Hi Maureen, there are many who have all they need, and still feel depressed.  Perhaps we need to exercise more to release feel-good endorphines.  There is surely a lot of inter relations between brain and body.  At least, nowadays people can get medication for depression, it is treatable and can be cured, and life becomes full of meaning again.

http://www.mentalhealthamerica.net/conditions/depression

Hi Maureen,

I agree with Miranda's answer. These additional resources may interest you.

http://medical-dictionary.thefreedictionary.com/endogenous+depression

http://www.healthline.com/health/depression/endogenous-depression#Overview1

http://depressivedisorder.blogspot.com/2010/09/endogenous-depression-basics-symptoms.html

Dear Maureen! Please evaluate some more papers in the attachment. All the best. Vladimir

Anyone with depression should seek professional treatment, possibly including talk therapy and antidepressant medications.

Any form of mood disorder can also benefit by teaching the patient transcending, such as through the effective and proven Natural Stress Relief (NSR) course.

Transcending is an effortless mental technique that brings deep rest to elminate internal, stored stresses. Over time, the regular practice of transcending gradually eliminates all internal stresses, producing a flexible individual capable of peace, happiness, love, productivity, and contentment in life. Transcending also improves the success rate of standard psychiatric interventions. Join the other doctors who are currently recommending NSR for selected patients. Further information at www.nsrusa.org .

NSR is a 501(c)(3) nonprofit organization entirely run by volunteers.

Perceived poor intimate relationships being a risk fact for this disorder strikes the point that if they have difficulty with relationships with others then they may have difficulty with relationship to the self. (Inter/Intra personal)  Perception plays a large part in this disorder in that how you perceive your life is the key point not how your life actually is.  So you could have everything as you say but if you feel you have nothing then that is how you feel. More and more the chemical theories of depression are being discounted in favour of peception. 

I would warn readers that the biochemical (neurotransmitter) theory of the cause of most endogenous depression is stil the one with hard evidence, and still the one whose treatment with antidepressants is the most successful. There is certainly room for other theories and treatments (almost half of all patients are 'resistant' to the first antidepressant tried). Before taking as truth anything posted on this website, I recommend that you consult with a trained psychiatrist, someone having both experience and knowledge concerning the diagnosis and treatment of depression. This is not a medical website and the postings here should not be taken as medical advice.

Thank you David for your kind advice.  Perhaps I should have set the context a bit better when requesting info about this.  Im researching this topic for my MSc Dissertation as I am training to be a family and systemic psychotherapist and I am currently at the scooping stage in that the end result will be a Systematic Review.  My dissertation is not necessarily looking for straight medical evidence but looking at the evidence that is out there in the research world and also opinions and thoughts of people who have an interest and/or can give me some information about this.  So far I have come across research pointing towards medical intervention - but in the world (society) we live in - Im also considering whether there is the capacity for other interventions  that support the individual/family who have to live with this condition - mainly as a sole intervention or a combination - I may find that other trials have been undertaken.  Thats the benefit of research - isn't it - to question what is put out there.  I hope this explains my thoughts and considerations.

Thank you everyone for your contributions because they have given me food for thought  and broaden my horizons.

Please continue to post here as I am very interested to hear from everyone.

Best wishes

Maureen,

I have had some good reaction with depression clients.  Understand I am not the diagnosing clinician, however, I educate people in the use of mindful meditation in a non-secular basis.  You must keep with any regiment you are on medically, yet the addition of a mindfulness education and practice will give you more peace.  (Google Jon Kabbat-Zin)

Hi Maureen,

The individual (or group) psychotherapy intervention for the treatment of depression with the strongest empirical evidence is called Behavioral Activation; this is the "active ingredient" in Cognitive Behavioral Therapy. If you review the scientific literature, you will find it is as effective as medications at treating depression and more effective at preventing relapse. FYI, while there are undoubtedly cases where it makes sense to consider a purely biological source of depression (e.g., thyroid or brain disease) and to treat the underlying medical condition accordingly, there are compelling reasons to question the medical model of depression as simply reflecting a neurotransmitter imbalance (you can read more in the link below). Also, it may be worth considering that "having" everything doesn't necessarily result in fulfillment; for many (all?) people greater satisfaction is to be found in what you are "giving" through purposeful activity guided by personal values (check out the literature on Acceptance and Commitment Therapy, which combines behavioral activation, mindfulness practice, and values clarification to treat depression).

Warm regards,

Paul

http://www.christophermartell.com/ba.php

http://www.portlanddepressiontreatment.com/is-depression-just-a-chemical-imbalance/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2223147/

Paul,

I have a client who will benefit from your literature on Acceptance and Commitment Therapy, which combines behavioral activation, mindfulness practice, and values clarification to treat depression.  I hope it helps Maureen also.

Thank you,

Michael 

'Having everything' is a difficult problem for depressed people. The response is, "I have everything and I don't appreciate it. I don't appreciate the people who gave me everything. I am ungrateful. I must be a really bad person."

You asked a loaded question. I am not an expert.  I work with high school students with depression.  Is the depression clinical or medically diagnosed?  I noticed that with my students that are not either, it is a mater of where their focus is.  Example:  if their focus is on self or gossip they stay depressed.  If they change their focus to help others their depression seems to dissipate.  Clinical and medical depression are different.  Those students require medication and a lot of work.  Some of my student it is a chemical imbalance and they are medicated.  

Endogenous depression once again demonstrates how complex internal causes of brain pathology. All it complicated as the individual characteristics of a person. So, in each case requires individual approach to solving the problem.

My old tutor (a psychologist), back in the 80s, always said that when the doctors diagnose endogenous depression, it's that they just haven't asked enough questions. Didn't realise it's still a diagnosis.  Haven't heard of it in years - and I treat people with depression.

Depression, even if labeled endogenous, is about (at least felt) lack of autonomy, i.e. dependency and lack of power. Patients with diagnosis 'endogenous depression', who were separated from their partners and families - although they resisted in the beginning - recovered from the depression. So Fionnula is on the right track, I think.

The question with the ambiguous change from "you" to "I" can be read as "I gave you everything, but I feel, it was not enough" and the answer "You could not let me go – it is not always about giving".

Dirk Fabricius ,

Patients...who were separated from their partners and families...recovered from the depression.

A statement presented as fact, without qualification, citation, or attribution. I challenge it. Produce your references or withdraw your statement. It is at least an overgeneralization, at most a fabrication.

Science is not based on opinion presented as fact. It is based on evidence. I don't believe that all patients who are separated from partners and families recover from depression. As counter examples, I have known many depression patients separated in a residential hospital who did not recover from depression in any reasonable time. Separation did not provide them with any ammunition to fight their disorder that I could see.

Separation is nothing special with respect to depression. If it were, it would be a standard treatment.

The standard treatments are talk therapy and antidepressant medications.

David Spector,

you are right insofar, that I did not name my reference. Here it is: Matakas, F.& Rohrbach, E. (2005): Zur Psychodynamik der schweren Depression und die therapeutischen Konsequenzen. Psyche (Sonderheft), S. 892 - 917.

I did not say "All patients", and I did not deny, that therapy and drugs are often necessary. "At least felt …" in my statement point to the fact, that powerlessness and dependency maybe not the factual state; also, this states are often produced by the patient as "collaborator". 

Still, I would hold, that depression is not about possession, but rather about relationship, attachment and being oneself, an autonomous individual. The question was not about depression, also not about endogenous depression, but on having everything and being depressed nevertheless, thats what I understood at least.

Hi Dirk would you be able to let me have a translated version or a copy of this so that I can get it translated.  Thank you.  Best wishes

Dirk, I am trying to understand your words, but few of them seem to be precise. Are you saying that wealthy people who suffer from endogenous major depression will recover if they give their wealth away?

Not having access to your reference, I cannot verify that there is research showing that some number of depressed patients (what percentage?) recover (in what time period?) when separated from those to whom they are attached. I do not believe that this would generally be the result. I see no convincing rationale for a balance in neurotransmitters to result from separation, or for any reduction in internal stress to result, either.

It seems to me that you are too enamored of the psychodynamic approach. It has not received much experimental support compared to psychopharmcology. Adopting your interpretation of one research study as fact is not a recommended practice.

Is it really endogenic depression?  There is overlap in exogenic and endogenic, which I think supports the cause of medication+therapy.

Hello Maureen, as far as I know there is no translation. Unfortunately – retired and living in Berlin – I have no immediate access, but I hope I can send you a copy next week, when I will be in Frankfurt. Matakas & Rohrbach are part of a network, which was founded, as far as I know, by Stavros Mentzos of Goethe-University, aimed to find out the psychodynamics of psychosis and possibilities of psychotherapeutic treatments. You will find respective literature in the paper.

@ David

Just reading "Psychiatry under the influence* by Whitaker, R.& Cosgrove, L. (2015) I question the "(Im-)Balance of neurotransmitters" and psychopharmacology, separated from psycho- and sociodynamics, as core concepts and hold to a neuropsychoanalytic view. But again, I was dealing with Maureens question, which fits better in the psychodynamic domain, without stating, that this is the one and only meaningful approach in the field.

Endogenous depression emerges from bio-emotional structures deeply repressed in the individual due to their long personal bio-stresses, empty harrowing generators, psycho-physical nausea and psycho-mental disorientations. Its bio-neuropsychological dysfunctions require regressive psychotherapies techniques. It is to find, to unify and to experience their mind-body ego.