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stress response
suppression of the PNS and activation of the SNS
stress regulatiion
regulated via negative feedback through glucocorticoid receptors in the PVN, hippocampus and ACC
chronic stress and regulation
impairs the negatve feedback loop through damage to the hippocampus, leading to sustained cortisol levels and energy inefficiency
MDD
marked by persistent, debilitating symptoms like low mood, sleep disturbance and fatigue
MDD and HPA axis dysregulation
both high and low cortisol levels can induce depressive symptoms
treatments that reduce subgenual ACC activity
alleviates depressive symptoms
chronic stress and monoamines
depletes noradrenaline, serotonin and dopamine
SSRIs - lipophillic
block serotonin reuptake to increase synaptic availability
neurogenesis suppression
depression suppresses hippocampal neurogenesis
enhancement of neurogenesis
SSRIs and exercise enhance neurogenesis, necessary for antidepressant
where are glucocorticoids released from
adrenal cortex
where do glucocorticoids bind to
the PVN of the hypothalamus, hippocampus and ACC
what does the binding of glucocorticoids do
inhibits further release of CRH and ACTH which suppresses the HPA through negative feedback
subgenual ACC
implicated in mood regulation and depression
subgenual ACC activity and anti-depressants
its activity decreases in response to SSRIs