POMC and adrenal gland hyperfunction: On the one hand, most patients with depression have been shown to present with hypercortisolemia both in plasma and CSF, increased cortisol response to adrenocorticotropic hormone (ACTH) and a deficient feedback mechanism, reflected in an abnormal dexamethasone suppression test[11] as well as by enlarged pituitary and adrenal glands[196–198].