b. Types of Depression. Depression may be classified as either exogenous or
endogenous. Exogenous depression is often referred to as situational depression
because it comes from something outside the person. Possible causes include the loss
of a loved one (death or departure of a parent or child); loss of self-esteem due to
business failure, rejection, or divorce; or inability to express or admit anger toward
others ("holding it in"). Endogenous depression just comes out of the blue and is not
caused by any situation or event. It may be caused by a chemical imbalance in the
brain. Much research in this area indicates that this type of depression may be due to
some mental illness or even a dietary deficiency. Endogenous depression, the type that
comes out of the blue, is more severe than exogenous depression. The patient may
need to have psychiatric help immediately.
c. Signs and Symptoms of Severe Depression: General. There are a
number of signs and symptoms of severe depression. Included are the following:
Trouble with concentration and memory.
Feelings of guilt about inconsequential events.
Insomnia or excessive sleepiness.
Feelings of hopelessness and worthlessness.
Withdrawal from activities and interests.
Decreased interactions with family and friends.
Decreased work productivity.
Decreased relationship with coworkers.
Changes in bowel habits.
(10) Weight loss or gain.
(11) Decreased libido (sexual drive).
(12) Slowed speech and/or motor activity.
d. Signs and Symptoms of Severe Depression: Symptom Clusters. An
individual suffering from severe depression will usually have more than just one sign or
symptom. He may have several signs/symptoms--a cluster of signs/symptoms.