Endogenous and Exogenous Depression

Endogenous Depression
Credit: Jamie Grill/Getty Images

The literal translation from the Latin of the word endogenous is "from within." At one point in time, psychiatrists and researchers used the terms endogenous and exogenous, which means "from without," to differentiate whether depression came from internal causes, such as biological and/or genetic, or external causes like stressful or traumatic events. This distinction was made because it was believed that it would make a difference in what types of treatments should be applied.

How They Differ

While there is considerable overlap in the way these types of symptoms have been characterized, endogenous depression is a type of depression which seemingly occurs for no reason. It appears to be chemical and/or genetic. It is also often accompanied by feelings of guilt, worthlessness and an inability to enjoy normally pleasurable things.

Exogenous, or reactive, depression, on the other hand, is usually triggered by some sort of outside stressor like the loss of a loved one, divorce, losing a job or relationship difficulties. Whereas in endogenous depression the world may seem like a dark and sad place because of you, yourself, are dark and sad inside, in exogenous depression, the world seems dark and sad because of what's going on in your life. In addition, exogenous depression tends to be characterized by a lack of certain physical symptoms, such as problems with sleep and appetite.

Whether depression is endogenous or exogenous, it is nearly always triggered into existence by some life stressor. This means that if a person is genetically and/or biochemically predisposition to have depression, a significant life stressor can push that tendency into existence.


Contrary to what was once believed, there is no need to treat endogenous depression any differently from exogenous depression. Both types create the same biochemical imbalance within the brain and respond to the same type of treatments.

The first line of treatment for either type is generally the administration of antidepressant medications. A drug from a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) is often the first choice due to the fact that they tend to be quite effective as well as well-tolerated. In addition, psychotherapy will be recommended for many patients. Discussing your options with your doctor or psychiatrist can help you figure out the best treatment options.

Depression Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

In cases of more severe, suicidal depression, electroconvulsive therapy (ECT) can bring about rapid relief from depression. Antipsychotic medications may also be necessary in certain cases.

Do the Differences Between Really Matter?

As far as how depression is currently treated, it does not seem to make a difference what type of depression a person has. Studies done back in the 1980s and '90s were not able to establish any kind of link between the type of depression that a person manifested and how well antidepressants relieved its symptoms.

However, ideas may change in the future. A 2012 study found that there is evidence of different pathways in the brain which are responsible for these two types of depression. While the results are still very preliminary, it could mean that these two types of depression may be targeted in different ways in the future.

Was this page helpful?

Article Sources