Cortisol and Seasonal Changes in Mood and Behavior

By Leo Sher, MD | October 1, 2006

Another study of depressed patients showed a significantly biannual rhythm in the postdexamethasone cortisol values in depressed men, with peaks in June and December and troughs in March and September.⁵¹ The hypothesis that the spring/fall group and the winter/summer group represent different biologic subtypes of major depression is also supported by the observation that the number of binding sites to serotonin receptors during spring and fall is 12% higher than in winter and summer.⁵²

Treatment of SAD

Light therapy is recommended as a first-line treatment for SAD in expert and consensus clinical guidelines.^53-57 It is possible that light therapy reduces HPA-axis abnormalities associated with SAD.

It has also been shown that antidepressants may prevent and treat SAD.^57,58 A recent report suggests that light treatment showed earlier response onset and lower rates of some adverse events relative to fluoxetine(Drug information on fluoxetine), but there were no other significant differences in outcome between light therapy and antidepressant medication.⁵⁷ Another study concluded that it is possible to prevent recurrence of SAD episodes by beginning bupropion treatment early in the season while patients are still well.⁵⁸ Antidepressants may act by normalizing the pathologic changes in HPA function in SAD patients. Also of interest, a recent report suggests that mifepristone(Drug information on mifepristone),⁵⁹ a steroid antagonist, may be useful for the treatment of SAD.

Increased cortisol secretion caused by major and minor stressful events may contribute to the development of SAD and other depressive disorders in vulnerable individuals.⁶⁰ Therefore, one of the goals of prevention of such stress-related disorders is to help individuals to be more competent in managing their behavior and emotions in reaction to the negative aspects of their environment.

Dr Sher is an associate clinical professor of psychiatry at Columbia University College of Physicians and Surgeons and a research psychiatrist in the department of neuroscience at the New York State Psychiatric Institute in New York City. He reports no conflicts of interest regarding the subject matter of this article.

Pages: 1 2 3 4

Drugs Mentioned in This Article
Bupropion (Wellbutrin)
Bupropion (Wellbutrin, Zyban)
Dexamethasone (Decadron, others)
Fenfluramine (Pondimin)
Fluoxetine (Prozac, Sarafem)
Mifepristone (Mifeprex)

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Cortisol and Seasonal Changes in Mood and Behavior

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