Endogenous & Exogenous Depression: Definition, Symptoms, & Treatment

What Is Depression?

Depression is a serious mental health condition and is classified as a mood disorder. Those who struggle with depression experience many symptoms such as changes in sleep, weight, appearance, motivation, joy, and sociability. Those who struggle often report having such a low mood that they have no motivation to properly care for themselves.

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

Causes of Endogenous Depression

While researchers have not identified a specific cause, it is likely that endogenous depression manifests from a combination of genetic and psychological factors, including:

• Life stressors
• Biological predisposition
• Genetic predisposition
• Family history and general exposure to depression
• Physical manifestation of depression

What Is Exogenous Depression?

Exogenous depression is a type of reactive depression, meaning that it results from a specific, external cause. Also called situational depression, the symptoms of reactive depression can mimic those of MDD.

Cause of Exogenous Depression

Exogenous depression 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 depression ater surgery or depression after 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 Today, this is no longer applicable.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
• Depression & 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.

Diagnosis of Endogenous Vs. Exogenous Depression

The biggest difference in the diagnosis process between endogenous and exogenous depression is determining stress levels before the onset of major depression. Those with endogenous depression tend to develop this type of depression organically, not due to previous stress or trauma. Exogenous depression onsets following a stressful or traumatic event. That is the biggest differentiator when coming up with one of these diagnoses.

Treatment of Endogenous & Exogenous Depression

Knowing how to treat depression 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 crippling depression 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 9-1-1.⁶

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 behavioral therapy (CBT): cognitive therapy models, such as CBT for depression or dialectical behavioral therapy (DBT), often focus on recognizing how certain beliefs affect feelings and behaviors
• Psychodynamic therapy: psychodynamic therapy explores how past issues and experiences affect current areas of functioning
• Experiential therapies: experiential therapies may integrate concepts of art, writing, dance, or other forms of expression to help with mood regulation

How to Find a Therapist

It can be helpful to explore the process of finding a therapist through an online therapist directory. 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.

Here are ways to cope with endogenous and exogenous depression:

• Meditate: meditation for depression 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 clear benefits of nature on mental health.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 On Endogenous & Exogenous Depression

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.