Major Depressive Disorder (Recurrent)

Major depressive disorder, recurrent is defined by the occurrence of two or more major depressive episodes separated by at least two months of remission. Etiological factors are similar to single-episode MDD, including genetic predisposition, dysregulated neurotransmitter systems, and chronic psychosocial stressors. Clinically, patients experience repeated episodes of depressed mood, anhedonia, cognitive impairment, sleep disturbances, and somatic complaints, with increased risk of comorbid anxiety, substance use, and suicidal behavior. Diagnosis requires careful longitudinal assessment to confirm multiple discrete episodes and rule out bipolar disorder or substance-induced mood disorders. Treatment involves long-term pharmacotherapy, psychotherapy to prevent relapse, lifestyle modification, and close monitoring for recurrence, emphasizing the importance of maintenance therapy.