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aria-controls="toc-Pathophysiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Pathophysiology subsection </button> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> <li id="toc-Immune_pathogenesis_theories_on_depression" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Immune_pathogenesis_theories_on_depression"> <div class="vector-toc-text"> 3.1 Immune pathogenesis theories on depression </div> </a> <ul id="toc-Immune_pathogenesis_theories_on_depression-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 4 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Assessment" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Assessment"> <div class="vector-toc-text"> 4.1 Assessment </div> </a> <ul id="toc-Assessment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-DSM_and_ICD_criteria" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#DSM_and_ICD_criteria"> <div class="vector-toc-text"> 4.2 DSM and ICD criteria </div> </a> <ul id="toc-DSM_and_ICD_criteria-sublist" class="vector-toc-list"> <li id="toc-Major_depressive_episode" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Major_depressive_episode"> <div class="vector-toc-text"> 4.2.1 Major depressive episode </div> </a> <ul id="toc-Major_depressive_episode-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Subtypes" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Subtypes"> <div class="vector-toc-text"> 4.2.2 Subtypes </div> </a> <ul id="toc-Subtypes-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Differential_diagnoses" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential_diagnoses"> <div class="vector-toc-text"> 4.3 Differential diagnoses </div> </a> <ul id="toc-Differential_diagnoses-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Screening_and_prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Screening_and_prevention"> <div class="vector-toc-text"> 5 Screening and prevention </div> </a> <ul id="toc-Screening_and_prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 6 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Lifestyle" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lifestyle"> <div class="vector-toc-text"> 6.1 Lifestyle </div> </a> <ul id="toc-Lifestyle-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Talking_therapies" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Talking_therapies"> <div class="vector-toc-text"> 6.2 Talking therapies </div> </a> <ul id="toc-Talking_therapies-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antidepressants" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antidepressants"> <div class="vector-toc-text"> 6.3 Antidepressants </div> </a> <ul id="toc-Antidepressants-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_medications_and_supplements" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_medications_and_supplements"> <div class="vector-toc-text"> 6.4 Other medications and supplements </div> </a> <ul id="toc-Other_medications_and_supplements-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Electroconvulsive_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Electroconvulsive_therapy"> <div class="vector-toc-text"> 6.5 Electroconvulsive therapy </div> </a> <ul id="toc-Electroconvulsive_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other"> <div class="vector-toc-text"> 6.6 Other </div> </a> <ul id="toc-Other-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> 7 Prognosis </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prognosis subsection </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Ability_to_work" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ability_to_work"> <div class="vector-toc-text"> 7.1 Ability to work </div> </a> <ul id="toc-Ability_to_work-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Life_expectancy_and_the_risk_of_suicide" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Life_expectancy_and_the_risk_of_suicide"> <div class="vector-toc-text"> 7.2 Life expectancy and the risk of suicide </div> </a> <ul id="toc-Life_expectancy_and_the_risk_of_suicide-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 8 Epidemiology </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Epidemiology subsection </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-Comorbidity" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Comorbidity"> <div class="vector-toc-text"> 8.1 Comorbidity </div> </a> <ul id="toc-Comorbidity-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 9 History </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> 10 Society and culture </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Society and culture subsection </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Terminology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Terminology"> <div class="vector-toc-text"> 10.1 Terminology </div> </a> <ul id="toc-Terminology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cultural_dimension" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cultural_dimension"> <div class="vector-toc-text"> 10.2 Cultural dimension </div> </a> <ul id="toc-Cultural_dimension-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Stigma" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Stigma"> <div class="vector-toc-text"> 10.3 Stigma </div> </a> <ul id="toc-Stigma-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 11 References </div> </a> <button aria-controls="toc-References-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle References subsection </button> <ul id="toc-References-sublist" class="vector-toc-list"> <li id="toc-Cited_works" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cited_works"> <div class="vector-toc-text"> 11.1 Cited works </div> </a> <ul id="toc-Cited_works-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Major depressive disorder</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 90 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-90" aria-hidden="true" > 90 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Kliniese_depressie" title="Kliniese depressie – Afrikaans" lang="af" hreflang="af" data-title="Kliniese depressie" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target">Afrikaans</a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D8%B6%D8%B7%D8%B1%D8%A7%D8%A8_%D8%A7%D9%83%D8%AA%D8%A6%D8%A7%D8%A8%D9%8A" title="اضطراب اكتئابي – Arabic" lang="ar" hreflang="ar" data-title="اضطراب اكتئابي" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%97%E0%A7%81%E0%A7%B0%E0%A7%81%E0%A6%A4%E0%A7%B0_%E0%A6%85%E0%A7%B1%E0%A6%B8%E0%A6%BE%E0%A6%A6%E0%A6%9C%E0%A6%A8%E0%A6%BF%E0%A6%A4_%E0%A6%AC%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A7%E0%A6%BF" title="গুৰুতৰ অৱসাদজনিত ব্যাধি – Assamese" lang="as" hreflang="as" data-title="গুৰুতৰ অৱসাদজনিত ব্যাধি" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target">অসমীয়া</a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Trestornu_depresivu_mayor" title="Trestornu depresivu mayor – Asturian" lang="ast" hreflang="ast" data-title="Trestornu depresivu mayor" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target">Asturianu</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Depressiya" title="Depressiya – Azerbaijani" lang="az" hreflang="az" data-title="Depressiya" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%AF%DB%8C%D9%BE%D8%B1%D8%A6%D8%B3%DB%8C%D9%88_%D8%A8%D9%88%D8%B2%D9%88%DA%A9%D9%84%D9%88%DA%AF%D9%88" title="دیپرئسیو بوزوکلوگو – South Azerbaijani" lang="azb" hreflang="azb" data-title="دیپرئسیو بوزوکلوگو" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target">تۆرکجه</a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%97%E0%A7%81%E0%A6%B0%E0%A7%81%E0%A6%A4%E0%A6%B0_%E0%A6%AC%E0%A6%BF%E0%A6%B7%E0%A6%BE%E0%A6%A6%E0%A6%9C%E0%A6%A8%E0%A6%BF%E0%A6%A4_%E0%A6%AC%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A7%E0%A6%BF" title="গুরুতর বিষাদজনিত ব্যাধি – Bangla" lang="bn" hreflang="bn" data-title="গুরুতর বিষাদজনিত ব্যাধি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target">বাংলা</a></li><li class="interlanguage-link interwiki-zh-min-nan mw-list-item"><a href="https://zh-min-nan.wikipedia.org/wiki/Iu-ut-ch%C3%A8ng" title="Iu-ut-chèng – Minnan" lang="nan" hreflang="nan" data-title="Iu-ut-chèng" data-language-autonym="閩南語 / Bân-lâm-gú" data-language-local-name="Minnan" class="interlanguage-link-target">閩南語 / Bân-lâm-gú</a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%94%D1%8D%D0%BF%D1%80%D1%8D%D1%81%D1%96%D1%8F" title="Дэпрэсія – Belarusian" lang="be" hreflang="be" data-title="Дэпрэсія" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target">Беларуская</a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%94%D1%8D%D0%BF%D1%80%D1%8D%D1%81%D1%96%D1%8F" title="Дэпрэсія – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Дэпрэсія" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target">Беларуская (тарашкевіца)</a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%93%D0%BE%D0%BB%D1%8F%D0%BC%D0%BE_%D0%B4%D0%B5%D0%BF%D1%80%D0%B5%D1%81%D0%B8%D0%B2%D0%BD%D0%BE_%D1%80%D0%B0%D0%B7%D1%81%D1%82%D1%80%D0%BE%D0%B9%D1%81%D1%82%D0%B2%D0%BE" title="Голямо депресивно разстройство – Bulgarian" lang="bg" hreflang="bg" data-title="Голямо депресивно разстройство" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target">Български</a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Klini%C4%8Dka_depresija" title="Klinička depresija – Bosnian" lang="bs" hreflang="bs" data-title="Klinička depresija" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target">Bosanski</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Depressi%C3%B3_major" title="Depressió major – Catalan" lang="ca" hreflang="ca" data-title="Depressió major" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Deprese" title="Deprese – Czech" lang="cs" hreflang="cs" data-title="Deprese" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-da badge-Q17559452 badge-recommendedarticle mw-list-item" title="recommended article"><a href="https://da.wikipedia.org/wiki/Depression_(psykisk)" title="Depression (psykisk) – Danish" lang="da" hreflang="da" data-title="Depression (psykisk)" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-se mw-list-item"><a href="https://se.wikipedia.org/wiki/Depre%C5%A1uvdna" title="Deprešuvdna – Northern Sami" lang="se" hreflang="se" data-title="Deprešuvdna" data-language-autonym="Davvisámegiella" data-language-local-name="Northern Sami" class="interlanguage-link-target">Davvisámegiella</a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Depression" title="Depression – German" lang="de" hreflang="de" data-title="Depression" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Depressioon" title="Depressioon – Estonian" lang="et" hreflang="et" data-title="Depressioon" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target">Eesti</a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9C%CE%B5%CE%AF%CE%B6%CF%89%CE%BD_%CE%BA%CE%B1%CF%84%CE%B1%CE%B8%CE%BB%CE%B9%CF%80%CF%84%CE%B9%CE%BA%CE%AE_%CE%B4%CE%B9%CE%B1%CF%84%CE%B1%CF%81%CE%B1%CF%87%CE%AE" title="Μείζων καταθλιπτική διαταραχή – Greek" lang="el" hreflang="el" data-title="Μείζων καταθλιπτική διαταραχή" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target">Ελληνικά</a></li><li class="interlanguage-link interwiki-eml mw-list-item"><a href="https://eml.wikipedia.org/wiki/Dist%C3%B9rub_depres%C3%AC%E1%B9%BF" title="Distùrub depresìṿ – Emiliano-Romagnolo" lang="egl" hreflang="egl" data-title="Distùrub depresìṿ" data-language-autonym="Emiliàn e rumagnòl" data-language-local-name="Emiliano-Romagnolo" class="interlanguage-link-target">Emiliàn e rumagnòl</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Trastorno_depresivo_mayor" title="Trastorno depresivo mayor – Spanish" lang="es" hreflang="es" data-title="Trastorno depresivo mayor" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Depresio_(medicino)" title="Depresio (medicino) – Esperanto" lang="eo" hreflang="eo" data-title="Depresio (medicino)" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Depresio-nahasmendu_larri" title="Depresio-nahasmendu larri – Basque" lang="eu" hreflang="eu" data-title="Depresio-nahasmendu larri" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target">Euskara</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D8%AE%D8%AA%D9%84%D8%A7%D9%84_%D8%A7%D9%81%D8%B3%D8%B1%D8%AF%DA%AF%DB%8C_%D8%B9%D9%85%D8%AF%D9%87" title="اختلال افسردگی عمده – Persian" lang="fa" hreflang="fa" data-title="اختلال افسردگی عمده" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fo mw-list-item"><a href="https://fo.wikipedia.org/wiki/Tunglyndi" title="Tunglyndi – Faroese" lang="fo" hreflang="fo" data-title="Tunglyndi" data-language-autonym="Føroyskt" data-language-local-name="Faroese" class="interlanguage-link-target">Føroyskt</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/D%C3%A9pression_(psychiatrie)" title="Dépression (psychiatrie) – French" lang="fr" hreflang="fr" data-title="Dépression (psychiatrie)" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-fy mw-list-item"><a href="https://fy.wikipedia.org/wiki/Klinyske_depresje" title="Klinyske depresje – Western Frisian" lang="fy" hreflang="fy" data-title="Klinyske depresje" data-language-autonym="Frysk" data-language-local-name="Western Frisian" class="interlanguage-link-target">Frysk</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Trastorno_depresivo_maior" title="Trastorno depresivo maior – Galician" lang="gl" hreflang="gl" data-title="Trastorno depresivo maior" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-gu mw-list-item"><a href="https://gu.wikipedia.org/wiki/%E0%AA%AE%E0%AB%87%E0%AA%9C%E0%AA%B0_%E0%AA%A1%E0%AA%BF%E0%AA%AA%E0%AB%8D%E0%AA%B0%E0%AB%87%E0%AA%B8%E0%AA%BF%E0%AA%B5_%E0%AA%A1%E0%AA%BF%E0%AA%B8%E0%AA%93%E0%AA%B0%E0%AB%8D%E0%AA%A1%E0%AA%B0" title="મેજર ડિપ્રેસિવ ડિસઓર્ડર – Gujarati" lang="gu" hreflang="gu" data-title="મેજર ડિપ્રેસિવ ડિસઓર્ડર" data-language-autonym="ગુજરાતી" data-language-local-name="Gujarati" class="interlanguage-link-target">ગુજરાતી</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%A3%BC%EC%9A%94_%EC%9A%B0%EC%9A%B8_%EC%9E%A5%EC%95%A0" title="주요 우울 장애 – Korean" lang="ko" hreflang="ko" data-title="주요 우울 장애" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Babban_rashin_damuwa" title="Babban rashin damuwa – Hausa" lang="ha" hreflang="ha" data-title="Babban rashin damuwa" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target">Hausa</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%84%D5%A5%D5%AE_%D5%A4%D5%A5%D5%BA%D6%80%D5%A5%D5%BD%D5%AB%D5%BE_%D5%AD%D5%A1%D5%B6%D5%A3%D5%A1%D6%80%D5%B8%D6%82%D5%B4" title="Մեծ դեպրեսիվ խանգարում – Armenian" lang="hy" hreflang="hy" data-title="Մեծ դեպրեսիվ խանգարում" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%8F%E0%A4%95%E0%A4%A7%E0%A5%8D%E0%A4%B0%E0%A5%81%E0%A4%B5%E0%A5%80%E0%A4%AF_%E0%A4%85%E0%A4%B5%E0%A4%B8%E0%A4%BE%E0%A4%A6" title="एकध्रुवीय अवसाद – Hindi" lang="hi" hreflang="hi" data-title="एकध्रुवीय अवसाद" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target">हिन्दी</a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Klini%C4%8Dka_depresija" title="Klinička depresija – Croatian" lang="hr" hreflang="hr" data-title="Klinička depresija" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target">Hrvatski</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Gangguan_depresi_mayor" title="Gangguan depresi mayor – Indonesian" lang="id" hreflang="id" data-title="Gangguan depresi mayor" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/%C3%9Eunglyndi_(ge%C3%B0r%C3%B6skun)" title="Þunglyndi (geðröskun) – Icelandic" lang="is" hreflang="is" data-title="Þunglyndi (geðröskun)" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target">Íslenska</a></li><li class="interlanguage-link interwiki-it badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://it.wikipedia.org/wiki/Disturbo_depressivo" title="Disturbo depressivo – Italian" lang="it" hreflang="it" data-title="Disturbo depressivo" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%99%D7%9B%D7%90%D7%95%D7%9F_%D7%A7%D7%9C%D7%99%D7%A0%D7%99" title="דיכאון קליני – Hebrew" lang="he" hreflang="he" data-title="דיכאון קליני" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%AA%E0%B3%8D%E0%B2%B0%E0%B2%A7%E0%B2%BE%E0%B2%A8_%E0%B2%96%E0%B2%BF%E0%B2%A8%E0%B3%8D%E0%B2%A8%E0%B2%A4%E0%B3%86%E0%B2%AF_%E0%B2%85%E0%B2%B8%E0%B3%8D%E0%B2%B5%E0%B2%B8%E0%B3%8D%E0%B2%A5%E0%B2%A4%E0%B3%86" title="ಪ್ರಧಾನ ಖಿನ್ನತೆಯ ಅಸ್ವಸ್ಥತೆ – Kannada" lang="kn" hreflang="kn" data-title="ಪ್ರಧಾನ ಖಿನ್ನತೆಯ ಅಸ್ವಸ್ಥತೆ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target">ಕನ್ನಡ</a></li><li class="interlanguage-link interwiki-rn mw-list-item"><a href="https://rn.wikipedia.org/wiki/Ikiyingiyingi" title="Ikiyingiyingi – Rundi" lang="rn" hreflang="rn" data-title="Ikiyingiyingi" data-language-autonym="Ikirundi" data-language-local-name="Rundi" class="interlanguage-link-target">Ikirundi</a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Major_Depressive_Disorder" title="Major Depressive Disorder – Swahili" lang="sw" hreflang="sw" data-title="Major Depressive Disorder" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target">Kiswahili</a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Depresyona_kl%C3%AEn%C3%AEk%C3%AA" title="Depresyona klînîkê – Kurdish" lang="ku" hreflang="ku" data-title="Depresyona klînîkê" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target">Kurdî</a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Rekurenti_depres%C4%ABvi_trauc%C4%93jumi" title="Rekurenti depresīvi traucējumi – Latvian" lang="lv" hreflang="lv" data-title="Rekurenti depresīvi traucējumi" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target">Latviešu</a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Klinikin%C4%97_depresija" title="Klinikinė depresija – Lithuanian" lang="lt" hreflang="lt" data-title="Klinikinė depresija" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target">Lietuvių</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Depresszi%C3%B3_(betegs%C3%A9g)" title="Depresszió (betegség) – Hungarian" lang="hu" hreflang="hu" data-title="Depresszió (betegség)" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%94%D0%B5%D0%BF%D1%80%D0%B5%D1%81%D0%B8%D0%B2%D0%BD%D0%B8_%D1%80%D0%B0%D1%81%D1%82%D1%80%D0%BE%D1%98%D1%81%D1%82%D0%B2%D0%B0" title="Депресивни растројства – Macedonian" lang="mk" hreflang="mk" data-title="Депресивни растројства" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target">Македонски</a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B5%E0%B4%BF%E0%B4%B7%E0%B4%BE%E0%B4%A6%E0%B4%B0%E0%B5%8B%E0%B4%97%E0%B4%82" title="വിഷാദരോഗം – Malayalam" lang="ml" hreflang="ml" data-title="വിഷാദരോഗം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target">മലയാളം</a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%AE%E0%A5%81%E0%A4%96%E0%A5%8D%E0%A4%AF_%E0%A4%A8%E0%A5%88%E0%A4%B0%E0%A4%BE%E0%A4%B6%E0%A5%8D%E0%A4%AF%E0%A4%BE%E0%A4%9A%E0%A4%BE_%E0%A4%B5%E0%A4%BF%E0%A4%95%E0%A4%BE%E0%A4%B0" title="मुख्य नैराश्याचा विकार – Marathi" lang="mr" hreflang="mr" data-title="मुख्य नैराश्याचा विकार" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target">मराठी</a></li><li class="interlanguage-link interwiki-mzn mw-list-item"><a href="https://mzn.wikipedia.org/wiki/%D8%A7%D8%AE%D8%AA%D9%84%D8%A7%D9%84%D8%A7%D8%AA_%D8%A7%D9%81%D8%B3%D8%B1%D8%AF%DA%AF%DB%8C" title="اختلالات افسردگی – Mazanderani" lang="mzn" hreflang="mzn" data-title="اختلالات افسردگی" data-language-autonym="مازِرونی" data-language-local-name="Mazanderani" class="interlanguage-link-target">مازِرونی</a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Kecelaruan_episod_kemurungan_major" title="Kecelaruan episod kemurungan major – Malay" lang="ms" hreflang="ms" data-title="Kecelaruan episod kemurungan major" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target">Bahasa Melayu</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Depressie_(klinisch)" title="Depressie (klinisch) – Dutch" lang="nl" hreflang="nl" data-title="Depressie (klinisch)" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%A1%E0%A4%BF%E0%A4%AA%E0%A5%8D%E0%A4%B0%E0%A5%87%E0%A4%B8%E0%A4%A8" title="डिप्रेसन – Nepali" lang="ne" hreflang="ne" data-title="डिप्रेसन" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target">नेपाली</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%81%86%E3%81%A4%E7%97%85" title="うつ病 – Japanese" lang="ja" hreflang="ja" data-title="うつ病" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-frr mw-list-item"><a href="https://frr.wikipedia.org/wiki/Swaarmudaghaid" title="Swaarmudaghaid – Northern Frisian" lang="frr" hreflang="frr" data-title="Swaarmudaghaid" data-language-autonym="Nordfriisk" data-language-local-name="Northern Frisian" class="interlanguage-link-target">Nordfriisk</a></li><li class="interlanguage-link interwiki-no badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://no.wikipedia.org/wiki/Depresjon" title="Depresjon – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Depresjon" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Depression" title="Depression – Occitan" lang="oc" hreflang="oc" data-title="Depression" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target">Occitan</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AA%E0%AD%8D%E0%AC%B0%E0%AC%AE%E0%AD%81%E0%AC%96_%E0%AC%85%E0%AC%AC%E0%AC%B8%E0%AC%BE%E0%AC%A6_%E0%AC%AC%E0%AD%87%E0%AC%AE%E0%AC%BE%E0%AC%B0%E0%AD%80" title="ପ୍ରମୁଖ ଅବସାଦ ବେମାରୀ – Odia" lang="or" hreflang="or" data-title="ପ୍ରମୁଖ ଅବସାଦ ବେମାରୀ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Klinik_depressiya" title="Klinik depressiya – Uzbek" lang="uz" hreflang="uz" data-title="Klinik depressiya" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target">Oʻzbekcha / ўзбекча</a></li><li class="interlanguage-link interwiki-pap mw-list-item"><a href="https://pap.wikipedia.org/wiki/Depresion_(clinico)" title="Depresion (clinico) – Papiamento" lang="pap" hreflang="pap" data-title="Depresion (clinico)" data-language-autonym="Papiamentu" data-language-local-name="Papiamento" class="interlanguage-link-target">Papiamentu</a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%B9%D9%85%D8%AF%D9%87_%D8%A7%D9%81%D8%B3%D8%B1%D8%AF%DA%AB%D9%8A" title="عمده افسردګي – Pashto" lang="ps" hreflang="ps" data-title="عمده افسردګي" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target">پښتو</a></li><li class="interlanguage-link interwiki-pl badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://pl.wikipedia.org/wiki/Zaburzenia_depresyjne" title="Zaburzenia depresyjne – Polish" lang="pl" hreflang="pl" data-title="Zaburzenia depresyjne" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Transtorno_depressivo_maior" title="Transtorno depressivo maior – Portuguese" lang="pt" hreflang="pt" data-title="Transtorno depressivo maior" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Depresie" title="Depresie – Romanian" lang="ro" hreflang="ro" data-title="Depresie" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target">Română</a></li><li class="interlanguage-link interwiki-rm mw-list-item"><a href="https://rm.wikipedia.org/wiki/Depressiun" title="Depressiun – Romansh" lang="rm" hreflang="rm" data-title="Depressiun" data-language-autonym="Rumantsch" data-language-local-name="Romansh" class="interlanguage-link-target">Rumantsch</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%91%D0%BE%D0%BB%D1%8C%D1%88%D0%BE%D0%B5_%D0%B4%D0%B5%D0%BF%D1%80%D0%B5%D1%81%D1%81%D0%B8%D0%B2%D0%BD%D0%BE%D0%B5_%D1%80%D0%B0%D1%81%D1%81%D1%82%D1%80%D0%BE%D0%B9%D1%81%D1%82%D0%B2%D0%BE" title="Большое депрессивное расстройство – Russian" lang="ru" hreflang="ru" data-title="Большое депрессивное расстройство" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sco mw-list-item"><a href="https://sco.wikipedia.org/wiki/Major_depressive_disorder" title="Major depressive disorder – Scots" lang="sco" hreflang="sco" data-title="Major depressive disorder" data-language-autonym="Scots" data-language-local-name="Scots" class="interlanguage-link-target">Scots</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/%D2%AArregullimi_depresiv_madhor" title="Ҫrregullimi depresiv madhor – Albanian" lang="sq" hreflang="sq" data-title="Ҫrregullimi depresiv madhor" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B7%83%E0%B7%8F%E0%B6%BA%E0%B6%B1%E0%B7%92%E0%B6%9A_%E0%B7%80%E0%B7%92%E0%B7%81%E0%B7%8F%E0%B6%AF%E0%B6%BA" title="සායනික විශාදය – Sinhala" lang="si" hreflang="si" data-title="සායනික විශාදය" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target">සිංහල</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Depression_(mental_illness)" title="Depression (mental illness) – Simple English" lang="en-simple" hreflang="en-simple" data-title="Depression (mental illness)" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Depresia_(psychol%C3%B3gia)" title="Depresia (psychológia) – Slovak" lang="sk" hreflang="sk" data-title="Depresia (psychológia)" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target">Slovenčina</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Velika_depresivna_motnja" title="Velika depresivna motnja – Slovenian" lang="sl" hreflang="sl" data-title="Velika depresivna motnja" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-so mw-list-item"><a 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Not to be confused with <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression (mood)</a>.</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Update plainlinks metadata ambox ambox-content ambox-Update" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/42px-Ambox_current_red_Americas.svg.png" decoding="async" width="42" height="34" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/63px-Ambox_current_red_Americas.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/84px-Ambox_current_red_Americas.svg.png 2x" data-file-width="360" data-file-height="290" /></div></td><td class="mbox-text"><div class="mbox-text-span">This article needs to be updated. The reason given is: Many outdated sources and information (older than five years). Please help update this article to reflect recent events or newly available information. (July 2024)</div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Major depressive disorder</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Clinical depression, major depression, unipolar depression, unipolar disorder, recurrent depression</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Van_Gogh_-_Trauernder_alter_Mann.jpeg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Van_Gogh_-_Trauernder_alter_Mann.jpeg/220px-Van_Gogh_-_Trauernder_alter_Mann.jpeg" decoding="async" width="220" height="289" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Van_Gogh_-_Trauernder_alter_Mann.jpeg/330px-Van_Gogh_-_Trauernder_alter_Mann.jpeg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d2/Van_Gogh_-_Trauernder_alter_Mann.jpeg/440px-Van_Gogh_-_Trauernder_alter_Mann.jpeg 2x" data-file-width="3845" data-file-height="5057" /></a></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/At_Eternity%27s_Gate" title="At Eternity's Gate">Sorrowing Old Man (At Eternity's Gate)</a>, an 1890 portrait by <a href="/wiki/Vincent_van_Gogh" title="Vincent van Gogh">Vincent van Gogh</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a>, <a href="/wiki/Clinical_psychology" title="Clinical psychology">clinical psychology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Depression_(mood)" title="Depression (mood)">Low mood</a>, low <a href="/wiki/Self-esteem" title="Self-esteem">self-esteem</a>, <a href="/wiki/Anhedonia" title="Anhedonia">loss of interest</a> in normally enjoyable activities, <a href="/wiki/Psychomotor_retardation" title="Psychomotor retardation">low energy</a>, <a href="/wiki/Pain" title="Pain">pain</a> without a clear cause,<a href="#cite_note-NIH2016-1">[1]</a> disturbed sleep pattern (<a href="/wiki/Insomnia" title="Insomnia">insomnia</a> or <a href="/wiki/Hypersomnia" title="Hypersomnia">hypersomnia</a>)</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Self-harm" title="Self-harm">Self-harm</a>, <a href="/wiki/Suicide" title="Suicide">suicide</a><a href="#cite_note-Rich2014-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">Age 20s<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013165-3">[3]</a><a href="#cite_note-Kes2013-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">> 2 weeks<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Environmental (e.g. <a href="/wiki/Psychological_trauma" title="Psychological trauma">adverse life experiences</a>), <a href="/wiki/Genetics" title="Genetics">genetic predisposition</a>, psychological factors such as <a href="/wiki/Psychological_stress" title="Psychological stress">stress</a><a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">Family history</a>, major life changes, certain <a href="/wiki/Medication" title="Medication">medications</a>, <a href="/wiki/Chronic_health_problem" class="mw-redirect" title="Chronic health problem">chronic health problems</a>, <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorder</a><a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar disorder</a>, <a href="/wiki/ADHD" class="mw-redirect" title="ADHD">ADHD</a>, <a href="/wiki/Sadness" title="Sadness">sadness</a><a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013167–168-6">[6]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Psychotherapy" title="Psychotherapy">Psychotherapy</a>, <a href="/wiki/Antidepressant_medication" class="mw-redirect" title="Antidepressant medication">antidepressant medication</a>, <a href="/wiki/Electroconvulsive_therapy" title="Electroconvulsive therapy">electroconvulsive therapy</a>, <a href="/wiki/Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">transcranial magnetic stimulation</a>, <a href="/wiki/Exercise" title="Exercise">exercise</a><a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-Coo2013-7">[7]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Antidepressant" title="Antidepressant">Antidepressants</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">163 million (2017)<a href="#cite_note-GBD_2017_prevalence-8">[8]</a></td></tr></tbody></table> Major depressive disorder (MDD), also known as clinical depression, is a <a href="/wiki/Mental_disorder" title="Mental disorder">mental disorder</a><a href="#cite_note-9">[9]</a> characterized by at least two weeks of pervasive <a href="/wiki/Depression_(mood)" title="Depression (mood)">low mood</a>, low <a href="/wiki/Self-esteem" title="Self-esteem">self-esteem</a>, and <a href="/wiki/Anhedonia" title="Anhedonia">loss of interest or pleasure</a> in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s,<a href="#cite_note-Spitzer-10">[10]</a> the term was adopted by the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> for this <a href="/wiki/Syndrome" title="Syndrome">symptom cluster</a> under <a href="/wiki/Mood_disorder" title="Mood disorder">mood disorders</a> in the 1980 version of the <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM-III), and has become widely used since. The disorder causes the second-most <a href="/wiki/Years_lived_with_disability" class="mw-redirect" title="Years lived with disability">years lived with disability</a>, after <a href="/wiki/Low_back_pain" title="Low back pain">lower back pain</a>.<a href="#cite_note-11">[11]</a> The diagnosis of major depressive disorder is based on the person's reported experiences, behavior reported by relatives or friends, and a <a href="/wiki/Mental_status_examination" title="Mental status examination">mental status examination</a>.<a href="#cite_note-Pat2015-12">[12]</a> There is no laboratory test for the disorder, but testing may be done to rule out physical conditions that can cause similar symptoms.<a href="#cite_note-Pat2015-12">[12]</a> The most common time of onset is in a person's 20s,<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013165-3">[3]</a><a href="#cite_note-Kes2013-4">[4]</a> with females affected about twice as often as males.<a href="#cite_note-Kes2013-4">[4]</a> The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent <a href="/wiki/Major_depressive_episode" title="Major depressive episode">major depressive episodes</a>. Those with major depressive disorder are typically treated with <a href="/wiki/Psychotherapy" title="Psychotherapy">psychotherapy</a> and <a href="/wiki/Antidepressant_medication" class="mw-redirect" title="Antidepressant medication">antidepressant medication</a>.<a href="#cite_note-NIH2016-1">[1]</a> Medication appears to be effective, but the effect may be significant only in the most severely depressed.<a href="#cite_note-Fou2010-13">[13]</a><a href="#cite_note-14">[14]</a> Hospitalization (which may be <a href="/wiki/Involuntary_commitment" title="Involuntary commitment">involuntary</a>) may be necessary in cases with associated <a href="/wiki/Self-neglect" title="Self-neglect">self-neglect</a> or a significant risk of harm to self or others. <a href="/wiki/Electroconvulsive_therapy" title="Electroconvulsive therapy">Electroconvulsive therapy</a> (ECT) may be considered if other measures are not effective.<a href="#cite_note-NIH2016-1">[1]</a> Major depressive disorder is believed to be caused by a combination of <a href="/wiki/Genetics" title="Genetics">genetic</a>, environmental, and psychological factors,<a href="#cite_note-NIH2016-1">[1]</a> with about 40% of the risk being genetic.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a> Risk factors include a <a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">family history</a> of the condition, major life changes, childhood traumas, certain medications, <a href="/wiki/Chronic_health_problem" class="mw-redirect" title="Chronic health problem">chronic health problems</a>, and <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorders</a>.<a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a> It can negatively affect a person's personal life, work life, or education, and cause issues with a person's sleeping habits, eating habits, and general health.<a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Symptoms_and_signs">Symptoms and signs</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Digital_media_use_and_mental_health#Depression" title="Digital media use and mental health">Digital media use and mental health § Depression</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg/220px-A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg" decoding="async" width="220" height="301" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/65/A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg/330px-A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/65/A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg/440px-A_woman_diagnosed_as_suffering_from_melancholia._Colour_lith_Wellcome_L0026686.jpg 2x" data-file-width="1180" data-file-height="1617" /></a><figcaption>An 1892 <a href="/wiki/Lithograph" class="mw-redirect" title="Lithograph">lithograph</a> of a woman diagnosed with <a href="/wiki/Melancholia" title="Melancholia">melancholia</a></figcaption></figure> A person having a <a href="/wiki/Major_depressive_episode" title="Major depressive episode">major depressive episode</a> usually exhibits a low mood, which pervades all aspects of life, and an inability to experience pleasure in previously enjoyable activities.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013160-15">[15]</a> Depressed people may be preoccupied with or <a href="/wiki/Rumination_(psychology)" title="Rumination (psychology)">ruminate</a> over thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness or hopelessness.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013161-16">[16]</a> Other symptoms of depression include poor concentration and memory,<a href="#cite_note-17">[17]</a> withdrawal from social situations and activities, reduced <a href="/wiki/Libido" title="Libido">sex drive</a>, irritability, and thoughts of death or suicide. <a href="/wiki/Insomnia" title="Insomnia">Insomnia</a> is common; in the typical pattern, a person wakes very early and cannot get back to sleep. <a href="/wiki/Hypersomnia" title="Hypersomnia">Hypersomnia</a>, or oversleeping, can also happen,<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013163-18">[18]</a> as well as day-night rhythm disturbances, such as <a href="/wiki/Diurnal_mood_variation" title="Diurnal mood variation">diurnal mood variation</a>.<a href="#cite_note-19">[19]</a> Some antidepressants may also cause insomnia due to their stimulating effect.<a href="#cite_note-20">[20]</a> In severe cases, depressed people may have <a href="/wiki/Psychosis" title="Psychosis">psychotic</a> symptoms. These symptoms include <a href="/wiki/Delusion" title="Delusion">delusions</a> or, less commonly, <a href="/wiki/Hallucination" title="Hallucination">hallucinations</a>, usually unpleasant.<a href="#cite_note-21">[21]</a> People who have had previous episodes with psychotic symptoms are more likely to have them with future episodes.<a href="#cite_note-22">[22]</a> A depressed person may report multiple physical symptoms such as <a href="/wiki/Fatigue" title="Fatigue">fatigue</a>, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries, according to the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>'s criteria for depression.<a href="#cite_note-23">[23]</a> <a href="/wiki/Appetite" title="Appetite">Appetite</a> often decreases, resulting in weight loss, although increased appetite and weight gain occasionally occur.<a href="#cite_note-APA349-24">[24]</a> Major depression significantly affects a person's family and <a href="/wiki/Social_predictors_of_depression" title="Social predictors of depression">personal relationships</a>, work or school life, sleeping and eating habits, and general health.<a href="#cite_note-NIMHPub-25">[25]</a> Family and friends may notice <a href="/wiki/Psychomotor_agitation" title="Psychomotor agitation">agitation</a> or <a href="/wiki/Psychomotor_retardation" title="Psychomotor retardation">lethargy</a>.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013163-18">[18]</a> Older depressed people may have <a href="/wiki/Cognition#Psychology" title="Cognition">cognitive</a> symptoms of recent onset, such as forgetfulness,<a href="#cite_note-26">[26]</a> and a more noticeable slowing of movements.<a href="#cite_note-27">[27]</a> Depressed children may often display an irritable rather than a depressed mood;<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013163-18">[18]</a> most lose interest in school and show a steep decline in academic performance.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013164-28">[28]</a> Diagnosis may be delayed or missed when symptoms are interpreted as "normal moodiness".<a href="#cite_note-APA349-24">[24]</a> Elderly people may not present with classical depressive symptoms.<a href="#cite_note-SBU-29">[29]</a> Diagnosis and treatment is further complicated in that the elderly are often simultaneously treated with a number of other drugs, and often have other concurrent diseases.<a href="#cite_note-SBU-29">[29]</a> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Biology_of_depression" title="Biology of depression">Biology of depression</a> and <a href="/wiki/Epigenetics_of_depression" title="Epigenetics of depression">Epigenetics of depression</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Diathesis_stress_model_cup_analogy.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Diathesis_stress_model_cup_analogy.svg/220px-Diathesis_stress_model_cup_analogy.svg.png" decoding="async" width="220" height="153" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/67/Diathesis_stress_model_cup_analogy.svg/330px-Diathesis_stress_model_cup_analogy.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/67/Diathesis_stress_model_cup_analogy.svg/440px-Diathesis_stress_model_cup_analogy.svg.png 2x" data-file-width="512" data-file-height="355" /></a><figcaption>A cup analogy demonstrating the <a href="/wiki/Diathesis%E2%80%93stress_model" title="Diathesis–stress model">diathesis–stress model</a> that under the same amount of stressors, person 2 is more vulnerable than person 1, because of their predisposition<a href="#cite_note-30">[30]</a></figcaption></figure> The etiology of depression is not yet fully understood.<a href="#cite_note-31">[31]</a><a href="#cite_note-32">[32]</a><a href="#cite_note-33">[33]</a><a href="#cite_note-34">[34]</a> The <a href="/wiki/Biopsychosocial_model" title="Biopsychosocial model">biopsychosocial model</a> proposes that biological, psychological, and social factors all play a role in causing depression.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a><a href="#cite_note-35">[35]</a> The <a href="/wiki/Diathesis%E2%80%93stress_model" title="Diathesis–stress model">diathesis–stress model</a> specifies that depression results when a preexisting vulnerability, or <a href="/wiki/Diathesis_(medicine)" title="Diathesis (medicine)">diathesis</a>, is activated by stressful life events. The preexisting vulnerability can be either <a href="/wiki/Gene" title="Gene">genetic</a>,<a href="#cite_note-36">[36]</a><a href="#cite_note-37">[37]</a> implying an interaction between <a href="/wiki/Nature_and_nurture" class="mw-redirect" title="Nature and nurture">nature and nurture</a>, or <a href="/wiki/Schema_(psychology)" title="Schema (psychology)">schematic</a>, resulting from views of the world learned in childhood.<a href="#cite_note-38">[38]</a> American psychiatrist <a href="/wiki/Aaron_Beck" title="Aaron Beck">Aaron Beck</a> suggested that a <a href="/wiki/Beck%27s_cognitive_triad" title="Beck's cognitive triad">triad</a> of automatic and spontaneous negative thoughts about the <a href="/wiki/Self-image" title="Self-image">self</a>, the <a href="/wiki/Social_environment" title="Social environment">world or environment</a>, and the future may lead to other depressive signs and symptoms.<a href="#cite_note-Beck-39">[39]</a><a href="#cite_note-40">[40]</a> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3></div> Genes play a major role in the development of depression.<a href="#cite_note-41">[41]</a> <a href="/wiki/Behavioural_genetics" title="Behavioural genetics">Family and twin studies</a> find that nearly 40% of individual differences in risk for major depressive disorder can be <a href="/wiki/Heritability" title="Heritability">explained by genetic factors</a>.<a href="#cite_note-42">[42]</a> Like most psychiatric disorders, major depressive disorder is likely influenced by many individual genetic changes.<a href="#cite_note-43">[43]</a> In 2018, a <a href="/wiki/Genome-wide_association_study" title="Genome-wide association study">genome-wide association study</a> discovered 44 genetic variants linked to risk for major depression;<a href="#cite_note-44">[44]</a> a 2019 study found 102 variants in the genome linked to depression.<a href="#cite_note-45">[45]</a> However, it appears that major depression is less heritable compared to bipolar disorder and schizophrenia.<a href="#cite_note-46">[46]</a><a href="#cite_note-47">[47]</a> Research focusing on specific candidate genes has been criticized for its tendency to generate false positive findings.<a href="#cite_note-48">[48]</a> There are also other efforts to examine interactions between life stress and polygenic risk for depression.<a href="#cite_note-49">[49]</a> <div class="mw-heading mw-heading3"><h3 id="Other_health_problems">Other health problems</h3></div> Depression can also arise after a chronic or terminal medical condition, such as <a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV/AIDS</a> or <a href="/wiki/Asthma" title="Asthma">asthma</a>, and may be labeled "secondary depression".<a href="#cite_note-50">[50]</a><a href="#cite_note-51">[51]</a> It is unknown whether the underlying diseases induce depression through effect on quality of life, or through shared etiologies (such as degeneration of the <a href="/wiki/Basal_ganglia" title="Basal ganglia">basal ganglia</a> in <a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a> or immune dysregulation in asthma).<a href="#cite_note-52">[52]</a> Depression may also be <a href="/wiki/Iatrogenic" class="mw-redirect" title="Iatrogenic">iatrogenic</a> (the result of healthcare), such as drug-induced depression. Therapies associated with depression include <a href="/wiki/Interferon" title="Interferon">interferons</a>, <a href="/wiki/Beta-blockers" class="mw-redirect" title="Beta-blockers">beta-blockers</a>, <a href="/wiki/Isotretinoin" title="Isotretinoin">isotretinoin</a>, <a href="/wiki/Contraceptives" class="mw-redirect" title="Contraceptives">contraceptives</a>,<a href="#cite_note-53">[53]</a> cardiac agents, <a href="/wiki/Anticonvulsants" class="mw-redirect" title="Anticonvulsants">anticonvulsants</a>, <a href="/wiki/Antimigraine_drug" title="Antimigraine drug">antimigraine drugs</a>, <a href="/wiki/Antipsychotics" class="mw-redirect" title="Antipsychotics">antipsychotics</a>, and <a href="/wiki/Hormone_therapy" title="Hormone therapy">hormonal agents</a> such as <a href="/wiki/Gonadotropin-releasing_hormone_agonist" title="Gonadotropin-releasing hormone agonist">gonadotropin-releasing hormone agonist</a> (GnRH agonist).<a href="#cite_note-54">[54]</a> <a href="/wiki/Celiac_disease" class="mw-redirect" title="Celiac disease">Celiac disease</a> is another possible contributing factor.<a href="#cite_note-55">[55]</a> Substance use in early age is associated with increased risk of developing depression later in life.<a href="#cite_note-56">[56]</a> Depression occurring after giving birth is called <a href="/wiki/Postpartum_depression" title="Postpartum depression">postpartum depression</a> and is thought to be the result of hormonal changes associated with <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a>.<a href="#cite_note-57">[57]</a> <a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a>, a type of depression associated with seasonal changes in sunlight, is thought to be triggered by decreased sunlight.<a href="#cite_note-58">[58]</a> Vitamin B2, B6 and B12 deficiency may cause depression in females.<a href="#cite_note-59">[59]</a> <div class="mw-heading mw-heading3"><h3 id="Environmental">Environmental</h3></div> <a href="/wiki/Adverse_childhood_experiences" title="Adverse childhood experiences">Adverse childhood experiences</a> (incorporating <a href="/wiki/Child_abuse" title="Child abuse">childhood abuse</a>, neglect and <a href="/wiki/Dysfunctional_family" title="Dysfunctional family">family dysfunction</a>) markedly increase the risk of major depression, especially if more than one type.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013166-5">[5]</a> Childhood trauma also correlates with severity of depression, poor responsiveness to treatment and length of illness. Some are more susceptible than others to developing mental illness such as depression after trauma, and various genes have been suggested to control susceptibility.<a href="#cite_note-60">[60]</a> Couples in unhappy marriages have a higher risk of developing clinical depression.<a href="#cite_note-61">[61]</a> There appears to be a link between <a href="/wiki/Air_pollution" title="Air pollution">air pollution</a> and depression and suicide. There may be an association between long-term <a href="/wiki/PM2.5" class="mw-redirect" title="PM2.5">PM2.5</a> exposure and depression, and a possible association between short-term <a href="/wiki/PM10" class="mw-redirect" title="PM10">PM10</a> exposure and suicide.<a href="#cite_note-pmid31850801-62">[62]</a> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Biology_of_depression" title="Biology of depression">Biology of depression</a> and <a href="/wiki/Epigenetics_of_depression" title="Epigenetics of depression">Epigenetics of depression</a></div> The pathophysiology of depression is not completely understood, but current theories center around <a href="/wiki/Monoamine" class="mw-redirect" title="Monoamine">monoaminergic</a> systems, the <a href="/wiki/Circadian_rhythm" title="Circadian rhythm">circadian rhythm</a>, immunological dysfunction, <a href="/wiki/HPA_axis" class="mw-redirect" title="HPA axis">HPA-axis</a> dysfunction and structural or functional abnormalities of emotional circuits. Derived from the effectiveness of monoaminergic drugs in treating depression, the monoamine theory posits that insufficient activity of <a href="/wiki/Monoamine_neurotransmitter" title="Monoamine neurotransmitter">monoamine neurotransmitters</a> is the primary cause of depression. Evidence for the monoamine theory comes from multiple areas. First, acute depletion of <a href="/wiki/Tryptophan" title="Tryptophan">tryptophan</a>—a necessary precursor of <a href="/wiki/Serotonin" title="Serotonin">serotonin</a> and a monoamine—can cause depression in those in remission or relatives of people who are depressed, suggesting that decreased serotonergic neurotransmission is important in depression.<a href="#cite_note-63">[63]</a> Second, the correlation between depression risk and polymorphisms in the <a href="/wiki/5-HTTLPR" title="5-HTTLPR">5-HTTLPR</a> gene, which codes for serotonin receptors, suggests a link. Third, decreased size of the <a href="/wiki/Locus_coeruleus" title="Locus coeruleus">locus coeruleus</a>, decreased activity of <a href="/wiki/Tyrosine_hydroxylase" title="Tyrosine hydroxylase">tyrosine hydroxylase</a>, increased density of <a href="/wiki/Alpha-2_adrenergic_receptor" title="Alpha-2 adrenergic receptor">alpha-2 adrenergic receptor</a>, and evidence from rat models suggest decreased <a href="/wiki/Adrenergic_nervous_system" class="mw-redirect" title="Adrenergic nervous system">adrenergic</a> neurotransmission in depression.<a href="#cite_note-64">[64]</a> Furthermore, decreased levels of <a href="/wiki/Homovanillic_acid" title="Homovanillic acid">homovanillic acid</a>, altered response to <a href="/wiki/Dextroamphetamine" title="Dextroamphetamine">dextroamphetamine</a>, responses of depressive symptoms to <a href="/wiki/Dopamine_receptor" title="Dopamine receptor">dopamine receptor</a> agonists, decreased <a href="/wiki/Dopamine_receptor_D1" title="Dopamine receptor D1">dopamine receptor D1</a> binding in the <a href="/wiki/Striatum" title="Striatum">striatum</a>,<a href="#cite_note-65">[65]</a> and <a href="/wiki/Polymorphism_(biology)" title="Polymorphism (biology)">polymorphism</a> of <a href="/wiki/Dopamine_receptor" title="Dopamine receptor">dopamine receptor</a> genes implicate <a href="/wiki/Dopamine" title="Dopamine">dopamine</a>, another monoamine, in depression.<a href="#cite_note-66">[66]</a><a href="#cite_note-67">[67]</a> Lastly, increased activity of <a href="/wiki/Monoamine_oxidase" title="Monoamine oxidase">monoamine oxidase</a>, which degrades monoamines, has been associated with depression.<a href="#cite_note-68">[68]</a> However, the monoamine theory is inconsistent with observations that serotonin depletion does not cause depression in healthy persons, that antidepressants instantly increase levels of monoamines but take weeks to work, and the existence of atypical antidepressants which can be effective despite not targeting this pathway.<a href="#cite_note-69">[69]</a> One proposed explanation for the therapeutic lag, and further support for the deficiency of monoamines, is a desensitization of self-inhibition in <a href="/wiki/Raphe_nuclei" title="Raphe nuclei">raphe nuclei</a> by the increased serotonin mediated by antidepressants.<a href="#cite_note-70">[70]</a> However, disinhibition of the dorsal raphe has been proposed to occur as a result of decreased serotonergic activity in tryptophan depletion, resulting in a depressed state mediated by increased serotonin. Further countering the monoamine hypothesis is the fact that rats with lesions of the dorsal raphe are not more depressive than controls, the finding of increased jugular <a href="/wiki/5-Hydroxyindoleacetic_acid" title="5-Hydroxyindoleacetic acid">5-HIAA</a> in people who are depressed that normalized with <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">selective serotonin reuptake inhibitor</a> (SSRI) treatment, and the preference for <a href="/wiki/Carbohydrate" title="Carbohydrate">carbohydrates</a> in people who are depressed.<a href="#cite_note-71">[71]</a> Already limited, the monoamine hypothesis has been further oversimplified when presented to the general public.<a href="#cite_note-72">[72]</a> A 2022 review found no consistent evidence supporting the serotonin hypothesis, linking serotonin levels and depression.<a href="#cite_note-73">[73]</a> <a href="/wiki/HPA_axis" class="mw-redirect" title="HPA axis">HPA-axis</a> abnormalities have been suggested in depression given the association of <a href="/wiki/CRHR1" class="mw-redirect" title="CRHR1">CRHR1</a> with depression and the increased frequency of <a href="/wiki/Dexamethasone_suppression_test" title="Dexamethasone suppression test">dexamethasone test</a> non-suppression in people who are depressed. However, this abnormality is not adequate as a diagnosis tool, because its sensitivity is only 44%.<a href="#cite_note-74">[74]</a> These stress-related abnormalities are thought to be the cause of hippocampal volume reductions seen in people who are depressed.<a href="#cite_note-75">[75]</a> Furthermore, a <a href="/wiki/Meta-analysis" title="Meta-analysis">meta-analysis</a> yielded decreased dexamethasone suppression, and increased response to psychological stressors.<a href="#cite_note-76">[76]</a> Further abnormal results have been obscured with the <a href="/wiki/Cortisol_awakening_response" title="Cortisol awakening response">cortisol awakening response</a>, with increased response being associated with depression.<a href="#cite_note-77">[77]</a> There is also a connection between the gut microbiome and the central nervous system, otherwise known as the <a href="/wiki/Gut%E2%80%93brain_axis" title="Gut–brain axis">Gut-Brain axis</a>, which is a two-way communication system between the brain and the gut. Experiments have shown that <a href="/wiki/Microbiota" title="Microbiota">microbiota</a> in the gut can play an important role in depression as people with MDD often have gut-brain dysfunction. One analysis showed that those with MDD have different bacteria living in their guts. Bacteria <a href="/wiki/Bacteroidota" title="Bacteroidota">Bacteroidetes</a> and Firmicutes were most affected in people with MDD, and they are also impacted in people with <a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">irritable bowel syndrome</a>.<a href="#cite_note-:0-78">[78]</a> Another study showed that people with IBS have a higher chance of developing depression, which shows the two are connected.<a href="#cite_note-79">[79]</a> There is even evidence suggesting that altering the microbes in the gut can have regulatory effects on developing depression.<a href="#cite_note-:0-78">[78]</a> Theories unifying <a href="/wiki/Neuroimaging" title="Neuroimaging">neuroimaging</a> findings have been proposed. The first model proposed is the limbic-cortical model, which involves hyperactivity of the ventral paralimbic regions and hypoactivity of frontal regulatory regions in emotional processing.<a href="#cite_note-80">[80]</a> Another model, the cortico-striatal model, suggests that abnormalities of the <a href="/wiki/Prefrontal_cortex" title="Prefrontal cortex">prefrontal cortex</a> in regulating striatal and subcortical structures result in depression.<a href="#cite_note-81">[81]</a> Another model proposes hyperactivity of <a href="/wiki/Salience_network" title="Salience network">salience structures</a> in identifying negative stimuli, and hypoactivity of cortical regulatory structures resulting in a negative <a href="/wiki/Emotional_bias" title="Emotional bias">emotional bias</a> and depression, consistent with emotional bias studies.<a href="#cite_note-82">[82]</a> <div class="mw-heading mw-heading3"><h3 id="Immune_pathogenesis_theories_on_depression">Immune pathogenesis theories on depression</h3></div> The newer field of <a href="/wiki/Psychoneuroimmunology" title="Psychoneuroimmunology">psychoneuroimmunology</a>, the study between the immune system and the nervous system and emotional state, suggests that cytokines may impact depression. <a href="/wiki/Depression_and_immune_function" title="Depression and immune function">Immune system abnormalities</a> have been observed, including increased levels of <a href="/wiki/Cytokines" class="mw-redirect" title="Cytokines">cytokines</a> -cells produced by immune cells that affect inflammation- involved in generating <a href="/wiki/Sickness_behavior" title="Sickness behavior">sickness behavior</a>, creating a pro-inflammatory profile in MDD.<a href="#cite_note-83">[83]</a><a href="#cite_note-84">[84]</a><a href="#cite_note-85">[85]</a> Some people with depression have increased levels of pro-inflammatory cytokines and some have decreased levels of anti-inflammatory cytokines.<a href="#cite_note-86">[86]</a> Research suggests that treatments can reduce pro-inflammatory cell production, like the experimental treatment of ketamine with treatment-resistant depression.<a href="#cite_note-87">[87]</a> With this, in MDD, people will more likely have a Th-1 dominant immune profile, which is a pro-inflammatory profile. This suggests that there are components of the immune system affecting the pathology of MDD.<a href="#cite_note-88">[88]</a> Another way <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> can affect depression is in the <a href="/wiki/Kynurenine_pathway" title="Kynurenine pathway">kynurenine pathway</a>, and when this is overactivated, it can cause depression. This can be due to too much <a href="/wiki/Microglia" title="Microglia">microglial</a> activation and too little <a href="/wiki/Astrocyte" title="Astrocyte">astrocytic</a> activity. When microglia get activated, they release pro-inflammatory cytokines that cause an increase in the production of <a href="/wiki/Cytochrome_c_oxidase_subunit_2" title="Cytochrome c oxidase subunit 2">COX2</a>. This, in turn, causes the production of <a href="/wiki/Prostaglandin_E2" title="Prostaglandin E2">PGE2</a>, which is a <a href="/wiki/Prostaglandin" title="Prostaglandin">prostaglandin</a>, and this catalyzes the production of <a href="/wiki/Indolamines" title="Indolamines">indolamine</a>, IDO. IDO causes <a href="/wiki/Tryptophan" title="Tryptophan">tryptophan</a> to get converted into <a href="/wiki/Kynurenine" title="Kynurenine">kynurenine</a> and kynurenine becomes <a href="/wiki/Quinolinic_acid" title="Quinolinic acid">quinolinic acid</a>.<a href="#cite_note-89">[89]</a> Quinolinic acid is an agonist for <a href="/wiki/N-Methyl-D-aspartic_acid" title="N-Methyl-D-aspartic acid">NMDA</a> receptors, so it activates the pathway. Studies have shown that the post-mortem brains of patients with MDD have higher levels of quinolinic acid than people who did not have MDD. With this, researchers have also seen that the concentration of quinolinic acid correlates to the severity of depressive symptoms.<a href="#cite_note-90">[90]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div> <div class="mw-heading mw-heading3"><h3 id="Assessment">Assessment</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Rating_scales_for_depression" title="Rating scales for depression">Rating scales for depression</a></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:A_wretched_man_with_an_approaching_depression;_represented_b_Wellcome_V0011145.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/af/A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg/220px-A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg" decoding="async" width="220" height="337" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/af/A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg/330px-A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/af/A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg/440px-A_wretched_man_with_an_approaching_depression%3B_represented_b_Wellcome_V0011145.jpg 2x" data-file-width="2206" data-file-height="3384" /></a><figcaption>Caricature of a man with depression</figcaption></figure> A diagnostic assessment may be conducted by a suitably trained <a href="/wiki/General_practitioner" title="General practitioner">general practitioner</a>, or by a <a href="/wiki/Psychiatrist" title="Psychiatrist">psychiatrist</a> or <a href="/wiki/Psychologist" title="Psychologist">psychologist</a>,<a href="#cite_note-NIMHPub-25">[25]</a> who <a href="/wiki/Psychiatric_history" title="Psychiatric history">records</a> the person's current circumstances, biographical history, current symptoms, family history, and alcohol and drug use. The assessment also includes a <a href="/wiki/Mental_state_examination" class="mw-redirect" title="Mental state examination">mental state examination</a>, which is an assessment of the person's current mood and thought content, in particular the presence of themes of hopelessness or <a href="/wiki/Pessimism" title="Pessimism">pessimism</a>, <a href="/wiki/Self-harm" title="Self-harm">self-harm</a> or suicide, and an absence of positive thoughts or plans.<a href="#cite_note-NIMHPub-25">[25]</a> Specialist mental health services are rare in rural areas, and thus diagnosis and management is left largely to <a href="/wiki/Primary_care" title="Primary care">primary-care</a> clinicians.<a href="#cite_note-91">[91]</a> This issue is even more marked in developing countries.<a href="#cite_note-92">[92]</a> <a href="/wiki/Rating_scale" title="Rating scale">Rating scales</a> are not used to diagnose depression, but they provide an indication of the severity of symptoms for a time period, so a person who scores above a given cut-off point can be more thoroughly evaluated for a depressive disorder diagnosis. Several rating scales are used for this purpose;<a href="#cite_note-93">[93]</a> these include the <a href="/wiki/Hamilton_Rating_Scale_for_Depression" title="Hamilton Rating Scale for Depression">Hamilton Rating Scale for Depression</a>,<a href="#cite_note-94">[94]</a> the <a href="/wiki/Beck_Depression_Inventory" title="Beck Depression Inventory">Beck Depression Inventory</a><a href="#cite_note-95">[95]</a> or the <a href="/wiki/Suicide_Behaviors_Questionnaire-Revised" title="Suicide Behaviors Questionnaire-Revised">Suicide Behaviors Questionnaire-Revised</a>.<a href="#cite_note-96">[96]</a> <a href="/wiki/Primary-care_physician" class="mw-redirect" title="Primary-care physician">Primary-care physicians</a> have more difficulty with underrecognition and undertreatment of depression compared to psychiatrists. These cases may be missed because for some people with depression, <a href="#physicalSymptoms">physical symptoms</a> often accompany depression. In addition, there may also be barriers related to the person, provider, and/or the medical system. Non-psychiatrist physicians have been shown to miss about two-thirds of cases, although there is some evidence of improvement in the number of missed cases.<a href="#cite_note-97">[97]</a> A doctor generally performs a medical examination and selected investigations to rule out other causes of depressive symptoms. These include blood tests measuring <a href="/wiki/Thyroid-stimulating_hormone" title="Thyroid-stimulating hormone">TSH</a> and <a href="/wiki/Thyroxine" class="mw-redirect" title="Thyroxine">thyroxine</a> to exclude <a href="/wiki/Hypothyroidism" title="Hypothyroidism">hypothyroidism</a>; <a href="/wiki/Blood_tests#Biochemical_analysis" class="mw-redirect" title="Blood tests">basic electrolytes</a> and serum <a href="/wiki/Calcium" title="Calcium">calcium</a> to rule out a <a href="/wiki/Metabolic_disorder" title="Metabolic disorder">metabolic disturbance</a>; and a <a href="/wiki/Complete_blood_count" title="Complete blood count">full blood count</a> including <a href="/wiki/Erythrocyte_sedimentation_rate" title="Erythrocyte sedimentation rate">ESR</a> to rule out a <a href="/wiki/Systemic_infection" class="mw-redirect" title="Systemic infection">systemic infection</a> or chronic disease.<a href="#cite_note-98">[98]</a> Adverse affective reactions to medications or alcohol misuse may be ruled out, as well. <a href="/wiki/Testosterone" title="Testosterone">Testosterone</a> levels may be evaluated to diagnose <a href="/wiki/Hypogonadism" title="Hypogonadism">hypogonadism</a>, a cause of depression in men.<a href="#cite_note-99">[99]</a> <a href="/wiki/Vitamin_D" title="Vitamin D">Vitamin D</a> levels might be evaluated, as low levels of vitamin D have been associated with greater risk for depression.<a href="#cite_note-Parker2017-100">[100]</a> Subjective cognitive complaints appear in older depressed people, but they can also be indicative of the onset of a <a href="/wiki/Dementia" title="Dementia">dementing disorder</a>, such as <a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a>.<a href="#cite_note-101">[101]</a><a href="#cite_note-102">[102]</a> <a href="/wiki/Neuropsychological_assessment" title="Neuropsychological assessment">Cognitive testing</a> and brain imaging can help distinguish depression from dementia.<a href="#cite_note-103">[103]</a> A <a href="/wiki/CT_scan" title="CT scan">CT scan</a> can exclude brain pathology in those with psychotic, rapid-onset or otherwise unusual symptoms.<a href="#cite_note-104">[104]</a> No biological tests confirm major depression.<a href="#cite_note-105">[105]</a> In general, investigations are not repeated for a subsequent episode unless there is a medical <a href="/wiki/Indication_(medicine)" title="Indication (medicine)">indication</a>. <div class="mw-heading mw-heading3"><h3 id="DSM_and_ICD_criteria">DSM and ICD criteria</h3></div> The most widely used criteria for diagnosing depressive conditions are found in the <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a>'s <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM) and the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>'s <a href="/wiki/ICD" class="mw-redirect" title="ICD">International Statistical Classification of Diseases and Related Health Problems</a> (ICD). The latter system is typically used in European countries, while the former is used in the US and many other non-European nations,<a href="#cite_note-106">[106]</a> and the authors of both have worked towards conforming one with the other.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013xii-107">[107]</a> Both DSM and ICD mark out typical (main) depressive symptoms.<a href="#cite_note-DSMvsICD-108">[108]</a> The most recent edition of the DSM is the Fifth Edition, Text Revision (DSM-5-TR),<a href="#cite_note-109">[109]</a> and the most recent edition of the ICD is the Eleventh Edition (ICD-11).<a href="#cite_note-110">[110]</a> Under mood disorders, ICD-11 classifies major depressive disorder as either single episode depressive disorder (where there is no history of depressive episodes, or of <a href="/wiki/Mania" title="Mania">mania</a>) or recurrent depressive disorder (where there is a history of prior episodes, with no history of mania).<a href="#cite_note-ICD11_6A70_and_6A71-111">[111]</a> ICD-11 symptoms, present nearly every day for at least two weeks, are a depressed mood or <a href="/wiki/Anhedonia" title="Anhedonia">anhedonia</a>, accompanied by other symptoms such as "difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue."<a href="#cite_note-ICD11_6A70_and_6A71-111">[111]</a> These symptoms must affect work, social, or domestic activities. The ICD-11 system allows further specifiers for the current depressive episode: the severity (mild, moderate, severe, unspecified); the presence of psychotic symptoms (with or without psychotic symptoms); and the degree of remission if relevant (currently in partial remission, currently in full remission).<a href="#cite_note-ICD11_6A70_and_6A71-111">[111]</a> These two disorders are classified as "Depressive disorders", in the category of "Mood disorders".<a href="#cite_note-ICD11_6A70_and_6A71-111">[111]</a> According to DSM-5, at least one of the symptoms is either depressed mood or loss of interest or pleasure. Depressed mood occurs nearly every day as subjective feelings like sadness, emptiness, and hopelessness or observations made by others (e.g. appears tearful). Loss of interest or pleasure occurs in all, or almost all activities of the day, nearly every day. These symptoms, as well as five out of the nine more specific symptoms listed, must frequently occur for more than two weeks (to the extent in which it impairs functioning) for the diagnosis.<a href="#cite_note-112">[112]</a><a href="#cite_note-113">[113]</a>[<a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">failed verification</a>] Major depressive disorder is classified as a mood disorder in the DSM-5.<a href="#cite_note-Parker2014-114">[114]</a> The diagnosis hinges on the presence of single or recurrent <a href="/wiki/Major_depressive_episode" title="Major depressive episode">major depressive episodes</a>.<a href="#cite_note-APA162-115">[115]</a> Further qualifiers are used to classify both the episode itself and the course of the disorder. The category <a href="/wiki/Depressive_Disorder_Not_Otherwise_Specified" class="mw-redirect" title="Depressive Disorder Not Otherwise Specified">Unspecified Depressive Disorder</a> is diagnosed if the depressive episode's manifestation does not meet the criteria for a major depressive episode.<a href="#cite_note-Parker2014-114">[114]</a> <div class="mw-heading mw-heading4"><h4 id="Major_depressive_episode">Major depressive episode</h4></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Major_depressive_episode" title="Major depressive episode">Major depressive episode</a></div> A major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks.<a href="#cite_note-APA349-24">[24]</a> Episodes may be isolated or recurrent and are categorized as mild (few symptoms in excess of minimum criteria), moderate, or severe (marked impact on social or occupational functioning). An episode with psychotic features—commonly referred to as <a href="/wiki/Psychotic_depression" title="Psychotic depression">psychotic depression</a>—is automatically rated as severe.<a href="#cite_note-Parker2014-114">[114]</a> If the person has had an episode of <a href="/wiki/Mania" title="Mania">mania</a> or <a href="/wiki/Hypomania" title="Hypomania">markedly elevated mood</a>, a diagnosis of <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a> is made instead. Depression without mania is sometimes referred to as unipolar because the mood remains at one emotional state or "pole".<a href="#cite_note-116">[116]</a> <a href="/wiki/Grief" title="Grief">Bereavement</a> is not an exclusion criterion in the DSM-5, and it is up to the clinician to distinguish between normal reactions to a loss and MDD. Excluded are a range of related diagnoses, including <a href="/wiki/Dysthymia" title="Dysthymia">dysthymia</a>, which involves a chronic but milder mood disturbance;<a href="#cite_note-Sadock552-117">[117]</a> <a href="/wiki/Recurrent_brief_depression" title="Recurrent brief depression">recurrent brief depression</a>, consisting of briefer depressive episodes;<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013183-118">[118]</a><a href="#cite_note-119">[119]</a> <a href="/wiki/Minor_depressive_disorder" title="Minor depressive disorder">minor depressive disorder</a>, whereby only some symptoms of major depression are present;<a href="#cite_note-120">[120]</a> and <a href="/wiki/Adjustment_disorder" title="Adjustment disorder">adjustment disorder with depressed mood</a>, which denotes low mood resulting from a psychological response to an identifiable event or <a href="/wiki/Stress_(biological)" class="mw-redirect" title="Stress (biological)">stressor</a>.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013168-121">[121]</a> <div class="mw-heading mw-heading4"><h4 id="Subtypes">Subtypes</h4></div> The DSM-5 recognizes six further subtypes of MDD, called specifiers, in addition to noting the length, severity and presence of psychotic features: <ul><li>"<a href="/wiki/Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a>" is characterized by a loss of pleasure in most or all activities, a failure of reactivity to pleasurable stimuli, a quality of depressed mood more pronounced than that of <a href="/wiki/Grief" title="Grief">grief</a> or loss, a worsening of symptoms in the morning hours, early-morning waking, <a href="/wiki/Psychomotor_retardation" title="Psychomotor retardation">psychomotor retardation</a>, excessive weight loss (not to be confused with <a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">anorexia nervosa</a>), or excessive guilt.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013185-122">[122]</a></li> <li>"<a href="/wiki/Atypical_depression" title="Atypical depression">Atypical depression</a>" is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant <a href="/wiki/Weight_gain" title="Weight gain">weight gain</a> or increased appetite (comfort eating), excessive sleep or sleepiness (<a href="/wiki/Hypersomnia" title="Hypersomnia">hypersomnia</a>), a sensation of heaviness in limbs known as leaden paralysis, and significant long-term social impairment as a consequence of hypersensitivity to perceived <a href="/wiki/Social_rejection" title="Social rejection">interpersonal rejection</a>.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013185–186-123">[123]</a></li> <li>"<a href="/wiki/Catatonic_depression" title="Catatonic depression">Catatonic depression</a>" is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here, the person is mute and almost stuporous, and either remains immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms also occur in <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a> or in manic episodes, or may be caused by <a href="/wiki/Neuroleptic_malignant_syndrome" title="Neuroleptic malignant syndrome">neuroleptic malignant syndrome</a>.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013119–120-124">[124]</a></li> <li>"Depression with <a href="/wiki/Anxiety" title="Anxiety">anxious</a> distress" was added into the DSM-5 as a means to emphasize the common co-occurrence between depression or <a href="/wiki/Mania" title="Mania">mania</a> and anxiety, as well as the risk of suicide of depressed individuals with anxiety. Specifying in such a way can also help with the prognosis of those diagnosed with a depressive or bipolar disorder.<a href="#cite_note-Parker2014-114">[114]</a></li> <li>"Depression with <a href="/wiki/Postpartum_depression" title="Postpartum depression">peri-partum</a> onset" refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth or while a woman is pregnant. DSM-IV-TR used the classification "postpartum depression", but this was changed to not exclude cases of depressed woman during pregnancy. Depression with peripartum onset has an incidence rate of 3–6% among new mothers. The DSM-5 mandates that to qualify as depression with peripartum onset, onset occurs during pregnancy or within one month of delivery.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013186–187-125">[125]</a></li> <li>"<a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a>" (SAD) is a form of depression in which depressive episodes come on in the autumn or winter, and resolve in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times, over a two-year period or longer.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013187-126">[126]</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnoses">Differential diagnoses</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Differential_diagnoses_of_depression" title="Differential diagnoses of depression">Differential diagnoses of depression</a></div> To confirm major depressive disorder as the most likely diagnosis, other <a href="/wiki/Differential_diagnosis" title="Differential diagnosis">potential diagnoses</a> must be considered, including <a href="/wiki/Dysthymia" title="Dysthymia">dysthymia</a>, <a href="/wiki/Adjustment_disorder" title="Adjustment disorder">adjustment disorder</a> with depressed mood, or <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>. Dysthymia is a chronic, milder mood disturbance in which a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as <a href="/wiki/Double_depression" title="Double depression">double depression</a>).<a href="#cite_note-Sadock552-117">[117]</a> <a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment disorder with depressed mood</a> is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode.<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013168-121">[121]</a> Other disorders need to be ruled out before diagnosing major depressive disorder. They include depressions due to physical illness, <a href="/wiki/Medications" class="mw-redirect" title="Medications">medications</a>, and <a href="/wiki/Substance_use_disorder" title="Substance use disorder">substance use disorders</a>. Depression due to physical illness is diagnosed as a <a href="/wiki/Mood_disorder#Due_to_another_medical_condition" title="Mood disorder">mood disorder due to a general medical condition</a>. This condition is determined based on history, laboratory findings, or <a href="/wiki/Physical_examination" title="Physical examination">physical examination</a>. When the depression is caused by a medication, non-medical use of a psychoactive substance, or exposure to a <a href="/wiki/Toxin" title="Toxin">toxin</a>, it is then diagnosed as a specific mood disorder (previously called substance-induced mood disorder).<a href="#cite_note-FOOTNOTEAmerican_Psychiatric_Association2013167-127">[127]</a> <div class="mw-heading mw-heading2"><h2 id="Screening_and_prevention">Screening and prevention</h2></div> Preventive efforts may result in decreases in rates of the condition of between 22 and 38%.<a href="#cite_note-Cuijpers2008-128">[128]</a> Since 2016, the <a href="/wiki/United_States_Preventive_Services_Task_Force" title="United States Preventive Services Task Force">United States Preventive Services Task Force</a> (USPSTF) has recommended screening for depression among those over the age 12;<a href="#cite_note-129">[129]</a><a href="#cite_note-130">[130]</a> though a 2005 <a href="/wiki/Cochrane_review" class="mw-redirect" title="Cochrane review">Cochrane review</a> found that the routine use of screening questionnaires has little effect on detection or treatment.<a href="#cite_note-Gil2005-131">[131]</a> Screening the general population is not recommended by authorities in the UK or Canada.<a href="#cite_note-132">[132]</a> Behavioral interventions, such as <a href="/wiki/Interpersonal_therapy" class="mw-redirect" title="Interpersonal therapy">interpersonal therapy</a> and <a href="/wiki/Cognitive-behavioral_therapy" class="mw-redirect" title="Cognitive-behavioral therapy">cognitive-behavioral therapy</a>, are effective at preventing new onset depression.<a href="#cite_note-Cuijpers2008-128">[128]</a><a href="#cite_note-Munoz2012-133">[133]</a><a href="#cite_note-Cuijpers2012-134">[134]</a> Because such interventions appear to be most effective when delivered to individuals or small groups, it has been suggested that they may be able to reach their large target audience most efficiently through the <a href="/wiki/Internet" title="Internet">Internet</a>.<a href="#cite_note-135">[135]</a> The Netherlands mental health care system provides preventive interventions, such as the "Coping with Depression" course (CWD) for people with sub-threshold depression. The course is claimed to be the most successful of psychoeducational interventions for the treatment and prevention of depression (both for its adaptability to various populations and its results), with a risk reduction of 38% in major depression and an efficacy as a treatment comparing favorably to other psychotherapies.<a href="#cite_note-Munoz2012-133">[133]</a><a href="#cite_note-Cuijpers2009-136">[136]</a> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Management_of_depression" title="Management of depression">Management of depression</a></div> The most common and effective treatments for depression are psychotherapy, medication, and electroconvulsive therapy (ECT); a combination of treatments is the most effective approach when depression is resistant to treatment.<a href="#cite_note-Karrouri2021-137">[137]</a> <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> treatment guidelines recommend that initial treatment should be individually tailored based on factors including severity of symptoms, co-existing disorders, prior treatment experience, and personal preference. Options may include pharmacotherapy, psychotherapy, exercise, ECT, <a href="/wiki/Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">transcranial magnetic stimulation</a> (TMS) or <a href="/wiki/Light_therapy" title="Light therapy">light therapy</a>. <a href="/wiki/Antidepressant" title="Antidepressant">Antidepressant</a> medication is recommended as an initial treatment choice in people with mild, moderate, or severe major depression, and should be given to all people with severe depression unless ECT is planned.<a href="#cite_note-apaguidelines-138">[138]</a> There is evidence that collaborative care by a team of health care practitioners produces better results than routine single-practitioner care.<a href="#cite_note-139">[139]</a> Psychotherapy is the treatment of choice (over medication) for people under 18,<a href="#cite_note-NICE2004-140">[140]</a> and <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive behavioral therapy</a> (CBT), third wave CBT and <a href="/wiki/Interpersonal_psychotherapy" title="Interpersonal psychotherapy">interpersonal therapy</a> may help prevent depression.<a href="#cite_note-141">[141]</a> The UK <a href="/wiki/National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence</a> (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatment of mild depression because the <a href="/wiki/Risk-benefit_ratio" class="mw-redirect" title="Risk-benefit ratio">risk-benefit ratio</a> is poor. The guidelines recommend that antidepressants treatment in combination with psychosocial interventions should be considered for:<a href="#cite_note-NICE2004-140">[140]</a> <dl><dd><ul><li>People with a history of moderate or severe depression</li> <li>Those with mild depression that has been present for a long period</li> <li>As a second line treatment for mild depression that persists after other interventions</li> <li>As a first line treatment for moderate or severe depression.</li></ul></dd></dl> The guidelines further note that <a href="/wiki/Antidepressant" title="Antidepressant">antidepressant</a> treatment should be continued for at least six months to reduce the risk of <a href="/wiki/Relapse" title="Relapse">relapse</a>, and that <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a> are better tolerated than <a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">tricyclic antidepressants</a>.<a href="#cite_note-NICE2004-140">[140]</a> Treatment options are more limited in developing countries, where access to mental health staff, medication, and psychotherapy is often difficult. Development of mental health services is minimal in many countries; depression is viewed as a phenomenon of the developed world despite evidence to the contrary, and not as an inherently life-threatening condition.<a href="#cite_note-142">[142]</a> There is insufficient evidence to determine the effectiveness of psychological versus medical therapy in children.<a href="#cite_note-143">[143]</a> <div class="mw-heading mw-heading3"><h3 id="Lifestyle">Lifestyle</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Neurobiological_effects_of_physical_exercise#Major_depressive_disorder" title="Neurobiological effects of physical exercise">Neurobiological effects of physical exercise § Major depressive disorder</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Soccer_football_informal_in_Manipur_India_cropped.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Soccer_football_informal_in_Manipur_India_cropped.jpg/220px-Soccer_football_informal_in_Manipur_India_cropped.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/59/Soccer_football_informal_in_Manipur_India_cropped.jpg/330px-Soccer_football_informal_in_Manipur_India_cropped.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/59/Soccer_football_informal_in_Manipur_India_cropped.jpg/440px-Soccer_football_informal_in_Manipur_India_cropped.jpg 2x" data-file-width="3236" data-file-height="2425" /></a><figcaption>Physical exercise is one recommended way to manage mild depression.</figcaption></figure> <a href="/wiki/Physical_exercise" class="mw-redirect" title="Physical exercise">Physical exercise</a> has been found to be effective for major depression, and may be recommended to people who are willing, motivated, and healthy enough to participate in an exercise program as treatment.<a href="#cite_note-144">[144]</a> It is equivalent to the use of medications or psychological therapies in most people.<a href="#cite_note-Coo2013-7">[7]</a> In older people it does appear to decrease depression.<a href="#cite_note-145">[145]</a> Sleep and diet may also play a role in depression, and interventions in these areas may be an effective add-on to conventional methods.<a href="#cite_note-146">[146]</a> In observational studies, <a href="/wiki/Smoking_cessation" title="Smoking cessation">smoking cessation</a> has benefits in depression as large as or larger than those of medications.<a href="#cite_note-147">[147]</a> <div class="mw-heading mw-heading3"><h3 id="Talking_therapies">Talking therapies</h3></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Behavioral_theories_of_depression" title="Behavioral theories of depression">Behavioral theories of depression</a></div> <a href="/wiki/Talking_therapy" class="mw-redirect" title="Talking therapy">Talking therapy</a> (psychotherapy) can be delivered to individuals, groups, or families by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical <a href="/wiki/Social_work" title="Social work">social workers</a>, counselors, and psychiatric nurses. A 2012 review found psychotherapy to be better than no treatment but not other treatments.<a href="#cite_note-148">[148]</a> With more complex and chronic forms of depression, a combination of medication and psychotherapy may be used.<a href="#cite_note-149">[149]</a><a href="#cite_note-150">[150]</a> There is moderate-quality evidence that psychological therapies are a useful addition to standard antidepressant treatment of <a href="/wiki/Treatment-resistant_depression" title="Treatment-resistant depression">treatment-resistant depression</a> in the short term.<a href="#cite_note-151">[151]</a> Psychotherapy has been shown to be effective in older people.<a href="#cite_note-152">[152]</a><a href="#cite_note-153">[153]</a> Successful psychotherapy appears to reduce the recurrence of depression even after it has been stopped or replaced by occasional booster sessions. The most-studied form of psychotherapy for depression is CBT, which teaches clients to challenge self-defeating, but enduring ways of thinking (cognitions) and change counter-productive behaviors. CBT can perform as well as antidepressants in people with major depression.<a href="#cite_note-154">[154]</a> CBT has the most research evidence for the treatment of depression in children and adolescents, and CBT and interpersonal psychotherapy (IPT) are preferred therapies for adolescent depression.<a href="#cite_note-abct-155">[155]</a> In people under 18, according to the <a href="/wiki/National_Institute_for_Health_and_Clinical_Excellence" class="mw-redirect" title="National Institute for Health and Clinical Excellence">National Institute for Health and Clinical Excellence</a>, medication should be offered only in conjunction with a psychological therapy, such as <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">CBT</a>, <a href="/wiki/Interpersonal_psychotherapy" title="Interpersonal psychotherapy">interpersonal therapy</a>, or <a href="/wiki/Family_therapy" title="Family therapy">family therapy</a>.<a href="#cite_note-NICEkids5-156">[156]</a> Several variables predict success for cognitive behavioral therapy in adolescents: higher levels of rational thoughts, less hopelessness, fewer negative thoughts, and fewer cognitive distortions.<a href="#cite_note-157">[157]</a> CBT is particularly beneficial in preventing relapse.<a href="#cite_note-158">[158]</a><a href="#cite_note-159">[159]</a> Cognitive behavioral therapy and occupational programs (including modification of work activities and assistance) have been shown to be effective in reducing sick days taken by workers with depression.<a href="#cite_note-Nieuwenhuijsen2020-160">[160]</a> Several variants of cognitive behavior therapy have been used in those with depression, the most notable being <a href="/wiki/Rational_emotive_behavior_therapy" title="Rational emotive behavior therapy">rational emotive behavior therapy</a>,<a href="#cite_note-FOOTNOTEBeckRushShawEmery198710-161">[161]</a> and <a href="/wiki/Mindfulness-based_cognitive_therapy" title="Mindfulness-based cognitive therapy">mindfulness-based cognitive therapy</a>.<a href="#cite_note-162">[162]</a> Mindfulness-based stress reduction programs may reduce depression symptoms.<a href="#cite_note-163">[163]</a><a href="#cite_note-164">[164]</a> Mindfulness programs also appear to be a promising intervention in youth.<a href="#cite_note-165">[165]</a> <a href="/wiki/Problem_solving_therapy" class="mw-redirect" title="Problem solving therapy">Problem solving therapy</a>, cognitive behavioral therapy, and interpersonal therapy are effective interventions in the elderly.<a href="#cite_note-Alexopoulos2019-166">[166]</a> <a href="/wiki/Psychoanalysis" title="Psychoanalysis">Psychoanalysis</a> is a school of thought, founded by <a href="/wiki/Sigmund_Freud" title="Sigmund Freud">Sigmund Freud</a>, which emphasizes the resolution of <a href="/wiki/Unconscious_mind" title="Unconscious mind">unconscious</a> mental conflicts.<a href="#cite_note-167">[167]</a> Psychoanalytic techniques are used by some practitioners to treat clients presenting with major depression.<a href="#cite_note-168">[168]</a> A more widely practiced therapy, called <a href="/wiki/Psychodynamic_psychotherapy" title="Psychodynamic psychotherapy">psychodynamic psychotherapy</a>, is in the tradition of psychoanalysis but less intensive, meeting once or twice a week. It also tends to focus more on the person's immediate problems, and has an additional social and interpersonal focus.<a href="#cite_note-FOOTNOTEBarlowDurand200520-169">[169]</a> In a meta-analysis of three controlled trials of Short Psychodynamic Supportive Psychotherapy, this modification was found to be as effective as medication for mild to moderate depression.<a href="#cite_note-170">[170]</a> <div class="mw-heading mw-heading3"><h3 id="Antidepressants">Antidepressants</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Zoloft_bottles.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/48/Zoloft_bottles.jpg/220px-Zoloft_bottles.jpg" decoding="async" width="220" height="196" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/48/Zoloft_bottles.jpg/330px-Zoloft_bottles.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/48/Zoloft_bottles.jpg/440px-Zoloft_bottles.jpg 2x" data-file-width="1223" data-file-height="1088" /></a><figcaption><a href="/wiki/Sertraline" title="Sertraline">Sertraline</a> (Zoloft) is used primarily to treat major depression in adults.</figcaption></figure> Conflicting results have arisen from studies that look at the effectiveness of antidepressants in people with acute, mild to moderate depression.<a href="#cite_note-171">[171]</a> A review commissioned by the <a href="/wiki/National_Institute_for_Health_and_Care_Excellence" title="National Institute for Health and Care Excellence">National Institute for Health and Care Excellence</a> (UK) concluded that there is strong evidence that <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a>, such as <a href="/wiki/Escitalopram" title="Escitalopram">escitalopram</a>, <a href="/wiki/Paroxetine" title="Paroxetine">paroxetine</a>, and <a href="/wiki/Sertraline" title="Sertraline">sertraline</a>, have greater efficacy than <a href="/wiki/Placebo" title="Placebo">placebo</a> on achieving a 50% reduction in depression scores in moderate and severe major depression, and that there is some evidence for a similar effect in mild depression.<a href="#cite_note-Depression_in_Adults-172">[172]</a> Similarly, a Cochrane systematic review of clinical trials of the generic <a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">tricyclic antidepressant</a> <a href="/wiki/Amitriptyline" title="Amitriptyline">amitriptyline</a> concluded that there is strong evidence that its efficacy is superior to placebo.<a href="#cite_note-173">[173]</a> Antidepressants work less well for the elderly than for younger individuals with depression.<a href="#cite_note-Alexopoulos2019-166">[166]</a> To find the most effective antidepressant medication with minimal side-effects, the dosages can be adjusted, and if necessary, combinations of different classes of antidepressants can be tried. Response rates to the first antidepressant administered range from 50 to 75%, and it can take at least six to eight weeks from the start of medication to improvement.<a href="#cite_note-apaguidelines-138">[138]</a><a href="#cite_note-174">[174]</a> Antidepressant medication treatment is usually continued for 16 to 20 weeks after remission, to minimize the chance of recurrence,<a href="#cite_note-apaguidelines-138">[138]</a> and even up to one year of continuation is recommended.<a href="#cite_note-175">[175]</a> People with chronic depression may need to take medication indefinitely to avoid relapse.<a href="#cite_note-NIMHPub-25">[25]</a> <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a> are the primary medications prescribed, owing to their relatively mild side-effects, and because they are less toxic in overdose than other antidepressants.<a href="#cite_note-2008-BNF-204-176">[176]</a> People who do not respond to one SSRI can be switched to <a href="/wiki/List_of_antidepressants" title="List of antidepressants">another antidepressant</a>, and this results in improvement in almost 50% of cases.<a href="#cite_note-177">[177]</a> Another option is to augment the atypical antidepressant <a href="/wiki/Bupropion" title="Bupropion">bupropion</a> to the SSRI as an adjunctive treatment.<a href="#cite_note-178">[178]</a> <a href="/wiki/Venlafaxine" title="Venlafaxine">Venlafaxine</a>, an antidepressant with a different mechanism of action, may be modestly more effective than SSRIs.<a href="#cite_note-179">[179]</a> However, venlafaxine is not recommended in the UK as a first-line treatment because of evidence suggesting its risks may outweigh benefits,<a href="#cite_note-180">[180]</a> and it is specifically discouraged in children and adolescents as it increases the risk of suicidal thoughts or attempts.<a href="#cite_note-NIHR-2022-181">[181]</a><a href="#cite_note-Zhou-2020-182">[182]</a><a href="#cite_note-Hetrick-2021-183">[183]</a><a href="#cite_note-Solmi-2020-184">[184]</a><a href="#cite_note-Boaden-2020-185">[185]</a><a href="#cite_note-Correll-2021-186">[186]</a><a href="#cite_note-187">[187]</a> For children and adolescents with moderate-to-severe depressive disorder, <a href="/wiki/Fluoxetine" title="Fluoxetine">fluoxetine</a> seems to be the best treatment (either with or without <a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">cognitive behavioural therapy</a>) but more research is needed to be certain.<a href="#cite_note-NIHR-2020-188">[188]</a><a href="#cite_note-Zhou-2020-182">[182]</a><a href="#cite_note-189">[189]</a><a href="#cite_note-Hetrick-2021-183">[183]</a> <a href="/wiki/Sertraline" title="Sertraline">Sertraline</a>, <a href="/wiki/Escitalopram" title="Escitalopram">escitalopram</a>, <a href="/wiki/Duloxetine" title="Duloxetine">duloxetine</a> might also help in reducing symptoms. Some antidepressants have not been shown to be effective.<a href="#cite_note-Lancet2016Kid-190">[190]</a><a href="#cite_note-Zhou-2020-182">[182]</a> Medications are not recommended in children with mild disease.<a href="#cite_note-191">[191]</a> There is also insufficient evidence to determine effectiveness in those with depression complicated by <a href="/wiki/Dementia" title="Dementia">dementia</a>.<a href="#cite_note-192">[192]</a> Any antidepressant can cause <a href="/wiki/Hyponatremia" title="Hyponatremia">low blood sodium</a> levels;<a href="#cite_note-193">[193]</a> nevertheless, it has been reported more often with SSRIs.<a href="#cite_note-2008-BNF-204-176">[176]</a> It is not uncommon for SSRIs to cause or worsen insomnia; the sedating <a href="/wiki/Atypical_antidepressant" title="Atypical antidepressant">atypical antidepressant</a> <a href="/wiki/Mirtazapine" title="Mirtazapine">mirtazapine</a> can be used in such cases.<a href="#cite_note-194">[194]</a><a href="#cite_note-195">[195]</a> Irreversible <a href="/wiki/Monoamine_oxidase_inhibitor" title="Monoamine oxidase inhibitor">monoamine oxidase inhibitors</a>, an older class of antidepressants, have been plagued by potentially life-threatening dietary and drug interactions. They are still used only rarely, although newer and better-tolerated agents of this class have been developed.<a href="#cite_note-196">[196]</a> The safety profile is different with reversible monoamine oxidase inhibitors, such as <a href="/wiki/Moclobemide" title="Moclobemide">moclobemide</a>, where the risk of serious dietary interactions is negligible and dietary restrictions are less strict.<a href="#cite_note-197">[197]</a> It is unclear whether antidepressants affect a person's risk of suicide.<a href="#cite_note-198">[198]</a> For children, adolescents, and probably young adults between 18 and 24 years old, there is a higher risk of both <a href="/wiki/Suicidal_ideation" title="Suicidal ideation">suicidal ideations</a> and <a href="/wiki/Suicidal_behavior" class="mw-redirect" title="Suicidal behavior">suicidal behavior</a> in those treated with SSRIs.<a href="#cite_note-FDA-199">[199]</a><a href="#cite_note-200">[200]</a> For adults, it is unclear whether SSRIs affect the risk of suicidality. One review found no connection;<a href="#cite_note-201">[201]</a> another an increased risk;<a href="#cite_note-202">[202]</a> and a third no risk in those 25–65 years old and a decreased risk in those more than 65.<a href="#cite_note-203">[203]</a> A <a href="/wiki/Black_box_warning" class="mw-redirect" title="Black box warning">black box warning</a> was introduced in the United States in 2007 on SSRIs and other antidepressant medications due to the increased risk of suicide in people younger than 24 years old.<a href="#cite_note-204">[204]</a> Similar precautionary notice revisions were implemented by the Japanese Ministry of Health.<a href="#cite_note-205">[205]</a> <div class="mw-heading mw-heading3"><h3 id="Other_medications_and_supplements">Other medications and supplements</h3></div> The combined use of antidepressants plus <a href="/wiki/Benzodiazepine" title="Benzodiazepine">benzodiazepines</a> demonstrates improved effectiveness when compared to antidepressants alone, but these effects may not endure. The addition of a benzodiazepine is balanced against possible harms and other alternative treatment strategies when antidepressant mono-therapy is considered inadequate.<a href="#cite_note-Ogawa2019-206">[206]</a> For treatment-resistant depression, adding on the <a href="/wiki/Atypical_antipsychotic" title="Atypical antipsychotic">atypical antipsychotic</a> <a href="/wiki/Brexpiprazole" title="Brexpiprazole">brexpiprazole</a> for short-term or acute management may be considered.<a href="#cite_note-Ralovska2023-207">[207]</a> Brexpiprazole may be effective for some people, however, the evidence as of 2023 supporting its use is weak and this medication has potential adverse effects including weight gain and <a href="/wiki/Akathisia" title="Akathisia">akathisia</a>.<a href="#cite_note-Ralovska2023-207">[207]</a> Brexpiprazole has not been sufficiently studied in older people or children and the use and effectiveness of this <a href="/wiki/Adjunctive_therapy" class="mw-redirect" title="Adjunctive therapy">adjunctive</a> therapy for longer term management is not clear.<a href="#cite_note-Ralovska2023-207">[207]</a> <a href="/wiki/Ketamine" title="Ketamine">Ketamine</a> may have a rapid antidepressant effect lasting less than two weeks; there is limited evidence of any effect after that, common acute side effects, and longer-term studies of safety and adverse effects are needed.<a href="#cite_note-208">[208]</a><a href="#cite_note-209">[209]</a> A nasal spray form of <a href="/wiki/Esketamine" title="Esketamine">esketamine</a> was approved by the FDA in March 2019 for use in treatment-resistant depression when combined with an oral antidepressant; risk of substance use disorder and concerns about its safety, serious adverse effects, tolerability, effect on suicidality, lack of information about dosage, whether the studies on it adequately represent broad populations, and escalating use of the product have been raised by an international panel of experts.<a href="#cite_note-210">[210]</a><a href="#cite_note-211">[211]</a> <a href="/wiki/Nonsteroidal_anti-inflammatory_drug" title="Nonsteroidal anti-inflammatory drug">Nonsteroidal anti-inflammatory drugs</a> (NSAIDs) and cytokine inhibitors are effective in treating depression. For instance, <a href="/wiki/Celecoxib" title="Celecoxib">Celecoxib</a>, an NSAID, is a selective COX-2 inhibitor– which is an enzyme that helps in the production of pain and inflammation.<a href="#cite_note-212">[212]</a> In recent clinical trials, this NSAID has been shown helpful with treatment-resistant depression as it helps inhibit proinflammatory signaling.<a href="#cite_note-213">[213]</a> <a href="/wiki/Statin" title="Statin">Statins</a>, which are anti-inflammatory medications prescribed to lower cholesterol levels, have also been shown to have antidepressant effects. When prescribed for patients already taking SSRIs, this add-on treatment was shown to improve anti-depressant effects of SSRIs when compared to the placebo group. With this, statins have been shown to be effective in preventing depression in some cases too.<a href="#cite_note-214">[214]</a> There is insufficient high quality evidence to suggest <a href="/wiki/Omega-3_fatty_acid" title="Omega-3 fatty acid">omega-3 fatty acids</a> are effective in depression.<a href="#cite_note-215">[215]</a> There is limited evidence that vitamin D supplementation is of value in alleviating the symptoms of depression in individuals who are vitamin D-deficient.<a href="#cite_note-Parker2017-100">[100]</a> <a href="/wiki/Lithium_(medication)" title="Lithium (medication)">Lithium</a> appears effective at lowering the risk of suicide in those with bipolar disorder and unipolar depression to nearly the same levels as the general population.<a href="#cite_note-216">[216]</a> There is a narrow range of effective and safe dosages of lithium thus close monitoring may be needed.<a href="#cite_note-217">[217]</a> Low-dose <a href="/wiki/Thyroid_hormone" class="mw-redirect" title="Thyroid hormone">thyroid hormone</a> may be added to existing antidepressants to treat persistent depression symptoms in people who have tried multiple courses of medication.<a href="#cite_note-APA_MDD_Guideline-218">[218]</a> Limited evidence suggests <a href="/wiki/Stimulants" class="mw-redirect" title="Stimulants">stimulants</a>, such as <a href="/wiki/Amphetamine" title="Amphetamine">amphetamine</a> and <a href="/wiki/Modafinil" title="Modafinil">modafinil</a>, may be effective in the short term, or as <a href="/wiki/Adjuvant_therapy" title="Adjuvant therapy">adjuvant therapy</a>.<a href="#cite_note-219">[219]</a><a href="#cite_note-220">[220]</a> Also, it is suggested that <a href="/wiki/Folate" title="Folate">folate</a> supplements may have a role in depression management.<a href="#cite_note-221">[221]</a> There is tentative evidence for benefit from <a href="/wiki/Testosterone" title="Testosterone">testosterone</a> in males.<a href="#cite_note-222">[222]</a> <div class="mw-heading mw-heading3"><h3 id="Electroconvulsive_therapy">Electroconvulsive therapy</h3></div> <a href="/wiki/Electroconvulsive_therapy" title="Electroconvulsive therapy">Electroconvulsive therapy</a> (ECT) is a standard <a href="/wiki/Psychiatry" title="Psychiatry">psychiatric</a> treatment in which <a href="/wiki/Seizure" title="Seizure">seizures</a> are electrically induced in a person with depression to provide relief from psychiatric illnesses.<a href="#cite_note-223">[223]</a>: 1880  ECT is used with <a href="/wiki/Informed_consent" title="Informed consent">informed consent</a><a href="#cite_note-Beloucif-224">[224]</a> as a last line of intervention for major depressive disorder.<a href="#cite_note-FDA2011rev-225">[225]</a> A round of ECT is effective for about 50% of people with treatment-resistant major depressive disorder, whether it is unipolar or <a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">bipolar</a>.<a href="#cite_note-226">[226]</a> Follow-up treatment is still poorly studied, but about half of people who respond relapse within twelve months.<a href="#cite_note-227">[227]</a> Aside from effects in the brain, the general physical risks of ECT are similar to those of brief <a href="/wiki/General_anesthesia" class="mw-redirect" title="General anesthesia">general anesthesia</a>.<a href="#cite_note-SG-228">[228]</a>: 259  Immediately following treatment, the most common adverse effects are confusion and memory loss.<a href="#cite_note-FDA2011rev-225">[225]</a><a href="#cite_note-229">[229]</a> ECT is considered one of the least harmful treatment options available for severely depressed pregnant women.<a href="#cite_note-Pompili2014Rev-230">[230]</a> A usual course of ECT involves multiple administrations, typically given two or three times per week, until the person no longer has symptoms. ECT is administered under <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a> with a <a href="/wiki/Muscle_relaxant" title="Muscle relaxant">muscle relaxant</a>.<a href="#cite_note-231">[231]</a> Electroconvulsive therapy can differ in its application in three ways: electrode placement, frequency of treatments, and the electrical waveform of the stimulus. These three forms of application have significant differences in both adverse side effects and symptom remission. After treatment, drug therapy is usually continued, and some people receive maintenance ECT.<a href="#cite_note-FDA2011rev-225">[225]</a> ECT appears to work in the short term via an <a href="/wiki/Anticonvulsant" title="Anticonvulsant">anticonvulsant</a> effect mostly in the <a href="/wiki/Frontal_lobes" class="mw-redirect" title="Frontal lobes">frontal lobes</a>, and longer term via <a href="/wiki/Neurotrophic" class="mw-redirect" title="Neurotrophic">neurotrophic</a> effects primarily in the <a href="/wiki/Medial_temporal_lobe" class="mw-redirect" title="Medial temporal lobe">medial temporal lobe</a>.<a href="#cite_note-Abbott2014-232">[232]</a> <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3></div> <a href="/wiki/Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">Transcranial magnetic stimulation</a> (TMS) or <a href="/wiki/Deep_transcranial_magnetic_stimulation" class="mw-redirect" title="Deep transcranial magnetic stimulation">deep transcranial magnetic stimulation</a> is a noninvasive method used to stimulate small regions of the brain.<a href="#cite_note-233">[233]</a> TMS was approved by the FDA for treatment-resistant major depressive disorder (trMDD) in 2008<a href="#cite_note-234">[234]</a> and as of 2014 evidence supports that it is probably effective.<a href="#cite_note-235">[235]</a> The American Psychiatric Association,<a href="#cite_note-236">[236]</a> the Canadian Network for Mood and Anxiety Disorders,<a href="#cite_note-237">[237]</a> and the Royal Australia and New Zealand College of Psychiatrists have endorsed TMS for trMDD.<a href="#cite_note-238">[238]</a> <a href="/wiki/Transcranial_direct_current_stimulation" class="mw-redirect" title="Transcranial direct current stimulation">Transcranial direct current stimulation</a> (tDCS) is another noninvasive method used to stimulate small regions of the brain with a weak electric current. Several meta-analyses have concluded that active tDCS was useful for treating depression.<a href="#cite_note-239">[239]</a><a href="#cite_note-240">[240]</a> There is a small amount of evidence that <a href="/wiki/Sleep_deprivation" title="Sleep deprivation">sleep deprivation</a> may improve depressive symptoms in some individuals,<a href="#cite_note-241">[241]</a> with the effects usually showing up within a day. This effect is usually temporary. Besides sleepiness, this method can cause a side effect of <a href="/wiki/Mania" title="Mania">mania</a> or <a href="/wiki/Hypomania" title="Hypomania">hypomania</a>.<a href="#cite_note-242">[242]</a> There is insufficient evidence for <a href="/wiki/Reiki" title="Reiki">Reiki</a><a href="#cite_note-243">[243]</a> and <a href="/wiki/Dance_movement_therapy" class="mw-redirect" title="Dance movement therapy">dance movement therapy</a> in depression.<a href="#cite_note-244">[244]</a> <a href="/wiki/Medical_cannabis" title="Medical cannabis">Cannabis</a> is specifically not recommended as a treatment.<a href="#cite_note-245">[245]</a> The <a href="/wiki/Human_microbiome" title="Human microbiome">microbiome</a> of people with major depressive disorder differs from that of healthy people, and <a href="/wiki/Probiotic" title="Probiotic">probiotic</a> and <a href="/wiki/Synbiotics" title="Synbiotics">synbiotic</a> treatment may achieve a modest depressive symptom reduction.<a href="#cite_note-246">[246]</a><a href="#cite_note-247">[247]</a> With this, <a href="/wiki/Fecal_microbiota_transplant" title="Fecal microbiota transplant">fecal microbiota transplants</a> (FMT) are being researched as add-on therapy treatments for people who do not respond to typical therapies. It has been shown that the patient's depressive symptoms improved, with minor gastrointestinal issues, after a FMT, with improvements in symptoms lasting at least 4 weeks after the transplant.<a href="#cite_note-248">[248]</a> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div> Studies have shown that 80% of those with a first major depressive episode will have at least one more during their life,<a href="#cite_note-249">[249]</a> with a lifetime average of four episodes.<a href="#cite_note-250">[250]</a> Other general population studies indicate that around half those who have an episode recover (whether treated or not) and remain well, while the other half will have at least one more, and around 15% of those experience chronic recurrence.<a href="#cite_note-251">[251]</a> Studies recruiting from selective inpatient sources suggest lower recovery and higher chronicity, while studies of mostly outpatients show that nearly all recover, with a median episode duration of 11 months. Around 90% of those with severe or psychotic depression, most of whom also meet criteria for other mental disorders, experience recurrence.<a href="#cite_note-252">[252]</a><a href="#cite_note-253">[253]</a> Cases when outcome is poor are associated with inappropriate treatment, severe initial symptoms including psychosis, early age of onset, previous episodes, incomplete recovery after one year of treatment, pre-existing severe mental or medical disorder, and <a href="/wiki/Family_dysfunction" class="mw-redirect" title="Family dysfunction">family dysfunction</a>.<a href="#cite_note-254">[254]</a> A high proportion of people who experience full symptomatic remission still have at least one not fully resolved symptom after treatment.<a href="#cite_note-Culpepper2015-255">[255]</a> Recurrence or chronicity is more likely if symptoms have not fully resolved with treatment.<a href="#cite_note-Culpepper2015-255">[255]</a> Current guidelines recommend continuing antidepressants for four to six months after remission to prevent relapse. Evidence from many <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomized controlled trials</a> indicates continuing antidepressant medications after recovery can reduce the chance of relapse by 70% (41% on placebo vs. 18% on antidepressant). The preventive effect probably lasts for at least the first 36 months of use.<a href="#cite_note-256">[256]</a> Major depressive episodes often resolve over time, whether or not they are treated. Outpatients on a waiting list show a 10–15% reduction in symptoms within a few months, with approximately 20% no longer meeting the full criteria for a depressive disorder.<a href="#cite_note-257">[257]</a> The <a href="/wiki/Median" title="Median">median</a> duration of an episode has been estimated to be 23 weeks, with the highest rate of recovery in the first three months.<a href="#cite_note-258">[258]</a> According to a 2013 review, 23% of untreated adults with mild to moderate depression will remit within 3 months, 32% within 6 months and 53% within 12 months.<a href="#cite_note-259">[259]</a> <div class="mw-heading mw-heading3"><h3 id="Ability_to_work">Ability to work</h3></div> Depression may affect people's ability to work. The combination of usual clinical care and support with return to work (like working less hours or changing tasks) probably reduces sick leave by 15%, and leads to fewer depressive symptoms and improved work capacity, reducing sick leave by an annual average of 25 days per year.<a href="#cite_note-Nieuwenhuijsen2020-160">[160]</a> Helping depressed people return to work without a connection to clinical care has not been shown to have an effect on sick leave days. Additional psychological interventions (such as online cognitive behavioral therapy) lead to fewer sick days compared to standard management only. Streamlining care or adding specific providers for depression care may help to reduce sick leave.<a href="#cite_note-Nieuwenhuijsen2020-160">[160]</a> <div class="mw-heading mw-heading3"><h3 id="Life_expectancy_and_the_risk_of_suicide">Life expectancy and the risk of suicide</h3></div> Depressed individuals have a shorter <a href="/wiki/Life_expectancy" title="Life expectancy">life expectancy</a> than those without depression, in part because people who are depressed are at risk of dying of suicide.<a href="#cite_note-260">[260]</a> About 50% of people who die of suicide have a <a href="/wiki/Mood_disorder" title="Mood disorder">mood disorder</a> such as major depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and <a href="/wiki/Borderline_personality_disorder" title="Borderline personality disorder">borderline personality disorder</a>.<a href="#cite_note-FOOTNOTEBarlowDurand2005248–49-261">[261]</a><a href="#cite_note-262">[262]</a> About 2–8% of adults with major depression die by <a href="/wiki/Suicide" title="Suicide">suicide</a>.<a href="#cite_note-Rich2014-2">[2]</a><a href="#cite_note-263">[263]</a> In the US, the lifetime risk of suicide associated with a diagnosis of major depression is estimated at 7% for men and 1% for women,<a href="#cite_note-264">[264]</a> even though suicide attempts are more frequent in women.<a href="#cite_note-265">[265]</a> Depressed people also have a higher <a href="/wiki/Mortality_rate" title="Mortality rate">rate of dying</a> from other causes.<a href="#cite_note-266">[266]</a> There is a 1.5- to 2-fold increased risk of <a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>, independent of other known risk factors, and is itself linked directly or indirectly to risk factors such as smoking and obesity. People with major depression are less likely to follow medical recommendations for treating and preventing <a href="/wiki/Cardiovascular_disorders" class="mw-redirect" title="Cardiovascular disorders">cardiovascular disorders</a>, further increasing their risk of medical complications.<a href="#cite_note-267">[267]</a> <a href="/wiki/Cardiologists" class="mw-redirect" title="Cardiologists">Cardiologists</a> may not recognize underlying depression that complicates a cardiovascular problem under their care.<a href="#cite_note-268">[268]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Epidemiology_of_depression" title="Epidemiology of depression">Epidemiology of depression</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg/250px-Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg.png" decoding="async" width="250" height="110" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg/375px-Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f2/Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg/500px-Unipolar_depressive_disorders_world_map_-_DALY_-_WHO2004.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption><a href="/wiki/Disability-adjusted_life_year" title="Disability-adjusted life year">Disability-adjusted life year</a> for unipolar depressive disorders per 100,000 inhabitants in 2004:<a href="#cite_note-269">[269]</a> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 10em;"> <style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend">  no data</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  <700</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  700–775</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  775–850</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  850–925</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  925–1,000</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,000–1,075</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,075–1,150</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,150–1,225</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,225–1,300</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,300–1,375</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  1,375–1,450</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend">  >1,450</div> </div></figcaption></figure> Major depressive disorder affected approximately 163 million people in 2017 (2% of the global population).<a href="#cite_note-GBD_2017_prevalence-8">[8]</a> The percentage of people who are affected at one point in their life varies from 7% in Japan to 21% in France. In most countries the number of people who have depression during their lives falls within an 8–18% range. Lifetime rates are higher in the <a href="/wiki/Developed_world" class="mw-redirect" title="Developed world">developed world</a> (15%) compared to the <a href="/wiki/Developing_world" class="mw-redirect" title="Developing world">developing world</a> (11%).<a href="#cite_note-Kes2013-4">[4]</a> In the United States, 8.4% of adults (21 million individuals) have at least one episode within a year-long period; the probability of having a major depressive episode is higher for females than males (10.5% to 6.2%), and highest for those aged 18 to 25 (17%).<a href="#cite_note-NIMHMajorDepression-270">[270]</a> 15% of adolescents, ages 12 to 17, in America are also affected by depression, which is equal to 3.7 million teenagers.<a href="#cite_note-:1-271">[271]</a> Among individuals reporting two or more races, the US prevalence is highest.<a href="#cite_note-NIMHMajorDepression-270">[270]</a> Out of all the people suffering from MDD, only about 35% seek help from a professional for their disorder.<a href="#cite_note-:1-271">[271]</a> Major depression is about twice as common in women as in men, although it is unclear why this is so, and whether factors unaccounted for are contributing to this.<a href="#cite_note-Kuehner03-272">[272]</a> The relative increase in occurrence is related to pubertal development rather than chronological age, reaches adult ratios between the ages of 15 and 18, and appears associated with psychosocial more than hormonal factors.<a href="#cite_note-Kuehner03-272">[272]</a> In 2019, major depressive disorder was identified (using either the DSM-IV-TR or ICD-10) in the <a href="/wiki/Global_Burden_of_Disease_Study" title="Global Burden of Disease Study">Global Burden of Disease Study</a> as the fifth most common cause of <a href="/wiki/Years_lived_with_disability" class="mw-redirect" title="Years lived with disability">years lived with disability</a> and the 18th most common for <a href="/wiki/Disability-adjusted_life_years" class="mw-redirect" title="Disability-adjusted life years">disability-adjusted life years</a>.<a href="#cite_note-273">[273]</a> People are most likely to develop their first depressive episode between the ages of 30 and 40, and there is a second, smaller peak of incidence between ages 50 and 60.<a href="#cite_note-274">[274]</a> The risk of major depression is increased with neurological conditions such as <a href="/wiki/Stroke" title="Stroke">stroke</a>, <a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a>, or <a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a>, and during the first year after childbirth (<a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a>).<a href="#cite_note-275">[275]</a> It is also more common after cardiovascular illnesses, and is related more to those with a poor cardiac <a href="/wiki/Prognosis" title="Prognosis">disease outcome</a> than to a better one.<a href="#cite_note-276">[276]</a><a href="#cite_note-277">[277]</a> Depressive disorders are more common in urban populations than in rural ones and the prevalence is increased in groups with poorer socioeconomic factors, e.g., homelessness.<a href="#cite_note-278">[278]</a> Depression is common among those over 65 years of age and increases in frequency beyond this age.<a href="#cite_note-SBU-29">[29]</a> The risk of depression increases in relation to the frailty of the individual.<a href="#cite_note-279">[279]</a> Depression is one of the most important factors which negatively impact quality of life in adults, as well as the elderly.<a href="#cite_note-SBU-29">[29]</a> Both symptoms and treatment among the elderly differ from those of the rest of the population.<a href="#cite_note-SBU-29">[29]</a> Major depression was the leading cause of <a href="/wiki/Disease_burden" title="Disease burden">disease burden</a> in North America and other high-income countries, and the fourth-leading cause worldwide as of 2006. In the year 2030, it is predicted to be the second-leading cause of disease burden worldwide after <a href="/wiki/HIV" title="HIV">HIV</a>, according to the WHO.<a href="#cite_note-280">[280]</a> Delay or failure in seeking treatment after relapse and the failure of health professionals to provide treatment are two barriers to reducing disability.<a href="#cite_note-281">[281]</a> <div class="mw-heading mw-heading3"><h3 id="Comorbidity">Comorbidity</h3></div> Major depression frequently <a href="/wiki/Comorbidity" title="Comorbidity">co-occurs</a> with other psychiatric problems. The 1990–92 <a href="/wiki/National_Comorbidity_Survey" title="National Comorbidity Survey">National Comorbidity Survey</a> (US) reported that half of those with major depression also have lifetime <a href="/wiki/Anxiety" title="Anxiety">anxiety</a> and its associated disorders, such as <a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">generalized anxiety disorder</a>.<a href="#cite_note-282">[282]</a> Anxiety symptoms can have a major impact on the course of a depressive illness, with delayed recovery, increased risk of relapse, greater disability and increased suicidal behavior.<a href="#cite_note-283">[283]</a> Depressed people have increased rates of alcohol and substance use, particularly dependence,<a href="#cite_note-284">[284]</a><a href="#cite_note-285">[285]</a> and around a third of individuals diagnosed with <a href="/wiki/Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">attention deficit hyperactivity disorder</a> (ADHD) develop comorbid depression.<a href="#cite_note-286">[286]</a> <a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">Post-traumatic stress disorder</a> and depression often co-occur.<a href="#cite_note-NIMHPub-25">[25]</a> Depression may also coexist with ADHD, complicating the diagnosis and treatment of both.<a href="#cite_note-287">[287]</a> Depression is also frequently comorbid with <a href="/wiki/Alcohol_use_disorder" class="mw-redirect" title="Alcohol use disorder">alcohol use disorder</a> and <a href="/wiki/Personality_disorder" title="Personality disorder">personality disorders</a>.<a href="#cite_note-288">[288]</a> Depression can also be exacerbated during particular months (usually winter) in those with <a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">seasonal affective disorder</a>. While <a href="/wiki/Digital_media_use_and_mental_health" title="Digital media use and mental health">overuse of digital media</a> has been associated with depressive symptoms, using digital media may also improve mood in some situations.<a href="#cite_note-289">[289]</a><a href="#cite_note-290">[290]</a> Depression and <a href="/wiki/Pain" title="Pain">pain</a> often co-occur. One or more pain symptoms are present in 65% of people who have depression, and anywhere from 5 to 85% of people who are experiencing pain will also have depression, depending on the setting—a lower prevalence in general practice, and higher in specialty clinics. Depression is often underrecognized, and therefore undertreated, in patients presenting with pain.<a href="#cite_note-291">[291]</a> Depression often coexists with physical disorders common among the elderly, such as <a href="/wiki/Stroke" title="Stroke">stroke</a>, other <a href="/wiki/Cardiovascular_diseases" class="mw-redirect" title="Cardiovascular diseases">cardiovascular diseases</a>, <a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a>, and <a href="/wiki/Chronic_obstructive_pulmonary_disease" title="Chronic obstructive pulmonary disease">chronic obstructive pulmonary disease</a>.<a href="#cite_note-292">[292]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/History_of_depression" title="History of depression">History of depression</a></div> The Ancient Greek physician <a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a> described a syndrome of <a href="/wiki/Melancholia" title="Melancholia">melancholia</a> (μελαγχολία, melankholía) as a distinct disease with particular mental and physical symptoms; he characterized all "fears and despondencies, if they last a long time" as being symptomatic of the ailment.<a href="#cite_note-293">[293]</a> It was a similar but far broader concept than today's depression; prominence was given to a clustering of the symptoms of sadness, dejection, and despondency, and often fear, anger, delusions and obsessions were included.<a href="#cite_note-Radden2003-294">[294]</a> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Hippocrates_pushkin02.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Hippocrates_pushkin02.jpg/220px-Hippocrates_pushkin02.jpg" decoding="async" width="220" height="294" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Hippocrates_pushkin02.jpg/330px-Hippocrates_pushkin02.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/18/Hippocrates_pushkin02.jpg/440px-Hippocrates_pushkin02.jpg 2x" data-file-width="760" data-file-height="1014" /></a><figcaption>Diagnoses of depression go back at least as far as <a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a>.</figcaption></figure> The term depression itself was derived from the Latin verb deprimere, meaning "to press down".<a href="#cite_note-295">[295]</a> From the 14th century, "to depress" meant to subjugate or to bring down in spirits. It was used in 1665 in English author <a href="/wiki/Richard_Baker_(chronicler)" title="Richard Baker (chronicler)">Richard Baker's</a> Chronicle to refer to someone having "a great depression of spirit", and by English author <a href="/wiki/Samuel_Johnson%27s_health" class="mw-redirect" title="Samuel Johnson's health">Samuel Johnson</a> in a similar sense in 1753.<a href="#cite_note-296">[296]</a> The term also came into use in <a href="/wiki/Depression_(physiology)" title="Depression (physiology)">physiology</a> and <a href="/wiki/Depression_(economics)" class="mw-redirect" title="Depression (economics)">economics</a>. An early usage referring to a psychiatric symptom was by French psychiatrist <a href="/wiki/Louis_Delasiauve" title="Louis Delasiauve">Louis Delasiauve</a> in 1856, and by the 1860s it was appearing in medical dictionaries to refer to a physiological and metaphorical lowering of emotional function.<a href="#cite_note-297">[297]</a> Since <a href="/wiki/Aristotle" title="Aristotle">Aristotle</a>, melancholia had been associated with men of learning and intellectual brilliance, a hazard of contemplation and creativity. However, by the 19th century, this association has largely shifted and melancholia became more commonly linked with women.<a href="#cite_note-Radden2003-294">[294]</a> Although melancholia remained the dominant diagnostic term, depression gained increasing currency in medical treatises and was a synonym by the end of the century; German psychiatrist <a href="/wiki/Emil_Kraepelin" title="Emil Kraepelin">Emil Kraepelin</a> may have been the first to use it as the overarching term, referring to different kinds of melancholia as depressive states.<a href="#cite_note-Davison2006-298">[298]</a> Freud likened the state of melancholia to mourning in his 1917 paper Mourning and Melancholia. He theorized that <a href="/wiki/Object_(philosophy)" class="mw-redirect" title="Object (philosophy)">objective</a> loss, such as the loss of a valued relationship through death or a romantic break-up, results in <a href="/wiki/Subject_(philosophy)" class="mw-redirect" title="Subject (philosophy)">subjective</a> loss as well; the depressed individual has identified with the object of affection through an <a href="/wiki/Unconscious_mind" title="Unconscious mind">unconscious</a>, <a href="/wiki/Narcissism" title="Narcissism">narcissistic</a> process called the libidinal <a href="/wiki/Cathexis" title="Cathexis">cathexis</a> of the <a href="/wiki/Id,_ego_and_super-ego" class="mw-redirect" title="Id, ego and super-ego">ego</a>. Such loss results in severe melancholic symptoms more profound than mourning; not only is the outside world viewed negatively but the ego itself is compromised.<a href="#cite_note-299">[299]</a> The person's decline of self-perception is revealed in his belief of his own blame, inferiority, and unworthiness.<a href="#cite_note-300">[300]</a> He also emphasized early life experiences as a predisposing factor.<a href="#cite_note-Radden2003-294">[294]</a> <a href="/wiki/Adolf_Meyer_(psychiatrist)" title="Adolf Meyer (psychiatrist)">Adolf Meyer</a> put forward a mixed social and biological framework emphasizing reactions in the context of an individual's life, and argued that the term depression should be used instead of melancholia.<a href="#cite_note-Lewis1934-301">[301]</a> The first version of the DSM (DSM-I, 1952) contained depressive reaction and the DSM-II (1968) depressive neurosis, defined as an excessive reaction to internal conflict or an identifiable event, and also included a depressive type of manic-depressive psychosis within Major affective disorders.<a href="#cite_note-DSMII-302">[302]</a> The term unipolar (along with the related term bipolar) was coined by the neurologist and psychiatrist <a href="/wiki/Karl_Kleist" title="Karl Kleist">Karl Kleist</a>, and subsequently used by his disciples <a href="/wiki/Edda_Neele" title="Edda Neele">Edda Neele</a> and <a href="/wiki/Karl_Leonhard" title="Karl Leonhard">Karl Leonhard</a>.<a href="#cite_note-303">[303]</a> The term Major depressive disorder was introduced by a group of US clinicians in the mid-1970s as part of proposals for diagnostic criteria based on patterns of symptoms (called the "Research Diagnostic Criteria", building on earlier <a href="/wiki/Feighner_Criteria" title="Feighner Criteria">Feighner Criteria</a>),<a href="#cite_note-Spitzer-10">[10]</a> and was incorporated into the DSM-III in 1980.<a href="#cite_note-Philipp1991-304">[304]</a> The <a href="/wiki/American_Psychiatric_Association" title="American Psychiatric Association">American Psychiatric Association</a> added "major depressive disorder" to the <a href="/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders" title="Diagnostic and Statistical Manual of Mental Disorders">Diagnostic and Statistical Manual of Mental Disorders</a> (DSM-III),<a href="#cite_note-Her2008-305">[305]</a> as a split of the previous <a href="/wiki/Depressive_neurosis" class="mw-redirect" title="Depressive neurosis">depressive neurosis</a> in the DSM-II, which also encompassed the conditions now known as dysthymia and <a href="/wiki/Adjustment_disorder_with_depressed_mood" class="mw-redirect" title="Adjustment disorder with depressed mood">adjustment disorder with depressed mood</a>.<a href="#cite_note-Her2008-305">[305]</a> To maintain consistency the ICD-10 used the same criteria, with only minor alterations, but using the DSM diagnostic threshold to mark a mild depressive episode, adding higher threshold categories for moderate and severe episodes.<a href="#cite_note-DSMvsICD-108">[108]</a><a href="#cite_note-Philipp1991-304">[304]</a> The ancient idea of melancholia still survives in the notion of a melancholic subtype. The new definitions of depression were widely accepted, albeit with some conflicting findings and views. There have been some continued empirically based arguments for a return to the diagnosis of melancholia.<a href="#cite_note-ActaPsychiatrica06-306">[306]</a><a href="#cite_note-307">[307]</a> There has been some criticism of the expansion of coverage of the diagnosis, related to the development and promotion of antidepressants and the biological model since the late 1950s.<a href="#cite_note-308">[308]</a> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Depression_and_culture" title="Depression and culture">Depression and culture</a></div> <div class="mw-heading mw-heading3"><h3 id="Terminology">Terminology</h3></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Abraham_Lincoln_O-60_by_Brady,_1862.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c2/Abraham_Lincoln_O-60_by_Brady%2C_1862.jpg/220px-Abraham_Lincoln_O-60_by_Brady%2C_1862.jpg" decoding="async" width="220" height="335" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c2/Abraham_Lincoln_O-60_by_Brady%2C_1862.jpg/330px-Abraham_Lincoln_O-60_by_Brady%2C_1862.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/c/c2/Abraham_Lincoln_O-60_by_Brady%2C_1862.jpg 2x" data-file-width="427" data-file-height="650" /></a><figcaption>The 16th <a href="/wiki/President_of_the_United_States" title="President of the United States">American president</a>, <a href="/wiki/Abraham_Lincoln" title="Abraham Lincoln">Abraham Lincoln</a>, had "<a href="/wiki/Depression_(mood)" title="Depression (mood)">melancholy</a>", a condition that now may be referred to as clinical depression.<a href="#cite_note-309">[309]</a></figcaption></figure> The term "depression" is used in a number of different ways. It is often used to mean this syndrome but may refer to other <a href="/wiki/Mood_disorder" title="Mood disorder">mood disorders</a> or simply to a low mood. People's conceptualizations of depression vary widely, both within and among cultures. "Because of the lack of scientific certainty," one commentator has observed, "the debate over depression turns on questions of language. What we call it—'disease,' 'disorder,' 'state of mind'—affects how we view, diagnose, and treat it."<a href="#cite_note-310">[310]</a> There are cultural differences in the extent to which serious depression is considered an illness requiring personal professional treatment, or an indicator of something else, such as the need to address social or moral problems, the result of biological imbalances, or a reflection of individual differences in the understanding of distress that may reinforce feelings of powerlessness, and emotional struggle.<a href="#cite_note-311">[311]</a><a href="#cite_note-312">[312]</a> <div class="mw-heading mw-heading3"><h3 id="Cultural_dimension">Cultural dimension</h3></div> Cultural differences contribute to different prevalence of symptoms. "Do the Chinese <a href="/wiki/Somatization" title="Somatization">somatize</a> depression? A cross-cultural study" by Parker et al. discusses the cultural differences in prevalent symptoms of depression between <a href="/wiki/Individualistic_culture" title="Individualistic culture">individualistic</a> and <a href="/wiki/Collectivistic_culture" class="mw-redirect" title="Collectivistic culture">collectivistic cultures</a>. The authors reveal that individuals with depression in collectivistic cultures tend to present more somatic symptoms and less affective symptoms compared to those in individualistic cultures. The finding suggests that individualistic cultures 'warranting' or <a href="/wiki/Emotional_validation" title="Emotional validation">validating</a> one's expression of emotions explains this cultural difference since collectivistic cultures see this as a taboo against the social cooperation it deems one of the most significant values.<a href="#cite_note-313">[313]</a> <div class="mw-heading mw-heading3"><h3 id="Stigma">Stigma</h3></div> Historical figures were often reluctant to discuss or seek treatment for depression due to <a href="/wiki/Social_stigma" title="Social stigma">social stigma</a> about the condition, or due to ignorance of diagnosis or treatments. Nevertheless, analysis or interpretation of letters, journals, artwork, writings, or statements of family and friends of some historical personalities has led to the presumption that they may have had some form of depression. People who may have had depression include English author <a href="/wiki/Mary_Shelley" title="Mary Shelley">Mary Shelley</a>,<a href="#cite_note-314">[314]</a> American-British writer <a href="/wiki/Henry_James" title="Henry James">Henry James</a>,<a href="#cite_note-315">[315]</a> and American president <a href="/wiki/Abraham_Lincoln" title="Abraham Lincoln">Abraham Lincoln</a>.<a href="#cite_note-316">[316]</a> Some well-known contemporary people with possible depression include Canadian songwriter <a href="/wiki/Leonard_Cohen" title="Leonard Cohen">Leonard Cohen</a><a href="#cite_note-317">[317]</a> and American playwright and novelist <a href="/wiki/Tennessee_Williams" title="Tennessee Williams">Tennessee Williams</a>.<a href="#cite_note-318">[318]</a> Some pioneering psychologists, such as Americans <a href="/wiki/William_James" title="William James">William James</a><a href="#cite_note-319">[319]</a><a href="#cite_note-HistoryJames-320">[320]</a> and <a href="/wiki/John_B._Watson" title="John B. Watson">John B. Watson</a>,<a href="#cite_note-321">[321]</a> dealt with their own depression. <figure typeof="mw:File/Thumb"><a href="/wiki/File:Norges_statsminister_Kjell_Magne_Bondevik.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Norges_statsminister_Kjell_Magne_Bondevik.jpg/150px-Norges_statsminister_Kjell_Magne_Bondevik.jpg" decoding="async" width="150" height="225" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Norges_statsminister_Kjell_Magne_Bondevik.jpg/225px-Norges_statsminister_Kjell_Magne_Bondevik.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ec/Norges_statsminister_Kjell_Magne_Bondevik.jpg/300px-Norges_statsminister_Kjell_Magne_Bondevik.jpg 2x" data-file-width="2336" data-file-height="3504" /></a><figcaption>In 1998, the Norwegian PM <a href="/wiki/Kjell_Magne_Bondevik" title="Kjell Magne Bondevik">Kjell Magne Bondevik</a> publicly announced he will take a break in order to recover from a depressive episode.</figcaption></figure> There has been a continuing discussion of whether neurological disorders and mood disorders may be linked to <a href="/wiki/Creativity" title="Creativity">creativity</a>, a discussion that goes back to <a href="/wiki/Aristotle" title="Aristotle">Aristotelian</a> times.<a href="#cite_note-322">[322]</a><a href="#cite_note-323">[323]</a> British literature gives many examples of reflections on depression.<a href="#cite_note-324">[324]</a> English philosopher <a href="/wiki/John_Stuart_Mill" title="John Stuart Mill">John Stuart Mill</a> experienced a several-months-long period of what he called "a dull state of nerves", when one is "unsusceptible to enjoyment or pleasurable excitement; one of those moods when what is pleasure at other times, becomes insipid or indifferent". He quoted English poet <a href="/wiki/Samuel_Taylor_Coleridge" title="Samuel Taylor Coleridge">Samuel Taylor Coleridge</a>'s "Dejection" as a perfect description of his case: "A grief without a pang, void, dark and drear, / A drowsy, stifled, unimpassioned grief, / Which finds no natural outlet or relief / In word, or sigh, or tear."<a href="#cite_note-325">[325]</a><a href="#cite_note-326">[326]</a> English writer <a href="/wiki/Samuel_Johnson" title="Samuel Johnson">Samuel Johnson</a> used the term "the black dog" in the 1780s to describe his own depression,<a href="#cite_note-McKinlay05-327">[327]</a> and it was subsequently popularized by British Prime Minister Sir <a href="/wiki/Winston_Churchill" title="Winston Churchill">Winston Churchill</a>, who also had the disorder.<a href="#cite_note-McKinlay05-327">[327]</a> <a href="/wiki/Johann_Wolfgang_von_Goethe" title="Johann Wolfgang von Goethe">Johann Wolfgang von Goethe</a> in his <a href="/wiki/Goethe%27s_Faust" title="Goethe's Faust">Faust, Part I</a>, published in 1808, has <a href="/wiki/Mephistopheles" title="Mephistopheles">Mephistopheles</a> assume the form of a black dog, specifically a <a href="/wiki/Poodle" title="Poodle">poodle</a>. Social stigma of major depression is widespread, and contact with mental health services reduces this only slightly. Public opinions on treatment differ markedly to those of health professionals; alternative treatments are held to be more helpful than pharmacological ones, which are viewed poorly.<a href="#cite_note-328">[328]</a> In the UK, the <a href="/wiki/Royal_College_of_Psychiatrists" title="Royal College of Psychiatrists">Royal College of Psychiatrists</a> and the <a href="/wiki/Royal_College_of_General_Practitioners" title="Royal College of General Practitioners">Royal College of General Practitioners</a> conducted a joint Five-year Defeat Depression campaign to educate and reduce stigma from 1992 to 1996;<a href="#cite_note-329">[329]</a> a <a href="/wiki/Ipsos_MORI" title="Ipsos MORI">MORI</a> study conducted afterwards showed a small positive change in public attitudes to depression and treatment.<a href="#cite_note-330">[330]</a> While serving his first term as Prime Minister of Norway, <a href="/wiki/Kjell_Magne_Bondevik" title="Kjell Magne Bondevik">Kjell Magne Bondevik</a> attracted international attention in August 1998 when he announced that he was suffering from a depressive episode, becoming the highest ranking world <a href="/wiki/Leadership" title="Leadership">leader</a> to admit to suffering from a mental illness while in office. Upon this revelation, <a href="/wiki/Anne_Enger" title="Anne Enger">Anne Enger</a> became acting Prime Minister for three weeks, from 30 August to 23 September, while he recovered from the depressive episode. Bondevik then returned to office. Bondevik received thousands of supportive letters, and said that the experience had been positive overall, both for himself and because it made mental illness more publicly acceptable.<a href="#cite_note-Jones2011Fighting-331">[331]</a><a href="#cite_note-332">[332]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-NIH2016-1">^ <a href="#cite_ref-NIH2016_1-0">a</a> <a href="#cite_ref-NIH2016_1-1">b</a> <a href="#cite_ref-NIH2016_1-2">c</a> <a href="#cite_ref-NIH2016_1-3">d</a> <a href="#cite_ref-NIH2016_1-4">e</a> <a href="#cite_ref-NIH2016_1-5">f</a> <a href="#cite_ref-NIH2016_1-6">g</a> <a href="#cite_ref-NIH2016_1-7">h</a> <a href="#cite_ref-NIH2016_1-8">i</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.nimh.nih.gov/health/topics/depression/index.shtml">"Depression"</a>. 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Psychiatric Times. 26 (3). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090722165650/http://www.psychiatrictimes.com/display/article/10168/1387631">Archived</a> from the original on 22 July 2009.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychiatric+Times&rft.atitle=Cognitive+Difficulties+Associated+With+Depression%3A+What+Are+the+Implications+for+Treatment%3F&rft.volume=26&rft.issue=3&rft.date=2009&rft.aulast=Delgado&rft.aufirst=PL&rft.au=Schillerstrom%2C+J&rft_id=http%3A%2F%2Fwww.psychiatrictimes.com%2Fdisplay%2Farticle%2F10168%2F1387631&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-27"><a href="#cite_ref-27">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFaculty_of_Psychiatry_of_Old_Age,_NSW_Branch,_RANZCPKitchingRaphael2001" class="citation book cs1">Faculty of Psychiatry of Old Age, NSW Branch, RANZCP, Kitching D, Raphael B (2001). <a rel="nofollow" class="external text" href="http://www.health.nsw.gov.au/mhdao/publications/Publications/depression-elderly.pdf">Consensus Guidelines for Assessment and Management of Depression in the Elderly</a> (PDF). North Sydney, New South Wales: NSW Health Department. p. 2. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7347-3341-2" title="Special:BookSources/978-0-7347-3341-2"><bdi>978-0-7347-3341-2</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150401162939/http://www.health.nsw.gov.au/mhdao/publications/Publications/depression-elderly.pdf">Archived</a> (PDF) from the original on 1 April 2015.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Consensus+Guidelines+for+Assessment+and+Management+of+Depression+in+the+Elderly&rft.place=North+Sydney%2C+New+South+Wales&rft.pages=2&rft.pub=NSW+Health+Department&rft.date=2001&rft.isbn=978-0-7347-3341-2&rft.au=Faculty+of+Psychiatry+of+Old+Age%2C+NSW+Branch%2C+RANZCP&rft.au=Kitching%2C+D&rft.au=Raphael%2C+B&rft_id=http%3A%2F%2Fwww.health.nsw.gov.au%2Fmhdao%2Fpublications%2FPublications%2Fdepression-elderly.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-FOOTNOTEAmerican_Psychiatric_Association2013164-28"><a href="#cite_ref-FOOTNOTEAmerican_Psychiatric_Association2013164_28-0">^</a> <a href="#CITEREFAmerican_Psychiatric_Association2013">American Psychiatric Association 2013</a>, p. 164. </li> <li id="cite_note-SBU-29">^ <a href="#cite_ref-SBU_29-0">a</a> <a href="#cite_ref-SBU_29-1">b</a> <a href="#cite_ref-SBU_29-2">c</a> <a href="#cite_ref-SBU_29-3">d</a> <a href="#cite_ref-SBU_29-4">e</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.sbu.se/en/publications/sbu-assesses/depression-treatment-for-the-elderly/">"Depression treatment for the elderly"</a>. <a href="/wiki/Swedish_Agency_for_Health_Technology_Assessment_and_Assessment_of_Social_Services" title="Swedish Agency for Health Technology Assessment and Assessment of Social Services">Swedish Agency for Health Technology Assessment and Assessment of Social Services</a> (SBU). 27 January 2015. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160618011954/http://www.sbu.se/en/publications/sbu-assesses/depression-treatment-for-the-elderly/">Archived</a> from the original on 18 June 2016. Retrieved 16 June 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Swedish+Agency+for+Health+Technology+Assessment+and+Assessment+of+Social+Services+%28SBU%29&rft.atitle=Depression+treatment+for+the+elderly&rft.date=2015-01-27&rft_id=http%3A%2F%2Fwww.sbu.se%2Fen%2Fpublications%2Fsbu-assesses%2Fdepression-treatment-for-the-elderly%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-30"><a href="#cite_ref-30">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHankinAbela2005" class="citation book cs1">Hankin BL, Abela JR (2005). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=1Fd0LneB724C&pg=PR7">Development of Psychopathology: A Vulnerability-Stress Perspective</a>. SAGE Publications. pp. 32–34. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4129-0490-2" title="Special:BookSources/978-1-4129-0490-2"><bdi>978-1-4129-0490-2</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Development+of+Psychopathology%3A+A+Vulnerability-Stress+Perspective&rft.pages=32-34&rft.pub=SAGE+Publications&rft.date=2005&rft.isbn=978-1-4129-0490-2&rft.aulast=Hankin&rft.aufirst=BL&rft.au=Abela%2C+JR&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D1Fd0LneB724C%26pg%3DPR7&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-31"><a href="#cite_ref-31">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFOtteGoldPenninxPariante2016" class="citation journal cs1">Otte C, Gold SM, Penninx BW, Pariante CM, Etkin A, Fava M, et al. 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Disease Primers. 2 (1). <a href="/wiki/Springer_Nature" title="Springer Nature">Springer Nature</a> (published 15 September 2016): 16065. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnrdp.2016.65">10.1038/nrdp.2016.65</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27629598">27629598</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4047310">4047310</a>. <q>Despite advances in our understanding of the neuro-biology of MDD, no established mechanism can explain all aspects of the disease.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews.+Disease+Primers&rft.atitle=Major+depressive+disorder&rft.volume=2&rft.issue=1&rft.pages=16065&rft.date=2016-09&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A4047310%23id-name%3DS2CID&rft_id=info%3Apmid%2F27629598&rft_id=info%3Adoi%2F10.1038%2Fnrdp.2016.65&rft.aulast=Otte&rft.aufirst=C&rft.au=Gold%2C+SM&rft.au=Penninx%2C+BW&rft.au=Pariante%2C+CM&rft.au=Etkin%2C+A&rft.au=Fava%2C+M&rft.au=Mohr%2C+DC&rft.au=Schatzberg%2C+AF&rft_id=https%3A%2F%2Fkclpure.kcl.ac.uk%2Fws%2Ffiles%2F57263080%2FMajor_Deppressive_Disorder_.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-32"><a href="#cite_ref-32">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBolandVerduin2022" class="citation book cs1">Boland RJ, Verduin ML (14 March 2022). 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Philadelphia: <a href="/wiki/Wolters_Kluwer" title="Wolters Kluwer">Wolters Kluwer</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-9751-6748-6" title="Special:BookSources/978-1-9751-6748-6"><bdi>978-1-9751-6748-6</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/1264172789">1264172789</a>. <q>Although there is no single unifying theory, several theories have emerged over the last century that attempt to account for the various clinical, psychological, and biologic findings in depression.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Kaplan+%26+Sadock%27s+concise+textbook+of+clinical+psychiatry&rft.place=Philadelphia&rft.edition=5th&rft.pub=Wolters+Kluwer&rft.date=2022-03-14&rft_id=info%3Aoclcnum%2F1264172789&rft.isbn=978-1-9751-6748-6&rft.aulast=Boland&rft.aufirst=RJ&rft.au=Verduin%2C+ML&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-33"><a href="#cite_ref-33">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSontheimer2021" class="citation book cs1">Sontheimer H (20 May 2021). 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(January 2008). <a rel="nofollow" class="external text" href="http://www.nd.edu/~ghaeffel/Resources/Haeffel%20et%20al.,%202008.pdf">"Association between polymorphisms in the dopamine transporter gene and depression: evidence for a gene-environment interaction in a sample of juvenile detainees"</a> (PDF). Psychological Science. 19 (1): 62–69. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1467-9280.2008.02047.x">10.1111/j.1467-9280.2008.02047.x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18181793">18181793</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:15520723">15520723</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20081217031910/http://www.nd.edu/~ghaeffel/Resources/Haeffel%20et%20al.%2C%202008.pdf">Archived</a> (PDF) from the original on 17 December 2008.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Psychological+Science&rft.atitle=Association+between+polymorphisms+in+the+dopamine+transporter+gene+and+depression%3A+evidence+for+a+gene-environment+interaction+in+a+sample+of+juvenile+detainees&rft.volume=19&rft.issue=1&rft.pages=62-69&rft.date=2008-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A15520723%23id-name%3DS2CID&rft_id=info%3Apmid%2F18181793&rft_id=info%3Adoi%2F10.1111%2Fj.1467-9280.2008.02047.x&rft.aulast=Haeffel&rft.aufirst=GJ&rft.au=Getchell%2C+M&rft.au=Koposov%2C+RA&rft.au=Yrigollen%2C+CM&rft.au=Deyoung%2C+CG&rft.au=Klinteberg%2C+BA&rft.au=Oreland%2C+L&rft.au=Ruchkin%2C+VV&rft.au=Grigorenko%2C+EL&rft_id=http%3A%2F%2Fwww.nd.edu%2F~ghaeffel%2FResources%2FHaeffel%2520et%2520al.%2C%25202008.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-38"><a href="#cite_ref-38">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSlavich2004" class="citation web cs1">Slavich GM (2004). <a rel="nofollow" class="external text" href="http://www.psychologicalscience.org/observer/getArticle.cfm?id=1640">"Deconstructing depression: A diathesis-stress perspective (Opinion)"</a>. APS Observer. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110511233644/http://www.psychologicalscience.org/observer/getArticle.cfm?id=1640">Archived</a> from the original on 11 May 2011. Retrieved 11 November 2008.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=APS+Observer&rft.atitle=Deconstructing+depression%3A+A+diathesis-stress+perspective+%28Opinion%29&rft.date=2004&rft.aulast=Slavich&rft.aufirst=GM&rft_id=http%3A%2F%2Fwww.psychologicalscience.org%2Fobserver%2FgetArticle.cfm%3Fid%3D1640&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-Beck-39"><a href="#cite_ref-Beck_39-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBeckRushShawEmery1979" class="citation book cs1">Beck AT, Rush AJ, Shaw BF, Emery G (1979). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=L09cRS0xWj0C">Cognitive therapy of depression</a>. New York: The Guilford Press. pp. 11–12. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-89862-000-7" title="Special:BookSources/0-89862-000-7"><bdi>0-89862-000-7</bdi></a>. Retrieved 26 February 2022.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Cognitive+therapy+of+depression&rft.place=New+York&rft.pages=11-12&rft.pub=The+Guilford+Press&rft.date=1979&rft.isbn=0-89862-000-7&rft.aulast=Beck&rft.aufirst=AT&rft.au=Rush%2C+AJ&rft.au=Shaw%2C+BF&rft.au=Emery%2C+G&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DL09cRS0xWj0C&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-40"><a href="#cite_ref-40">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNietoRoblesVazquez2020" class="citation journal cs1">Nieto I, Robles E, Vazquez C (December 2020). "Self-reported cognitive biases in depression: A meta-analysis". Clinical Psychology Review. 82: 101934. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.cpr.2020.101934">10.1016/j.cpr.2020.101934</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33137610">33137610</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:226243519">226243519</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Psychology+Review&rft.atitle=Self-reported+cognitive+biases+in+depression%3A+A+meta-analysis&rft.volume=82&rft.pages=101934&rft.date=2020-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A226243519%23id-name%3DS2CID&rft_id=info%3Apmid%2F33137610&rft_id=info%3Adoi%2F10.1016%2Fj.cpr.2020.101934&rft.aulast=Nieto&rft.aufirst=I&rft.au=Robles%2C+E&rft.au=Vazquez%2C+C&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-41"><a href="#cite_ref-41">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDoWeersing2017" class="citation book cs1">Do MC, Weersing VR (3 April 2017). Wenzel A (ed.). The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, California: <a href="/wiki/SAGE_Publishing" class="mw-redirect" title="SAGE Publishing">SAGE Publishing</a>. p. 1014. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4135%2F9781483365817">10.4135/9781483365817</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4833-6582-4" title="Special:BookSources/978-1-4833-6582-4"><bdi>978-1-4833-6582-4</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/982958263">982958263</a>. <q>Depression is highly heritable, as youths with a parent with a history of depression are approximately 4 times as likely to develop the disorder as youths who do not have a parent with depression.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+SAGE+encyclopedia+of+abnormal+and+clinical+psychology&rft.place=Thousand+Oaks%2C+California&rft.pages=1014&rft.pub=SAGE+Publishing&rft.date=2017-04-03&rft_id=info%3Aoclcnum%2F982958263&rft_id=info%3Adoi%2F10.4135%2F9781483365817&rft.isbn=978-1-4833-6582-4&rft.aulast=Do&rft.aufirst=MC&rft.au=Weersing%2C+VR&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-42"><a href="#cite_ref-42">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSullivanNealeKendler2000" class="citation journal cs1">Sullivan PF, Neale MC, Kendler KS (October 2000). 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The American Journal of Psychiatry. 157 (10): 1552–1562. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fappi.ajp.157.10.1552">10.1176/appi.ajp.157.10.1552</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11007705">11007705</a>. <q>The heritability of major depression is likely to be in the range of 31%–42%. This is probably the lower bound, and the level of heritability is likely to be substantially higher for reliably diagnosed major depression or for subtypes such as recurrent major depression. In comparison, the heritabilities of schizophrenia and bipolar disorder are estimated to be approximately 70%.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+American+Journal+of+Psychiatry&rft.atitle=Genetic+epidemiology+of+major+depression%3A+review+and+meta-analysis&rft.volume=157&rft.issue=10&rft.pages=1552-1562&rft.date=2000-10&rft_id=info%3Adoi%2F10.1176%2Fappi.ajp.157.10.1552&rft_id=info%3Apmid%2F11007705&rft.aulast=Sullivan&rft.aufirst=PF&rft.au=Neale%2C+MC&rft.au=Kendler%2C+KS&rft_id=https%3A%2F%2Fdoi.org%2F10.1176%252Fappi.ajp.157.10.1552&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-47"><a href="#cite_ref-47">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFJordeCareyBamshad2019" class="citation book cs1">Jorde LB, Carey JC, Bamshad MJ (27 September 2019). 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Retrieved 18 August 2008.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Black+Dog+Institute+website&rft.atitle=Churchill%27s+Black+Dog%3F%3A+The+History+of+the+%27Black+Dog%27+as+a+Metaphor+for+Depression&rft.date=2005&rft_id=http%3A%2F%2Fwww.blackdoginstitute.org.au%2Fdocs%2FMcKinlay.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-328"><a href="#cite_ref-328">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFJormAngermeyerKatschnig2000" class="citation book cs1">Jorm AF, Angermeyer M, Katschnig H (2000). <a rel="nofollow" class="external text" href="https://archive.org/details/unmetneedinpsych0000unse/page/409">"Public knowledge of and attitudes to mental disorders: a limiting factor in the optimal use of treatment services"</a>. In Andrews G, Henderson S (eds.). 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(June 1997). <a rel="nofollow" class="external text" href="https://doi.org/10.1176%2Fajp.154.6.59">"The Defeat Depression Campaign: psychiatry in the public arena"</a>. 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The British Journal of Psychiatry. 173 (6): 519–22. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1192%2Fbjp.173.6.519">10.1192/bjp.173.6.519</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9926082">9926082</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:21172113">21172113</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+British+Journal+of+Psychiatry&rft.atitle=Changes+in+public+attitudes+to+depression+during+the+Defeat+Depression+Campaign&rft.volume=173&rft.issue=6&rft.pages=519-22&rft.date=1998-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A21172113%23id-name%3DS2CID&rft_id=info%3Apmid%2F9926082&rft_id=info%3Adoi%2F10.1192%2Fbjp.173.6.519&rft.aulast=Paykel&rft.aufirst=ES&rft.au=Hart%2C+D&rft.au=Priest%2C+RG&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-Jones2011Fighting-331"><a href="#cite_ref-Jones2011Fighting_331-0">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBondevik2011" class="citation journal cs1">Bondevik KM (December 2011). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131031035031/http://www.who.int/bulletin/volumes/89/12/11-041211/en/index.html">"Fighting stigma with openness. Interview by Ben Jones"</a>. Bulletin of the World Health Organization. 89 (12): 862–863. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2471%2FBLT.11.041211">10.2471/BLT.11.041211</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260893">3260893</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22271941">22271941</a>. Archived from <a rel="nofollow" class="external text" href="https://www.who.int/bulletin/volumes/89/12/11-041211/en/index.html">the original</a> on 31 October 2013. Retrieved 19 July 2013.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Bulletin+of+the+World+Health+Organization&rft.atitle=Fighting+stigma+with+openness.+Interview+by+Ben+Jones&rft.volume=89&rft.issue=12&rft.pages=862-863&rft.date=2011-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3260893%23id-name%3DPMC&rft_id=info%3Apmid%2F22271941&rft_id=info%3Adoi%2F10.2471%2FBLT.11.041211&rft.aulast=Bondevik&rft.aufirst=KM&rft_id=https%3A%2F%2Fwww.who.int%2Fbulletin%2Fvolumes%2F89%2F12%2F11-041211%2Fen%2Findex.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"> </li> <li id="cite_note-332"><a href="#cite_ref-332">^</a> <a href="/wiki/BBC" title="BBC">BBC</a> <a href="/wiki/Newsnight" title="Newsnight">Newsnight</a>, 21 January 2008. </li> </ol></div></div> <div class="mw-heading mw-heading3"><h3 id="Cited_works">Cited works</h3></div> <style data-mw-deduplicate="TemplateStyles:r1235611614">.mw-parser-output .spoken-wikipedia{border:1px solid #a2a9b1;background-color:var(--background-color-interactive-subtle,#f8f9fa);margin:0.5em 0;padding:0.2em;line-height:1.5em;font-size:90%}.mw-parser-output .spoken-wikipedia-header{text-align:center}.mw-parser-output .spoken-wikipedia-listen-to{font-weight:bold}.mw-parser-output .spoken-wikipedia-files{text-align:center;margin-top:10px;margin-bottom:0.4em}.mw-parser-output .spoken-wikipedia-icon{float:left;margin-left:5px;margin-top:10px}.mw-parser-output .spoken-wikipedia-disclaimer{margin-left:60px;margin-top:10px;font-size:95%;line-height:1.4em}.mw-parser-output .spoken-wikipedia-footer{margin-top:10px;text-align:center}@media(min-width:720px){.mw-parser-output .spoken-wikipedia{width:20em;float:right;clear:right;margin-left:1em}}</style><div class="spoken-wikipedia noprint haudio"><div class="spoken-wikipedia-header">Listen to this article (1 hour and 20 minutes)</div><div class="spoken-wikipedia-files"><figure class="mw-halign-center" typeof="mw:File"><audio id="mwe_player_0" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="200" style="width:200px;" data-durationhint="4805" data-mwtitle="Mdd2_003.ogg" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/5/5d/Mdd2_003.ogg" type="audio/ogg; codecs="vorbis"" data-width="0" data-height="0" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/5d/Mdd2_003.ogg/Mdd2_003.ogg.mp3" type="audio/mpeg" data-transcodekey="mp3" data-width="0" data-height="0" /></audio><figcaption></figcaption></figure> </div><div class="spoken-wikipedia-icon"><img alt="Spoken Wikipedia icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Sound-icon.svg/45px-Sound-icon.svg.png" decoding="async" width="45" height="34" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Sound-icon.svg/68px-Sound-icon.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/47/Sound-icon.svg/90px-Sound-icon.svg.png 2x" data-file-width="128" data-file-height="96" /></div><div class="spoken-wikipedia-disclaimer"><a href="/wiki/File:Mdd2_003.ogg" title="File:Mdd2 003.ogg">This audio file</a> was created from a revision of this article dated 6 October 2014 (2014-10-06), and does not reflect subsequent edits.</div><div class="spoken-wikipedia-footer">(<a href="/wiki/Wikipedia:Media_help" class="mw-redirect" title="Wikipedia:Media help">Audio help</a> · <a href="/wiki/Wikipedia:Spoken_articles" title="Wikipedia:Spoken articles">More spoken articles</a>)</div></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAmerican_Psychiatric_Association2000a" class="citation book cs1">American Psychiatric Association (2000a). 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UK: BMJ Group and RPS Publishing. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-85369-778-7" title="Special:BookSources/978-0-85369-778-7"><bdi>978-0-85369-778-7</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=British+National+Formulary+%28BNF+56%29&rft.place=UK&rft.pub=BMJ+Group+and+RPS+Publishing&rft.date=2008&rft.isbn=978-0-85369-778-7&rft.au=Royal+Pharmaceutical+Society+of+Great+Britain&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fbritishnationalf0000unse_k4e9&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSadock2002" class="citation book cs1">Sadock VA, Sadock BJ, Kaplan HI (2003). Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry. Philadelphia: Lippincott Williams & Wilkins. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7817-3183-6" title="Special:BookSources/978-0-7817-3183-6"><bdi>978-0-7817-3183-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Kaplan+%26+Sadock%27s+synopsis+of+psychiatry%3A+behavioral+sciences%2Fclinical+psychiatry&rft.place=Philadelphia&rft.pub=Lippincott+Williams+%26+Wilkins&rft.date=2003&rft.isbn=978-0-7817-3183-6&rft.aulast=Sadock&rft.aufirst=VA&rft.au=Sadock%2C+BJ&rft.au=Kaplan%2C+HI&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREF-ICD11-6A70" class="citation encyclopaedia cs1"><a rel="nofollow" class="external text" href="https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/578635574">"6A70 Single episode depressive disorder"</a>. International Classification of Diseases 11th Revision. World Health Organization. February 2022 [adopted in 2019]. Retrieved 9 July 2022.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=6A70+Single+episode+depressive+disorder&rft.btitle=International+Classification+of+Diseases+11th+Revision&rft.pub=World+Health+Organization&rft.date=2022-02&rft_id=https%3A%2F%2Ficd.who.int%2Fbrowse11%2Fl-m%2Fen%23%2Fhttp%3A%2F%2Fid.who.int%2Ficd%2Fentity%2F578635574&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREF-ICD11-6A71" class="citation encyclopaedia cs1"><a rel="nofollow" class="external text" href="https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/578635574">"6A71 Recurrent depressive disorder"</a>. International Classification of Diseases 11th Revision. World Health Organization. February 2022 [adopted in 2019]. Retrieved 9 July 2022.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=6A71+Recurrent+depressive+disorder&rft.btitle=International+Classification+of+Diseases+11th+Revision&rft.pub=World+Health+Organization&rft.date=2022-02&rft_id=https%3A%2F%2Ficd.who.int%2Fbrowse11%2Fl-m%2Fen%23%2Fhttp%3A%2F%2Fid.who.int%2Ficd%2Fentity%2F578635574&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMajor+depressive+disorder" class="Z3988"></li></ul> </div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output 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dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q42844" class="extiw" title="d:Q42844">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#578635574">6A70</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1194756772">6A71</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/F32">F32</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/F33">F33</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=296.2">296.2</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=296.3">296.3</a></li><li><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a>: <a rel="nofollow" class="external text" href="https://omim.org/entry/608516">608516</a></li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003865">D003865</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb3589.htm">3589</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/003213.htm">003213</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/532-overview">med/532</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/depression-pro">Major depressive disorder</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Mental_disorders" title="Template:Mental disorders"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Mental_disorders" title="Template talk:Mental disorders"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Mental_disorders" title="Special:EditPage/Template:Mental disorders"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Mental_disorders_(Classification)" style="font-size:114%;margin:0 4em"><a href="/wiki/Mental_disorder" title="Mental disorder">Mental disorders</a> (<a href="/wiki/Classification_of_mental_disorders" title="Classification of mental disorders">Classification</a>)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Adult_personality_and_behavior" style="font-size:114%;margin:0 4em">Adult personality and behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Sexual</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ego-dystonic_sexual_orientation" title="Ego-dystonic sexual orientation">Ego-dystonic sexual orientation</a></li> <li><a href="/wiki/Paraphilia" title="Paraphilia">Paraphilia</a> <ul><li><a href="/wiki/Sexual_fetishism" title="Sexual fetishism">Fetishism</a></li> <li><a href="/wiki/Voyeurism" title="Voyeurism">Voyeurism</a></li></ul></li> <li><a href="/wiki/Sexual_anhedonia" title="Sexual anhedonia">Sexual anhedonia</a></li> <li><a href="/wiki/Sexual_anorexia" title="Sexual anorexia">Sexual anorexia</a></li> <li><a href="/wiki/Sexual_maturation_disorder" title="Sexual maturation disorder">Sexual maturation disorder</a></li> <li><a href="/wiki/Sexual_relationship_disorder" title="Sexual relationship disorder">Sexual relationship disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Factitious_disorder" title="Factitious disorder">Factitious disorder</a> <ul><li><a href="/wiki/Factitious_disorder_imposed_on_self" title="Factitious disorder imposed on self">Munchausen syndrome</a></li></ul></li> <li><a href="/wiki/Fear_of_intimacy" title="Fear of intimacy">Fear of intimacy</a></li> <li><a href="/wiki/Gender_dysphoria" title="Gender dysphoria">Gender dysphoria</a></li> <li><a href="/wiki/Intermittent_explosive_disorder" title="Intermittent explosive disorder">Intermittent explosive disorder</a></li> <li><a href="/wiki/Excoriation_disorder" title="Excoriation disorder">Dermatillomania</a></li> <li><a href="/wiki/Kleptomania" title="Kleptomania">Kleptomania</a></li> <li><a href="/wiki/Pyromania" title="Pyromania">Pyromania</a></li> <li><a href="/wiki/Trichotillomania" title="Trichotillomania">Trichotillomania</a></li> <li><a href="/wiki/Personality_disorder" title="Personality disorder">Personality disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Childhood_and_learning" style="font-size:114%;margin:0 4em"><a href="/wiki/Mental_disorders_diagnosed_in_childhood" title="Mental disorders diagnosed in childhood">Childhood and learning</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">Emotional and behavioral</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">ADHD</a></li> <li><a href="/wiki/Conduct_disorder" title="Conduct disorder">Conduct disorder</a> <ul><li><a href="/wiki/Oppositional_defiant_disorder" title="Oppositional defiant disorder">ODD</a></li></ul></li> <li><a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">Emotional and behavioral disorders</a> <ul><li><a href="/wiki/Separation_anxiety_disorder" title="Separation anxiety disorder">Separation anxiety disorder</a></li></ul></li> <li><a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">Movement disorders</a> <ul><li><a href="/wiki/Stereotypic_movement_disorder" title="Stereotypic movement disorder">Stereotypic</a></li></ul></li> <li>Social functioning <ul><li><a href="/wiki/Disinhibited_attachment_disorder" title="Disinhibited attachment disorder">DAD</a></li> <li><a href="/wiki/Reactive_attachment_disorder" title="Reactive attachment disorder">RAD</a></li> <li><a href="/wiki/Selective_mutism" title="Selective mutism">Selective mutism</a></li></ul></li> <li><a href="/wiki/Speech_disorder" title="Speech disorder">Speech</a> <ul><li><a href="/wiki/Cluttering" title="Cluttering">Cluttering</a></li> <li><a href="/wiki/Stuttering" title="Stuttering">Stuttering</a></li></ul></li> <li><a href="/wiki/Tic_disorder" title="Tic disorder">Tic disorder</a> <ul><li><a href="/wiki/Tourette_syndrome" title="Tourette syndrome">Tourette syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Intellectual_disability" title="Intellectual disability">Intellectual disability</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/X-linked_intellectual_disability" title="X-linked intellectual disability">X-linked intellectual disability</a> <ul><li><a href="/wiki/Lujan%E2%80%93Fryns_syndrome" title="Lujan–Fryns syndrome">Lujan–Fryns syndrome</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Psychological development (<a href="/wiki/Developmental_disability" title="Developmental disability">developmental disabilities</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pervasive_developmental_disorder" title="Pervasive developmental disorder">Pervasive</a></li> <li><a href="/wiki/Specific_developmental_disorder" title="Specific developmental disorder">Specific</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Mood_(affective)" style="font-size:114%;margin:0 4em"><a href="/wiki/Mood_disorder" title="Mood disorder">Mood</a> (affective)</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar</a> <ul><li><a href="/wiki/Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I</a></li> <li><a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II</a></li> <li><a href="/wiki/Bipolar_disorder_not_otherwise_specified" title="Bipolar disorder not otherwise specified">Bipolar NOS</a></li> <li><a href="/wiki/Cyclothymia" title="Cyclothymia">Cyclothymia</a></li></ul></li> <li><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a> <ul><li><a href="/wiki/Atypical_depression" title="Atypical depression">Atypical depression</a></li> <li><a href="/wiki/Dysthymia" title="Dysthymia">Dysthymia</a></li> <li><a class="mw-selflink selflink">Major depressive disorder</a></li> <li><a href="/wiki/Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a></li> <li><a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a></li></ul></li> <li><a href="/wiki/Mania" title="Mania">Mania</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurological_and_symptomatic" style="font-size:114%;margin:0 4em">Neurological and symptomatic</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Autism_spectrum" class="mw-redirect" title="Autism spectrum">Autism spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Autism" title="Autism">Autism</a></li> <li><a href="/wiki/Asperger_syndrome" title="Asperger syndrome">Asperger syndrome</a></li> <li><a href="/wiki/High-functioning_autism" title="High-functioning autism">High-functioning autism</a></li> <li><a href="/wiki/Pervasive_developmental_disorder_not_otherwise_specified" title="Pervasive developmental disorder not otherwise specified">PDD-NOS</a></li> <li><a href="/wiki/Savant_syndrome" title="Savant syndrome">Savant syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/HIV-associated_neurocognitive_disorder" title="HIV-associated neurocognitive disorder">AIDS dementia complex</a></li> <li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's disease</a></li> <li><a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">Huntington's disease</a></li> <li><a href="/wiki/Mild_cognitive_impairment" title="Mild cognitive impairment">Mild cognitive impairment</a></li> <li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">Parkinson's disease</a></li> <li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's disease</a></li> <li><a href="/wiki/Sundowning" title="Sundowning">Sundowning</a></li> <li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li> <li><a href="/wiki/Wandering_(dementia)" title="Wandering (dementia)">Wandering</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delirium" title="Delirium">Delirium</a></li> <li><a href="/wiki/Organic_brain_syndrome" title="Organic brain syndrome">Organic brain syndrome</a></li> <li><a href="/wiki/Post-concussion_syndrome" title="Post-concussion syndrome">Post-concussion syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Neurotic,_stress-related_and_somatoform" style="font-size:114%;margin:0 4em"><a href="/wiki/Neurosis" title="Neurosis">Neurotic</a>, <a href="/wiki/Stress_(biology)" title="Stress (biology)">stress</a>-related and <a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">somatoform</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adjustment_disorder" title="Adjustment disorder">Adjustment disorder</a> with depressed mood</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anxiety_disorder" title="Anxiety disorder">Anxiety</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Phobia" title="Phobia">Phobia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agoraphobia" title="Agoraphobia">Agoraphobia</a></li> <li><a href="/wiki/Childhood_phobia" title="Childhood phobia">Childhood phobia</a></li> <li><a href="/wiki/Social_anxiety" title="Social anxiety">Social anxiety</a></li> <li><a href="/wiki/Social_anxiety_disorder" title="Social anxiety disorder">Social phobia</a> <ul><li><a href="/wiki/Anthropophobia" class="mw-redirect" title="Anthropophobia">Anthropophobia</a></li> <li><a href="/wiki/Specific_social_phobia" title="Specific social phobia">Specific social phobia</a></li></ul></li> <li><a href="/wiki/Specific_phobia" title="Specific phobia">Specific phobia</a> <ul><li><a href="/wiki/Claustrophobia" title="Claustrophobia">Claustrophobia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">Generalized anxiety disorder</a></li> <li><a href="/wiki/Obsessive%E2%80%93compulsive_disorder" title="Obsessive–compulsive disorder">OCD</a></li> <li><a href="/wiki/Panic_attack" title="Panic attack">Panic attack</a></li> <li><a href="/wiki/Panic_disorder" title="Panic disorder">Panic disorder</a></li> <li><a href="/wiki/Psychological_stress" title="Psychological stress">Stress</a> <ul><li><a href="/wiki/Acute_stress_reaction" title="Acute stress reaction">Acute stress reaction</a></li> <li><a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">PTSD</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dissociative_disorder" class="mw-redirect" title="Dissociative disorder">Dissociative</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Depersonalization-derealization_disorder" title="Depersonalization-derealization disorder">Depersonalization-derealization disorder</a></li> <li><a href="/wiki/Dissociative_identity_disorder" title="Dissociative identity disorder">Dissociative identity disorder</a></li> <li><a href="/wiki/Dissociative_fugue" title="Dissociative fugue">Dissociative fugue</a></li> <li><a href="/wiki/Psychogenic_amnesia" class="mw-redirect" title="Psychogenic amnesia">Psychogenic amnesia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Somatic_symptom_disorder" title="Somatic symptom disorder">Somatic symptom</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Body_dysmorphic_disorder" title="Body dysmorphic disorder">Body dysmorphic disorder</a></li> <li><a href="/wiki/Conversion_disorder" title="Conversion disorder">Conversion disorder</a> <ul><li><a href="/wiki/Ganser_syndrome" title="Ganser syndrome">Ganser syndrome</a></li> <li><a href="/wiki/Globus_pharyngis" title="Globus pharyngis">Globus pharyngis</a></li> <li><a href="/wiki/Psychogenic_non-epileptic_seizure" title="Psychogenic non-epileptic seizure">Psychogenic non-epileptic seizures</a></li></ul></li> <li><a href="/wiki/False_pregnancy" title="False pregnancy">False pregnancy</a></li> <li><a href="/wiki/Hypochondriasis" title="Hypochondriasis">Hypochondriasis</a></li> <li><a href="/wiki/Mass_psychogenic_illness" title="Mass psychogenic illness">Mass psychogenic illness</a></li> <li><a href="/wiki/Nosophobia" title="Nosophobia">Nosophobia</a></li> <li><a href="/wiki/Psychogenic_pain" title="Psychogenic pain">Psychogenic pain</a></li> <li><a href="/wiki/Somatization_disorder" class="mw-redirect" title="Somatization disorder">Somatization disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Physiological_and_physical_behavior" style="font-size:114%;margin:0 4em">Physiological and physical behavior</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eating_disorder" title="Eating disorder">Eating</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">Anorexia nervosa</a></li> <li><a href="/wiki/Bulimia_nervosa" title="Bulimia nervosa">Bulimia nervosa</a></li> <li><a href="/wiki/Rumination_syndrome" title="Rumination syndrome">Rumination syndrome</a></li> <li><a href="/wiki/Other_specified_feeding_or_eating_disorder" title="Other specified feeding or eating disorder">Other specified feeding or eating disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Nonorganic <a href="/wiki/Sleep_disorder" title="Sleep disorder">sleep</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersomnia" title="Hypersomnia">Hypersomnia</a></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a></li> <li><a href="/wiki/Parasomnia" title="Parasomnia">Parasomnia</a> <ul><li><a href="/wiki/Night_terror" title="Night terror">Night terror</a></li> <li><a href="/wiki/Nightmare" title="Nightmare">Nightmare</a></li> <li><a href="/wiki/Rapid_eye_movement_sleep_behavior_disorder" title="Rapid eye movement sleep behavior disorder">REM sleep behavior disorder</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychiatric_disorders_of_childbirth" title="Psychiatric disorders of childbirth">Postnatal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Postpartum_depression" title="Postpartum depression">Postpartum depression</a></li> <li><a href="/wiki/Postpartum_psychosis" title="Postpartum psychosis">Postpartum psychosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sexual_dysfunction#Sexual_desire_disorders" title="Sexual dysfunction">Sexual desire</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersexuality" title="Hypersexuality">Hypersexuality</a></li> <li><a href="/wiki/Hypoactive_sexual_desire_disorder" title="Hypoactive sexual desire disorder">Hypoactive sexual desire disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Psychoactive_substances,_substance_abuse_and_substance-related" style="font-size:114%;margin:0 4em"><a href="/wiki/Psychoactive_drug" title="Psychoactive drug">Psychoactive</a> substances, <a href="/wiki/Substance_abuse" title="Substance abuse">substance abuse</a> and substance-related</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drug_overdose" title="Drug overdose">Drug overdose</a></li> <li><a href="/wiki/Substance_intoxication" title="Substance intoxication">Intoxication</a></li> <li><a href="/wiki/Physical_dependence" title="Physical dependence">Physical dependence</a></li> <li><a href="/wiki/Rebound_effect" title="Rebound effect">Rebound effect</a></li> <li><a href="/wiki/Stimulant_psychosis" title="Stimulant psychosis">Stimulant psychosis</a></li> <li><a href="/wiki/Substance_dependence" title="Substance dependence">Substance dependence</a></li> <li><a href="/wiki/Drug_withdrawal" title="Drug withdrawal">Withdrawal</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Schizophrenia,_schizotypal_and_delusional" style="font-size:114%;margin:0 4em"><a href="/wiki/Schizophrenia" title="Schizophrenia">Schizophrenia</a>, <a href="/wiki/Schizotypal_personality_disorder" title="Schizotypal personality disorder">schizotypal</a> and <a href="/wiki/Delusional_disorder" title="Delusional disorder">delusional</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Delusional</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delusional_disorder" title="Delusional disorder">Delusional disorder</a></li> <li><a href="/wiki/Folie_%C3%A0_deux" title="Folie à deux">Folie à deux</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Psychosis" title="Psychosis">Psychosis</a> and schizophrenia-like</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brief_reactive_psychosis" class="mw-redirect" title="Brief reactive psychosis">Brief reactive psychosis</a></li> <li><a href="/wiki/Schizoaffective_disorder" title="Schizoaffective disorder">Schizoaffective disorder</a></li> <li><a href="/wiki/Schizophreniform_disorder" title="Schizophreniform disorder">Schizophreniform disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Schizophrenia</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Childhood_schizophrenia" title="Childhood schizophrenia">Childhood schizophrenia</a></li> <li><a href="/wiki/Disorganized_schizophrenia" title="Disorganized schizophrenia">Disorganized (hebephrenic) schizophrenia</a></li> <li><a href="/wiki/Pseudoneurotic_schizophrenia" title="Pseudoneurotic schizophrenia">Pseudoneurotic schizophrenia</a></li> <li><a href="/wiki/Simple-type_schizophrenia" title="Simple-type schizophrenia">Simple-type schizophrenia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Catatonia" title="Catatonia">Catatonia</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible mw-collapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Symptoms_and_uncategorized" style="font-size:114%;margin:0 4em">Symptoms and uncategorized</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Impulse-control_disorder" title="Impulse-control disorder">Impulse-control disorder</a></li> <li><a href="/wiki/Kl%C3%BCver%E2%80%93Bucy_syndrome" title="Klüver–Bucy syndrome">Klüver–Bucy syndrome</a></li> <li><a href="/wiki/Psychomotor_agitation" title="Psychomotor agitation">Psychomotor agitation</a></li> <li><a href="/wiki/Stereotypy" title="Stereotypy">Stereotypy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Mood_disorder" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Mood_disorders" title="Template:Mood disorders"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Mood_disorders" title="Template talk:Mood disorders"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Mood_disorders" title="Special:EditPage/Template:Mood disorders"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Mood_disorder" style="font-size:114%;margin:0 4em"><a href="/wiki/Mood_disorder" title="Mood disorder">Mood disorder</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Affective_spectrum" title="Affective spectrum">Spectrum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar disorder</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bipolar_I_disorder" title="Bipolar I disorder">Bipolar I</a></li> <li><a href="/wiki/Bipolar_II_disorder" title="Bipolar II disorder">Bipolar II</a></li> <li><a href="/wiki/Cyclothymia" title="Cyclothymia">Cyclothymia</a></li> <li><a href="/wiki/Bipolar_disorder_not_otherwise_specified" title="Bipolar disorder not otherwise specified">Bipolar NOS</a></li> <li><a href="/wiki/Bipolar_disorder_in_children" title="Bipolar disorder in children">Childhood</a></li> <li><a href="/wiki/Hypomania" title="Hypomania">Hypomania</a></li> <li><a href="/wiki/Mania" title="Mania">Mania</a></li> <li><a href="/wiki/Mixed_affective_state" title="Mixed affective state">Mixed affective state</a></li> <li><a href="/wiki/Rapid_cycling" class="mw-redirect" title="Rapid cycling">Rapid cycling</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Major depressive disorder</a></li> <li><a href="/wiki/Dysthymia" title="Dysthymia">Dysthymia</a></li> <li><a href="/wiki/Seasonal_affective_disorder" title="Seasonal affective disorder">Seasonal affective disorder</a></li> <li><a href="/wiki/Atypical_depression" title="Atypical depression">Atypical depression</a></li> <li><a href="/wiki/Melancholic_depression" class="mw-redirect" title="Melancholic depression">Melancholic depression</a></li> <li><a href="/wiki/Major_depressive_episode" title="Major depressive episode">Major depressive episode</a></li> <li><a href="/wiki/Depression_in_childhood_and_adolescence" title="Depression in childhood and adolescence">Depression in childhood and adolescence</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Comorbidities</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Schizoaffective_disorder" title="Schizoaffective disorder">Schizoaffective disorder</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Symptom" class="mw-redirect" title="Symptom">Symptoms</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Delusion" title="Delusion">Delusion</a></li> <li><a href="/wiki/Depression_(differential_diagnoses)" class="mw-redirect" title="Depression (differential diagnoses)">Depression (differential diagnoses)</a></li> <li><a href="/wiki/Emotional_dysregulation" title="Emotional dysregulation">Emotional dysregulation</a> <ul><li><a href="/wiki/Anhedonia" title="Anhedonia">Anhedonia</a></li> <li><a href="/wiki/Dysphoria" title="Dysphoria">Dysphoria</a></li> <li><a href="/wiki/Suicidal_ideation" title="Suicidal ideation">Suicidal ideation</a></li></ul></li> <li><a href="/wiki/Episodic_memory" title="Episodic memory">Episodic memory</a></li> <li><a href="/wiki/Hallucination" title="Hallucination">Hallucination</a></li> <li><a href="/wiki/Mood_swing" title="Mood swing">Mood swing</a></li> <li><a href="/wiki/Sleep_disorder" title="Sleep disorder">Sleep disorder</a> <ul><li><a href="/wiki/Hypersomnia" title="Hypersomnia">Hypersomnia</a></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a></li></ul></li> <li><a href="/wiki/Psychosis" title="Psychosis">Psychosis</a></li> <li><a href="/wiki/Psychotic_depression" title="Psychotic depression">Psychotic depression</a></li> <li><a href="/wiki/Racing_thoughts" title="Racing thoughts">Racing thoughts</a></li> <li><a href="/wiki/Reduced_affect_display" title="Reduced affect display">Reduced affect display</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/List_of_diagnostic_classification_and_rating_scales_used_in_psychiatry" title="List of diagnostic classification and rating scales used in psychiatry">Diagnosis</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bipolar_Spectrum_Diagnostic_Scale" title="Bipolar Spectrum Diagnostic Scale">Bipolar Spectrum Diagnostic Scale</a></li> <li><a href="/wiki/Child_Mania_Rating_Scale" title="Child Mania Rating Scale">Child Mania Rating Scale</a></li> <li><a href="/wiki/General_Behavior_Inventory" title="General Behavior Inventory">General Behavior Inventory</a></li> <li><a href="/wiki/Hypomania_Checklist" title="Hypomania Checklist">Hypomania Checklist</a></li> <li><a href="/wiki/Mood_Disorder_Questionnaire" title="Mood Disorder Questionnaire">Mood Disorder Questionnaire</a></li> <li><a href="/wiki/Rating_scales_for_depression" title="Rating scales for depression">Rating scales for depression</a></li> <li><a href="/wiki/Young_Mania_Rating_Scale" title="Young Mania Rating Scale">Young Mania Rating Scale</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Treatment_of_bipolar_disorder" title="Treatment of bipolar disorder">Treatment</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anticonvulsant" title="Anticonvulsant">Anticonvulsants</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carbamazepine" title="Carbamazepine">Carbamazepine</a></li> <li><a href="/wiki/Lamotrigine" title="Lamotrigine">Lamotrigine</a></li> <li><a href="/wiki/Oxcarbazepine" title="Oxcarbazepine">Oxcarbazepine</a></li> <li><a href="/wiki/Valproate" title="Valproate">Valproate</a> <ul><li><a href="/wiki/Sodium_valproate" class="mw-redirect" title="Sodium valproate">Sodium valproate</a></li> <li><a href="/wiki/Valproate_semisodium" class="mw-redirect" title="Valproate semisodium">Valproate semisodium</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sympathomimetic_drug" title="Sympathomimetic drug">Sympathomimetics</a>, <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a> and similar</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bupropion" title="Bupropion">Bupropion</a></li> <li><a href="/wiki/Dextroamphetamine" title="Dextroamphetamine">Dextroamphetamine</a></li> <li><a href="/wiki/Escitalopram" title="Escitalopram">Escitalopram</a></li> <li><a href="/wiki/Fluoxetine" title="Fluoxetine">Fluoxetine</a></li> <li><a href="/wiki/Methylphenidate" title="Methylphenidate">Methylphenidate</a></li> <li><a href="/wiki/Sertraline" title="Sertraline">Sertraline</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other <a href="/wiki/Mood_stabilizer" title="Mood stabilizer">mood stabilizers</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotics</a></li> <li><a href="/wiki/Atypical_antipsychotic" title="Atypical antipsychotic">Atypical antipsychotics</a></li> <li><a href="/wiki/Lithium_(medication)" title="Lithium (medication)">Lithium</a> <ul><li><a href="/wiki/Lithium_carbonate" title="Lithium carbonate">Lithium carbonate</a></li> <li><a href="/wiki/Lithium_citrate" title="Lithium citrate">Lithium citrate</a></li> <li><a href="/wiki/Lithium_sulfate" title="Lithium sulfate">Lithium sulfate</a></li> <li><a href="/wiki/Lithium_toxicity" title="Lithium toxicity">Lithium toxicity</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Non-pharmaceutical</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clinical_psychology" title="Clinical psychology">Clinical psychology</a></li> <li><a href="/wiki/Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">Cognitive behavioral therapy</a></li> <li><a href="/wiki/Dialectical_behavior_therapy" title="Dialectical behavior therapy">Dialectical behavior therapy</a></li> <li><a href="/wiki/Electroconvulsive_therapy" title="Electroconvulsive therapy">Electroconvulsive therapy</a></li> <li><a href="/wiki/Involuntary_commitment" title="Involuntary commitment">Involuntary commitment</a></li> <li><a href="/wiki/Light_therapy" title="Light therapy">Light therapy</a></li> <li><a href="/wiki/Psychotherapy" title="Psychotherapy">Psychotherapy</a></li> <li><a href="/wiki/Transcranial_magnetic_stimulation" title="Transcranial magnetic stimulation">Transcranial magnetic stimulation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/History_of_bipolar_disorder" title="History of bipolar disorder">History</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Emil_Kraepelin" title="Emil Kraepelin">Emil Kraepelin</a></li> <li><a href="/wiki/Frederick_K._Goodwin" title="Frederick K. Goodwin">Frederick K. Goodwin</a></li> <li><a href="/wiki/John_Cade" title="John Cade">John Cade</a></li> <li><a href="/wiki/Karl_Leonhard" title="Karl Leonhard">Karl Leonhard</a></li> <li><a href="/wiki/Kay_Redfield_Jamison" title="Kay Redfield Jamison">Kay Redfield Jamison</a></li> <li><a href="/wiki/Mogens_Schou" title="Mogens Schou">Mogens Schou</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Digital_media_use_and_mental_health" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digital_media_use_and_mental_health" title="Template:Digital media use and mental health"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digital_media_use_and_mental_health" title="Template talk:Digital media use and mental health"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digital_media_use_and_mental_health" title="Special:EditPage/Template:Digital media use and mental health"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Digital_media_use_and_mental_health" style="font-size:114%;margin:0 4em"><a href="/wiki/Digital_media_use_and_mental_health" title="Digital media use and mental health">Digital media use and mental health</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Proposed or recognised diagnostic categories</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Computer_addiction" title="Computer addiction">Computer addiction</a></li> <li><a href="/wiki/Internet_addiction_disorder" title="Internet addiction disorder">Internet addiction disorder</a></li> <li><a href="/wiki/Internet_sex_addiction" title="Internet sex addiction">Internet sex addiction</a></li> <li><a href="/wiki/Online_gambling" title="Online gambling">Online problem gambling</a></li> <li><a href="/wiki/Problematic_smartphone_use" title="Problematic smartphone use">Problematic smartphone use</a> <ul><li><a href="/wiki/Nomophobia" title="Nomophobia">Nomophobia</a></li></ul></li> <li><a href="/wiki/Problematic_social_media_use" title="Problematic social media use">Problematic social media use</a></li> <li><a href="/wiki/Television_addiction" title="Television addiction">Television addiction</a></li> <li><a href="/wiki/Video_game_addiction" title="Video game addiction">Video game addiction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Disciplines involved</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Digital_anthropology" title="Digital anthropology">Digital anthropology</a></li> <li><a href="/wiki/Digital_sociology" class="mw-redirect" title="Digital sociology">Digital sociology</a></li> <li><a href="/wiki/Ergonomics" title="Ergonomics">Ergonomics</a> <ul><li><a href="/wiki/Cognitive_ergonomics" title="Cognitive ergonomics">Cognitive ergonomics</a></li> <li><a href="/wiki/Computer-mediated_communication" title="Computer-mediated communication">Computer-mediated communication</a></li> <li><a href="/wiki/Cyberpsychology" title="Cyberpsychology">Cyberpsychology</a></li> <li><a href="/wiki/Engineering_psychology" title="Engineering psychology">Engineering psychology</a></li> <li><a href="/wiki/Human%E2%80%93computer_interaction" title="Human–computer interaction">Human–computer interaction</a></li> <li><a href="/wiki/Media_naturalness_theory" title="Media naturalness theory">Media naturalness theory</a></li> <li><a href="/wiki/Neuroergonomics" title="Neuroergonomics">Neuroergonomics</a></li></ul></li> <li><a href="/wiki/Neuroscience" title="Neuroscience">Neuroscience</a></li> <li><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a> <ul><li><a href="/wiki/Evolutionary_psychiatry" title="Evolutionary psychiatry">Evolutionary</a></li></ul></li> <li><a href="/wiki/Psychology" title="Psychology">Psychology</a> <ul><li><a href="/wiki/Clinical_psychology" title="Clinical psychology">Clinical</a></li> <li><a href="/wiki/Cognitive_psychology" title="Cognitive psychology">Cognitive</a></li> <li><a href="/wiki/Evolutionary_psychology" title="Evolutionary psychology">Evolutionary</a></li> <li><a href="/wiki/Social_psychology" title="Social psychology">Social</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Associated psychiatric conditions</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anxiety_disorder" title="Anxiety disorder">Anxiety disorder</a> <ul><li><a href="/wiki/Generalized_anxiety_disorder" title="Generalized anxiety disorder">Generalized anxiety disorder</a></li> <li><a href="/wiki/Obsessive%E2%80%93compulsive_disorder" title="Obsessive–compulsive disorder">Obsessive–compulsive disorder</a></li> <li><a href="/wiki/Social_anxiety_disorder" title="Social anxiety disorder">Social anxiety disorder</a></li></ul></li> <li><a href="/wiki/Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">Attention deficit hyperactivity disorder</a></li> <li><a href="/wiki/Autism" title="Autism">Autism</a></li> <li><a href="/wiki/Bipolar_disorder" title="Bipolar disorder">Bipolar disorder</a></li> <li><a class="mw-selflink selflink">Depression</a></li> <li><a href="/wiki/Eating_disorder" title="Eating disorder">Eating disorder</a> <ul><li><a href="/wiki/Anorexia_nervosa" title="Anorexia nervosa">Anorexia nervosa</a></li> <li><a href="/wiki/Body_image_disturbance" title="Body image disturbance">Body image disturbance</a></li></ul></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a></li> <li><a href="/wiki/Narcissistic_personality_disorder" title="Narcissistic personality disorder">Narcissistic personality disorder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Behavioral_addiction" title="Behavioral addiction">Behavioral addiction</a></li> <li><a href="/wiki/Behavioral_modernity" title="Behavioral modernity">Behavioral modernity</a></li> <li><a href="/wiki/Body_image" title="Body image">Body image</a></li> <li><a href="/wiki/Criticism_of_Facebook" title="Criticism of Facebook">Criticism of Facebook</a> <ul><li><a href="/wiki/2021_Facebook_leak" title="2021 Facebook leak">2021 Facebook company files leak</a></li></ul></li> <li><a href="/wiki/Cyberbullying" title="Cyberbullying">Cyberbullying</a></li> <li><a href="/wiki/Cyberpathology" title="Cyberpathology">Cyberpathology</a></li> <li><a href="/wiki/Digital_detox" title="Digital detox">Digital detox</a></li> <li><a href="/wiki/Digital_zombie" title="Digital zombie">Digital zombie</a></li> <li><a href="/wiki/Evolution_of_cognition" title="Evolution of cognition">Evolution of cognition</a></li> <li><a href="/wiki/Evolutionary_mismatch" title="Evolutionary mismatch">Evolutionary mismatch</a></li> <li><a href="/wiki/Fear_of_missing_out" title="Fear of missing out">Fear of missing out</a></li> <li><a href="/wiki/Mobile_phones_and_driving_safety" title="Mobile phones and driving safety">Mobile phones and driving safety</a></li> <li><a href="/wiki/Promotion_of_anorexia" class="mw-redirect" title="Promotion of anorexia">Promotion of anorexia</a></li> <li><a href="/wiki/Psychological_effects_of_Internet_use" title="Psychological effects of Internet use">Psychological effects of Internet use</a></li> <li><a href="/wiki/Screen_time" title="Screen time">Screen time</a> <ul><li><a href="/wiki/Binge-watching" title="Binge-watching">Binge-watching</a></li> <li><a href="/wiki/Social_aspects_of_television" title="Social aspects of television">Social aspects of television</a></li> <li><a href="/wiki/Television_consumption" title="Television consumption">Television consumption</a></li></ul></li> <li><a href="/wiki/Smartphones_and_pedestrian_safety" title="Smartphones and pedestrian safety">Smartphones and pedestrian safety</a></li> <li><a href="/wiki/Social_media_and_suicide" title="Social media and suicide">Social media and suicide</a></li> <li><a href="/wiki/Social_media_restrictions_on_children_in_Australia" title="Social media restrictions on children in Australia">Social media restrictions on children in Australia</a></li> <li><a href="/wiki/Spaving" title="Spaving">Spaving</a></li> <li><a href="/wiki/Suicide_and_the_Internet" title="Suicide and the Internet">Suicide and the Internet</a></li> <li><a href="/wiki/Technophilia" title="Technophilia">Technophilia</a> <ul><li><a href="/wiki/Technophobia" title="Technophobia">Technophobia</a></li></ul></li> <li><a href="/wiki/Technostress" title="Technostress">Technostress</a></li> <li><a href="/wiki/Texting_while_driving" title="Texting while driving">Texting while driving</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link 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/></a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">International</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><a rel="nofollow" class="external text" href="http://id.worldcat.org/fast/890969/">FAST</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85037053">United States</a></li><li><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb11931859k">France</a></li><li><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb11931859k">BnF data</a></li><li><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/01190900">Japan</a></li><li><a rel="nofollow" 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[\"CITEREFAndrewsBharwaniLeeFox2015\"] = 1,\n [\"CITEREFAppletonVoyiasSallisDawson2021\"] = 1,\n [\"CITEREFAranaBaldessariniOrnsteen1985\"] = 1,\n [\"CITEREFArcherBowerGilbodyet_al2012\"] = 1,\n [\"CITEREFBachmann2018\"] = 1,\n [\"CITEREFBahrLopezRey2019\"] = 1,\n [\"CITEREFBairRobinsonKatonKroenke2003\"] = 1,\n [\"CITEREFBarlowDurand2005\"] = 1,\n [\"CITEREFBeckRushShawEmery1979\"] = 1,\n [\"CITEREFBeckRushShawEmery1987\"] = 1,\n [\"CITEREFBecker2008\"] = 1,\n [\"CITEREFBeckettNiklison-Chirou2022\"] = 1,\n [\"CITEREFBelmakerAgam2008\"] = 1,\n [\"CITEREFBeloucif2013\"] = 1,\n [\"CITEREFBerrios1988\"] = 1,\n [\"CITEREFBlackStockingsCampbellet_al2019\"] = 1,\n [\"CITEREFBlair-WestMellsop2001\"] = 1,\n [\"CITEREFBoadenTomlinsonCorteseCipriani2020\"] = 2,\n [\"CITEREFBodenFergusson2011\"] = 1,\n [\"CITEREFBolandVerduin2022\"] = 1,\n [\"CITEREFBolwig2007\"] = 1,\n [\"CITEREFBondevik2011\"] = 1,\n [\"CITEREFBonnet2003\"] = 1,\n [\"CITEREFBottsRyan\"] = 1,\n [\"CITEREFBraithwaiteZhangKirkbrideOsborn2019\"] = 1,\n [\"CITEREFBraunBschorFranklinBaethge2016\"] = 1,\n [\"CITEREFBridleSpanjersPatelAtherton2012\"] = 1,\n [\"CITEREFBrookBrookZhangCohen2002\"] = 1,\n [\"CITEREFBrunsvoldOepen2008\"] = 1,\n [\"CITEREFBurlingame1997\"] = 1,\n [\"CITEREFCarhart-HarrisMaybergMaliziaNutt2008\"] = 1,\n [\"CITEREFCartaAltamuraHardoyPinna2003\"] = 1,\n [\"CITEREFCaspiSugdenMoffittTaylor2003\"] = 1,\n [\"CITEREFCassanoFava2002\"] = 1,\n [\"CITEREFCepoiuMcCuskerColeSewitch2008\"] = 1,\n [\"CITEREFCheungZuckerbrotJensenLaraque2018\"] = 1,\n [\"CITEREFCiprianiHawtonStocktonGeddes2013\"] = 1,\n [\"CITEREFCiprianiZhouDel_GiovaneHetrick2016\"] = 1,\n [\"CITEREFClaytonLewis1981\"] = 1,\n [\"CITEREFCoelhoCanterErnst2007\"] = 1,\n [\"CITEREFCohen1979\"] = 1,\n [\"CITEREFCommittee_on_Electroconvulsive_Therapy2001\"] = 1,\n [\"CITEREFCooneyDwanGreigLawlor2013\"] = 1,\n [\"CITEREFCordes2013\"] = 1,\n [\"CITEREFCorpGitlinAltshuler2014\"] = 1,\n [\"CITEREFCorrellCorteseCroattoMonaco2021\"] = 1,\n [\"CITEREFCorrigerPickering2019\"] = 1,\n [\"CITEREFCoxCallahanChurchillet_al2014\"] = 1,\n [\"CITEREFCuijpers2012\"] = 1,\n [\"CITEREFCuijpersMuñozClarkeLewinsohn2009\"] = 1,\n [\"CITEREFCuijpersvan_StratenSmit2006\"] = 1,\n [\"CITEREFCuijpersvan_StratenSmitMihalopoulos2008\"] = 1,\n [\"CITEREFCulpepperMuskinStahl2015\"] = 1,\n [\"CITEREFDaleSorourMilner2008\"] = 1,\n [\"CITEREFDavisCharneyCoyleNemeroff2002\"] = 1,\n [\"CITEREFDavison2006\"] = 1,\n [\"CITEREFDedovicNgiam2015\"] = 1,\n [\"CITEREFDelgadoMoreno2000\"] = 1,\n [\"CITEREFDelgadoSchillerstrom2009\"] = 1,\n [\"CITEREFDepartment_of_Health_and_Human_Services1999\"] = 1,\n [\"CITEREFDierckxHeijnenvan_den_BroekBirkenhäger2012\"] = 1,\n [\"CITEREFDoWeersing2017\"] = 1,\n [\"CITEREFDoidgeSimonLanceeet_al2002\"] = 1,\n [\"CITEREFDollVázquez-CastellanosSchaubSchweinfurth2022\"] = 1,\n [\"CITEREFDowlatiHerrmannSwardfagerLiu2010\"] = 1,\n [\"CITEREFDuff2006\"] = 1,\n [\"CITEREFDuncanKeller2011\"] = 1,\n [\"CITEREFDunlopNemeroff2007\"] = 1,\n [\"CITEREFDworetzky1997\"] = 1,\n [\"CITEREFEatonAnthonyGalloet_al1997\"] = 1,\n [\"CITEREFEatonShaoNestadtet_al2008\"] = 1,\n [\"CITEREFElhaiDvorakLevineHall2017\"] = 1,\n [\"CITEREFEveraertVrijsenMartin-Willettvan_de_Kraats2022\"] = 1,\n [\"CITEREFFaculty_of_Psychiatry_of_Old_Age,_NSW_Branch,_RANZCPKitching2001\"] = 1,\n [\"CITEREFFavaParkSonino2006\"] = 1,\n [\"CITEREFFerenchickRamanujPincus2019\"] = 1,\n [\"CITEREFFergussonDoucetteGlasset_al2005\"] = 1,\n [\"CITEREFFinkBolwigParkerShorter2007\"] = 1,\n [\"CITEREFFisherPowersTuerkEdgerton1975\"] = 1,\n [\"CITEREFFondLoundouHamdaniBoukouaci2014\"] = 1,\n [\"CITEREFFournierDeRubeisHollonDimidjian2010\"] = 1,\n [\"CITEREFFregniEl-HagrassyPacheco-Barrioset_al2021\"] = 1,\n [\"CITEREFFreud1984\"] = 1,\n [\"CITEREFGBD_2017_Disease_and_Injury_Incidence_and_Prevalence_Collaborators2018\"] = 1,\n [\"CITEREFGartlehnerWagnerMatyaset_al2017\"] = 1,\n [\"CITEREFGeddesCarneyDavieset_al2003\"] = 1,\n [\"CITEREFGelenbergFreemanMarkowitz\"] = 1,\n [\"CITEREFGelenbergFreemanMarkowitzRosenbaum2010\"] = 1,\n [\"CITEREFGiedkeSchwärzler2002\"] = 1,\n [\"CITEREFGilbodyHouseSheldon2005\"] = 1,\n [\"CITEREFGlobal_Burden_of_Disease_Study_2013_Collaborators2015\"] = 1,\n [\"CITEREFGoldfarbTrudel2019\"] = 1,\n [\"CITEREFGrahamSalimi-KhorshidiHaganWalsh2013\"] = 1,\n [\"CITEREFGrant1995\"] = 1,\n [\"CITEREFGriffithsFarrerChristensen2010\"] = 1,\n [\"CITEREFGruenbergGoldsteinPincus2005\"] = 1,\n [\"CITEREFGuaianaBarbuiHotopf2007\"] = 1,\n [\"CITEREFGunnellSaperiaAshby2005\"] = 1,\n [\"CITEREFGutlapalliFarhatIrfanMuthiah2022\"] = 1,\n [\"CITEREFHaeffelGetchellKoposovYrigollen2008\"] = 1,\n [\"CITEREFHallowellRatey2005\"] = 1,\n [\"CITEREFHamiltonEtkinFurmanLemus2012\"] = 1,\n [\"CITEREFHammad2004\"] = 1,\n [\"CITEREFHankinAbela2005\"] = 1,\n [\"CITEREFHasler2010\"] = 1,\n [\"CITEREFHealy1999\"] = 1,\n [\"CITEREFHeffernan1996\"] = 1,\n [\"CITEREFHergenhahn2005\"] = 1,\n [\"CITEREFHersenRosqvist2008\"] = 1,\n [\"CITEREFHestadAlexanderRootweltAaseth2022\"] = 1,\n [\"CITEREFHetrickCoxWittBir2016\"] = 1,\n [\"CITEREFHetrickMcKenzieBaileySharma2021\"] = 1,\n [\"CITEREFHetrickMcKenzieCoxSimmons2012\"] = 1,\n [\"CITEREFHirschfeld2001\"] = 1,\n [\"CITEREFHogeBickhamCantor2017\"] = 1,\n [\"CITEREFHolmaHolmaMelartinRytsälä2008\"] = 1,\n [\"CITEREFHowardAdamsClarkeHafferty2019\"] = 1,\n [\"CITEREFIglesias-GonzálezAznar-LouGil-Girbauet_al2017\"] = 1,\n [\"CITEREFIjazDaviesWilliamset_al2018\"] = 1,\n [\"CITEREFInstitute_for_Health_Metrics_and_Evaluation2020\"] = 1,\n [\"CITEREFIoannouWartenbergGreenbrooket_al2021\"] = 1,\n [\"CITEREFJainWalshEisendrathChristensen2014\"] = 1,\n [\"CITEREFJames1920\"] = 1,\n [\"CITEREFJelovacKolshusMcLoughlin2013\"] = 1,\n [\"CITEREFJestePalmerJeste2004\"] = 1,\n [\"CITEREFJordeCareyBamshad2019\"] = 1,\n [\"CITEREFJormAngermeyerKatschnig2000\"] = 1,\n [\"CITEREFJosefssonLindwallArcher2014\"] = 1,\n [\"CITEREFJoyceHerbison2015\"] = 1,\n [\"CITEREFKanaiTakeuchiFurukawaet_al2003\"] = 1,\n [\"CITEREFKarasz2005\"] = 1,\n [\"CITEREFKarrouriHammaniBenjellounOtheman2021\"] = 1,\n [\"CITEREFKatz1998\"] = 1,\n [\"CITEREFKaufmann1993\"] = 1,\n [\"CITEREFKennedyLamParikhPatten2009\"] = 1,\n [\"CITEREFKesslerBromet2013\"] = 1,\n [\"CITEREFKesslerNelsonMcGonagleet_al1996\"] = 1,\n [\"CITEREFKewalramaniBollingerPostolache2008\"] = 1,\n [\"CITEREFKhanFaucettLichtenbergKirsch2012\"] = 1,\n [\"CITEREFKhouryLecomteFortinet_al2013\"] = 1,\n [\"CITEREFKirschDeaconHuedo-MedinaScoboria2008\"] = 1,\n [\"CITEREFKrishnadasCavanagh2012\"] = 1,\n [\"CITEREFKrishnan2007\"] = 1,\n [\"CITEREFKrystalAbdallahSanacoraCharney2019\"] = 1,\n [\"CITEREFKuehner2003\"] = 1,\n [\"CITEREFLacasseLeo2005\"] = 1,\n [\"CITEREFLefaucheurAndré-ObadiaAntalet_al2014\"] = 1,\n [\"CITEREFLeuchtHuhnLeucht2012\"] = 1,\n [\"CITEREFLewis1934\"] = 1,\n [\"CITEREFLimosinMekaouiHautecouverture2007\"] = 1,\n [\"CITEREFLopez-DuranKovacsGeorge2009\"] = 1,\n [\"CITEREFLoprestiHoodDrummond2013\"] = 1,\n [\"CITEREFMalhiByrowBassettBoyce2016\"] = 1,\n [\"CITEREFMaloney_F2005\"] = 1,\n [\"CITEREFMannMcGrathRoose2013\"] = 1,\n [\"CITEREFMathersLoncar2006\"] = 1,\n [\"CITEREFMayberg1997\"] = 1,\n [\"CITEREFMcIntyreRosenblatNemeroffet_al2021\"] = 1,\n [\"CITEREFMcNallyBhagwagarHannestad2008\"] = 1,\n [\"CITEREFMcPhersonMartin2010\"] = 1,\n [\"CITEREFMedics_and_Foods_Department\"] = 1,\n [\"CITEREFMeekumsKarkouNelson2015\"] = 1,\n [\"CITEREFMelartinRytsäläLeskeläLestelä-Mielonen2002\"] = 1,\n [\"CITEREFMelkerson2008\"] = 1,\n [\"CITEREFMelrose2015\"] = 1,\n [\"CITEREFMeltzer-Brody2017\"] = 1,\n [\"CITEREFMeyerGinovartBoovariwalaet_al2006\"] = 1,\n [\"CITEREFMill_JS2003\"] = 1,\n [\"CITEREFMoffaMartinAlonzoet_al2020\"] = 1,\n [\"CITEREFMoncrieffCooperStockmanet_al2022\"] = 1,\n [\"CITEREFMurray2007\"] = 1,\n [\"CITEREFMuñozBeardsleeLeykin2012\"] = 1,\n [\"CITEREFNelsonBickfordDelucchiFiedorowicz2018\"] = 1,\n [\"CITEREFNelsonDevanand2011\"] = 1,\n [\"CITEREFNietoRoblesVazquez2020\"] = 1,\n [\"CITEREFNieuwenhuijsenVerbeekNeumeyer-Gromenet_al2020\"] = 1,\n [\"CITEREFOgawaTakeshimaHayasakaet_al2019\"] = 1,\n [\"CITEREFOquendoBongiovi-GarciaGalfalvyet_al2007\"] = 1,\n [\"CITEREFOrengoFullertonTan2004\"] = 1,\n [\"CITEREFOsimoPillingerRodriguezKhandaker2020\"] = 1,\n [\"CITEREFOsmanBaggeGutierrezKonick2001\"] = 1,\n [\"CITEREFOtteGoldPenninxPariante2016\"] = 1,\n [\"CITEREFPalmerGatesLader2003\"] = 1,\n [\"CITEREFPapakostasThaseFavaNelson2007\"] = 1,\n [\"CITEREFParker1996\"] = 1,\n [\"CITEREFParker2014\"] = 1,\n [\"CITEREFParkerBrotchieGraham2017\"] = 1,\n [\"CITEREFParkerCheahRoy2001\"] = 1,\n [\"CITEREFPatel2013\"] = 1,\n [\"CITEREFPatelArayaBolton2004\"] = 1,\n [\"CITEREFPatton2015\"] = 1,\n [\"CITEREFPaykel2007\"] = 1,\n [\"CITEREFPaykelHartPriest1998\"] = 1,\n [\"CITEREFPaykelTyleeWrightet_al1997\"] = 1,\n [\"CITEREFPeyrotVan_der_AuweraMilaneschiDolan2018\"] = 1,\n [\"CITEREFPhilippMaierDelmo1991\"] = 1,\n [\"CITEREFPita_E2001\"] = 1,\n [\"CITEREFPompiliDominiciGiordanoet_al2014\"] = 1,\n [\"CITEREFPosternakMiller2001\"] = 1,\n [\"CITEREFPosternakSolomonLeonet_al2006\"] = 1,\n [\"CITEREFRachayonJirakranSodsaiSughondhabirom2024\"] = 1,\n [\"CITEREFRadden2003\"] = 1,\n [\"CITEREFRalovskaKoyvhevMarinovFurukawa2023\"] = 1,\n [\"CITEREFRapaportJuddSchettlerYonkers2002\"] = 1,\n [\"CITEREFReidMaclullich2006\"] = 1,\n [\"CITEREFRichardsO\u0026#039;Hara2014\"] = 1,\n [\"CITEREFRickards2005\"] = 1,\n [\"CITEREFRogersPies2008\"] = 1,\n [\"CITEREFRoyal_Pharmaceutical_Society_of_Great_Britain2008\"] = 1,\n [\"CITEREFRuhéMasonSchene2007\"] = 1,\n [\"CITEREFRush2007\"] = 1,\n [\"CITEREFRushMarangellSackeimet_al2005\"] = 1,\n [\"CITEREFSadock2002\"] = 1,\n [\"CITEREFSanadaNakajimaKurokawaBarceló-Soler2020\"] = 1,\n [\"CITEREFSartoriusHendersonStrotzkaet_al\"] = 1,\n [\"CITEREFSaveanuNemeroff2012\"] = 1,\n [\"CITEREFSavitzDrevets2013\"] = 1,\n [\"CITEREFSchulmanShapiro2008\"] = 1,\n [\"CITEREFSeymour2002\"] = 1,\n [\"CITEREFSharpLipsky2002\"] = 1,\n [\"CITEREFSimkinBlack2014\"] = 1,\n [\"CITEREFSimon2001\"] = 1,\n [\"CITEREFSimonton2005\"] = 1,\n [\"CITEREFSiu2016\"] = 1,\n [\"CITEREFSiuBibbins-DomingoGrossmanet_al2016\"] = 1,\n [\"CITEREFSlavich2004\"] = 1,\n [\"CITEREFSolmiFornaroOstinelliZangani2020\"] = 1,\n [\"CITEREFSontheimer2021\"] = 1,\n [\"CITEREFSoysalVeroneseThompsonet_al2017\"] = 1,\n [\"CITEREFSpitzerEndicottRobins1975\"] = 1,\n [\"CITEREFSterba_R1947\"] = 1,\n [\"CITEREFStoneLaughrenJoneset_al2009\"] = 1,\n [\"CITEREFStrakowskiNelson2015\"] = 1,\n [\"CITEREFStrikHonigMaes2001\"] = 1,\n [\"CITEREFSukhramYilmazGu2022\"] = 1,\n [\"CITEREFSullivanNealeKendler2000\"] = 2,\n [\"CITEREFSwardfagerHerrmannMarzoliniet_al2011\"] = 1,\n [\"CITEREFTaylorCarneyGeddesGoodwin2003\"] = 1,\n [\"CITEREFTaylorMcNeillGirlinget_al2014\"] = 1,\n [\"CITEREFThase1999\"] = 1,\n [\"CITEREFThase2006\"] = 1,\n [\"CITEREFTilburyRapley2004\"] = 1,\n [\"CITEREFVargheseBrown2001\"] = 1,\n [\"CITEREFWaltherBreidensteinMiller2019\"] = 1,\n [\"CITEREFWeissman1987\"] = 1,\n [\"CITEREFWhitefordHarrisMcKeonet_al2012\"] = 1,\n [\"CITEREFWhooleySimon2000\"] = 1,\n [\"CITEREFWilsonMottramVassilas2008\"] = 1,\n [\"CITEREFWolpert1999\"] = 1,\n [\"CITEREFWrayRipkeMattheisenTrzaskowski2018\"] = 1,\n [\"CITEREFWrightPersad2007\"] = 1,\n [\"CITEREFWuZhangLiZhang2021\"] = 1,\n [\"CITEREFYohannesBaldwin2008\"] = 1,\n [\"CITEREFZhouTengZhangDel_Giovane2020\"] = 1,\n [\"CITEREFZhuTuChen2022\"] = 1,\n [\"CITEREFZimmermanChelminskiPosternak2004\"] = 1,\n [\"CITEREFZingoneSwiftCardSanders2015\"] = 1,\n [\"CITEREFZisookRushHaightClines2006\"] = 1,\n [\"CITEREFde_MaatDekkerSchoeverset_al2007\"] = 1,\n [\"CITEREFde_VriesRoestBoset_al2019\"] = 1,\n [\"physicalSymptoms\"] = 1,\n}\ntemplate_list = table#1 {\n [\"!\"] = 1,\n [\"Anchor\"] = 1,\n [\"Authority control\"] = 1,\n [\"Citation\"] = 1,\n [\"Cite book\"] = 39,\n [\"Cite conference\"] = 1,\n [\"Cite encyclopedia\"] = 3,\n [\"Cite journal\"] = 228,\n [\"Cite report\"] = 1,\n [\"Cite web\"] = 30,\n [\"Cs1 config\"] = 1,\n [\"Digital media use and mental health\"] = 1,\n [\"Distinguish\"] = 1,\n [\"Div col\"] = 1,\n [\"Div col end\"] = 1,\n [\"Doi\"] = 1,\n [\"Failed verification\"] = 1,\n [\"Featured article\"] = 1,\n [\"For\"] = 1,\n [\"Further\"] = 5,\n [\"Harvnb\"] = 10,\n [\"Hatnote group\"] = 1,\n [\"ICD10\"] = 2,\n [\"ICD11\"] = 2,\n [\"ICD9\"] = 2,\n [\"ISBN\"] = 1,\n [\"Infobox medical condition (new)\"] = 1,\n [\"Lang\"] = 2,\n [\"Legend\"] = 13,\n [\"Main\"] = 5,\n [\"Medical condition classification and resources\"] = 1,\n [\"Mental and behavioural disorders\"] = 1,\n [\"Mood disorders\"] = 1,\n [\"Pd-notice\"] = 1,\n [\"Pp-semi-indef\"] = 1,\n [\"Refbegin\"] = 1,\n [\"Refend\"] = 1,\n [\"Reflist\"] = 1,\n [\"Rp\"] = 2,\n [\"See also\"] = 2,\n [\"Sfn\"] = 29,\n [\"Short description\"] = 1,\n [\"Spoken Wikipedia\"] = 1,\n [\"TOC limit\"] = 1,\n [\"Transliteration\"] = 1,\n [\"Update\"] = 1,\n [\"Use dmy dates\"] = 1,\n [\"Webarchive\"] = 3,\n}\narticle_whitelist = table#1 {\n}\n","limitreport-profile":[["?","400","19.6"],["MediaWiki\\Extension\\Scribunto\\Engines\\LuaSandbox\\LuaSandboxCallback::callParserFunction","300","14.7"],["dataWrapper 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disorder","url":"https:\/\/en.wikipedia.org\/wiki\/Major_depressive_disorder","sameAs":"http:\/\/www.wikidata.org\/entity\/Q42844","mainEntity":"http:\/\/www.wikidata.org\/entity\/Q42844","author":{"@type":"Organization","name":"Contributors to Wikimedia projects"},"publisher":{"@type":"Organization","name":"Wikimedia Foundation, Inc.","logo":{"@type":"ImageObject","url":"https:\/\/www.wikimedia.org\/static\/images\/wmf-hor-googpub.png"}},"datePublished":"2001-10-30T00:53:08Z","dateModified":"2024-11-20T19:59:55Z","image":"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/d\/d2\/Van_Gogh_-_Trauernder_alter_Mann.jpeg","headline":"all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities"}</script> </body> </html>