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Depression & Cortisol
Updated on May 9, 2023
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Depression & Cortisol

Key Takeaways

Stress is a natural reaction to threats or situations we feel are out of our control. But it isn’t always a bad thing. Some positive effects of stress include increased alertness and even energy.

Our bodies are capable of handling stress in small doses at a time. Our glands release chemical substances or hormones during stressful life events to help us deal with those problems. 

“Cortisol is the most important hormone released during stress. This single hormone affects almost all organ systems,” says our in-house expert, Dr. Rizza Mira.

The body’s stress response is usually short-lived, and your hormone levels return to normal after. Unfortunately, you can develop long-term or chronic stress when the body feels constantly threatened.

Chronic stress leads to elevated cortisol levels. Consistently high cortisol can affect your everyday life and can potentially contribute to mood disorders like depression.

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What Is Cortisol?

Cortisol is a hormone produced by the adrenal glands. Like many other hormones, cortisol acts as a chemical messenger, travels from the adrenal gland, and sends signals to other body parts.

“Cortisol levels send a signal to the brain to increase or decrease its production. Maintaining a healthy brain and adrenal connection is important so that cortisol levels are regulated,” says Dr. Mira.

It moves through the bloodstream to take part in various body functions, such as:

  • Regulating your body’s use of carbs, fats, and proteins
  • Reducing inflammation
  • Controlling your blood pressure
  • Regulating blood sugar level
  • Managing your sleep-wake cycle
  • Boosting and balancing your energy

Cortisol is best known for its vital role in your body’s stress response. Your adrenal glands release cortisol when the body perceives a threat from its environment.

It is a part of the body’s fight-or-flight or acute stress response. This chain of reactions prepares you to either face the situation or run off to safety.   


Your body will release cortisol when it's under stress. It sends a message to the rest of your body that you may be in danger, activating your fight-or-flight response. It's a hormone that helps your body prepare for any threat.

Effects Of Cortisol On The Body

Your body’s cortisol level changes throughout the day. For instance, cortisol levels peak early in the day and ease at night. This shifting cycle happens daily.1 

Your cortisol levels also depend on what you’re experiencing. The body releases more cortisol under stressful situations like dangerous circumstances, meeting a deadline, or losing a loved one.

A brief spike in cortisol level has beneficial effects on your body systems, such as:1 

  • Boosting your energy
  • Increasing your alertness
  • Strengthening your immunity 
  • Helping maintain balance within the body
  • Increasing sugar levels

But some people experience an increase in their cortisol levels during stressful periods. It happens when the glands fail to recognize an influx of stress chemicals already. 

Chronic Stress & Your Cortisol Levels

Your cortisol levels increase when you’re stressed, this is a normal part of your body’s response to what are called “stressors.” 

Chronic stress, however, can continuously elevate cortisol to unhealthy levels. It can cause different unwanted symptoms. 

“Chronically high cortisol levels can lead to generalized inflammation. This is a common culprit for cancers, arthritis, or autoimmune conditions,” says Dr. Mira.

Signs of High Cortisol

The general signs of a high cortisol level include:

  • Unexplained weight gain
  • Fat growth around the face, neck, and abdomen area
  • High blood pressure
  • Acne
  • Easy bruising
  • Muscle weakness
  • Severe fatigue
  • Feeling irritable
  • Difficulty with focusing
  • Headaches

If you show signs of elevated cortisol, your doctor may order a cortisol test. Cortisol tests are interpreted along with other laboratory tests to find the cause of your symptoms. 


Your body responds to stress as it happens. Heightened cortisol levels usually go away after some time, but chronic stress may put you at risk because of persistent stress reactions. Elevated cortisol can either cause or exacerbate conditions.

Scientists describe the relationship between stress and depression as bidirectional. It means that one can lead to the other or the other way around. Both can worsen each other’s effects.2

Chronic stress can tax your stress response.

The effects of stress on your mood and behavior can contribute to depressive symptoms. 

“Stress is seen as the most important and common trigger for depression,” says Dr. Mira

Depression or major depressive disorder (MDD) is a mood disorder. Doctors often describe it as a sudden lack of interest in things you usually enjoy doing. 

Major depression also makes you feel sad for no apparent reason. It causes changes in your behavior, like withdrawing from close friends and family. Then there are the physical signs, such as:

  • Feeling tired all the time
  • Feeling sick and ‘run-down’
  • Frequent headaches
  • A churning gut
  • Having sleep problems
  • Losing appetite
  • Changing weight

How Does Your Body's Stress Response Lead to Depression?

Our stress response starts in our amygdala — a brain structure responsible for our emotions. Stress stimuli travel through the hypothalamic-pituitary-adrenal (HPA) axis. 

The HPA axis is the complex pathway between the hypothalamus, the pituitary gland, and the adrenal glands. During stress, the body will activate the HPA axis. It releases hormones that can cause symptoms all over the body. 3

Depression & Cortisol 1

The glands will secrete chemicals into our bloodstream, including cortisol. Stress chemicals then stimulate many parts of the brain like the amygdala, hippocampus, and prefrontal cortex.

However, problems happen when the HPA axis is dysregulated. It may cause excessive secretion of stress hormones.5

Excessive stress chemicals can potentially cause physical signs of depression, like weight gain. These chemicals also affect the neurons and the brain.5 

Stress chemicals stimulate the hippocampus and prefrontal cortex to amplify your memory, thinking, and focus because you need them to face the situation. Remembering the stressor helps your body handle it if you encounter it again.6

Too much stimulation may cause the neurons in our brains to become exhausted and lose plasticity. Scientists believe that loss of neuroplasticity is also a key part of depression.7 


When the body is flooded with cortisol, it can be negatively affected. Excessive cortisol can lead to depression, especially when you're consistently encountering your stressor. Constant stress causes neurons to lose plasticity, leading to depression.

High Cortisol & Depression

Health experts still don’t know the exact cause of depression, but they observe that several factors contribute to it, such as:8

  • Environmental factors, such as stressful or traumatic events
  • Genetic factors inherited from your parents
  • Biological factors like hormone levels

A 2015 review of studies shows that chronic stress can lead to mental health problems, such as depression and anxiety. Researchers believe it’s because chronic stress leads to persistently high cortisol, which affects the brain.9 

One review of studies suggests that stressful events cause changes in the HPA axis. The review shows that many patients with major depression have elevated cortisol secretion.10

Other Studies on Cortisol and Depression

Another review looks at human and animal models (mice) studies. This research connects increased cortisol responses to more severe signs of MDD.11

The review concludes that baseline cortisol isn’t the best way to diagnose MDD. Instead, it mentions that it’s more accurate to use the changes in the body’s response to stress.11 

Recent studies also suggest that increased cortisol secretion may lower the brain’s serotonin production. Serotonin acts as a hormone that regulates your mood, facilitating happiness and optimism.12 

Serotonin levels are lowered during depression. Most modern anti-depressant drugs or serotonin reuptake inhibitors (SSRIs) work by increasing the serotonin in the brain.12

These studies, however, don’t necessarily mean that high levels of cortisol are the leading cause of depression. Chronic stress doesn't always cause depression but may increase your risk of depressive reactions.


Increased cortisol doesn't just put the body under constant stress and less neuroplasticity, studies show that it also affects serotonin production.

Why You Need To Control Stress

Stress not only contributes to developing depression and other mental health problems. It can burden almost all organ systems in the body: the heart, kidneys, liver, and pancreas.

For instance, stress can aggravate chronic pain disorders. Studies also reveal that stress is a risk factor for different health conditions, such as:13,14

  • Heart disease
  • Diabetes
  • Ulcers
  • Impotence
  • Lowered sexual drive

Elevated cortisol levels can affect your blood pressure and blood sugar (glucose) levels. It can also lead to cancers, autoimmune disorders, and inflammatory conditions like arthritis and inflammatory bowel disease. You’ll need to learn how to cope with your stress in a healthy way to avoid persistent high cortisol.1 

Stress management techniques can potentially help lower your body’s cortisol levels.

Stress Management Tips

You must learn to switch to your relaxation response after your fight-or-flight response is activated. This is essential in keeping your cortisol from rising uncontrollably.  

Various stress management techniques can relax your body. But first, you need to identify what causes your stress. 

“Most stressors come from the mind’s perception of things,” says Dr. Mira.

By identifying your stressors, you can also control your body from reacting to stress. Once you know what triggers your stress, you can start making lifestyle changes.  

You can begin by forming habits that help you cope when your stress response starts. 

Many swear by these strategies to achieve a relaxed state: 

  • Practicing breathing techniques
  • Exercising regularly
  • Focusing on positive images or using guided imagery
  • Writing in a journal
  • Listening to music
  • Meditating
  • Having a healthy sex life
  • Doing yoga

Relaxing the body and the mind can help maintain healthy levels of cortisol. 

“Exercising increases the levels of “happy hormones” to help balance the negative effects of stress,” says Dr. Mira. 

Learning stress management techniques and practicing them can be effective in achieving a low-stress lifestyle.


Managing stress doesn't just keep you away from elevated cortisol but also other conditions that are affected by stress, like high blood pressure and heart disease. By finding a good balance and time to relax, you can maintain healthy levels of cortisol.

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Updated on May 9, 2023
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14 sources cited
Updated on May 9, 2023
  1. Cortisol.” Cleveland Clinic.
  2. From Stress to Depression: Bringing Together Cognitive and Biological Science.” Current Directions in Psychological Science.
  3. “The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress.” Dialogues in Clinical Neuroscience.
  4. Traumatic stress: effects on the brain.” Dialogues in Clinical Neuroscience.
  5. Dysregulated Hypothalamic–Pituitary–Adrenal Axis Function Contributes to Altered Endocrine and Neurobehavioral Responses to Acute Stress.” Frontiers in Psychiatry.
  6. The link between stress and depression … and the 10 simple words that could help.” The Guardian.
  7. Neuroplasticity and depression: Rewiring the brain's networks through pharmacological therapy (Review).” Experimental and Therapeutic Medicine.
  8. Cortisol and Depression: What to Know.” Psych Central.
  9. The Links Between Stress and Depression: Psychoneuroendocrinological, Genetic, and Environmental Interactions.” The Journal of Neuropsychiatry and Clinical Neurosciences.
  10. The Effects of Psychological Stress on Depression.” Current Neuropharmacology.
  11. Cortisol and Major Depressive Disorder—Translating Findings From Humans to Animal Models and Back.” Frontiers in Psychiatry.
  12. Happiness & Health: The Biological Factors- Systematic Review Article.” Iranian Journal of Public Health.
  13. The Stress-Pain Connection.” Stanford Medicine.
  14. Five Reasons Why You Need To Manage Your Stress.” Aspen Counselling Center.
Dr. Rizza Mira
Dr. Rizza Mira
Medical Reviewer
Dr. Rizza Mira is a medical doctor and a general practitioner who specializes in pediatrics, nutrition, dietetics, and public health.

As a pediatrician, she is dedicated to the general health and well-being of children and expecting parents. She believes that good nutrition, a healthy lifestyle, and prevention of illness are key to ensuring the health of children and their families.

When she’s not in the hospital, Rizza advocates and mobilizes causes like breastfeeding, vaccination drives, and initiatives to prevent illness in the community.
Cristine Santander
Cristine Santander
Content Contributor
Cristine Santander is a content writer for KnowYourDNA. She has a B.S. in Psychology and enjoys writing about health and wellness.
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