Endogenous depression is also known as “biologically based” depression. Here’s a helpful primer to help you get better.

Endogenous depression refers to a form of depression that has no obvious external cause — no inciting stress, trauma, or grief seems to trigger it. This may indicate that genetic or biological factors could be causing periods of depression.

Sometimes you may find it difficult to pinpoint a cause of depression. Spells of depression can occur at any age, with or without a big change in your life. You could be experiencing something like a “biologically based depression” — endogenous depression.

In fact, the National Institute of Mental Health say that genetics and a family history of depression are risk factors for developing depression at some point in your life.

All this suggests a need for researchers to distinguish different origins of depression. Internal and external factors of depression might lead us to a better understanding of depression and how to overcome it more effectively.

Today, the official diagnosis for depression has changed.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), anyone experiencing endogenous or exogenous depression will likely receive a diagnosis of major depressive disorder (MDD).

Medical professionals no longer give endogenous depression as an official diagnosis, and the DSM-5 no longer lists endogenous depression as a diagnostic category. Still, some researchers and mental health professionals find that locating the sources of depression — internal or external — could help you with finding treatment that best suits the specific needs.

The exact cause of depression is still unknown. But researchers and mental health professionals believe that there are many contributing factors that could lead to you developing the mental health condition, including:

Any combination of these factors may contribute to clinical depression.

You can consider some of these factors “external” — like suddenly losing your job, experiencing a natural disaster, or grieving the death of a loved one.

You can also see some of these risk factors for depression as “internal” — like a family history of mood disorders, which genetically predisposes a person to a higher chance of having these disorders. If you were to feel depressed and think it’s because it runs in your family, this could be considered a form of endogenous depression.

Endogenous depression means a form of depression triggered by internal contributing factors, while exogenous depression refers to a form of depression brought on by external contributing factors.

Dr. Amelia Kelley, a therapist practicing in North Carolina and the author of “What I Wish I Knew,”explains how endogenous depression can feel sudden or mysterious at first: “Some describe their experience with this type of depression as feeling that it occurs for no specific reason.”

You can feel assured that endogenous depression does not mean your condition is any worse. Just because it may feel unexpected, does not mean your diagnosis, treatment, and recovery would be more difficult.

For example, talk therapy may offer healing and consolation to those processing a loss or trauma (external causes of depression). However, with endogenous depression, you may find that it takes longer than anticipated to discover the root of your depression.

“With exogenous depression, the source is often an external stressor such as trauma, loss, or other chronic issues,” says Kelley. “Those who suffer from this form of depression may feel that the world is a dark and sad place and that circumstances are the source of their depression.”

If you have symptoms of depression, help is available. Typical treatments for depression include talk therapy and antidepressants, depending on whether the cause is internal or external.

While endogenous and exogenous depression have different sources that trigger depression, the symptoms present in very similar ways and could include:

  • feelings of worthlessness or helplessness
  • low energy and fatigue
  • chronic anxiety and feelings of sadness
  • changes to appetite or noticeable weight changes
  • trouble falling asleep or oversleeping
  • strong thoughts of self-harm or suicide
  • loss of interest in favorite hobbies or tasks

If you have depression, you could experience some of these symptoms every day for 2 weeks or longer. You may find that it’s time to consider reaching out to a mental health professional for possible diagnosis and treatment.

Don’t be hard on yourself if you find it’s taking longer than expected to heal with treatment. It can be helpful and reassuring to remind yourself that you’re successfully taking steps toward feeling better and that tomorrow is a new day.

Whether you have endogenous or exogenous depression, your treatment plan will look very similar.

Most clinicians recommend either psychotherapy, medication, or a combination of both. Your mental health professional will work with you to develop a treatment plan that fits your needs using an empathetic approach, designing it based on your time, your financial health, and other complementary resources.


Talking with a mental health professional or trained counselor can help you overcome depression. There are many different types of therapy that all aim to help you heal and cope with the events in your life that may be contributing to your depression.

Treatment for both endogenous and exogenous depression could involve therapy, but the therapeutic techniques might vary somewhat.

“These treatments are also helpful for endogenous depression, but because endogenous depression is more internal, there is also a focus on improving thinking patterns with cognitive behavioral therapy (CBT),” says Kelley.

CBT is a scientifically proven method of therapy that helps you look at the people and circumstances in your life and how you react to them.

By using these CBT techniques in your everyday life, you can learn how to better approach the symptoms of depression — along with how to track and manage your feelings.

Antidepressant medication

Antidepressant medications can help reduce the severity of your depression symptoms.

Each type of antidepressant works in different ways. Still, most medications influence neurotransmitters in the brain and how they interact. This affects how you feel every day.

For example, serotonin reuptake inhibitors (SSRIs) continue to be one of the most commonly prescribed antidepressants. They work by limiting the absorption of serotonin — or the “happy chemical” in your brain.

“Though each type of depression may be instigated in different ways,” says Kelley, “research has shown that both [endogenous and exogenous depression] respond favorably to anti-depressant medications called selective serotonin reuptake inhibitors.

Other antidepressants include:

Your doctor or mental health professional can prescribe antidepressant medications. Some telemedicine services may even be able to prescribe you antidepressants online after a medical consultation.

Seeking professional mental health services might feel intimidating at first, especially if you don’t know where to look.

There are many resources available to help you find the right help — even when you’re feeling really low.

Check out our Find a Therapist and Mental Health Support resource that lists the many types of therapists, mental health apps, and cost-effective resources available.

If you’re looking to talk with someone about your search and where to find local support systems and support groups, the Substance Abuse and Mental Health Services Administration has a 24/7 hotline where you can learn more about at the SAMHSA’s National Helpline.

If you think someone may be at risk of self-harm or hurting another person, resources are available to help with this serious situation. You can get supportive help from a crisis and suicide prevention hotline. You can call the National Suicide Prevention Lifeline at 800-273-8255.

Everyone’s experience with depression is unique. You can explore treatments on your terms. If you feel ready for help, trained mental health professionals are available and can help you manage the symptoms of depression.

Whether you feel the cause of your depression is genetic or due to a traumatic event, the symptoms that you experience can be challenging in your daily life. There are resources that can help you not only cope but thrive.

When you find the right resources and treatment plan, you can begin to feel better, overcome symptoms of depression, and improve your everyday life.