Written by Oliver Greenwood: BSc(Hons) Applied Sport & Exercise Science.
Many people suffer from depression, it is the invisible disease that can affect anyone of any gender, any race and doesn't discrimunate against age or wealth.
It is therefore useful to know how hormones may influence the feelings of depression and anxiety.
This article will cover the folowing key points:
- Hormones, depression and anxiety
- Cortisol and depression
- Testosterone and depression
- Sports and depression
This article is going to investigate the effect hormones have on depression. Throughout this article key areas of discussion will include depression, testosterone, and cortisol.
The purpose for writing this article is because depression is an ever-rising issue worldwide, which has seen a sharp increase due to the recent pandemic. So, this article is to examine alternative treatment methods for depressive symptoms.
Can Hormones Cause Depression and Anxiety?
Recently, depression has become a stand-out, rising problem around the world with reports of more than 120 million people suffering from depression worldwide in the early 2000s (Lepine and Bridley, 2011).
However, just 10 years later in more recent times the World Health Organisation (WHO) have reported that depression is affecting more than 322 million people globally (WHO, 2020).
The WHO (2017) defined depression as “sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration”.
Depression can either be long lasting or recurrent, this will substantially impair one’s capability to function at work or school or cope with day-to-day life (WHO, 2017).
Depression and Fatalities
Additionally, depression can lead to the most fatal of consequences, which being suicide. The WHO (2017) reported an estimate of 788,000 people die from suicide every year, with many more attempting suicide.
This accounts for suicide being in the top 20 leading cause of all deaths worldwide, equalling approximately 1.5% of all fatalities. As you can see this is a massive issue which is not going to be changed overnight.
Although, there may be common bodily hormones that can aid the fight against depressive symptoms and in turn help reduces the risk of suicide.
Cortisol is a steroid hormone found in the body (yourhormones, 2019).
Cortisol is constructed in the cortex of the adrenal glands. It is released into the blood and transported around the body.
Cortisol’s functions are dependent upon the cell it is acting on. Some of these functions are;
- Controlling blood sugar levels
- Regulating metabolism
- Prompting memory formation
- Governing salt and water balance
- Influencing blood pressure and helping the development of the foetus (yourhormones, 2019)
Cortisol usually has its highest concentration within the blood during in the morning and decrease throughout the course of the day (yourhormones, 2019).
This is called a diurnal rhythm. However, with people that work at night this pattern is reversed, meaning that the release of cortisol is linked to daily activity.
Cortisol is controlled by the hypothalamus (which is located in the brain), the pituitary gland and the adrenal gland. When the cortisol levels are low within the body the hypothalamus releases a corticotrophin (releasing hormone), which then causes the pituitary gland to release another hormone (adrenocorticotropic) into the blood stream.
The newly released adrenocorticotropic hormone is detected by the adrenal glands, which stimulates the release or cortisol.
As the cortisol levels rise, they start to block the release of corticotrophin from the hypothalamus and adrenocorticotropic hormone from the pituitary.
The result of this is the adrenocorticotropic hormone levels start to drop, which then leads to a drop in cortisol levels. This is called a negative feedback loop.
Too Much Cortisol
Having too much cortisol over a prolonged period of time can lead to Cushing’s syndrome. There are a wide range of factors that can cause this; a tumour that produces adrenocorticotropic hormone (and therefore increases cortisol secretion) or taking certain types of drugs (yourhormones, 2019).
Symptoms include; rapid weight gain mainly in the face, chest and abdomen contrasted with slender arms and legs, a flushed and round face, high blood pressure, osteoporosis, skin changes (bruises and purple stretch marks), muscle weakness, mood swings, which show as anxiety, depression or irritability, increased thirst and frequency of urination (yourhormones, 2019).
Too little cortisol can be caused by a problem in the pituitary gland or adrenal gland.
Symptoms are gradual and consist of fatigue, dizziness, weight loss, muscle weakness and mood changes. If this is not treated it can become a potentially life threating condition (yourhormones, 2019).
Testosterone is a hormone typically associated with one’s masculinity (Patel et al., 2019). Testosterone has multiple human behaviour modifying functions (Neolife, 2018).
Testosterone has major benefits. One benefit testosterone brings to the table is its ability to decrease body fat (Traish, Saad, Guay, 2009).
This is because testosterone plays a vital part in the regulation of insulin, glucose and fat metabolism. When an individual’s testosterone levels decrease it causes problems for the body’s capability to regulate insulin (Kahn and Flier, 2000).
This causes the rate of glucose transport to decrease, as well as a decrease in insulins glucoses storage (Kahn and Flier, 2000). This results in adipose tissue being accumulated.
The accumulation of the adipose tissue contributes to further negative actions of decreased testosterone levels (Traish, Saad, Guay, 2009).
In a study conducted by Kalinchenko et al., (2010) 184 men had their body composition evaluated after 30 weeks after ingesting 1000mg of testosterone. The results of this testing showed an average weight loss of 4.3kg.
This is also supported by a study from Svartberg et al., (2008) who found a 5.4kg reduction of fat body mass in men with testosterone levels over 11.0nmol/L when compared with men who had testosterone levels under 11.0nmol/L.
One of the benefits associated with testosterone is commonly known for its capacity to increase muscle mass, which is why supplements such as Military Muscle help to increase your natural production of testosterone to combat the decline associated with age.
Increased testosterone in the body raises the rate of protein synthesis within muscles (Griggs et al., 1989).
For this to happen firstly, the muscle fibre diameter increases to allow enhanced blood flow, this leads to an increase in muscle protein synthesis in the sarcoplasm.
Finally, this increases synthesis of non-muscular (blood vessels and erythrocytes) which contributes to protein synthesis within the muscle and in turn increases muscle mass (Griggs et al., 1989).
A study conducted by Griggs et al., (1989) reported that muscle mass had increased but muscular strength had not. It had also been shown that lower levels of testosterone are directly related to a reduction of muscle mass.
Yuki et al., (2013) stated that protein synthesis is stimulated by testosterone along with preventing protein degradation within muscle cells.
Furthermore, testosterone increases satellite cell replication and activation resulting in an increase in muscle mass.
From these two articles above both reporting muscle mass is related to testosterone levels it shows these results are reliable.
Another benefit of testosterone is it can help reduce risk factors in common diseases such as; cardiovascular disease and coronary heart disease (Saad, 2012; Kelly and Jones, 2013).
One of the risk factors that testosterone helps to prevent is hypertension (high blood pressure). This often occurs when an individual’s diet is rich in carbohydrates, fats and alcohol (Jiang et al., 2016).
Having a poor diet choice leads to the production of triglycerides in the blood, which aid the formation of atherosclerosis (Jiang et al., 2016). This results in an accumulation of fat in branch vessels, which in turn harm the blood flow of large arteries due to a blockage (Jiang et al., 2016).
Wang et al., (2011) reported that low testosterone levels were associated with hypertension. This is supported by Webb et al., (1999) who stated that testosterone administration caused dilation of coronary arteries, resulting in there being less chance of coronary heart disease among individuals with higher testosterone levels.
In more recent times Jones (2010) also reported that there is an increased risk of hypertension when testosterone levels are low.
This is because of a reduction of tissue plasminogen activator and increased fibrinogen and plasminogen activator, which increases clotting in the blood vessels and arteries (Jones, 2010).
The final benefit that will be discussed is testosterone’s ability to lesson insulin resistance. Jones (2010) states that decreased testosterones levels increase body fat which in turn exacerbates insulin resistance.
Yialamas et al., (2007) conducted a study on acute testosterone withdrawal. Testing was 2 weeks long and included fourteen men. However, two participants couldn’t complete testing.
The results of this testing showed insulin sensitivity had reduced due to the withdrawal of testosterone from the twelve men. This suggests that lesser testosterone levels reduce insulin resistance.
Thus, increasing body weight, which leads hypertension and finally, diseases like cardiovascular or heart.
Pitteloud et al., (2005) reported on 60 males and found that testosterone levels were positively correlated with insulin resistance (P = 0.005). this is further backing up that testosterone is vital for the body to function effectively.
As we can see from the above research the benefits of testosterone are vastly great and showcase how beneficial it is towards physical health. However, do these benefits go as for to impact mental health?
Cortisol and Depression
Cortisol is the bodies built in ‘alarm system’ as it works with certain parts of the brain to control mood, motivation, and fear.
So, after the pressure or danger has passed cortisol levels should calm down. However, if you are constantly under stress and the ‘alarm system’ stays on, it could lead to health problems such as depression.
Herbert (2013) reported that higher levels of cortisol are associated with depression.
This is because excessive amounts of cortisol can endanger the brain, which makes it more vulnerable to noxious agents (Herbert, 2013).
This is also supported by Brown, Varghese and McEwen who similarly reported that cortisol secretion is directly related to depressive symptoms. However, more research needs to be conducted into this area to gain a better understanding of the effects.
Testosterone and Depression
As reported above lower levels of testosterone can cause many unwanted complications within the body.
One major benefit of higher testosterone levels is its ability to be able to fight depression.
Worldwide there is an issue regarding mental health. With depression alone affecting more than 120 million people (Lepine and Bridley, 2011).
Within this around 25% of the UK’s adult residents are suffering from Mental Health Issues (MHI) (Parker and Bailey, 2018).
Research conducted by Almeida et al., (2008) reported on 203 men who completed a self-report questionnaire and a 15-item geriatric depression scale. Participants then consumed the testosterone concentration (ranged between 20 to 1602 ng/dL).
The results showed there to be a negative relationship between testosterone levels and depressive symptoms. However, this was only a weak correlation (p= -0.07) meaning more research should be conducted within this area.
Does Sport Help Depression?
Football intervention have shown to be an effective method of combatting mental health.
Friedrich and Mason (2018) reported that the participants loved attending the intervention and enjoyed each-others company.
With another participant stating it was a special bonding experience which was influenced by shared life experiences.
Benkwitz and Healy (2019) reported that one participant had to really push himself to attend but since he has attended the intervention, he has made strong bonds with the other participants.
Friedrich and Mason (2018) reported that 67% of participants indicated that participation led to positive relationships. With one participant stating that the intervention has even improved their relationship with their family.
In the Hargreaves and Pringle (2019) study one participant stated it was ‘vital to have that connection between the team’.
From the Benkwitz, Morris and Healy (2019) study one staff member reported that participants went from not wanting to get involved to shaking everyone’s hand and making a connection with them.
This shows the importance the relationships and connections made while attending this type of intervention.
As it can bring individuals who are currently struggling with their mental health together, who otherwise may have never met.
Furthermore, this isn’t only benefiting relationships between participants at the intervention but also relationships with family and friends outside the intervention.
Friedrich and Mason (2018) reported that one participant’s confidence had increased through the praise given to them while they were playing. With another participant stating that they felt more comfortable when getting served in shops because of the intervention.
Llewellyn et al., (2020) stated that one participant reported that talking about what happened on the field is a good ice breaker to help gain confidence when talking to new people.
Friedrich and Mason (2018) reported that throughout the intervention participants self-esteem had improved resulting in them becoming more sociable and improving their interpersonal skills.
This demonstrates how taking part in a weekly football intervention can help make personal changes to a mental health patient.
As reported above it helps the participants to not only express themselves while playing, but to more comfortable in everyday life social situations.
Throughout this article key areas of depression, cortisol and testosterone have been discussed. From this article it is clear to see how cortisol and testosterone effect the body mentally.
This shows the upmost importance of testosterone and cortisol in the maintenance of day-to-day bodily functions and depressive symptoms.
The key points that have had a light shone on them in this article are testosterone’s ability to fight depression, high levels of cortisol have a negative effect on depressive symptoms and football interventions are great to help fight depressive symptoms.
Overall, naturally increasing your testosterone levels would be very beneficial towards the health of an individual.
Almeida, O.P. Yeap, B.B. Hankey, G.J. Jamrozik, K. and Flicker, L. (2008) Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men. Archives of general psychiatry, 65(3), pp.283-289. Available at: https://pubmed.ncbi.nlm.nih.gov/18316674/
Benkwitz, A. and Healy, L.C. (2019) ‘Think Football’: Exploring a football for mental health initiative delivered in the community through the lens of personal and social recovery. Mental Health and Physical Activity, 17, p.100292. Available at: http://irep.ntu.ac.uk/id/eprint/36673/
Benkwitz, A. Morris, M. and Healy, L.C. (2019) An Ethnographic Study Exploring Football Sessions for Medium-Secure Mental Health Service-Users: Utilising the CHIME Conceptual Framework as an Evaluative Tool. Journal of Psychosocial Rehabilitation and Mental Health, 6(1), pp.55-65. Available at: http://irep.ntu.ac.uk/id/eprint/35850/
Friedrich, B. and Mason, O.J. (2018) Qualitative evaluation of a football intervention for people with mental health problems in the north east of London. Mental Health and Physical Activity, 15, pp.132-138. Available at: https://discovery.ucl.ac.uk/id/eprint/10071436/
Griggs, R.C. Kingston, W.I.L.L.I.A.M. Jozefowicz, R.F. Herr, B.E. Forbes, G.I.L.B.E.R.T. and Halliday, D.A.V.I.D. (1989) Effect of testosterone on muscle mass and muscle protein synthesis. Journal of Applied Physiology, 66(1), pp.498-503. Available at: https://pubmed.ncbi.nlm.nih.gov/2917954/
Hargreaves, J. and Pringle, A. (2019) “Football is pure enjoyment”: An exploration of the behaviour change processes which facilitate engagement in football for people with mental health problems. Mental Health and Physical Activity, 16, pp.19-30. Available at: https://eprints.leedsbeckett.ac.uk/id/eprint/5726/
Herbert, J. (2013). Cortisol and depression: three questions for psychiatry. Psychological medicine, 43(3), 449-469. Available at: https://www.cambridge.org/core/journals/psychological-medicine/article/abs/cortisol-and-depression-three-questions-for-psychiatry/DF822DA317DD2AD4DBFEA995C1EC9BCB#
Jiang, S.Z. Lu, W. Zong, X.F. Ruan, H.Y. and Liu, Y. (2016) Obesity and hypertension. Experimental and therapeutic medicine, 12(4), pp.2395-2399. Available at: https://pubmed.ncbi.nlm.nih.gov/27703502/
Jones, T. H. (2010). Testosterone deficiency: a risk factor for cardiovascular disease? Trends in Endocrinology & Metabolism, 21(8), 496-503. Available at: https://pubmed.ncbi.nlm.nih.gov/20381374/
Kahn, B.B. and Flier, J.S. (2000) Obesity and insulin resistance. The Journal of clinical investigation, 106(4), pp.473-481. Available at: https://www.jci.org/articles/view/10842
Kalinchenko, S.Y. Tishova, Y.A. Mskhalaya, G.J. Gooren, L.J. Giltay, E.J. and Saad, F. (2010) Effects of testosterone supplementation on markers of the metabolic syndrome and inflammation in hypogonadal men with the metabolic syndrome: the double‐blinded placebo‐controlled Moscow study. Clinical endocrinology, 73(5), pp.602-612. Available at: https://pubmed.ncbi.nlm.nih.gov/20718771/
Kelly, D.M. and Jones, T.H. (2013) Testosterone: a metabolic hormone in health and disease. J Endocrinol, 217(3), pp.R25-45. Available at: https://pubmed.ncbi.nlm.nih.gov/23378050/
Lépine, J.P. and Briley, M. (2011) The increasing burden of depression. Neuropsychiatric disease and treatment. 7(Supply 1), p.3. Available at: https://core.ac.uk/download/pdf/194428316.pdf
Llewellyn, M. Cousins, A.L. and Tyson, P.J. (2020) ‘When you have the adrenalin pumping, it kind of flushes out any negative emotions’: a qualitative exploration of the benefits of playing football for people with mental health difficulties. Journal of Mental Health, pp.1-8. Available at: https://pubmed.ncbi.nlm.nih.gov/32677472/
Neolife (2018) Testosterone: the pleiotropic hormone [Online] Available from: < https://www.neolifesalud.com/blog/testosterone-the-pleiotropic-hormone/?lang=en > [Accessed 18 December 2018].
Patel, A.S. Leong, J.Y. Ramos, L. and Ramasamy, R. (2019) Testosterone is a contraceptive and should not be used in men who desire fertility. The world journal of men's health, 37(1), pp.45-54. Available at: https://pubmed.ncbi.nlm.nih.gov/30350483/
Parker, A.G. and Bailey, A.P. (2018) Exercise for adolescents and young people with mental illness. Exercise-Based Interventions for Mental Illness, pp.149-167. Available at: https://onlinelibrary.wiley.com/doi/pdf/10.1111/eip.13189
Pitteloud, N., Mootha, V. K., Dwyer, A. A., Hardin, M., Lee, H., Eriksson, K. F., ... & Hayes, F. J. (2005). Relationship between testosterone levels, insulin sensitivity, and mitochondrial function in men. Diabetes care, 28(7), 1636-1642. Available at: https://eje.bioscientifica.com/downloadpdf/journals/eje/161/4/591.pdf?pdfJsInlineViewToken=810766344&inlineView=true
Saad, F. (2012) Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease?. Diabetes/metabolism research and reviews, 28, pp.52-59. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261691/
Svartberg, J. Agledahl, I. Figenschau, Y. Sildnes, T. and Jorde, R. (2008) Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip. International journal of impotence research, 20(4), pp.378-387.Traish, A.M. Saad, F. and Guay, A. (2009) The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. Journal of andrology, 30(1), pp.23-32. Available at: https://www.nature.com/articles/ijir200819
Wang, C. Jackson, G. Jones, T.H. Matsumoto, A.M. Nehra, A. Perelman, M.A. Swerdloff, R.S. Traish, A. Zitzmann, M. and Cunningham, G. (2011) Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes care, 34(7), pp.1669-1675. Available at: https://core.ac.uk/download/pdf/8583066.pdf
WHO. (2020) Depression [Online] Available from: < https://www.who.int/news-room/fact-sheets/detail/depression > [Accessed 30 January 2020].
World Health Organization. (2017) Depression and other common mental disorders: global health estimates (No. WHO/MSD/MER/2017.2). World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf
Yialamas, M. A., Dwyer, A. A., Hanley, E., Lee, H., Pitteloud, N., & Hayes, F. J. (2007). Acute sex steroid withdrawal reduces insulin sensitivity in healthy men with idiopathic hypogonadotropic hypogonadism. The Journal of Clinical Endocrinology & Metabolism, 92(11), 4254-4259. Available at: https://pubmed.ncbi.nlm.nih.gov/17726076/
YourHormones (2019) Cortisol [Online] Available from: <https://www.yourhormones.info/hormones/cortisol/ > [Accessed January 2019]