Depression (major depressive disorder) - symptoms and causes (2023)


What is depression? Mayo Clinic expert explains.

Learn more about depression from Dr. Craig Sawchuk, clinical psychologist at the Mayo Clinic.

Hi, I'm Dr. Craig Sawchuk, clinical psychologist at the Mayo Clinic. And I'm here to talk to you about depression. Whether you're looking for answers for yourself, a friend, or a loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, a lot of stigma has built up around depression. Depression is not a weakness or a character flaw. It's not about being in a bad mood, and people who suffer from depression can't just let go. Depression is a common, serious and treatable condition. If you're dealing with depression, you're not alone. It really affects people of all ages, races, biological sexes, income levels and educational levels. About one in six people will experience a major depressive episode at some point in their lives, and up to 16 million adults suffer from clinical depression each year. There are many types of symptoms that make up depression. Emotionally, you may feel sad, depressed, irritable, or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disturbed. It's very hard to get motivated. And your thinking changes. It may just be hard to concentrate. Your thoughts are much more negative. You can be very hard on yourself, feeling hopeless and helpless about things. Even in some cases you think you don't want to live. Behaviorally, you just want to withdraw and withdraw from others, activities and daily responsibilities. All of these symptoms work together to trap you in a cycle of depression. The symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. Therefore, it is important to make an accurate diagnosis.

What causes depression?

While there is no single cause of depression, most experts believe there is a combination of biological, social, and psychological factors that contribute to the risk of depression. Biologically, we mean genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that occur throughout life, such as pregnancy and menopause. Changes in brain chemistry, particularly disturbances in neurotransmitters such as serotonin, which play an important role in regulating many bodily functions, including mood, sleep and appetite, are thought to be particularly important in depression. Socially stressful and traumatic life events, limited access to resources such as food, shelter and healthcare, and lack of social support contribute to the risk of developing depression. Psychologically, we think about how negative thoughts and problematic behaviors like avoidance and substance use increase our susceptibility to depression.

The good news is that treatment helps. There are effective treatments for depression and you have the opportunity to find out what is best for you. An important first step can be lifestyle changes that improve sleep habits, exercise, and address health issues. Medications, such as antidepressants, can ease the symptoms of depression. Therapy, especially cognitive behavioral therapy, teaches you the skills to better deal with negative thoughts and improve your coping skills to help you break out of the cycle of depression. Whatever the cause, remember that depression is not your fault and is treatable.

(Video) Major Depressive Disorder | DSM-5 Diagnosis, Symptoms and Treatment

To help diagnose depression, your doctor may perform a physical exam, lab tests, or a mental health assessment. These results will help you identify the different treatment options that work best for your situation.

Help is available. You don't have to fight depression alone. Take the next step and register. If you are hesitant to talk to a healthcare professional, talk to a friend or loved one about getting help. Living with depression is not easy, and you are not alone in your struggles. Always remember that effective therapies and support exist to help you feel better. Want to know more about depression? Visit Take care of yourself.

Depression is a mood disorder that causes persistent feelings of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may find it difficult to carry out normal daily activities, and at times you may feel that life is not worth living.

More than a blues attack, depression is not a weakness and can't just be "broken". Depression may require long-term treatment. But don't be discouraged. Most people with depression feel better with medication, psychotherapy, or both.

Treating depression at the Mayo Clinic


Although depression may occur only once in a lifetime, people tend to have multiple episodes. During these episodes, symptoms occur for most of the day, almost every day, and may include:

  • Feelings of sadness, tears, emptiness or hopelessness
  • Outbursts of anger, irritation or frustration, even over minor things
  • Loss of interest or pleasure in most or all usual activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or hypersomnia
  • Fatigue and lack of energy, even small tasks require extra effort
  • Decreased appetite and weight loss or increased desire to eat and weight gain
  • Restlessness, agitation or restlessness
  • Slowing down thinking, speech or body movements
  • Feeling worthless or guilty, dwelling on past failures or blaming yourself
  • Has difficulty thinking, concentrating, making decisions and remembering
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide or attempted suicide
  • Unexplained physical problems such as back pain or headaches

For many people with depression, the symptoms are usually severe enough to cause noticeable problems in everyday activities, such as work, school, social activities, or relationships with others. Some people may feel generally unhappy or unhappy without really knowing why.

(Video) Symptoms of Major Depressive Disorder

Symptoms of depression in children and adolescents

The typical symptoms of depression in children and adolescents are similar to those in adults, but there may be some differences.

  • In younger children, symptoms of depression may include sadness, irritability, clinginess, anxiety, pain, refusal to go to school, or being underweight.
  • In adolescents, symptoms may include sadness, irritability, feelings of negativity and worthlessness, anger, poor school performance or attendance, feeling misunderstood and highly vulnerable, recreational drug or alcohol use, overeating or sleeping, self-harm, loss of interest in normal activities and avoidance of interactions social.

Symptoms of depression in the elderly

Depression is not a normal part of aging and should never be taken lightly. Unfortunately, depression in the elderly is often undiagnosed and untreated, making them hesitant to seek help. Symptoms of depression may be different or less obvious in older people, such as:

  • Memory problems or personality changes
  • Physical aches or pains
  • Fatigue, loss of appetite, trouble sleeping, or loss of interest in sex - not caused by a medical condition or medication
  • They often prefer to stay at home rather than go out socializing or doing new things
  • Suicidal thoughts or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment with a doctor or mental health professional as soon as possible. If you are hesitant to seek treatment, talk to a friend or loved one, health care professional, religious leader, or someone else you trust.

When to seek emergency help

If you think you may be hurting yourself or attempting to kill yourself, call 911 in the US or your local emergency number immediately.

Also consider these options if you are having suicidal thoughts:

  • Call your doctor or mental health professional.
  • Contact a suicide hotline.
    • In the United States, call or text 988 to arrive988 Suicide & Crisis Lifeline, dostupan24 hours a day, seven days a week. Or use itLifeline chat. The services are free and confidential.
    • Veterans or members of the US military in crisis can call 988 and then press "1".Veteran Crisis Line. Lub SMS 838255. Oronline chat.
    • Suicide & Crisis Lifeline in the US has a Spanish-language hotline at 1-888-628-9454 (toll free).
  • Contact a close friend or loved one.
  • Contact a priest, spiritual leader, or someone in your religious community.

If you have a loved one who is at risk of suicide or has attempted suicide, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do it safely, take the person to the emergency room of the nearest hospital.

More information

  • Care for depression (major depressive disorder) at the Mayo Clinic
  • Male depression: understanding the problem
  • Nervous breakdown: what does it mean?
  • Pain and depression: is there a connection?

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(Video) Signs and Symptoms of Major Depressive Disorder


It is not known exactly what causes depression. As with many mental disorders, several factors may be involved, including:

(Video) Signs of Major Depressive Disorder

  • Biological differences.People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but ultimately may help determine the cause.
  • Brain chemistry.Neurotransmitters are naturally occurring chemicals in the brain that likely play a role in depression. Recent research suggests that changes in the function and action of these neurotransmitters, and how they interact with the nervous system involved in maintaining mood stability, may play an important role in depression and its treatment.
  • hormones.Changes in the body's hormonal balance may be involved in causing or promoting depression. Hormonal changes can occur during pregnancy and in the weeks or months following delivery (postpartum) and due to thyroid problems, menopause, or many other conditions.
  • Hereditary characteristics.Depression is more common in people whose relatives also suffer from the disease. Scientists are trying to find genes that may be involved in causing depression.

More information

  • Care for depression (major depressive disorder) at the Mayo Clinic
  • marijuana and depression
  • Vitamin B-12 and depression

Risk factors

Depression often starts in the teenage years, in your 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be partly because women are more likely to seek treatment.

Factors that seem to increase your risk of developing or causing depression include:

  • Certain personality traits, such as low self-esteem and excessive dependence, self-criticism, and pessimism
  • Traumatic or stressful events, such as physical or sexual abuse, death or loss of a loved one, difficult relationship, or financial problems
  • Relatives with a history of depression, bipolar disorder, alcoholism or suicide
  • Being lesbian, gay, bisexual or transgender, or differences in genital development that are not clearly male or female (intersex) in a non-supportive situation
  • History of other mental health disorders, such as anxiety disorders, eating disorders, or post-traumatic stress disorder
  • Alcohol or recreational drug abuse
  • Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
  • certain medications, such as certain high blood pressure medications or sleeping pills (discuss with your doctor before stopping any medication)


Depression is a serious disorder that can have a terrible effect on you and your family. Depression often gets worse if left untreated, causing emotional problems, behavioral problems, and health problems that affect every area of ​​your life.

Examples of depression-related complications include:

  • Being overweight or obese, which can lead to heart disease and diabetes
  • Pain or physical illness
  • Alcohol or drug abuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts, relationship difficulties and problems at work or school
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-injury such as cutting
  • Premature death due to diseases

More information

  • Care for depression (major depressive disorder) at the Mayo Clinic
  • Depression and Anxiety: Can I Have Both?


There is no foolproof way to prevent depression. However, these strategies can help.

  • Take steps to deal with stressto boost your resilience and boost your self-esteem.
  • Reach out to family and friendsespecially in times of crisis to help you deal with difficult spells.
  • Seek treatment at the first sign of a problemto prevent depression from getting worse.
  • Consider long-term maintenance therapyto prevent symptoms from returning.
(Video) Major Depressive Disorder

Mayo Clinic personnel

November 14, 2022


What are the 8 symptoms of major depressive disorder? ›

It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.

What are four symptoms associated with depression and major depressive disorder? ›

  • Feelings of sadness, tearfulness, emptiness or hopelessness.
  • Angry outbursts, irritability or frustration, even over small matters.
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports.
  • Sleep disturbances, including insomnia or sleeping too much.
Oct 14, 2022

What are 5 causes of depression? ›

Causes - Clinical depression
  • Stressful events. Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. ...
  • Personality. ...
  • Family history. ...
  • Giving birth. ...
  • Loneliness. ...
  • Alcohol and drugs. ...
  • Illness.

Which of the following are the major causes for depression and depression like symptoms? ›

Stressful life events: Difficult experiences, such as the death of a loved one, trauma, divorce, isolation and lack of support, can trigger depression. Medical conditions: Chronic pain and chronic conditions like diabetes can lead to depression. Medication: Some medications can cause depression as a side effect.

What are the 4 major types of depression? ›

Types of major depression include melancholia, psychotic and antenatal or postnatal. You may be diagnosed with mild, moderate or severe depression. Your mental health professional may diagnose you with depression if these symptoms: happen most days.

What are the major causes of depression? ›

What causes depression?
  • Childhood experiences.
  • Life events.
  • Styles of thinking.
  • Other mental health problems.
  • Physical health problems.
  • Family history.
  • Medication.
  • Recreational drugs and alcohol.

What are the two types of major depressive disorder? ›

Major depressive disorder and persistent depressive disorder are two of the most common types of depression that people experience, however, there are many types of depression.

What are two common symptoms of major depression? ›

While each person may experience symptoms differently, these are the most common symptoms of depression: Lasting sad, anxious, or “empty” mood. Loss of interest in almost all activities. Appetite and weight changes.

What depression does to the brain? ›

Depression causes the hippocampus to raise its cortisol levels, impeding the development of neurons in your brain. The shrinkage of brain circuits is closely connected to the reduction of the affected part's function. While other cerebral areas shrink due to high levels of cortisol, the amygdala enlarges.

What are the risks of depression? ›

Risk Factors
  • Genetics: A history of depression in your family may make it more likely for you to get it. ...
  • Death or loss: Sadness and grief are normal reactions. ...
  • Conflict: Personal turmoil or disputes with family or friends may lead to depression.
  • Abuse: Past physical, sexual, or emotional abuse can bring it on, as well.
Oct 31, 2021

What things happen during a depression? ›

Symptoms of severe depression
  • fatigue (exhaustion)
  • losing pleasure in things.
  • inability to concentrate.
  • difficulty making decisions.
  • sleep disturbance.
  • appetite changes.
  • feeling guilty.
  • feeling that they're worthless.
May 3, 2023

What are three of the causes of the depression? ›

What were the major causes of the Great Depression? Among the suggested causes of the Great Depression are: the stock market crash of 1929; the collapse of world trade due to the Smoot-Hawley Tariff; government policies; bank failures and panics; and the collapse of the money supply.

What is one of the three main types of depression? ›

Psycom explains the different types of depression, from major depressive disorder, to dysthymia, postpartum depression, seasonal affective disorder and more. Depression is more than just feeling sad.

What is the most common factor of depression? ›

Common Causes of Depression
  • Genetics.
  • Brain chemistry.
  • Certain medical conditions.
  • Substance use.
  • Stress.
  • Poor nutrition.
Mar 2, 2022

What are the 7 forms of depression? ›

7 Common Types of Depression
  • Major Depressive Disorder (MDD) ...
  • Persistent Depressive Disorder (PDD) ...
  • Bipolar Disorder. ...
  • Postpartum Depression (PPD) ...
  • Premenstrual Dysphoric Disorder (PMDD) ...
  • Seasonal Affective Disorder (SAD) ...
  • Atypical Depression.

What are the three core symptoms of depression? ›

The psychological symptoms of depression include: continuous low mood or sadness. feeling hopeless and helpless. having low self-esteem.

What are three ways to look at depression symptoms? ›

10 everyday signs of depression
  • Persistent low mood. ...
  • Loss of interest or pleasure in things you once enjoyed. ...
  • Feelings of guilt, hopelessness, or worthlessness. ...
  • Loss of sex drive. ...
  • Decreased energy, fatigue, or feeling slowed down. ...
  • Difficulty concentrating, remembering, or making decisions. ...
  • Trouble sleeping.
Jun 23, 2021

What is the hardest type of depression? ›

Clinical depression is the more-severe form of depression, also known as major depression or major depressive disorder. It isn't the same as depression caused by a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder.

How long do depressive episodes last? ›

Sometimes, depression symptoms will last for only a few weeks. For many people though, untreated depression could last months and even years. Regardless of how long you've experienced depression, the condition is treatable. In fact, seeking the support of a professional often helps symptoms resolve much sooner.

Is depression a form of mental illness? ›

Depression is a common mental disorder. Globally, it is estimated that 5% of adults suffer from the disorder. It is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities.

Is major depression disorder a disability? ›

Yes. People with depression are protected under the Americans with Disabilities Act (ADA). The ADA defines a person with a disability as anyone who: Has a physical or mental health problem that “substantially limits” at least one major life activity — this could be working or taking care of yourself.

How do people get diagnosed with depression? ›

To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.

Is major depressive disorder the same as bipolar? ›

Bipolar disorder and major depressive disorder are both mood disorders. They are similar in that both include periods of feeling low mood or lack of in everyday activities. Bipolar disorder, formerly called "manic depression" has periods of mania; depression does not.

Is major depressive disorder curable? ›

There's no cure for depression, but you still have plenty of options for treatment, all of which can improve your symptoms and minimize their impact on your daily life.

What is another name for major depressive disorder? ›

Clinical depression, also known as major depressive disorder (MDD), is a mental health condition that causes a persistently low or depressed mood and a loss of interest in activities that once brought joy.

What makes major depressive disorder different? ›

Major depressive disorder and minor depressive disorder (also known as “everyday depression”) are different in several ways. Most prominently, however, those with major depressive disorder experience more symptoms at a higher level of intensity than those with minor depressive disorder.

Who gets affected by depression? ›

Who Is Affected by Depression?
  • Major depressive disorder affects approximately 17.3 million American adults, or about 7.1% of the U.S. population age 18 and older, in a given year. ( ...
  • Major depressive disorder is more prevalent in women than in men. ( ...
  • 1.9 million children, 3 – 17, have diagnosed depression. (

What is stage 2 depression? ›

Stage 2: Establishment

This is the stage where depression starts to settle in and become the norm. Sadness, apathy, and general lack of interest may start to become the norm. You might start to feel less interest in things that you used to take great pleasure in.

Can the brain heal from depression? ›

Dendrites are cellular extensions found in the neurons, or nerve cells. This suggests that depression is not an irreversible neurodegenerative disorder. Instead, its impact on the brain may be reversible, and the brain can heal.

Can depression cause permanent brain damage? ›

The majority of changes and damage to the brain caused by untreated depression are not believed to be permanent, but more research is still needed. When depression is effectively treated, most people commonly experience an improvement in symptoms, and their brains return to typical function and structure.

Can untreated depression cause brain damage? ›

Years of untreated depression may lead to neurodegenerative levels of brain inflammation.

What are 2 things a person should do if they feel depressed? ›

Take care of yourself
  • Ask for help. Caring for someone with depression isn't easy. Ask other relatives or friends to help. ...
  • Take steps to stay healthy. Find time for yourself. ...
  • Be patient. Depression symptoms improve with treatment, but it can take time.

How do doctors treat depression? ›

There are various treatment options for depression. They include psychological treatments, medication and general measures such as relaxation techniques. Different treatment options are often combined. Depression is one of the most common mental illnesses.

Why is depression a serious problem? ›

It's important to seek support as early as possible, as the sooner a person gets treatment, the sooner they can recover. Untreated depression can have many negative effects on a person's life, including serious relationship and family problems, difficulty finding and holding down a job, and drug and alcohol problems.

What will happen if depression is not treated? ›

Untreated depression increases the chance of risky behaviors such as drug or alcohol addiction. It also can ruin relationships, cause problems at work, and make it difficult to overcome serious illnesses. Clinical depression, also known as major depression, is an illness that involves the body, mood, and thoughts.

What does the Bible say about depression? ›

Psalm 9:9. “The Lord is a stronghold for the oppressed, a stronghold in times of trouble.” The Good News: Depression can make you feel as though you're weighed down. But no matter how troubled you feel, this verse reminds you that the Lord is always there to support you.

How does depression affect the life of a person? ›

Depression affects your mood, thoughts, feelings, behaviors and physical health. Severe depression can result in losing the ability to feel pleasure in the things you once enjoyed. It can also cause you to withdraw from your social relationships even from people to whom you are closest.

What are the cause and effect of depression? ›

Stress, unhealthy diet, and limited exercise are all common parts of being depressed that might contribute to heart problems in the future. Sleep issues. Sleep changes are extremely common among depressed individuals and can include both insomnia and over-sleeping.

Is depression a chemical imbalance in the brain? ›

Introduction. The idea that depression is the result of abnormalities in brain chemicals, particularly serotonin (5-hydroxytryptamine or 5-HT), has been influential for decades, and provides an important justification for the use of antidepressants.

What are the different types of people with depression? ›

Types of Depression
  • Major Depression.
  • Persistent Depressive Disorder.
  • Bipolar Disorder.
  • Seasonal Affective Disorder (SAD)
  • Psychotic Depression.
  • Peripartum (Postpartum) Depression.
  • Premenstrual Dysphoric Disorder (PMDD)
  • 'Situational' Depression.
Jun 23, 2021

What is a characteristic of most types of depression? ›

Feeling hopeless/worthless:

Negative thoughts about life and worldly things. Feeling guilty and not worth living.

What is the most serious complication of major depression? ›

Individuals with MDD are at a high risk of developing comorbid anxiety disorders and substance use disorders, which further increases their risk of suicide. Depression can aggravate medical comorbidities such as diabetes, hypertension, chronic obstructive pulmonary disease, and coronary artery disease.

How can you prevent major depression? ›

But you can:
  1. Find ways to handle stress and improve your self-esteem.
  2. Take good care of yourself. Get enough sleep, eat well, and exercise regularly.
  3. Reach out to family and friends when times get hard.
  4. Get regular medical checkups, and see your provider if you don't feel right.
  5. Get help if you think you're depressed.
Sep 17, 2021

What are 3 key factors related to major depressive disorder? ›

Environmental stressors associated with depression include acute life events, chronic stress, and childhood exposure to adversity. Personal vulnerabilities associated with depression include cognitive, interpersonal, and personality factors.

What are two core symptoms of major depressive disorder? ›

Depressed mood” and “loss of interest or pleasure in nearly all activities” are core features of a major depressive episode, though a strong case can be made to pay increasing attention to symptoms of fatigue, sleep disturbance, anxiety, and neurocognitive and sexual dysfunction in the diagnosis and evaluation of ...

What are the 2 key features of a major depressive episode? ›

Clinical depression (major depressive disorder) causes a persistently low or depressed mood and a loss of interest in activities that you used to enjoy. The symptoms must last for at least two weeks to receive a diagnosis.

What are 10 major causes of depression? ›

What causes depression?
  • Childhood experiences.
  • Life events.
  • Styles of thinking.
  • Other mental health problems.
  • Physical health problems.
  • Family history.
  • Medication.
  • Recreational drugs and alcohol.

Who is most likely to develop major depressive disorder? ›

People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression.

What are four patient behaviors you would associate with major depressive disorder? ›

9 Major Depression Nursing Care Plans
  • Persistently low or depressed mood.
  • Anhedonia or decreased interest in pleasurable activities.
  • Feelings of guilt or worthlessness.
  • Lack of energy.
  • Poor concentration.
  • Appetite changes.
  • Psychomotor retardation or agitation.
  • Sleep disturbances.
Jun 2, 2023

What is a major depressive disorder most likely to be characterized by? ›

Major depressive disorder (MDD) is a debilitating disease that is characterized by depressed mood, diminished interests, impaired cognitive function and vegetative symptoms, such as disturbed sleep or appetite.

What are 3 signs of clinical depression? ›

The psychological symptoms of depression include:
  • continuous low mood or sadness.
  • feeling hopeless and helpless.
  • having low self-esteem.
  • feeling tearful.
  • feeling guilt-ridden.
  • feeling irritable and intolerant of others.
  • having no motivation or interest in things.
  • finding it difficult to make decisions.

What is the difference between major depressive disorder and major depressive episode? ›

Unsourced material may be challenged and removed. A major depressive episode (MDE) is a period characterized by the symptoms of major depressive disorder. Those affected primarily have a depressed mood for at least two weeks or more, and a loss of interest or pleasure in everyday activities.

How many symptoms must be present for major depressive disorder? ›

Major Depressive Episode:

- 5 or more depressive symptoms for ≥ 2 weeks. - Must have either depressed mood or loss of interest/pleasure. - Symptoms must cause significant distress or impairment. - No manic or hypomanic behavior.

Is major depressive disorder a disability? ›

Yes. People with depression are protected under the Americans with Disabilities Act (ADA). The ADA defines a person with a disability as anyone who: Has a physical or mental health problem that “substantially limits” at least one major life activity — this could be working or taking care of yourself.


1. Physical Symptoms of Depression
(Psych Hub)
2. Behavior Changes During Depression
(Psych Hub)
3. Bipolar disorder (depression & mania) - causes, symptoms, treatment & pathology
(Osmosis from Elsevier)
4. Depression Explained (Major Depressive Disorder)
(Rhesus Medicine)
5. Major Depressive Disorder | Clinical Presentation
6. Major Depressive Disorder (MDD): Symptoms and Treatments


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