Psychoneuroendocrinology and psychoimmunology

Meet the patient — and the cortisol story she has read

A 38-year-old woman with treatment-resistant depression hands you a printout: her CRP is mildly raised and she has read that "depression is inflammation". She asks whether she should stop her antidepressant and take an anti-inflammatory instead.^[5][6]

The biology she has half-grasped is real. The conclusion she has drawn is not. The fellowship task is to honour the mechanism — HPA drive, glucocorticoid receptor resistance, cytokine-to-brain signalling — without collapsing a person into a single number, and without ever letting a cortisol or a CRP triage her suicide risk.^[2][6]

Etymology for viva gold: allostasis, from Greek allos, "other", plus stasis, "standing" — achieving stability through change, not by holding a fixed set-point. It is the word that upgrades "fight or flight" into a framework examiners respect.^[1]

References16ShowHide

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2. [2]Pariante CM, Lightman SL The HPA axis in major depression: classical theories and new developments Trends Neurosci, 2008.PMID 18675469
3. [3]Holsboer F The corticosteroid receptor hypothesis of depression Neuropsychopharmacology, 2000.PMID 11027914
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