This is a complex and not completely understood area of pituitary medicine. Of course it is very logical and reasonable for anyone who has physical limitations, pain, discomfort to feel sad about a loss or change in their body functioning. Depression, which is different than sadness, is cited as a component of many chronic and/or serious physical illnesses. But pituitary disorders have a unique relationship with mental and emotional states. The chemistry of how such hormones as Prolactin and Cortisol act upon the brain is thought to either directly or indirectly causes psychological problems. There is also evidence linking emotional trauma, especially early in life, to later development of pituitary/Neuroendocrine disorders. Emotional factors are also known to affect the immune system. Thyroid hormones are also known to affect brain function and behavior and sensitive to environmental factors that cause stress. Therefore, a combination of stressful life events combined with a persons unique vulnerabilities and the powerful forces of certain hormones seem to commonly bring pituitary tumors and other Neuroendocrine disorders together with mental and emotional disturbances.