The definition of endogenous depression is…
Endogenous depression is a kind of major depressive disorder (acronym: MDD). Even though it was a distinct disorder at one time that is no so any more. Endogenous depression is rarely diagnosed anymore. It is currently diagnosed as major depressive disorder, which is also referred to as clinical depression. That is a mood disorder with persistent and intense feelings of sadness that continue for extended amounts of of time. The sadness has a very negative impact on mood and a person’s behavior. It can also impair me various physical functions such as sleep and appetite.
It is estimated that 6 to 7 percent of adult Americans suffer from major depressive disorder annually. Brain researchers still do not know what causes depression. Evidence show it could be caused by a series of different factors, including:
- Genetic factors
- Environmental factors
- Biological factors
- Psychological factors
Endogenous depression is triggered without the presence of a specific stressful event or trigger. Its symptoms usually appear suddenly. You do not have endogenous depression if it comes on after a loved one dies, at the end of a relationship, or after suffering some kind of trauma.
What is the difference between endogenous depression and exogenous depression?
Endogenous depression occurs without the an occurrence of stress or trauma. It is typically caused by a genetic and/or biological factor. It is sometimes referred to as “biologically based” depression. By contrast, exogenous depression is triggered after someone experiences a stressful or traumatic event, like a death in the family, a divorce or a trauma like an accident. This kind of depression is referred to as reactive depression.
Mental health workers no longer differentiate between these two types of major depressive disorders. A diagnosis is now simply: major depressive disorder.
What are the various endogenous depression symptoms?
The symptoms of endogenous depression are just like those experienced from major depressive disorder.
- Persistent feelings of hopelessness and/or sadness
- Loss of interest in activities that previously were pleasurable
- Persistent tiredness Fatigue
- Lack of motivation
- Trouble with concentrating, thinking and/or impaired decision-making
- Difficulty in getting to sleep and/or staying asleep
- Lack of interest in social activities
- Self imposed isolation
- Suicidal thoughts
- Muscle aches
- Loss or diminished appetite or alternately overeating
How do you get a Endogenous Depression diagnosis?
Go and see your family doctor or certified mental health professional. They can diagnose major depressive disorder.
- You will be required to give a medical history.
- Let them know about any medications you take
- Also provide info on any existing medical or mental health conditions.
- Provide a family history of depression, if applicable.
- Also let them know about any previous incidence of major depressive disorder, if applicable.
You will also answer questions about any symptoms you may be experiencing. Tell them when the symptoms started. Also if they started after you experienced a stressful or traumatic event in your life.
The healthcare provider might also have you fill out a questionnaire that examines how you’re feeling. These will help determine if you have MDD.
If you meet certain criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (DSM). This psychiatric manual is used by mental health workers to diagnose mental health conditions.
The key symptom to be diagnosed is: depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.”
Although the DSM once distinguished between endogenous and exogenous depression, it has since removed this. DSM-5 (the latest edition) does not provide the distinction.
What are the treatments for endogenous depression?
Recovering from major depressive disorder requires a plan. Symptoms are treated with both medication, therapy and other approaches. Usually there is a combination.
What medications are used to treat endogenous depression?
The primary medications used to treat MDD are selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Tricyclic antidepressants (TCAs) may also be used, however they are not used that often anymore.
All these medications work by increasing levels of key brain chemicals. This in turn results in a decrease of depressive symptoms.
Here are some examples of SSRIs that might be prescribed:
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
Side effects of SSRIs may include: headaches, nausea, and insomnia. However, these initial side usually fade and disappear after your body adapts to them.
SNRIs can also be used to treat people diagnosed with major depressive disorder. They include:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
Tricyclic antidepressants (TCAs) include:
- Trimipramine (Surmontil)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor)
The side effects of TCAs can sometimes be more serious than from other antidepressants. They can cause drowsiness, dizziness as well as weight gain. Be sure to read the information from the pharmacy. Go to see your doctor if you have an major issues with side effects. Some doctors may opt to change a medication in some cases
To get the benefit of the drug, it usually needs to be taken for a four to six weeks. After that, symptoms should start to improve. Some patients might need at least 12 weeks to experience an improvement in MDD symptoms, once on a medication.
According to the National Institute of Mental Health (NAMI), MDD sufferers that do not improve on one antidepressant medication usually improve on an alternate medication.
Even if symptoms start to disappear improve, medication should be continued. Medication changes should be done in consultation with the medical professional that made the diagnosis. Some doctors have you gradually decrease the medication instead of suddenly stopping it, which can cause unpleasant withdrawal symptoms.
Therapy for Endogenous Depression
Psychotherapy, which also goes by the term “talk therapy”, involves meeting with a therapist on a scheduled basis. The therapy can help people work through emotions and can be very helpful in treating endogenous depression as it pertains to life events and trauma. 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 can help with working through relationships that could contribute to depression.
In many cases, a combination of medication and therapy is effective in treating people with MDD.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) may be done if symptoms don’t improve with medication and therapy. ECT involves attaching electrodes to the head that send pulses of electricity to the brain, triggering a brief seizure. This type of treatment isn’t as scary as it sounds and it has improved tremendously over the years. It may help treat people with endogenous depression by changing chemical interactions in the brain.
Adjust your life and become active. Physical activities can help improve symptoms of endogenous depression. Don’t worry if the activities aren’t initially enjoyable. They will feel better as your mood starts to improve. Some ideas to try:
- Be active. Walk, hike, bike or swim. Get outside.
- Get active and do activities that you enjoy.
- Spend time with other people, including friends and loved ones.
- Write out your thoughts in a journal.
- Be sure to get at least six hours of sleep every night.
- Improve your diet. Eat healthy food that include whole grains, lean protein, and vegetables.
What is the prognosis for people diagnosed with endogenous depression?
Most people with major depressive disorder get better when they stick to their treatment plan. It typically takes several weeks to see an improvement in symptoms after beginning a regimen of antidepressants. Others may need to try a few different types of antidepressants before they start to notice a change.
The length of recovery also depends on how early treatment is received. When left untreated, MDD can last for several months or even years. Once treatment is received, however, symptoms can go away within two to three months.
Even when symptoms begin to subside, it’s important to keep taking all prescribed medications unless the provider who prescribed your medication tells you that it’s okay to stop. Ending treatment too early can lead to relapse or withdrawal symptoms known as antidepressant discontinuation syndrome.
What resources are available for people with endogenous depression?
There are numerous in-person and online support groups as well as other resources available for people coping with major depressive disorder.
Many organizations, such as the National Alliance on Mental Illness, offer education, support groups, and counseling. Employee assistance programs and religious groups also may offer help for those with endogenous depression.
Suicide Help Line
Dial 911 or go to a hospital or urgent care emergency room if you’re having thoughts of hurting yourself or others. Another option: Call the National Suicide Prevention Lifeline at 800-273-TALK (8255). This service is available 24 hours per day, seven days per week. You can also chat online with them.
Read these self help guides to become informed and discover new ways to overcome your depression.