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A hypothesis is proposed for the causation of remote injuries from Electrical and Lightning Injuries(ELI). This theory takes instruction from recent developments in biological psychiatry and in particular the cortisol theory of depression. This is reviewed and its consequences are given. The theory is developed as follows. Cortisol is a known stress hormone, and is likely to be activated by the trauma of an electrical injury. Intense trauma chronically affects the control mechanisms for cortisol production leading to chronic cortisol level excess. Cortisol damages the areas of the brain involved in the memory, learning, and fluency dysfunctions seen in ELI, and leads to loss of volume of those regions, due to cell death. Cortisol levels affect the production of BDNF - Brain Derived Neurotropic Factor - in a proportion of individuals. BDNF exists in polymorphic forms and BDNF in one form can be severely depleted by stress. The brain loses its plasticity as a result. Depression results, and is of a type consistent with ELI. It is hoped this theory will lead to experiments to support it, and will guide the use of medication for the injury.

The Origin of Remote Symptoms in Electrical and Lightning Injuries: An Attempt at Explanation and a Hypothesis for Testing