Endogenous Depression, Symptoms, & Treatment Options
What is Endogenous Depression?
Endogenous depression is a type of major depressive disorder (MDD). Although it used to be seen as a distinct disorder, endogenous depression is now rarely diagnosed. Instead, it’s currently diagnosed as MDD. MDD, also known as clinical depression, is a mood disorder characterized by persistent and intense feelings of sadness for extended periods. These feelings harm mood and behavior and various physical functions, including sleep and appetite. Nearly 7 percent  of adults in the United States experience MDD each year. Researchers don’t know the exact cause of depression. However, they believe that a combination of:
- Genetic factors
- Biological factors
- Psychological factors
- Environmental factors
Some people become depressed after losing a loved one, ending a relationship, or experiencing trauma. However, endogenous depression occurs without an apparent stressful event or other triggers. Symptoms often appear suddenly and for no apparent reason.
How Does Endogenous Depression Differ from Exogenous Depression?
Researchers used to differentiate endogenous depression and exogenous depression by the presence or absence of a stressful event before the onset of MDD:
Endogenous depression occurs without the presence of stress or trauma. In other words, it has no apparent outside cause. Instead, it may be primarily caused by genetic and biological factors. This is why endogenous depression might also be referred to as “biologically based” depression.
Exogenous depression happens after a stressful or traumatic event takes place. This type of depression is more commonly called “reactive” depression.
Mental health professionals used to differentiate between these two types of MDD, but this is no longer the case. Instead, most mental health professionals now make a general MDD diagnosis based on specific symptoms.
What is Depression?
Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and a loss of interest in activities you once enjoyed. In addition, it can lead to various emotional and physical problems and decrease your ability to function at work and home.
Depression symptoms can vary from mild to severe and can include:
- Feeling sad or having a depressed mood.
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Feeling worthless or guilty
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., inability to sit still, pacing, hand-wringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
What Are the Symptoms of Endogenous Depression?
People with endogenous depression start to experience symptoms suddenly and for no apparent reason. The type, frequency, and severity of symptoms may vary from person to person.
The symptoms of endogenous depression are similar to those of MDD. They include:
- Persistent feelings of sadness or hopelessness
- Loss of interest in activities or hobbies that were once pleasurable, including sex
- Lack of motivation
- Trouble concentrating, thinking, or making decisions
- Difficulty falling asleep or staying asleep
- Social isolation
- Thoughts of suicide
- Muscle aches
- Loss of appetite or overeating
How is Endogenous Depression Diagnosed?
Your primary care provider or mental health professional can diagnose MDD. They’ll first ask you about your medical history. Ensure them about any medications you’re taking and about any existing medical or mental health conditions. It’s also helpful to tell them if any of your family members have MDD or have had it in the past.
Your healthcare provider will also ask you about your symptoms. For example, they’ll want to know when the symptoms started and if they began after you experienced a stressful or traumatic event. Your healthcare provider may also give you a series of questionnaires that examine how you’re feeling. These questionnaires can help them determine whether they have MDD.
To be diagnosed with MDD, you must meet specific criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Mental health professionals often use this manual to diagnose mental health conditions. The main criteria for an MDD diagnosis are “depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.”
Although the manual used to distinguish between endogenous and exogenous forms of depression, the current version no longer provides that distinction. As a result, mental health professionals might diagnose endogenous depression if symptoms of MDD develop for no apparent reason.
How is Endogenous Depression Treated?
Overcoming MDD isn’t an easy task, but symptoms can be treated with a combination of medication and therapy.
The most common medications used to treat people with MDD include selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs). In addition, some people may be prescribed tricyclic antidepressants (TCAs), but these drugs aren’t used as extensively as they once were. These medications increase levels of certain brain chemicals that result in a decrease in depressive symptoms.
SSRIs are a type of antidepressant medication that people may take with MDD. Examples of SSRIs include:
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
SSRIs may cause headaches, nausea, and insomnia at first. However, these side effects usually go away after a short period.
SNRIs are another type of antidepressant medication that can treat people with MDD. Examples of SNRIs include:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
In some cases, TCAs might be used as a treatment method for people with MDD. Examples of TCAs include:
- Trimipramine (Surmontil)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor)
The side effects of TCAs can sometimes be more severe than those from other antidepressants. TCAs may cause drowsiness, dizziness, and weight gain. Carefully read the information provided by the pharmacy and speak to your doctor if you have any concerns. The medication usually needs to be taken for a minimum of four to six weeks before symptoms begin to improve. In some cases, it can take up to 12 weeks to improve symptoms.
If a particular medication doesn’t seem to be working, talk to your provider about switching to another medication. According to the National Institute of Mental Health (NAMI), people who didn’t get better after taking their first antidepressant medication had a much better chance of improving when they tried another medication or a combination of treatments.
Even when symptoms begin to improve, you should continue taking your medication. It would be best if you only stopped taking medication under the provider’s supervision who prescribed your medication. You may have to stop the drug gradually instead of all at once. Suddenly stopping an antidepressant can lead to withdrawal symptoms. Symptoms of MDD can also return if treatment is ended too soon.
Psychotherapy, also known as talk therapy, involves meeting with a therapist regularly. This type of therapy can help you cope with your condition and related issues. The two main types of psychotherapy are cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).
CBT can help you replace negative beliefs with healthy, positive ones. By deliberately practicing positive thinking and limiting negative thoughts, you can improve how your brain responds to negative situations.
IPT may help you work through troubling relationships that may be contributing to your condition.
In most cases, a combination of medication and therapy effectively treats people with MDD.
3. Lifestyle Changes
Making certain adjustments to your lifestyle and everyday activities can also help improve symptoms of endogenous depression. Even if the activities aren’t enjoyable at first, your body and mind will adapt over time. Here are some things to try:
- Go outside and do something active, such as hiking or biking.
- Participate in activities that you enjoyed before you became depressed.
- Spend time with other people, including friends and loved ones.
- Write in a journal.
- Get at least six hours of sleep each night.
- Maintain a healthy diet that consists of whole grains, lean protein, and vegetables.
We Level Up Treatment Center provides world-class care with round-the-clock medical professionals available to help you cope. In addition, we work as an integrated team providing information about endogenous depression and other aspects of treatment. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our specialists know what you are going through and answer any of your questions.
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 Depression. (n.d.)