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A diagnosis of MDD requires five or more of the following symptoms during the same two-week period: Depressed mood most of the day, nearly every day Loss of interest or pleasure in nearly all activities Significant changes in sleep or appetite Fatigue or loss of energy Feelings of worthlessness or excessive guilt Difficulty concentrating or making decisions Thoughts of death or suicide MDD is episodic

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Clin Endocrinol (Oxf) 62(6):650655 Persson L, Cao G, Stahle L, Sjoberg BG, Troutt JS, Konrad RJ et al (2010) Circulating proprotein convertase subtilisin kexin type 9 has a diurnal rhythm synchronous with cholesterol synthesis and is reduced by fasting in humans