How Does Depression Affect The Brain? Getting Treatment 2023

Reviewed by Dr. Drew Sutton, MD

A team of qualified and experienced fact-checkers carefully reviews our content before it is published on our website. At MIDSS, we rely on the latest and most reliable sources, which are cited in the text and listed at the end of each article. We also do not accept plagiarised and misleading content from our authors and contributors. Read more about our fact check and editorial process.

how does depression affect the brain

Depression is one of the most common mental health conditions affecting people in the world. As a matter of fact, it is 2nd most common[1] mental health condition in the world. It has been shown that depression does not affect a person’s mood and behavior alone, it also causes some changes to the brain’s structure itself. All of this may be worrying to you, and you may be wondering if there are any solutions.

The good news is, there are solutions for this, and depression and its effects on the brain can be treated. Now, you may have questions like “how does depression affect the brain?” and “what are the effects of depression on the brain”. Well, this article will help to answer all these questions. It would also help to provide information on depression and get the right type of care to help you feel better.

What Is Depression?

Clinical depression is a mental health condition, and research suggests that it affects about 5% of adults[2] in the world. It is a mood disorder typified by a general incessant feeling of sadness, that alters a person’s feelings, thoughts, behavior, and extension of their daily activities, and may cause other physical and emotional changes.

Classification of Depression

Depending on the number of symptoms and depression severity, it is classified into mild, moderate, and severe depression.

Common Symptoms Of Depression

There are various signs to know when a person is depressed. Some of the symptoms seen in clinical depression are:

  • Persistently sad moods;
  • Lack of interest in things they would normally be interested in
  • Feeling of reduced energy
  • Sleep disturbances
  • Very obvious changes in weight and/or appetite
  • A lack of self-worth
  • Impaired concentration and thinking
  • Feeling of future gloom and hopelessness
  • Memory problems 
  • Negative emotions like recurrent urges to harm oneself and recurrent suicidal thoughts.

What Happens To The Brain During Depression

Major depression affects the moods and behavior of people, mostly by affecting the function of the brain. However, it also affects brain form. So how does depression affect the brain form? Some of these ways are listed below.

Brain Shrinkage

One of the effects of depression is the shrinkage of various brain parts and gray matter volume, due to the increase of one of the stress hormones called cortisol.

The shrinkage of the affected parts also reduces their functions, resulting in some of the classical features seen in people with depression, including a distortion of their sleep patterns and abnormalities in their moods and emotions. Several brain regions affected are the prefrontal cortex, hippocampus and amygdala.

Brain Size In Co-Occurring Depression and Anxiety

Anxiety disorders are more common than depressive disorders, hence they may be found in some people at the same time. It has already been established that there is a brain shrink in certain parts (e.g the prefrontal cortex) in people with long-term depression. However, when a person has concurrent depression and an anxiety disorder, there is an associated increase in the size[3] of the amygdala. This part of the brain is responsible for regulating memory and emotional responses, hence, an increase in its size results in the elaboration of its functions.

So in people with an overlap of anxiety disorder and ongoing depression, there is a presence of depressive symptoms alongside heightened emotions like fear.

Brain Inflammation

There is an increase in the body’s inflammatory processes in major depressive disorder patients, causing brain inflammation. This inflammation is worse with prolonged depression, as in a persistent depressive disorder.

Prolonged inflammation can lead to damage and death of brain cells. This could further worsen the shrinkage of the brain and impair brain plasticity, thereby speeding up brain aging.

Structural Differences

Major depression affects the links and interactions between various parts of the brain and nerve cells. This may either be in the form of exaggeration or a reduction in the quality of these brain circuit links. The production and release of certain brain chemicals are also affected.

Oxygen restriction

The brain requires a constant delivery of oxygen by blood to form new brain cells. This flow of blood is kept constant by certain mechanisms. It has been shown that the mechanism that maintains a fairly constant flow of blood to the brain[4] is impaired in depression. This, in turn, reduces the amount of oxygen in the brain, causing damage to brain cells and brain cell death. This may not significantly affect brain function instantly, but over time it causes certain changes in the brain structure and also affects its function.

Reversing The Effects

Reading about how this condition affects the brain, may scare you a bit. However, it has been shown that many of the changes in the brain due to depressive episodes can be reversed when treated. For example, treating depressed people with certain medications like antidepressants has been shown to reduce brain inflammation. Some form of psychological therapy has also been shown to help.

Getting Treatment For Depression

Clinical depression tends to cause significant distress to both the people with it and their loved ones, and often it may look like there is no way out. However, most people who get adequate care will eventually experience a resolution of their symptoms. The following strategies are employed in the treatment of depression, and a combination of these techniques would help in improving results in treatment and reversing the effects of depression on the brain.

Going to therapy

Psychological therapy is a mainstay in the treatment of any major depressive episode. There are various types of psychotherapy[5] used to treat depressed people, depending on the cause. Psychological therapy may also be administered individually, in groups, or with other family members of people with a major depressive disorder.

Taking antidepressants

The use of antidepressant medications is especially important in treating a moderate or severe depressive episode and helps to increase the effectiveness of psychotherapy in major depressive disorder. Antidepressant treatment has also been shown to reverse some of the changes in a person’s brain and brain cells, like brain inflammation.

Exercising regularly

Physical exercise has been shown to improve mood[6] and physical health by releasing certain neurochemicals that basically help you feel good. Having a regular exercise routine and sticking to it also helps give you a sense of purpose and distract you from disturbing thoughts. It could also help build self-esteem and help improve personal relationships. All of this would help during the treatment of major depression.

Reducing your stress

Chronic stress may contribute to the risk of having depression, and may also reduce the effectiveness of treatment. During stress, there is the release of certain chemical messengers (e.g the hormone cortisol) that cause some of the brain changes seen in clinical depression. Hence, taking steps to control stress is an important strategy in the treatment of depression.


Depression is very common in society and an untreated major depressive disorder can cause significant distress for whole families. Hence it is important to know how to identify depression symptoms and seek help for clinical depression from the right places. With the right care, most of these changes in the brain can be reversed. Appropriately treating it would also help resolve the symptoms of depression, thereby improving clinical outcomes in people with depression, preventing a lifelong major depressive disorder and reducing the mortality gap.

Frequently Asked Questions

What changes take place in the brain in depression?

In clinical depression, various changes may occur in the brain’s architecture. This comprises a change in size of several areas of the brain, increased inflammation in the brain, changes in the links between regions, and reduction in the oxygen supply to the brain.

Who is at risk of having brain alterations in depression?

Most of the changes associated with clinical depression often take time to develop. Hence, people with long-standing depression are more likely to have these changes.

Can the effects of depression on the brain be reversed?

Yes, the effects can be reversed especially following treatment with antidepressant drugs and psychotherapy.

What treatment is used for depression?

A combination of psychotherapy, the use of drugs, and lifestyle modifications are used to treat depression.

Can exercising help in clinical depression?

Exercises help to make you feel good and take your mind off stressful thoughts, and they have been shown to be of great benefit in the treatment of depression.

+ 6 sources

MIDSS adheres to strict procurement guidelines and relies on peer-reviewed studies, academic research institutes, and medical associations. We work mainly with peer-reviewed studies to ensure the accuracy of the information. We avoid the use of tertiary references. You can read about how we ensure the accuracy and timeliness of our content in our editorial process.

  1. World Health Organization. “Mental Disorders.”, World Health Organization: WHO, 8 June 2022,
  2. World Health Organisation. “Depression.” Who, World Health Organization: WHO, 29 Nov. 2019,
  3. Espinoza Oyarce, Daniela A., et al. “Volumetric Brain Differences in Clinical Depression in Association with Anxiety: A Systematic Review with Meta-Analysis.” Journal of Psychiatry & Neuroscience, vol. 45, no. 6, 1 Nov. 2020, pp. 406–429, 10.1503/jpn.190156.
  4. Simpson, Les O. “Depression and Cerebral Blood Flow.”, 15 Dec. 2020,
  5. Health Quality Ontario. “Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.” Ontario Health Technology Assessment Series, vol. 17, no. 15, 2017, pp. 1–167,
  6. Mayo Clinic. “Depression and Anxiety: Exercise Eases Symptoms.” Mayo Clinic, 27 Sept. 2017,


Ich bin Arzt mit Erfahrung in allgemeiner Chirurgie. Vor dem Medizinstudium habe ich vergleichende Literaturwissenschaft studiert.


Drew is a retired ENT doctor who now lives in the Southeastern US. He was a member of the American Academy of Otolaryngology and a Fellow of the American College of Surgeons. He has a bachelor’s degree in Biology and Psychology and an MD degree. He completed his internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery and practiced for almost 30 years in all aspects of ENT, including a specialization in disorders of the ear and skull base. Drew is passionate about communicating his clinical experiences and making his knowledge more accessible to the general public by medical writing.

Help us rate this article

Thank you for your feedback

Keep in touch to see our improvement