Endogenous depression occurs without an external cause, because it is associated with brain disorders, and more specifically with the abnormal functioning of neurotransmitters. Is depression treatable? Yes, but a proper diagnosis and proper therapy are necessary. Treatment should last at least half a year to prevent relapse.
Endogenous expression – what is it?
Depression is a disease that according to various estimates may affect up to 17%. people at different stages of their lives. Its symptoms are often confused with a temporary decrease in mood. The main difference is the long-term course of depressive disorders and their significant impact on reducing normal functioning. In the course of severe depression, thoughts and even suicide attempts may occur, which unfortunately in the case of 15%. people are effective.
Depression can be caused by the experience of overwhelming events, such as death of a loved one, serious health problems or continuous failures. It also happens that depression occurs without any apparent cause and it is an endogenous depression, also known as large depression.
Both endogenous and exogenous depression can take forms such as:
- depressive episode,
- depressive recurrent disorder,
- a depressive episode in the course of bipolar disorder,
- depressive post-depressive,
- organic depressive disorders.
Endogenous expression – causes
Endogenous depression, as the name suggests, comes from the “inside of the body” and is not caused by any external causes. It is responsible for endogenous factors such as brain disorder caused by the abnormal concentration of some neurotransmitters. Neurotransmitters are chemical compounds whose task is to transfer information between neurons. These include dopamine, noradrenaline and serotonin.
Endogenous and exogenous expression
It is important to compare endogenous and exogenous depression (situational depression, psychogenic depression), which is usually preceded by some traumatic experience, which significantly affects the mood disorder. On the other hand, endogenous depression has no cause in any difficult experience and does not have to be preceded by any specific event.
Endogenous depression is sometimes perceived by the patient’s environment. It is difficult for people to believe that someone who has not met with major life problems may struggle with long-term mood depression.
What are the symptoms of endogenous depression?
Different types of depression may be characterized by varying severity and type of symptoms. Even the same type of depression in other patients may have a completely unrealistic course. There is, however, a set of symptoms that are considered basic for this disease entity, these are the so-called axial symptoms of depression. In the case of endogenous depression the following are:
- lowering the mood lasting for a long time, which is not clear to determine the cause,
- anhedonia, or difficulty in feeling the joy of life,
- emotional indifference, which can affect both positive and negative feelings,
- feeling of tired fatigue, which may result in neglecting their duties, loss of care for hygiene and complete abandonment of social life.
In addition, there may be other symptoms of endogenous depression:
- difficulties with concentration and attention, slowing down the thought processes,
- constant guilt,
- thoughts of suicide,
- sleep disorders,
- constant feeling of fear and mental tension,
- weight loss,
- low physical activity.
Depression can very often be associated with the occurrence of atypical symptoms that are rarely associated with this disease. This is so-called masked depression, in which the classic symptoms of this type of mood disorder are replaced by somatic symptoms – the so-called “masks”.
Endogenous depression can have the following masks:
- pain mask – pain related to different parts of the body;
- vegetative mask – pressure spikes, palpitations, nausea, vomiting;
- psychopathological mask – anxiety disorders, phobias, obsessions, endogenous psychosis;
- behavioral mask – falling into addiction;
- mask concerning circadian rhythm disorders – difficulty falling asleep, insomnia.
Endogenous expression – diagnosis
Diagnosis of any type of depression, including endogenous depression, should be done by an experienced physician. Due to the specificity of this disease, diagnostic criteria for depression should be known to specialists in psychiatry, medicine, paediatrics, geriatrics and family medicine.
According to the ICD-10 classification, the presence of at least two of the following symptoms and their persistence for a minimum of 2 weeks should be recognized for the diagnosis of a depressive episode:
- lowering the mood,
- increased fatigability, less activity.
In addition, at least two of the following symptoms should also occur:
- poor concentration,
- low self-esteem,
- feeling guilty,
- pessimistic thinking about the future,
- thoughts or suicide attempts,
- sleep disorders,
- reduce appetite.
If the occurrence of the above symptoms is hard to connect with the experience of a difficult, strongly incriminating event, one can recognize endogenous depression.
In order to facilitate the diagnosis and also for the purposes of objectivization of data in scientific research, a test for endogenous depression was created. There are many questionnaires available to diagnose depression in patients.
Endogenous expression – treatment and therapy
Treatment of endogenous depression is not different from treating other types of this disorder. The most commonly used are antidepressants (antidepressants) from the group of serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TLPD), whose action is based on modulating the concentration of neurotransmitters in the central nervous system.
How long does endogenous depression treatment take? The therapy is long-lasting and should be maintained for at least half a year.
In the case of endogenous depression, electroshock, which is a procedure under general anesthesia, can also bring good results. If the drugs used do not bring the expected results, and the course of depression is particularly severe, sometimes neurosurgical procedures involving the implantation of the vagus nerve stimulator are used.
In the case of depression, therapeutic sessions can also help. The most commonly used types are cognitive-behavioral psychotherapy and psychodynamic therapy. Many experts, however, question the effectiveness of these methods in the case of endogenous depression and recommends them when external factors are the cause of mood disorders.
Picture Credit: Paula Lavrador