Endogenous Depression: Causes, Symptoms, Types, Differences, Diagnosis and Treatment

It usually has a genetic component, so if there is a family tendency to depression, it may affect, although it is not a determining factor.

Depression can not be defined as a single disorder but rather as a primary name for several disorders with similar symptoms. However, the causes can differ depending on the individual mental state, and, consequently, doctors offer different treatment options.

Here we will talk about Endogenous Depression, its several causes, ways to identify the problem, and potential treatments offered in the medical world. Keep reading the details below to gather the essential information.

What is endogenous depression?

In most cases, depression is encouraged by certain intolerable events or, probably, when something serious happens to the person in the growth stage.

Patients with severe endogenous depression often have biochemical hypercortisolism. Plasma cortisol and urinary steroid excretion are increased and are not generally suppressed in dexamethasone tests at low doses.

Activation of the pituitary-adrenal axis in depression can be observed in up to 40-60% of patients in some series, with normal or slightly increased plasma adrenocorticotropic hormone levels.

Depressed patients have an adrenocorticotropic hormone response in plasma attenuated to the corticotropin-releasing hormone than normal controls. However, their basal levels of plasma cortisol are elevated and usually respond to the corticotropin-releasing hormone.


These results indicate that the pituitary corticotrope is intrinsically normal, with the attenuated response of the adrenocorticotropic hormone to the corticotropin-releasing hormone, which shows that they are sensitive to the negative feedback of the increase in cortisol levels (the opposite occurs in Cushing’s disease). ).

Despite the sudden increase in the adrenocorticotropic hormone, the typical cortisol response to the corticotropin-releasing hormone is compatible with hyperplasia and hyperresponsiveness of the adrenal cortex, as reported in depressed patients.

The dynamics of the adrenocorticotropic hormone are similar to that observed in normal subjects who were given a long-term infusion of corticotropin-releasing hormone and, therefore, point to the hypothalamus supra-hypothalamic regions as the leading cause of adrenocorticotropic hormone hypersecretion.

Although the source and importance of the corticotropin-releasing hormone in cerebrospinal fluid are debated, the finding is that depressed patients have increased levels of corticotropin-releasing hormone in the cerebrospinal fluid.

This finally seems to correlate positively with the degree of pituitary-adrenocortical hyperactivity; it has been taken as another indication that this condition is due to a hypothalamic dysfunction with overproduction of corticotropin-releasing hormone.

The hypercortisolémic state that accompanies depression often creates a severe diagnostic challenge. A depressed patient may present obesity, mild hirsutism, mild hypertension, and moderate glucose intolerance.

Although none is conclusive, several characteristics can more or less distinguish between transient functional hypercortisolism and true Cushing’s syndrome with secondary depression.

Classically in depression, the hypercortisolémic state is clinically and biologically mild. Urinary excretion of cortisol rarely exceeds three times the upper limit of normal.

The circadian pattern of plasma cortisol levels is less altered, and a phase change phenomenon is sometimes observed.

The cortisol response to insulin-induced hypoglycemia is present in depressed patients compared to patients with Cushing’s syndrome of any cause, including Cushing’s disease.

While the adrenocorticotropic hormone response to the corticotropin-releasing hormone is attenuated in contrast to the exaggerated response observed with Cushing’s disease, a wide overlap is observed.

However, the studies reveal few cases where it is not observed that patients have a specific cause for the state of depression.

In such cases, one may show few symptoms of depression, but it does not include any potential cause. It is assumed that the person facing this condition suffers from endogenous depression in medical terms.

Here the word endogenous means “Coming from within,” and this type of depression usually occurs due to a few unwanted biochemical changes within the human body.

The professionals are still looking for possible reasons behind their unleashing. More generally, endogenous depression is classified as a mood-related disorder that may also be genetic.

There are many cases where people are affected by this disorder from birth and have much stress.

Research shows that this type of disorder is often not treated in young people or children; Most of the time, people cannot accept that they face some disorder until they begin to create some emotional and physical difficulties in their lives.

Professionals say that endogenous depression is often characterized by loss of interest in essential activities, poor sleeping postures, and deterioration in concentration levels.

In earlier times, depression was cured by different practices; However, this information may be helpful only for researchers, but the fact is that in today’s world, the treatment and diagnosis options have varied a lot.

Currently, depression is classified as an endogenous or reactive type. Remember that reactive depression arises from a particular situation or event in a person’s life.

It may be due to serious illness, grief, etc. However, on the other hand, endogenous depression is related to patients who never show a positive response to treatment or medications and do not even know what endogenous depression is.

Potential causes of endogenous depression

As already discussed, endogenous depression is a genetic disorder that a person can develop by birth or early age due to a few unwanted chemical changes within the brain.

With various traumatic circumstances, stress often leads to situations in which the patient will not be able to get involved in particular life events.

Knowing that the person affected with endogenous depression can belong to any age group is essential. In most cases, people can not identify their symptoms in the long term and do not receive treatment during the early stages of development—symptoms associated with endogenous depression.

As there are no potential causes related to endogenous depression, we will analyze the symptoms that can help you identify the disease in time to choose the appropriate treatment.

Remember that the person suffering from endogenous depression often shows similar symptoms as other patients with depression.

Generally, you may appear anxious, experience few changes in sleep patterns, show fatigue, and face changes in regular eating habits. With sudden mood swings, you may also begin to lose self-confidence.

Studies reveal that the symptoms associated with endogenous depression often range from mild to severe, but all patients do not need to show similar symptoms.

Those with a mental illness or severe health concerns may face widespread symptoms. In general, the symptoms related to endogenous depression are categorized in four different sections as indicated below:

Impact on the patient’s physical well-being :

  • One can experience various problems of body pain.
  • It causes changes in sleep patterns.
  • One can face some difficulty while sleeping.
  • Endogenous depression is associated with prolonged fatigue.

Impact on feelings :

  • The person begins to have a sense of worthlessness.
  • It may show irritability over time.
  • Intolerable mood swings with the conditions of an outburst of temper.
  • Significant decrease in the level of motivation.
  • The person may feel tired all the time.

Impact on behavior :

  • You can find the affected person crying most of the time.
  • He/she will begin to move away from typical social situations.
  • Decay in sexual desire.
  • The person may also have less interest in personal preparation in some cases.
  • Start facing disinterest in most routine activities and even at work.

Impact on thought processing :

  • The person often has thought of self-destruction, and this is dangerous enough.
  • A feeling of self-pity
  • He/she often suffers from guilt.
  • Begin to develop a pessimistic attitude.
  • He often forgets things in the routine.
  • Decay in concentration levels.

If you or someone in your family suffers any of these symptoms, it is good to go to the endogenous depression clinic in May as soon as possible. Timely treatment can help you start a quick recovery.

There are so many symptoms associated with endogenous depression that it is necessary to analyze them with the doctor to implement the appropriate diagnosis that best suits individual needs.

Symptoms endogenous depression

The different types of mental disorders caused by the influence of diurnal or seasonal mood changes or these differences without any cause are referred to in medicine as endogenous depression.

Such disorders are severe forms of the disease. Therefore, it is essential to take appropriate measures to prevent the development of discomfort from excluding its progression.

The typical signs of the disease are thoughts about suicide caused by low self-esteem. Mainly, a person’s brain is actively absorbed by such thoughts in the morning, but it is not excluded at night.

A person with signs of this disease is prone to early awakenings and a lack of nocturnal sleep. He perceives the surrounding world differently, not as a pessimist but as an unnecessary creation, leading to a final idea of ​​suicide.

Believing that it is possible to be depressed without a cause is devastating.

Some people say they are depressed for no reason because they can not find an event in their life that may have caused so much sadness and apathy. This is a very confusing situation for the person and his family, who do not know the cause of the depression.

In fact, in all disorders and diseases, understanding their origin helps us in some way to make sense of what is happening. Identifying and understanding the cause of depression gives us greater control because everything has a certain logic.

Not knowing why depressive symptoms manifest a profound sense of helplessness, we believe we are at the mercy of circumstances. Therefore, we can not do much to combat depression.

However, one of the main mistakes is not knowing the difference between sadness and depression.

Sadness is a feeling that arises in response to any circumstance or thought. At the same time, depression is a disorder that includes sadness but is also accompanied by other symptoms that generate intense discomfort and the inability to continue daily activities.

This means that depression is not a reactive problem, so finding an environmental cause that justifies it is impossible.

Types of depression

There are two types of depression: reactive and circular (endogenous).

Reagent occurs in the case of unexpected stress: death of a loved one, a deadly disease, separation, etc.

Endogenous depression is an internal disease of a person. The provocation of the disease is due to the reduction of hormones, such as serotonin, dopamine, and norepinephrine.

By underestimating their development, the person in the subconscious has ridiculous thoughts about their uselessness in this world and a strong apathy, a sense of oppression, and uselessness.

The most vulnerable people who are characterized by the manifestation of disease are people with the following character traits:

  • Responsibility.
  • Integrity.
  • Anxiety.
  • He feels the need to fulfill his duty.
  • Uncertainty.
  • Modesty.

Often, people with temperament types become phlegmatic and melancholic phalanges of the disease. Endogenous depression can occur unexpectedly, even in an episode of total well-being in the family.

It is often tough to determine the first signs of endogenous depression in a person since, above all, this ailment is perfectly hidden behind the following factors:

  • Bad mood.
  • Sloth.
  • Fatigue.
  • Psychological problems.

It is worth noting that it is difficult for laymen to diagnose the disease “endogenous depression.”

Such symptoms of endogenous depression must alert the person and consider taking the appropriate measures to get rid of the ailment. Then, the symptoms of the disease are manifested by the following signs:

A person has periodic attacks of a bad mood, which occur in a background not caused. These attacks may disappear, but after a short time, they resume and appear even more.

Often, mood deterioration occurs in the spring or fall season. Depending on the saturation of the day, discomfort is characterized by activation in the morning and during the day. Towards night the symptoms diminished, but the nocturnal dreams already awaken a person of an ailment.

There is a slowness in body movements and mental activity. The patient is characterized by a lack of attention, slower perception, and the complexity of meditation. It is difficult for him to concentrate on a specific goal; sometimes, he does not hear and does not notice the people around him.

Afflicted with an ailment, you have symptoms of severe fatigue, even if you do nothing. Fatigue is based on the lack of will to perform any action.

The man himself (even without a good reason) is blamed for all sins, defects, and defects. A feeling of pessimism accompanies him everywhere, even during sleep, which he spends anxiously.

A long retirement to sleep characterizes the patient, but after a few hours, this dream is gone. For one person, it is difficult to fall asleep; it turns around almost in the morning.

Often, the symptoms of a circular depression are reflected in a person’s appetite, or rather, in his absence. The patient eats little or nothing, leading to weight loss, hunger, fainting, and a digestive system that causes gastritis.

People do not feel the physical pain, but he worries about other pain symptoms. These pains include melancholy, experience, and intrusive thoughts about suicide; often, the prolonged course of the disease causes twisted pains in the region of the joints, bones, and muscles.

A person has self-esteem and complete self-confidence. Perilous are these symptoms if the patient lives alone and there is no one to support and calm him down.

Suicidal thoughts lead to attempts to interrupt life but not finish the job because death is a complex and decisive step that people of weak spirits do not dare.

More symptoms of endogenous depression:

If you look at the image of a person’s life with this disease, it is sad and empty. The patient lies in bed all day and does not want anything. The lack of desire does not lie in his laziness but in the absence of any interest.

The hormones of joy, love, and pleasure do not occur in the brain. Therefore, only suffering is peculiar to a person.

Suicidal thoughts in patients end in attempts, but in rare cases, the progression of this severe disease still overcomes fears and pushes death. It is essential that people with the disease of endogenous depression not be left alone with themselves.

Depressive people are inactive in dialogue; they are immersed in their experiences, sitting or reclining. The people around feel like a person has been disconnected from life.

He is not mentally ill, but the disease symptoms are similar.

If the patient speaks, the topic of conversation is only one: his depression, heaviness in the soul, uselessness, etc. The person in this state goes further away, aggravating the disease. It is necessary to carry out medical measures as soon as possible.

Reasons for endogenous depression

The causes of the manifestations of endogenous depression are found in the lack of hormones, which were mentioned above. However, what are the reasons for this phenomenon? Consider it in more detail.

The genetic predisposition is the leading cause of the inadequate production of hormones, which affects the appearance of circular depressive illness. If the most distant generations, even natives, had a peculiar manifestation of this disease, then the probability of depression in the offspring is high.

It is possible to beat a person with weak character traits: distrust, indecision, anxiety. For those people, there is the fear of making any decision.

Sometimes, the drug does not exclude the cause of the disease through severe stress, although there is controversy. However, it is worth protecting yourself from stressful situations to exclude the factors of a possible disease manifestation.

It is often women who are exposed to the manifestation of the ailment, which is associated with the biological characteristics of the structure of the psyche.

Diagnosis for endogenous depression

The discomfort of a person’s soul, in his opinion, is not the reason to seek medical help, and this is the leading risk factor that affects the progression of the disease.

Many people consider the state of depression a normal phenomenon and believe that it will soon pass. These thoughts are wrong because it will be more challenging to get out of this state if you keep locking yourself in.

It is necessary to survey a person, using which a specialist doctor will be diagnosed. The diagnosis involves only examining the patient and talking to him, based on which mental abnormalities are detected.

See your family doctor or certified mental health professional. They can diagnose major depressive disorder.

  • You will be asked to provide a medical history.
  • Let them know about any medication you take.
  • Also, provide information about any existing medical or mental condition.
  • Provide a family history of depression, if applicable.
  • Also, inform them about any previous incidence of major depressive disorder, if applicable.

It will also answer questions about any symptoms you may experience. Tell them when the symptoms began and also if they started after experiencing a stressful or traumatic event in their life.

The health care provider may also ask you to complete a questionnaire to examine your feelings. This will help determine if you have endogenous depression.

The key symptom is depressed mood or loss of interest or pleasure in daily activities for more than two weeks.

Like many diseases, endogenous depression is best treated in the early stages of the leak, so treatment should not be postponed.

Treatment options available

The treatment of endogenous depression is carried out by taking medications. In addition, psychotherapeutic advice can also be prescribed. This consultation is essential because, through such preventive measures, the person calms down and adopts the habitual way of life.

It is possible to have the assistance of a professional medical expert regarding your mental health. To identify the symptoms and causes of depression, you will often be asked several questions related to your previous medical details.

It is essential to inform these professionals about the changes you suffer in your mental health at different times and provide details about medications if you are taking any of these for any specific health condition.

In addition, relatives should be informed about the diseases and possible treatments globally.

The health professional will try to know all the possible causes to take advantage of adequate medical health. You should also inform them if the symptoms are in the beginning stage or if they have increased after a specific traumatic event.

Some medical experts use it to perform a person’s test to get details about what they are facing at the current stage and what kind of mood these situations have developed for that person. Your answers will help you reach a reasonable conclusion so that the later diagnosis can be made well.

It is not an easy task to recover a person from endogenous depression. However, some options for particular medications and therapy-based treatments can help you get out of this problem.

If the treatment of the disease is carried out correctly, even despite the stage in which the progressive depression is found, the healing takes place quickly and without consequences.

Medications for endogenous depression:

Medical professionals have several options for treating depression and anxiety, but in the case of endogenous depression, options are limited. In most cases, the person affected with endogenous depression must follow the prescription of serotonin reuptake inhibitors.

Few other options are norepinephrine, serotonin, and reuptake inhibitors. Few medical experts can recommend tricyclic antidepressants, but in today’s world, they are rarely used.

These drugs extend their effectiveness to increase a few specific hormonal productions in the human brain so that the symptoms of depression can be reduced.

Some of the most commonly used drugs fall into selective serotonin reuptake inhibitors. The list includes famous names such as citalopram, escitalopram, sertraline, fluoxetine, paroxetine, etc.

Remember that many patients suffer few side effects with these medications, including insomnia, nausea, and headaches. However, after a few days, all these problems will reach their normal state.

The serotonin and norepinephrine reuptake inhibitors are other options, and the list includes drugs such as venlafaxine, duloxetine, sale famine, etc.

There are few cases where physicians prefer to use treatment methods based on tricyclic antidepressants such as nortriptylineimipramine, trimipramine, etc.

However, studies reveal that the side effects associated with the tricyclic antidepressant are more dangerous than all other antidepressants available on the market. In most cases, the tricyclic antidepressant causes weight gain and dizziness, and the person may also suffer from drowsiness.

If you experience any of these symptoms while using these medications, you need to go to the doctor and find the right solution. The person needs to consume these medications for at least 4 to 6 weeks, and the expert will continue to notice an improvement in symptoms.

In some critical cases, medication-based treatment can take up to 12 weeks to take advantage of an adequate improvement.

If you can not find any benefit of certain recommended medications, you must consult your doctor on time and replace them with a different prescription.

Studies reveal very few possibilities of observing positive changes immediately after the initial doses of drugs for patients with endogenous depression. In most treatment cases, one may need combination treatments for better results.

Even if this state of depression symptoms improves with a few weeks of prescription medication, it is essential to carry out the same routines for longer. One should stop medications only after the doctor’s recommendation.

Most medical experts follow a gradual deterioration in the doses of the drugs instead of stopping them altogether.

Therapy for endogenous depression:

The treatment is performed by a psychotherapist or psychiatrist in a hospital and includes:

An intelligent choice of method of curing antidepressants. Antidepressants affect increase the production of hormones in the brain.

Medications should be taken for several months or even years until they are fully recovered.

To increase the effectiveness of the treatment, it is not excluded that tranquilizers, stimulants, nootropics, and sedatives are prescribed to the patient.

Another option for treating endogenous depression is psychotherapy, also known as talk therapy. In this case, the patient needs to meet with experts regularly.

This therapy is sufficiently helpful for the treatment of cases of endogenous depression. There are also two options under this category: the first is known as Interpersonal Therapy, and the second option is Cognitive Behavioral Therapy.

Remember that the second on the list can help the person affected with endogenous depression replace most negative thoughts with positive ones.

In this case, one needs to practice positive thinking and limit the movement of negative thoughts in mind. Slowly begin to improve the ability of the person to respond to favorable situations better while discarding the negativities of life.

In another case, if you have relationship-related problems, you may need to undergo interpersonal therapy. Doctors may also prefer to use the combination of both treatments in some cases.

Lifestyle changes:

If you need to get out of the unwanted state of life of depression, then a few positive lifestyle changes are essential for man. It should start with a positive change in routine activities that can help improve the symptoms of endogenous depression.

Your body will not find these activities or appropriate changes at the initial level. However, over time, it will adapt to the differences, and the mind and body will begin to recover.

You can try these things to get positive results as soon as possible:

  • Try to improve your diet and switch to a healthy diet that includes vegetables, lean proteins, and whole grains.
  • Sleep at least 6 hours per night.
  • You can try writing new magazines or books with your creative thoughts.
  • Go out with your family, friends, and relatives to have fun and create happy memories.
  • Try to get involved in activities you often used to love before falling into depression.
  • Go on adventure sports such as cycling or hiking, etc.

One can quickly recover from problems of endogenous depression if the proper treatment is adjusted at the right time.

It is essential to contact your mental health expert regularly and follow his suggestions to eliminate all the health problems in your life.

Differences between endogenous depression and major depression

While there is considerable overlap in how these types of symptoms have been characterized, endogenous depression is a type of depression that occurs without any reason.

It seems to be chemical and genetic. It is often accompanied by feelings of guilt, uselessness, and the inability to enjoy normally pleasurable things.

Exogenous or reactive depression, on the other hand, is usually triggered by external stressors, such as the loss of a loved one, divorce, job loss, or relationship difficulties.

While in endogenous depression, the world may seem dark and sad because you, yourself, are dark and sad inside, in exogenous depression, the world seems dark and sad because of what is happening in your life.

In addition, exogenous depression tends to be characterized by a lack of specific physical symptoms, such as problems with sleep and appetite.

Whether depression is endogenous or exogenous, it is almost always triggered by stressful factors in life. A significant life stressor can push that tendency toward existence if a person has a genetic and biochemical predisposition to depression.

As for how depression is currently treated, it does not seem to make a difference what type of depression a person has. Studies conducted in the eighties and nineties could not establish any link between the type of depression a person manifested and how well the antidepressants alleviated their symptoms.

However, ideas may change in the future. A 2012 study found evidence of different brain pathways responsible for these two types of depression.

While the results are still very preliminary, it could mean that these two types of depression could be attacked in different ways in the future.

What is the difference between endogenous depression and exogenous depression?

In the 1980s, two types of depression were usually mentioned: endogenous depression and exogenous depression. The main difference was in the cause of the disorder.

Endogenous depression occurs without the occurrence of stress or trauma. Genetic and biological factors usually cause it. It is sometimes called “biological base” depression. For internal factors, from neurochemical imbalance to negative thought patterns.

Conversely, exogenous depression, also known as reactive depression, can find the trigger in the person’s life, which is experienced after someone experiences a stressful or traumatic event, such as a death in the family, a divorce, or trauma like an accident.

This type of depression is called reactive depression. However, this separation is not very useful for understanding the causes of depression. In the emergence and consolidation of this disorder, internal and external factors always intervene.

Depression is a multicausal disorder that affects the person’s characteristics, the resources to cope with the person, the biochemistry of the brain, and stressful events.

This means that although some people think they are depressed for no apparent reason, the fact is that they do not know the cause and can not identify the stressful event.

Mental health workers no longer differentiate these two types of major depressive disorders. A diagnosis now is simply: major depressive disorder.