What’s the difference between endogenous depression and exogenous depression (aka reactive depression)?

Endogenous Depression Results


An endogenous depression is there regardless of events in the outside world, although they can definitely exacerbate it. An exogenous depression is caused by adverse life events, environmental factors (nasty weather does it to some extent for most of us, for example) and has nothing to do with neurochemistry. The term “reactive depression” is perhaps more telling, in the sense that it helps one to put one’s finger on the main difficulty endogenous depression sufferers have to deal with in their relationships with the people around them.

Why reactive depression sufferers have it easy compared to endogenous depression sufferers.

People who don’t suffer from mood disorders only know that which they’ve experienced themselves and since their moods are, in the vast majority of cases, influenced by things happening to them and/or certain things in their environment, they can’t conceive of the concept that someone might be depressed independently of or indeed despite external events and environmental influences. To them, someone suffering from a depression on a balmy, sunny day, after they’ve just left their fulfilling, prestigious and well-paying job to go home to a beautiful and open-minded spouse via a bar where everyone knows their name and a short stop at their lover’s place (who, incidentally, is as physically attractive as he or she is unassuming) is beyond comprehension – after all, he or she is depressed ‘for no reason’. According to them, the sufferer just needs to get his or head ‘right’ – realize how good he or she has it and voila – problem solved, no more depression, because how can anyone ever be depressed about having such a fairy-tale life? To them, depression for ‘no reason’ (in fact, there is a reason, it just isn’t either identifiable, tangible or corrigible in the outside world they share with the sufferer) is no depression at all, it isn’t valid and the sufferer’s very real suffering isn’t real at all.

All types of depression are tough and I wouldn’t wish any of them on anyone. It isn’t a competition either, in the style of ‘my depression is worse than your depression‘. With that said, as difficult as it is to deal with the mess in your own head, its even more difficult to deal with the lack of support from those around us (if we’re lucky) and active disdain and derision for our weak-mindedness (if we’re not). Reactive depression sufferers can usually count on others to say ‘give the guy a break, his wife has just left him, his house has burnt down together with his incredible collection of rare bonsai trees his grandfather, whom he loved dearly, had brought back from Japan to be passed down through generations as a family heirloom and he now lives under a bridge with an ugly, old woman and has to suck stones for money’, which will usually grant them all kinds of leeway in social settings, but the best an endogenous depression sufferer can hope for is ‘leave that guy alone, he’s a moody so-and-so’.

How to explain that you don’t have reactive depression and what that means.

What I’ve found helpful is to draw parallels with an experience non-sufferers may have had. In a not particularly sunny climate, light seasonal depressions are quite common. The lack of sunlight in the winter causes a vitamin D deficiency, which in turn (it is thought) negatively affects a person’s baseline sense of well-being. How severe this is depends on each person’s individual sensitivity, but it is common enough to be noticed. Ask them to remember what the difference between the last gloomy day of the winter and the first really sunny day of the spring was in terms of how they felt; now explain to them that for you, it isn’t as simple as a sunny day or a vitamin D supplement.

Depression-related quote of the day.

It isn’t cheerful or helpful this time, but it underscores what I’ve written above:

Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem.
- David Burns

Can’t leave it at that, can we, so here goes:

Curiosity endows the people who have it with a generosity in argument and a serenity in their own mode of life which springs from their cheerful willingness to let life take the form it will.
- Alistair Cooke

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