Endogenous Depression
There are a few different disorders that fall under the broader classification of depression. Understanding more about them can help you identify if you or a loved one may be experiencing symptoms so that you can seek the appropriate treatment.
Endogenous depression is one type of depression that has been used at different times throughout history; let’s take a look at what endogenous depression is, how it may be different from other types, its risk factors, how it may manifest, and how it’s treated.
Exogenous vs. endogenous depression
There are different types of depression, including reactive depression subtypes that can be triggered by specific events or those that occur for no apparent reason. Psychologists used to separate cases of depression based on where they seemed to be coming from: within the individual due to genetic or biological factors (endogenous depression), or primarily as a result of their external circumstances (exogenous depression).
A person who has depression that is not due to environmental factors, such as a stressful or traumatic event or substance abuse, may have endogenous depression.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.
On the other hand, a person who was diagnosed with depression because they developed symptoms after going through a difficult breakup may have exogenous depression—also known as reactive depression.
Research
According to one article published in Comprehensive Clinical Psychology, about 75% of cases of depression are exogenous, with the remaining 25% being endogenous depression.
The distinction between these two types of depression is generally not used in clinical settings anymore, however. Instead, any qualifying symptoms of depression are now usually associated with major depressive disorder (MDD). This is at least partly because symptoms of depression can vary somewhat among individuals.
That’s why providers now typically treat each person according to their specific symptoms instead of classifying their condition using terms like endogenous depression and exogenous depression.
Most mental health professionals will provide a general MDD diagnosis, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), if you have exogenous or endogenous depression.
Depression biological factors
Research has shown that genetic and biological factors may contribute to depression, with multiple distinct molecular mechanisms that may play a part in its onset and progression. Understanding depression can be challenging, but knowing more about its causes can help family members better support their loved ones.
Molecular psychiatry has enabled researchers to pinpoint these distinct mechanisms using integrative animal models, giving us a more comprehensive understanding of the biologically based roots of this disorder.
Symptoms of endogenous depression
A depressed mood is a temporary feeling of sadness or being down that everyone experiences from time to time. However, persistent feelings of sadness or depressive episodes may indicate MDD, a serious mental health condition.
While a depressed mood can be part of MDD, it's different because it's not as long-lasting, severe, or disruptive to a person’s overall well-being.
Individual experiences may vary, but those experiencing major depressive disorder—regardless of its cause—tend to have similar symptoms. Some or all of these symptoms must occur every day and last for at least two weeks in order for a clinician to consider a diagnosis of MDD.
Symptoms may include:
- Feeling hopeless and/or worthless
- Having low energy or fatigue
- Having difficulty concentrating
- Undergoing significant changes in appetite, weight, and/or sleeping patterns
- Losing interest in activities once enjoyed
- Experiencing thoughts of self-harm or suicide
If you experience intense feelings of sadness for extended periods of more than two weeks, it is important to consult a healthcare provider. Left untreated, MDD can have serious impacts on a person’s overall physical and mental health.
If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.
Treatment options
If you’ve been experiencing symptoms of exogenous or endogenous depression, it’s typically best to connect with a qualified mental health care provider for professional advice regarding your specific situation.
A qualified mental health professional can develop a personalized treatment plan for individuals experiencing endogenous depression or MDD.
In many cases, the recommended treatment for MDD from any cause is psychotherapy, sometimes in combination with medication (such as selective serotonin reuptake inhibitors) to reduce symptoms.
Cognitive behavioral therapist
Aside from severe cases and/or those where the individual's safety may be at risk, people can generally choose whether to receive therapeutic treatment in person or virtually.
Research suggests that both formats can offer similar benefits in many cases, with some studies showing that online CBT specifically may decrease symptoms of conditions like depression and anxiety.
If you prefer meeting with someone in person, you can search for a provider in your local area. If you have health insurance and it covers mental health services, you might ask your insurance company for a list of in-network providers.
Online therapy
Or, if you prefer the idea of doing therapy from the comfort of your home, you might consider online therapy. It can also be a convenient option for those who live in rural areas or otherwise can’t locate adequate providers nearby, those who have difficulties leaving the house for any reason, or those who simply have a busy schedule and no time for commuting to and from appointments.
Virtual therapy is also typically more cost-effective than in-person sessions. If you’re interested in trying it, you might consider a virtual therapy platform like BetterHelp. You can get matched with a licensed therapist who you can speak with via phone, video call, and/or online chat to discuss the mental health challenges you have been facing.
Self-care tips
It’s important to note that symptoms of clinical major depressive disorder—regardless of the cause—are unlikely to resolve without professional treatment. However, certain lifestyle changes may aid in the efficacy of treatment and contribute to a decrease in symptoms.
Exercise
It can sometimes be difficult for people experiencing symptoms of depression to engage in regular physical exercise, but research suggests that the effects can be worthwhile. A 2020 study reports that “exercise interventions have a beneficial effect on depressive symptoms”.
Since regular physical activity can also help prevent a variety of physical ailments and contribute to overall health in general, adopting a workout routine can be helpful for virtually everyone.
Social support
Having friends and/or family who you can lean on for emotional support in difficult times is another element of life that may help manage mental health conditions like depression.
Take a look at one study, for example, that suggests that those who have a strong social support system are “more likely to be satisfied with their personal health” and are at a lower risk for medical conditions like “high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, and Alzheimer's disease”.
Expanding your social support system if needed and opening up to those people when you’re going through a difficult time can have many positive health effects.
Meditation
Humans have practiced meditation for thousands of years, and research has uncovered evidence to support its links to certain health benefits.
Research
Consider a 2019 study that found that “mindfulness-based meditation has positive effects on depression,” with effects that can last for six months or more. It also reports that “There are no apparent negative effects of mindfulness-based interventions, and their general health benefits justify their use as adjunctive therapy for patients with depression and anxiety disorders”.
Mindfulness meditation may be helpful to those experiencing depression because it helps an individual become more aware of their thoughts, which is often the first step toward adjusting flawed patterns of thinking that may cause distress.
Counselor reviews
If you’re interested in seeking online therapy to treat symptoms of depression, a platform like BetterHelp is one option.
Reviews of BetterHelp therapists:
"I put off finding a therapist for a long time. I dreaded my first conversation with Neil and all the awkward, clunky explanations I'd have to give about my depression and anxiety. All of the things that felt like dirty little secrets caused me so much pain. But I was pleasantly surprised by how Neil accurately picked up what I was saying and gave me more insight into how my brain worked. It made my issue feel less of a personal problem and more of a universal problem we could examine together. He always gives me a thoughtful response within a day or two any time I send a message. I think we've made more progress in between sessions just by communicating things coming up in real-time. Neil is intelligent and kind. I appreciate his communication style and highly recommend him”.
"Tamera is straightforward and supportive. She's not afraid of pointing out what to work on and giving you the right tools immediately. It is highly personalized just for your unique symptoms and situation! Tamera helped me manage my depression and anxiety, and I became more empowered to control my life. I feel a lot happier”.
Takeaway
The term “endogenous depression” isn’t typically used by clinicians anymore, as the broader diagnosis of major depressive disorder is now preferred for those experiencing symptoms of clinical depression. If you’re experiencing symptoms of endogenous depression or major depressive disorder, it’s generally recommended that you seek the support of a qualified mental health professional for evaluation and treatment advice.
FAQs
The primary difference between endogenous and exogenous depression is that the former occurs due to an internal predisposition.
On the other hand, the latter occurs without any form of internal predisposition. While it is easy to understand the latter as triggered by events outside of an individual's control, endogenous depression can be harder to understand fully.
For instance, an exogenous depression can occur following the death of a loved one. This is an external event that one can attribute the depression too – a reactive depression.
On the other hand, when endogenous depression occurs, there is no physical or traumatic event that one can attribute it to. It arises due to an internal trigger that may be challenging to identify.
What are the four major causes of depression?
Depression is a very common mental illness. According to mental health professionals, depression occurs due to a wide variety of risk factors, conditions or events.
However, there are four major causes or risk factors associated with depression. They are stressful life events, medical problems, loss and trauma, and genetics (family history of depression). Other general risk factors are personal problems, conflict, substance use disorders, and abuse.
Stressful life events result in significant stress on the body and mind. For instance, a stressful or traumatic experience can involve losing a spouse or one's job. Medical problems such as medical illnesses and medications are also associated.
It can also be caused by genetics, for instance, cases of depression in a family. Knowing your family's medical and mental health history can help you spot symptoms of depression when they occur. It's common for depression to be passed down through each generation.
What's the underlying cause of depression?
There's no one cause of depressive disorders. Usually, depression occurs due to a wide range of factors. As such, it is almost impossible to attribute the emergence of a depressive disorder to one cause.
For instance, genetics, medical problems, medications, stressful life events, death or loss of a loved one, and even conflict are factors that cause major depression.
However, depression occurs due to many events that people find hard to understand depending on the type. This is particularly applicable to people with endogenous depression.
Can this type of depression be cured?
Major depressive disorder, like all mental health conditions, cannot technically be “cured” because when someone is cured from a disease, it means that it is gone forever, and this is unfortunately the case with mental illness.
However, there are many treatments that can greatly improve symptoms of depression and help people live happier, well-balanced lives:
Talk therapy – including cognitive behavioral therapy (CBT), interpersonal therapy, psychoanalysis, and even support groups are among the first line treatment in depression, bipolar disorder, endogenous depression, and other depressive disorders
Antidepressant medication – selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, such as tricyclic antidepressants are sometimes prescribed to people with endogenous depression
Lifestyle changes – peer reviewed studies show that exercising regularly, eating a healthy diet, avoiding drugs and alcohol, and spending quality time with others can help improve symptoms of depression and severe anxiety
Electroconvulsive therapy (ECT) – mental health professionals sometimes recommend electroconvulsive therapy for with severe endogenous depression that doesn’t respond to antidepressant medication or therapy. ECT is considered a safe and effective treatment that can provide rapid and significant improvements to severe mental health symptoms.
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