A client asks a nurse about the differences between major depressive disorder (MDD) and dysthymia. Which of the following responses by the nurse is accurate?

Choice A rationale:

Genetic predisposition refers to a person's susceptibility to certain conditions based on their genetic makeup. While genetics can play a role in predisposing someone to depression, it is not considered a psychosocial factor. Genetic factors are biological in nature and do not directly involve social and psychological influences.

Choice B rationale:

The role of stress and life events is a significant psychosocial factor related to depression. Stressful life events, such as trauma, loss, or major life changes, can trigger or exacerbate depressive episodes in susceptible individuals. The interaction between these external stressors and an individual's psychological responses is a key aspect of psychosocial factors.

Choice C rationale:

Interpersonal relationships are another important psychosocial factor linked to depression. Poor interpersonal relationships, social isolation, and conflicts with friends or family can contribute to feelings of loneliness and despair, increasing the risk of developing depression.

Choice D rationale:

Cognitive factors, including negative thought patterns and distorted thinking, are considered psychosocial contributors to depression. Cognitive theories of depression emphasize how an individual's thought processes, self-perception, and interpretation of events can influence their emotional state. Dysfunctional thought patterns, such as excessive self-criticism or hopelessness, can contribute to the development and maintenance of depressive symptoms.

Choice E rationale:

Neurotransmitter imbalances are not psychosocial factors. They are more related to the biological underpinnings of depression rather than the social and psychological influences explored in psychosocial factors.

Choice A rationale:

Chronic stress is known to activate the Hypothalamic-Pituitary-Adrenal (HPA) axis, which leads to increased cortisol production. While cortisol is important for various physiological functions, chronic elevation of cortisol due to stress can actually have detrimental effects on the brain. Elevated cortisol levels have been associated with impaired neurogenesis (the formation of new neurons) and synaptic plasticity (the ability of synapses to change and adapt), both of which play crucial roles in maintaining cognitive function and mental health.

Choice B rationale:

This statement is not accurate. Chronic stress typically leads to hyperactivity, not hypoactivity, of the HPA axis, resulting in increased levels of cortisol. The increased cortisol levels can negatively impact neurogenesis and synaptic plasticity, which are key factors in depression and cognitive function.

Choice C rationale:

This is the correct statement. Chronic stress triggers hyperactivity of the HPA axis, causing elevated levels of cortisol. While cortisol is meant to help the body cope with stress in the short term, chronic elevation can lead to adverse effects on the brain. High cortisol levels have been linked to impaired neurogenesis and synaptic plasticity, contributing to the development of depression and cognitive deficits.

Choice D rationale:

This statement is not accurate. Chronic stress tends to lead to hyperactivity of the HPA axis and elevated cortisol levels. Reduced cortisol levels, as suggested in this choice, are not commonly associated with chronic stress and its impact on depression.