Including: change in appetite and weight (increase or loss); change in sleep patterns – less (insomnia) or more (hypersomnia); extreme loss of energy; observable slowness or agitation; diminished loss of interest and enjoyment in activities; feelings of self-reproach and excessive guilt over real or imaginary misdeeds (may develop into delusions); complaints or evidence of diminished ability to think or concentrate; recurrent thoughts of death or suicide, attempts or plans suicide