Chapter 6: Mood disorders

Development of Stress Resilience

emotional
emotional trauma emotional
trauma withdrawn trauma

brain circuits

unprovoked provoked, unprovoked, provoked,

compensated compensated resilient

symptoms

no symptoms mild symptoms no symptoms no symptoms

overactivation
normal
baseline
hypoactivation

Figure 6-40. Development of stress resilience. In a healthy individual, stress can cause a temporary activation of circuits which is resolved
when the stressor is removed. As shown here, when the circuit is unprovoked, no symptoms are produced. In the presence of a stressor
such as emotional trauma, the circuit is provoked yet able to compensate for the effects of the stressor. By its ability to process the information
load from the environment, it can avoid producing symptoms. When the stressor is withdrawn, the circuit returns to baseline functioning.
Individuals exposed to this type of short-term stress may even develop resilience to stress, whereby exposure to future stressors provokes
the circuit but does not result in symptoms.

developing major depression in response to future
adult stressors, especially if they are chronic, multiple,
and severe.
Symptoms and circuits in depression
Currently, the monoamine hypothesis of depres-
sion is now being applied to understanding how
monoamines regulate the efficiency of information
processing in a wide variety of neuronal circuits that
may be responsible for mediating the various symp-
toms of depression. Obviously, there are numerous
symptoms required for the diagnosis of a major
depressive episode (Figure 6-44). Each symptom is
hypothetically associated with inefficient informa-
tion processing in various brain circuits, with differ-
ent symptoms topographically localized to specific
brain regions (Figure 6-45).

273