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Endogenous & Exogenous Depression: Definition, Symptoms, & Treatment

Published: March 10, 2022 Updated: July 1, 2022
Published: 03/10/2022 Updated: 07/01/2022
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • What Is Endogenous Depression?Endogenous
  • What Is Exogenous Depression?Exogenous
  • Endogenous Depression vs. Exogenous DepressionVersus
  • Endogenous Depression SymptomsEndogenous Symptoms
  • Exogenous Depression SymptomsExogenous Symptoms
  • Treatment of Endogenous & Exogenous DepressionTreatment
  • How to Cope With Endogenous & Exogenous DepressionCoping
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Endogenous & Exogenous Depression InfographicsInfographics
Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

Although the terms aren’t commonly used when discussing mental health anymore, it can be helpful to understand the concepts of endogenous and exogenous depression. Endogenous depression refers to depression that presents as biological or genetic. There are no specific or apparent external variables. Exogenous depression, on the other hand, appears to be triggered by specific factors like stress or trauma.

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What Is Endogenous Depression?

Endogenous depression refers to a type of depression that was once diagnosed as a distinct disorder. Today, it’s best understood as major depressive disorder (MDD), a mood disorder characterized by pervasive negative feelings without an apparent cause.1 While researchers have not identified a specific cause, it is likely that endogenous depression manifests from a combination of genetic and psychological factors.

What Is Exogenous Depression?

Exogenous depression is a type of reactive depression, meaning that it results from a specific, external cause. It often mimics situational depression, in that the individual experiences depression as a result of a particular event like a divorce, financial hardship, or medical issue like surgery or a stroke. Exogenous depression can occur quickly after the challenging event.

Endogenous Depression vs. Exogenous Depression

Endogenous depression means the depression does not have a specific cause. Exogenous depression means the depression resulted from an identified stressor.2

Mental health experts used to distinguish endogenous depression from exogenous depression by assessing whether a stressor occurred before MDD symptoms emerged. Today, this is no longer applicable. Instead, practitioners will typically diagnose someone with depression based on a set criterion of symptoms.

Endogenous Depression Symptoms

Because endogenous depression does not have a specified cause, depression symptoms can occur suddenly and without warning.3 Symptoms may present as mild at first, but they can progress quickly. With that in mind, the average age at onset is during one’s mid-twenties, and women are nearly twice as likely to experience depression than men.4

Symptoms of endogenous depression include:5

  • Pervasive feelings of hopelessness or helplessness
  • Apathy – losing interest in usual hobbies or relationships
  • Difficulty with focus or concentration
  • Suicidal ideation or making attempts to hurt yourself
  • Isolating yourself from others
  • Significant appetite and weight changes
  • Body pain (headaches, gastrointestinal distress, muscle tightness)
  • Lack of motivation

Exogenous Depression Symptoms

Exogenous depression can arise in response to an upsetting event or stressor. For example, you might experience this depression after losing your job, breaking up with your significant other, or relocating to a new city. Symptoms can occur anytime after the event, and they may be either short-lived or persistent, depending on the situation.

Symptoms of exogenous depression are the same as endogenous depression, with the addition of intense regret or rumination to go back to the way things were before the stressful event.

Treatment of Endogenous & Exogenous Depression

Depression treatment is often multifaceted and customized to an individual’s specific situation and needs. Treatment may consist of a combination of psychotherapy, medication, and lifestyle habits. In severe instances, such as in the presence of suicidal ideation, crisis support is imperative. Get immediate help by contacting your therapist, reaching out to the suicide prevention hotline at 800-273-TALK, or calling 911.6

Medication

Medication for depression can be extremely beneficial in managing and treating depression symptoms. For example, selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Lexapro, Celexa, and Paxil, work by stabilizing serotonin levels in the brain. This process can help support mood and emotional regulation.

Therapy

Psychotherapy can help you understand your depression triggers and learn healthier skills for managing your symptoms. If medication is prescribed, it is highly recommended that you also regularly see a therapist. Therapy and lifestyle changes can greatly influence and enhance medication outcomes.

Different therapeutic modalities address treatment of depression variously:

  • Cognitive therapy models, such as CBT or DBT, often focus on recognizing how certain beliefs affect feelings and behaviors.
  • Psychodynamic therapists explore how past issues and experiences affect current areas of functioning.
  • Experiential therapies may integrate concepts of art, writing, dance, or other forms of expression to help with mood regulation.

It can be helpful to use an online therapist directory to start looking for a therapist who specializes in depression. While the origin of your depression likely won’t impact how your provider supports you, a good therapist can help you understand the thoughts, feelings, or experiences that may be maintaining your distressing symptoms.

How to Cope With Endogenous & Exogenous Depression

Coping with depression can be challenging, but it is possible to reduce your distress and overcome your struggles. Keep in mind that different coping skills may work better at some times than others. That’s why it’s important to have several skills you can refer to when you’re struggling. The more you practice them, the more second nature they will become.

The following are ways to cope with endogenous and exogenous depression:

  • Meditate: Meditation can help you feel more grounded and present in everyday life. There are many ways to meditate, including taking several deep breaths in a row, completing a guided imagery exercise, focusing on single-task mindfulness, or taking an intentional nature walk.
  • Spend time outside: Research shows that being outdoors can boost your mood.7 Commit to taking a morning walk, eating lunch outside, or spending the afternoon at the park.
  • Exercise: Exercise can release feel-good hormones that decrease depression symptoms. Find an activity you enjoy and participate in it several times a week.
  • Spend time with supportive loved ones: It’s important to make meaningful connections in your life. Laughing, seeking support, and feeling validated by others can lessen the intensity of your depression.
  • Reflect on your gratitude: Gratitude can help keep ‘the big picture’ into perspective. Try to commit to incorporating a regular gratitude exercise in your daily routine.
  • Limit numbing behaviors: Try to be mindful of your intake of nicotine, caffeine, alcohol, or mood-altering drugs. Limit excess time spent on social media or watching TV. Instead, try to focus on being more active and engaged with your everyday life.
  • Cuddle your pets: Connecting with animals can be extremely helpful in boosting your mood or self-esteem. If you don’t have your own animals, consider volunteering at a local rescue.
  • Plan something fun and exciting: Having something to look forward to can instill a sense of hope and joy. This will give you something to focus on even when life feels challenging.

Final Thoughts

Endogenous and exogenous depression can be challenging to deal with, but you can overcome your symptoms and live a meaningful life. Treatment is available, and reaching out for support now can make a tremendous difference in how you feel.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

BetterHelp (Online Therapy) – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Online-Therapy.com – Receive help for depression. The Online-Therapy.com standard plan includes a weekly 45 minute video session, unlimited text messaging between sessions, and self-guided activities like journaling. Recently, they added Yoga videos. Get Started

Brightside Health (Online Psychiatry) – If you’re struggling with depression, finding the right medication can make a difference. Brightside Health treatment plans start at $95 per month. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

Choosing Therapy’s Directory – Find an experienced therapist specialising in depression. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp, Online-Therapy.com, and Brightside.

For Further Reading

  • American Psychiatric Association: Help With Depression
  • NAMI Hotline
  • National Suicide Prevention Lifeline
  • Depression Center: Helpful Mental Health Resources

Endogenous & Exogenous Depression Infographics

Endogenous Depression vs. Exogenous Depression What is Exogenous Depression? What is Endogenous Depression?

7 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • The endogenous and reactive depression subtypes revisited: integrative animal and human studies implicate multiple distinct molecular mechanisms underlying major depressive disorder (2014, May). BMC Medicine. Retrieved from: https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-73.

  • The doctrine of the two depressions in historical perspective (2007). Acta Psychiatrica Scandinavica. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712975/.

  • Endogenous Depression (1998). Comprehensive Clinical Psychology. Retrieved from: https://www.sciencedirect.com/topics/medicine-and-dentistry/endogenous-depression

  • Mental Health Disorder Statistics (2022). John Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/mental-health-disorder-statistics

  • Depression: major depressive disorder (2018, February). Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007.

  • Are you thinking about suicide? How to stay safe and find treatment (2018, January). Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art-20048230.

  • Nurtured by nature (2020, April). American Psychological Association. Retrieved from: https://www.apa.org/monitor/2020/04/nurtured-nature.

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Headshot of Nicole Arzt, LMFT
Written by:

Nicole Arzt

LMFT
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • What Is Endogenous Depression?Endogenous
  • What Is Exogenous Depression?Exogenous
  • Endogenous Depression vs. Exogenous DepressionVersus
  • Endogenous Depression SymptomsEndogenous Symptoms
  • Exogenous Depression SymptomsExogenous Symptoms
  • Treatment of Endogenous & Exogenous DepressionTreatment
  • How to Cope With Endogenous & Exogenous DepressionCoping
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Endogenous & Exogenous Depression InfographicsInfographics
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