In my day working in mental health services there were clinically 2 types of depression: 1. Endogenous, thought to be organic in origin. 2. Reactive, thought to be as the word suggests, when situations and/or circumstances provoke depressive reactions.
Endogenous depression was much harder to treat, partly because the cause was not easy to identify and therefore not accesible to talking therapies, although psychologists would argue that cognitive behavioural therapy has a part to play. It is also true that those unfortunate enough to suffer with endogenous depression may suffer psychotic episodes that are often extremely distressing. Although not a fan of electric convulsive therapy it is true to say it can be useful in breaking the cycle and allow a patient to regain touch with reality as most of us experience it. This also allows the patient to perhaps learn coping strategies and for loved ones and the patient to recognise signs of relapse before ideas of self harm intrude.. Medications can have a part to play in both types of depression but needs careful consideration and application. Hope this helps..
