What is endogenous depression?
Endogenous depression is a type of depression that occurs internally. Endogenous depression is rarely diagnosed nowadays, even though it used to be viewed as a distinct disorder. It is instead diagnosed as MDD. The clinical term for MDD is Major Depressive Disorder, a mood disorder characterized by periods of persistent and intense sadness. Sleep and appetite are negatively affected by these feelings, as well as mood and behavior. Every year, more than 7 percent of American adults suffer from MDD. Researchers aren’t sure how depression develops. Theoretically, it can result from a combination of:
- Genetic factors
- Biological factors
- Psychological factors
- Environmental factors
Those who have lost a loved one, ended a relationship, or experienced trauma may become depressed. A stressful event or other trigger is not required for endogenous depression. There is often no apparent cause for endogenous depression.
Related: Double Depression Disorder
What are the differences between endogenous depression and exogenous depression?
Traditionally, researchers differentiated between endogenous depression and exogenous depression based on whether or not a stressful event occurred before the onset of the clinical symptoms:
There is no stress or trauma associated with endogenous depression. This means that it is not caused by external factors. Genetic and biological factors may be the primary causes. Thus, endogenous depression may also be called biological depression.
Stress or trauma can trigger exogenous depression. Reactive depression is the most common type of exogenous depression.
The phrase “two types of MDD” used to be differentiated by mental health professionals, but not anymore. Several symptoms of MDD have been used to diagnose the disorder by mental health professionals.
Related: Loneliness and Depression
What are the symptoms of endogenous depression?
Symptoms of endogenous depression begin suddenly and without apparent justification for some people. It is possible to experience different symptoms depending on the type, frequency, and severity of the condition.
MDD-like symptoms can also be experienced with endogenous depression. These symptoms include:
- Feeling hopeless or depressed all the time
- Involuntary withdrawal from previously pleasurable activities or hobbies
- Lack of motivation
- Inability to concentrate
- Sleep issues
- Social isolation
- Suicidal thoughts
- Aches and pains
- Eating too much or losing appetite
Read: Situational Depression
How is endogenous depression diagnosed?
Medical professionals and mental health professionals can diagnose MDD. The first step is to review your medical history. Don’t forget to let them know if you are taking any medications or have any existing medical conditions. Additionally, it can be helpful if you let them know if you or any of your family members suffer from MDD or have had it in the past.
You will also need to describe your symptoms to your health care provider. During your visit, your doctor will ask you when the symptoms began and whether they occurred after an emotionally stressful or traumatic event. Several questionnaires may be given by your healthcare provider to assess how you feel. Your answers to these questionnaires may assist your healthcare provider in diagnosing MDD.
Several criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) must be met before someone is diagnosed with MDD. Mental health professionals frequently use this manual to diagnose mental health conditions. An MDD diagnosis must be accompanied by a “depression or loss of interest in daily activities lasting more than two weeks.”
However, the current version no longer distinguishes between endogenous and exogenous depressions. If MDD symptoms appear for no apparent reason, mental health professionals are likely to diagnose endogenous depression.
Read: Melancholic Depression
How is endogenous depression treated?
A combination of medication and therapy can help those suffering from MDD overcome their symptoms.
People with MDD are commonly treated with SSRIs, as well as SNRIs, which are selective serotonin reuptake inhibitors. Although tricyclic antidepressants (TCAs) may be prescribed to some people, these drugs are not used as frequently as they once were. Some brain chemicals can help to reduce depression symptoms.
Patients with MDD may take antidepressant medications such as SSRIs. Here are some SSRI examples:
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
An initial side effect of SSRIs may include headaches, nausea and insomnia. Typically, these symptoms subside after a short period of time.
People with MDD can also use SNRIs as antidepressant medications. SNRI examples include the following:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
People with MDD may benefit from TCAs as a form of treatment. Some examples are:
- Trimipramine (Surmontil)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor)
It is possible for TCAs to cause more serious side effects than those associated with other antidepressants. There is a possibility that TCAs will cause drowsiness, dizziness and weight gain. Make sure you carefully read the pharmacy’s information and talk to your doctor if you have concerns. Symptoms usually improve after taking the medication for at least four to six weeks. Symptoms may not improve for up to 12 weeks in some cases.
Talk to your provider about switching to another medication if a certain medication doesn’t seem to be working. Several studies have shown that people who did not improve after taking their first antidepressant medication were much more likely to improve when they went on to take another medication or a combination of drugs.
Taking your medication should not stop when your symptoms improve. The provider who prescribed the medication should be able to stop you from taking it if needed. The drug might need to be discontinued gradually rather than all at once. Sudden discontinuation of antidepressants can cause withdrawal symptoms. In some cases, MDD symptoms may return if treatment is halted too soon.
Related: How to Help Someone with Depression
The process of psychotherapy, or talk therapy, requires regular meetings with a therapist. Your condition and any underlying issues may be helped through this type of therapy. Cognitive behavior therapy (CBT) and interpersonal therapy (IPT) are the main forms of psychotherapy.
Using cognitive behavior therapy, you can replace your negative beliefs with healthier ones. It is possible to improve how your brain handles stressful situations by practicing positive thinking and limiting negative thoughts.
You may benefit from IPT if you have troubled relationships that contribute to your well-being.
When it comes to treating MDD, most people need to combine medication and therapy.
Electroconvulsive therapy (ECT)
The use of electroconvulsive therapy (ECT) may be necessary if medication and therapy don’t relieve symptoms. ECT sends pulses of electricity to the brain through electrodes attached to the head, triggering a brief seizure. Treatments like this aren’t as scary as they sound, and they have improved greatly over the years. Changes in chemical interactions in the brain may help treat endogenous depression.
Related: How to Overcome Depression
You can also improve symptoms of endogenous depression by making certain changes to your daily routine and activities. The body and mind will adapt to the activities over time, even if they aren’t enjoyable at first. Here’s what you can try:
- Do some exercise such as hiking or biking outside.
- Reconnect with activities you enjoyed prior to becoming depressed.
- Spend time with your loved ones and friends.
- Take time to write in a journal.
- Make sure you get six hours of sleep every night.
- Be sure to eat a variety of whole grains, proteins, and vegetables to stay healthy.
Related: How to Deal with Teenage Depression
What is the outlook for people with endogenous depression?
When people follow their treatment plans, MDD usually gets better. It usually takes several weeks for symptoms to improve after starting an antidepressant regimen. It may take some time for them to notice a change when they are taking a variety of antidepressants.
It is also important to receive early treatment when treating depression. MDD can progress to more severe forms over time if left untreated. Most people do not experience symptoms after receiving treatment, but they will usually disappear within two months.
You should continue taking your prescribed medications even after symptoms have subsided unless your medical provider says it is okay for you to stop. If you stop treating yourself too soon, you can experience relapse or withdrawal symptoms called antidepressant discontinuation syndrome.
Read: COVID-19 and Depression
Resources for people with endogenous depression
MDD sufferers can find support groups in person, online, and other resources to help them cope.
A number of organizations offer education, support groups, and counseling, including the National Alliance on Mental Illness. Individuals with endogenous depression may also receive help from employee assistance programs and religious groups.
Suicide help line
If you think about harming yourself or others, call 911 or go to the nearest emergency room immediately. If you would like to contact the National Suicide Prevention Lifeline, call 800-273-TALK (8255). Services are available every day, 24 hours a day. They are also available online.
The following actions should be taken if you believe someone is in immediate danger of self-harm or harming another person:
- Contact 911 or local authorities.
- Wait for help to arrive.
- Make sure you remove all firearms, knives, medications, or other items that could cause harm.
- Please listen without judging, arguing, threatening, or yelling.
Consider contacting a crisis or suicide prevention hotline if you think someone is considering suicide. For more information, call 800-273-8255.