain volume, endocrine and immune systems that come with depression.
Some of the CFS folks experiment with the immune system side of it by antagonizing the opioid receptors with a small dose of naltrexone.
Physical pain seems to possibly have some links to psychic pain as well.
Posted by phidippus on April 19, 2012, at 18:26:16
In reply to Re: Cortisol Levels in Depression and OCD » phidippus, posted by mogger on April 18, 2012, at 22:19:48
I've never noticed melatonin to have any effect on my OCD.
Eric
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