depression can include anhedonia (i.e., loss of interest in previously enjoyed activities); changes in appetite, sleep, or motor activity; or fatigue or energy loss. Psychological effects of depression include feelings of worthlessness, guilt, and/or hopelessness; suicidal ideation; or decreases in concentration. Some individuals may experience bodily aches and pains. Depressive episodes are often cyclical, with patterns of symptom remission and recurrence, although years of chronic low-grade depressed