Historical view of endogenous depression causes.
Historically, endogenous depression has been understood to be caused by an imbalance in brain chemistry. Specifically, it was thought that abnormally low neurotransmitter levels, perhaps due to low baseline production of them, were to blame. Endogenous depression was considered to be at least partially genetic and strongly hereditary; in other words, a family history of endogenous depression would mean that you were highly likely to have it as well and while this would be the case from birth, it was likely to first manifest post-puberty as with other types of depression. Speaking more broadly, endogenous depression (in the historical view) presupposes depression episodes that occur independent of external factors such as adverse life events as opposed to reactive depression, which is brought on solely or primarily by such factors, hence the common moniker of “situational depression“.
Modern view of the causes of endogenous depression.
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The leading opinion in clinical and pharmacological psychiatry research circles holds that endogenous depression is caused by a dysregulation of the endogenous opioid system, but not the other systems such as the monoaminergic system, which is responsible for the well-known neurotransmitters dopamine and serotonin. The neurotransmitters implicated are beta-endorphin, dynorphins and met- and leu-enkephalins. Researchers and clinicians alike now use this view as the basis for classifying this sub-type of major depressive disorder.
The sufferer’s opinion on the nature and causes of endogenous depression.
Theory and research are great and, in the long run, are the only way we’re going to get anywhere in our understanding of mental health and mood disorders in particular. Without such understanding, our ability to get effective treatment that is safe, reliable and side-effect free is never going to get beyond where it is now, which is almost nowhere. However, such thorough understanding is a long way off and as such, anecdotal and experiential evidence is still equally if not more important. The view of endogenous depression currently being advanced by academics does not correspond particularly well with some sufferers’ experience.
It is a well-known fact that many undiagnosed mental health and especially mood disorder patients self-medicate with drugs available off the street. I’ve known one whose symptoms matched mine very well, so I am fairly confident that had he been diagnosed, the diagnosis would have been endogenous depression. If the research is to be believed, the only effective treatment would have been a course of synthetic opioids to compensate for the low production of the endogenous opioid system; in fact, while he did self-administer various equivalents of both artisanal and pharmaceutical origin, his symptoms did not abate sufficiently. From my own experience, I can tell you that on the few occasions when I have been prescribed pain medication containing synthetic opioid compounds, I did not feel any relief from my endogenous depression symptoms whatsoever.
In short, while the current research may be applicable to some endogenous depression cases, it is clearly not applicable to all of them and/or to varying degrees. We certainly don’t yet have a full picture of the causes, which makes diagnosis and treatment as difficult as it currently is.