Endogenous Depression: Definition, Symptoms & How To Treat 2023

endogenous depresion
Genetic and biological factors can increase one’s vulnerability to depression.

Endogenous depression is often considered a particularly challenging type of depression. It’s a mental health condition characterized by persistent sadness or a lack of interest in outside stimuli. A 2019 census reported[1] that 4.7% of polled participants reported feelings of depression.

It’s called endogenous because it is thought to come from within the individual due to a biological or genetic basis rather than being triggered by external events or circumstances, typically called reactive depression.

Endogenous depression presents unique challenges that significantly impact individuals’ mental health and overall well-being. In this article, we will explore the meaning of endogenous depression, common endogenous depression symptoms, and the various treatment options available.

What Are The Symptoms Of Endogenous Depression?

Common symptoms of endogenous depression include:

  • Persistent feelings of sadness or despair.
  • Loss of interest or pleasure in previously enjoyed activities.
  • Notable changes in appetite and weight.
  • Sleep disturbances.
  • Fatigue and a lack of energy.
  • Difficulty concentrating or making decisions.
  • Feelings of worthlessness or excessive guilt.
  • Suicidal thoughts or behaviors.

The symptoms which characterize endogenous depression can significantly interfere with one’s quality of life.

What Is Endogenous Depression?

Endogenous depression is also called major depressive disorder, MDD, or unipolar disorder. But what is endogenous depression? It’s a mental illness that originates within the individual, hence the term endogenous, meaning from within.

This distinguishes it from exogenous depression, triggered by external conditions like life events, environmental factors, or a stressful or traumatic event. Let’s compare the definitions of endogenous and exogenous depression.

According to the American Psychological Association,[2] the endogenous depression definition is:

“Depression that occurs in the absence of an obvious psychological stressor and in which a biological or genetic cause is implied.”

This is in contrast to the definition[3] of exogenous depression, which is:

“A major depressive episode that is precipitated by a distressing event or situation, such as a career or relationship setback.”

What Causes Endogenous Depression?

One of the defining aspects of endogenous depression is the strong influence of genetic and biological factors. Research[4] has found that individuals with first-degree family members — parent or sibling — diagnosed with major depression are two to three times more likely to develop the condition themselves, emphasizing the role of heredity and family history.

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Evidence from medical journals also suggest that endogenous depression occurs due to chemical imbalances in the brain — particularly neurotransmitters like serotonin, norepinephrine, and dopamine, which are crucial in mood regulation. Research has shown that these chemical interactions can lead[5] to depressive symptoms, enhancing our understanding of the disorder’s biological basis.

Biological differences, including changes in physical functions within the brain, have also been observed in individuals with endogenous depression. Specifically, studies show that people with endogenous depression often experience changes in how their brain’s stress response system, known as the hypothalamic-pituitary-adrenal, or the HPA axis,[6] operates. Individuals with endogenous depression also tend to have a smaller hippocampus,[7] a part of the brain crucial for memory and emotions. These findings further underline the biological basis of this type of depression.

Common Symptoms Of Endogenous Depression

You’re likely wondering — what are the symptoms of endogenous depression? Physical, emotional, and cognitive symptoms characterize endogenous depression.  While these symptoms can vary widely from person to person, they are typically persistent and severe enough to interfere with one’s day-to-day life.

Here are a few of the common symptoms of endogenous depression:

Pervasive Sadness And Loss Of Interest

endogenous depression
Pervasive sadness and loss of interest often accompany endogenous depression. Pervasive sadness and loss of interest often accompany endogenous depression.

Endogenous depression often sparks intense feelings of intense sadness, emptiness, or despair. These emotions extend beyond mere fleeting melancholy instances; they are deep and persistent, pervading daily life.

A signature symptom of endogenous depression is a significant decline in interest or pleasure in activities an individual used to enjoy. These could be hobbies, social interactions, or routine tasks like cooking or reading. This loss of interest often results in reduced activity levels and social withdrawal symptoms. Frequently accompanying these feelings is anhedonia, an inability to experience joy or pleasure.

Anhedonia is widely recognized as a core[8] or cardinal[9] symptom of depression, and it’s incorporated in the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5.

Changes In Appetite Or Weight

endogenous depression
Changes in appetite or weight are common in endogenous depression.

Endogenous depression can lead to significant fluctuations in appetite and weight. For some individuals, it results in a diminished appetite leading to weight loss. For others, it triggers comfort eating,[10] resulting in weight gain. Either scenario often reflects an unhealthy departure from the person’s typical eating habits and body weight.

Such variations in appetite and weight aren’t mere side effects of mood shifts but key symptoms of endogenous depression. The DSM-5 recognizes these changes as potential indicators of depressive episodes.

Sleep Disturbances

endogenous depression
People with major depressive disorder may struggle with sleep disturbances.

Endogenous depression is frequently associated with disruptions in sleep patterns.[11] These disturbances might manifest as insomnia — trouble falling or staying asleep — or hypersomnia, an excessive need for sleep. Such sleep irregularities are more than mere inconveniences; they are significant indicators, intruding into the daily life and well-being of individuals with endogenous depression.

Fatigue Or Lack Of Energy

endogenous depression
Fatigue and lack of energy are common endogenous depression symptoms.

Individuals with endogenous depression often experience profound fatigue[12] or a lack of energy. This is not just typical tiredness but a deep-seated, persistent exhaustion that doesn’t improve with rest and can interfere with daily functioning.

Such persistent fatigue is considered a substantial symptom of endogenous depression and is included in the diagnostic criteria for major depressive disorder in the DSM-5. Studies have also highlighted the prevalence of fatigue in depression,[12] indicating its importance in diagnosing depression.

Difficulty Concentrating Or Making Decisions

endogenous depression
Difficulty concentrating and making decisions are symptoms of endogenous depression.

Endogenous depression can manifest as difficulty in concentrating or making decisions. Individuals may find it challenging to focus on tasks, recall information, or make everyday choices, indicating a general cognitive impairment beyond occasional forgetfulness or indecisiveness.

Cognitive difficulties such as these are acknowledged symptoms[13] of major depressive disorder. Emerging research underscores the significance of cognitive symptoms[14] in clinical depression, further emphasizing their role in endogenous depression.

Feelings Of Worthlessness Or Excessive Guilt

endogenous depression
Those with endogenous depression may often feel worthless and guilty.

In endogenous depression, individuals often experience persistent feelings of worthlessness or excessive guilt. These feelings are disproportionate to the situation and often involve a negative self-evaluation not grounded in reality.

Such feelings are more than low self-esteem or regret; they are key symptoms[15] of endogenous depression. Research highlights the relationship between depression and excessive self-blame,[16] reinforcing the importance of these symptoms in endogenous depression.

Suicidal Thoughts Or Behaviors

endogenous depression
Suicidality is a common symptom of endogenous depression.

One of the most severe symptoms of endogenous depression is the occurrence of suicidal thoughts or behaviors. Individuals may harbor recurring thoughts of death or suicide; in extreme cases, they might act on these thoughts. These symptoms signify a critical level of distress and risk, so they must be taken seriously. 

The DSM-5 identifies suicidality as a significant symptom of major depressive disorder. The link between endogenous depression and suicide is well-documented in scientific literature,[17] emphasizing the urgent need for early detection and appropriate treatment.

Ways To Treat Endogenous Depression

Various treatment options are available for endogenous depression, including a combination of prescribed medications that target multiple distinct molecular mechanisms, talk therapy and lifestyle changes. 

Antidepressant Medications

Speaking to medical professionals can help those with endogenous depression and other comorbidities, such as bipolar disorder, combat their depressed mood based on their mental illness symptoms.

Antidepressant medication like selective serotonin reuptake inhibitors or SSRIs, serotonin and norepinephrine reuptake inhibitors, prescribed tricyclic antidepressants, antipsychotic medications, and other antidepressant medications can help regulate brain chemicals and alleviate depressive symptoms.


Talk therapy, such as cognitive-behavioral[18] or interpersonal therapy, can help individuals through various therapeutic techniques. Talk therapy can assist people in limiting negative thoughts and challenging negative beliefs, helping them develop effective coping strategies such as positive thinking.

Lifestyle Changes

Incorporating regular exercise,[19] maintaining a healthy diet full of nutrients, getting enough sleep, and engaging in stress-reduction techniques can all improve mental health.

Electroconvulsive Therapy

In severe cases or when other treatments are ineffective, electroconvulsive therapy[20] can be an option. Electroconvulsive therapy involves sending small electrical currents through the brain to trigger a brief seizure, which can help reset brain chemistry and improve depressive symptoms.

Support Groups

Connecting with others who have similar experiences can provide emotional support and valuable insights into managing endogenous depression.

Professional Support

Working with mental health professionals can help individuals create a tailored treatment plan and monitor progress, making adjustments as needed. Mental health professionals’ support can either be in person, or you can access online counseling

The Takeaway

Endogenous depression is a complex mental disorder that significantly impacts a person’s life. Untreated depression can have various adverse effects, so seeking help is important.

Those with symptoms of endogenous depression should consider working with medical professionals. Treatment may include medications, therapy, lifestyle changes, and support from others who have faced similar challenges.

Seeking help for mental illness is a sign of strength, not weakness. If you or someone you know is struggling with endogenous depression, contact mental health professionals, medical professionals, or a national suicide prevention lifeline for guidance and support.

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Emma Loker

Emma Loker is a professional writer specializing in psychology. She has a 1st class honors degree in Psychology and is currently training as a Child and Adolescent Psychotherapeutic Counsellor at the University of Cambridge.

Medically reviewed by:

Kathy Shattler

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