COMMENTARY

Stress and Resilience: Implications for Depression and Anxiety

Jerrold F. Rosenbaum, MD; Jennifer M. Covino, MPA

Disclosures

December 29, 2005

In This Article

Overview

The physical and psychological impact of stress and the subsequent response of an individual who fails to adapt to or demonstrate resilience in the face of a particular stressor continues to be a fruitful focus of scientific inquiry. Stress can be defined as the consequence of a physical, chemical, or emotional challenge (a stressor) that requires the organism either to adapt or suffer physical or mental strain or tension. If the stress results from a failure to adapt to stressors, it may be a factor in causing disease. Preclinical studies have indicated that stress can promote long-term changes in multiple neurochemical systems.[1] Resilience is the capacity to recover following a stress. From a genetic perspective, resilience is defined as the quality that prevents individuals who are at genetic risk for maladaptation and psychopathology from being affected by these problems.[2]

The vulnerability to stress and an individual's capacity for resilience and/or recovery are complex, reflecting the biological state and genetic and environmental risk or resilience factors. The contribution of stress to the onset and course of depression and anxiety requires more study. New tools, such as neuroimaging and genetics, may clarify our understanding of the role that stressors may play in either the new onset of illness or the exacerbation of symptoms associated with depression and anxiety.

This article addresses research reports in areas related to the role of stressors and adaptation to stress, including: the impact of stressors in the presence of a genetic polymorphism that may contribute to risk for depression; research on the neurocircuitry of learning, fear, and the extinction of fear, including 2 neuroimaging studies conducted at the Massachusetts General Hospital (MGH) in Boston; and a summary of a presentation on resilience given by Dennis Charney, MD, at the MGH.

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