Basic and clinical research has demonstrated a role for neurotrophic factors in the pathophysiology and treatment of mood disorders, contributing to a neurotrophic hypothesis of depression. Animal studies report that stress decreases the expression of brain derived neurotrophic factor (BDNF), as well as other trophic factors, in limbic brain structures, which could contribute to the atrophy and cell loss caused by stress and depression. In contrast, antidepressant treatment increases the expression of BDNF and increases the birth of newborn neurons in the adult hippocampus, effects that could block or even reverse the effects of stress. BDNF also produces antidepressant effects in behavioral models, further demonstrating the functional significance of this neurotrophic factor. The relevance of the basic research studies is supported by clinical studies demonstrating that levels of BDNF in brain and plasma of depressed patients is decreased relative to controls and that this effect is reversed by antidepressant treatments. Genetic studies are underway to identify polymorphisms of the BDNF gene that could directly contribute to depressive symptoms or increase vulnerability upon exposure to stress or other environmental factors. These findings further elucidate the cellular alterations underlying mood disorders and could lead to novel therapeutic interventions.