Stress, depression and immunity: the role of defense and coping styles

It is by now widely recognized that acute and chronic stress have an impact on the immune system. Acute stress may have a stimulating effect on the im mune system, while in the case of chronic stress - and in particular in dep ression - the immune system may be down-regulated. However, there is consid erable individual variability in the immune response to stress. This seems to a large extent to be determined by the subject's way of dealing with str ess. The perception and evaluation of a stressor and the specific ways of s tress coping may in different ways be related to various aspects of the str ess response: sympathetic nervous system (SNS) activation and activation of the hypothalamic-pituitary-adrenal (HPA) axis, both systems affecting the immune system. Prolonged exposure to stressors or to severe life stresses m ay outweigh the person's coping resources leading to feelings of depression . The affective changes with the accompanying changes in the HPA axis are o ne of the hypothesized mechanisms underlying the immune changes in depressi on. It should be noted that the relationship between depression and immunit y is affected by several other factors, such as gender and age and other pe rsonal resources. Increasing the subject's abilities to cope with stress an d to reduce the negative affect by psychological interventions may on the o ther hand have a beneficial effect on the immune system. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.