Endogenous Depression, Manic Depression,Major Depression and Just Plain Depression, Why Are They Different?

Question by Moxie: Endogenous depression, manic depression,major depression and just plain depression, why are they different?
How do we know the psych chose the right depression diagnosis?

Best answer:

Answer by Megumi D
Each of these depressive disorders is different because they have different symptoms and different etiologies (“sources”). Bipolar disorder (once called “manic depression”) and Major Depression are clinical, diagnostic categories in the DSM-IV TR, which has the diagnostic criteria for all of the psychiatric disorders.

“Endogenous depression” is not a clinical diagnosis, it describes a long-term depression that did not have a situational component. “Just plain depression” (I think you are talking about a depressed mood) is a mood, and may be a component of another disorder, such as schizophrenia or PTSD.

Bipolar disorder is a combination of mania, a very excitable mood that is like the “opposite” of a depressed mood, and depression. It has a strong genetic component, and is a separate disorder from Major Depression. It has several other diagnostic criteria, which must be present before a formal diagnosis of the disorder can be made.

Major Depression (also called “Unipolar disorder”) has multiple diagnostic criteria, such as depressed mood most of the time, most every day; anhedonia (lack of experiencing pleasure); thoughts of death; anger and agitation; impairment to social functioning; and several other criteria, a specified number of which must be present before a formal diagnosis of the disorder can be made.

There is also a disorder called Dysthymia, which is a “minor depression”. It is less severe than Major Depression, and has fewer criteria that must be met in order to make the diagnosis.

Sooo–bipolar d/o and major depressive d/o are formally diagnosed disorders; “depression” or a “depressed mood” (also called “dysphoria”) may be a component of many other clinical disorders. “Endogenous depression” is a depressed mood that does not have a component that is found in the person’s environment; nothing has happened, in particular, that would cause the individual to feel depressed.

When a psych makes a diagnosis, it is done after a rather lengthy interview or assessment process. Then, s/he reviews the person’s symptoms to see which criteria are present for what diagnosis. All the disorders are listed in the DSM-IV TR, with the criteria that must be met in order to make each diagnosis. If the patient has given accurate information to the clinician, then the clinician can make an accurate diagnosis. The DSM-IV TR is a book that is published by the American Psychiatric Association, and each and every mental health clinician uses it to diagnose disorders. You can check it out in a library, or you can go to BehaveNet.com “Clinical Capsules” webpages to look up the diagnostic criteria for any of the disorders in the DSM. For the depressive disorders, go to the section marked “Mood Disorders”. The web address is http://www.BehaveNet.com/capsules/disorders/dsm4TRclassification.htm#Mood That way, you can check it out to see if you think the psych got it right or not. After a few years in practice, most psychs sort of get a feel for diagnosing disorders…Diagnosis can be complicated because there are both “Axis I” disorders and “Axis II” personality disorders (as well as Axis III Physical Disorders) that sometimes interact with each other. A depressed mood can be a symptom of, for example, the Axis II diagnosis, Borderline Personality Disorder, which is often complicated by the Axis I disorder, Major Depressive Disorder. Hypothyroidism, for example, can also cause a depressed mood.

Answer by opester
Endogenous depression simply refers to depression in which there was no evidence of a stressor or precipitant associated with its onset. It is also thought to have a very definitive biological basis.
Manic Depression is now known as Bipolar Disorder and the following info from one of my previous posts describes it:
Bipolar Disorder comes in 2 forms, Bipolar I and Bipolar II. Bipolar I is the type most people think of where someone experiences shifts between depression, mania and/or mixed episodes. Bipola II is most like recurrent major depressive episodes interspersed with hypomanic episodes (which do not reach the level of a mania). The following is a general description of some of the criteria for depression and mania, but you should not attempt diagnosis yourself. You can check the exact criteria in a DSM IV and a thorough history needs to be taken for accurate diagnosis and assessment.
Criteria for Depression are five of the following during a 2 week period:
1) depressed mood more days than not, can be just irritable in adolescents and children and frequently men show more irritability
2) decreased or increased appetite accompanied by weight gain or loss
3) hypersomnia or insomnia
4) recurrent thoughts of death or dying, suicidal ideation
5) observable psychomotor retardation or agitation
5) anhedonia (loss of interest in previous pleasurable activities)
6) subjective feelings of restlessness or being slowed down
7) Difficulty concentrating and/or making decisions
Criteria for a Mania:
1) Decreased need for sleep without feeling tired despite only several hours per night or no sleep
2) Pressured speech that is difficult to interrupt(talking very rapidly and loudly with pressure to keep talking)
3) Flight of Ideas or “racing thoughts”
4) Increased energy
5) Engaging in a flurry of goal-directed activity-either impulsive behavior that has a high potential for damaging consequences-spending money, reckless driving, sexual promiscuity, etc. or excessively overproductive with respect to work
6) a consistently elevated or “high” mood or a consistently irritable mood
7) grandiose delusions-seeing oneself as more important or powerful than they truly are but in delusional proportions, not simply inflated self-esteem

Bipolar II is similar but the manic symtoms are less severe and rarely warrant hospitalization as they do not reach psychotic levels.

Additionally there is a condition called cyclothymia where a person cycles between hypomania and dysthymia (milder depression).

The condition most often has a genetic component and often there are first degree relatives with the disorder. there is also a higher prevalence of other mood disorders and eating disorders and alcoholism among relatives.

Major Depression consists of the same symptoms as identified above for the depressive episode and without any history of mania or hypomania. Major Depression is classified as either Single Episode (first episode) or Recurrent (more than one occurence) and the criteria to diagnose it requires the presence of multiple symptoms to be present for a minimum of 2 weeks.

“plain depression” may be an adjustment disorder (not usually medicated) in which a person has minimal symptoms of less than 6 months duration in reaction to an identifiable stressor. You may also be thinking of Dysthymia, which is a lower level depressive disorder with primary symptoms of low mood more days than not and low self-esteem for a minimum duration of at least 2 years. (Think of the character of the donkey in Winnie the Pooh and you have a good picture of Dysthymia)

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