PERSONALITY DISORDERS and DEPRESSION
All of us have some level of depression, anxiety, personality disorder, phobia, phillia, or other psychotic-measurable symptom. Afterall, "wholeness" means you have happy, anger, sad, glad, and ALL the range of emotional abilities. If you have an addiction to an emotion, you must then put that emotion aside and not use it anymore the same as for an addiction to a physical substance such as alcohol, nicotine, or others. Thus, if you have an addiction to fear, anger, or panic (for example) you must give up that emotion permanently just as with nicotine. If you don't, your body will remember and re-addict you immediately.
As you read over the summaries of these disorders, you will find you have some of most of them either now or occasionally. Don't think you need to run for a prozac prescription, just change the ones you see are in your life and make it better. Start to keep an eye out for any of these debilitating symptoms and give them the boot right straight off. You can turn your life around and no one else can do that for you. These symptoms are like open doors you can use to make appropriate changes so your life is better.
Now, however, if these symptoms fit you and you are having difficulties in your life because of some of these symptoms, you will need to take strong action. Log your symptoms. Write down your activities and emotional set each day or after any strong or unusual emotional outburst (even if it is only internal). If you can discern a pattern, begin to change that pattern by altering the events that trigger the pattern. After a suitable period of time, talk to your doctor about the journal (or log) and see if there is medical (chemical) help. Try appropriate self-help studies readily available in the library or on the internet. Don't jump over flaming barrels right off. Start at a reasonable level you can control. DON'T PUT YOURSELF IN THE HANDS OF ANYONE ELSE EXCEPT AS A LAST RESORT. AND BE ABSOLUTELY CERTAIN IT IS A LAST RESORT. Try everything else first. Keep yourself for yourself. You are extremely important to you and the rest of the world appreciates having you around even if we don't say it very well or very often.
The way I look at these symptoms (well, I'm doing the writing aren't I??) is that they essentially represent RITUALS! Yup! Rituals. Thus, if I find I am overly frightened by wasps, I make a ritual out of learning about wasps (paper wasps, potter wasps, wingless wasps, etc.), go out and look for wasps (cautiously of course), see how they live, where they go, get a little close, and gain understanding. By doing this my (pretend I think) phobia or fear is greatly lessened and even though I may remain very cautious around wasps all my life, I won't have a debilitating fear.
This exact technique won't work for all symptoms and sometimes nothing will work (people do die you know) but this kind of outlook is certainly an improvement over seeing these symptoms as SYMPTOMS. Notice that you must have a majority of the symptoms to have a disease or psychosis. So, if you take out a few of the easier ones, and lessen the tougher ones, you won't have a psychosis and you're healed. Even if you don't have a psychosis such as described about wasps (and I don't) but are very cautious about being stung by them because they hurt so much (and they do), a knowledgeble base greatly helps you to know how, where, when, and which to avoid (especially the red and black wingless wasps we call "mule-killers" here in Florida because a sting from them hurts so bad it could kill a mule). Being careful and cautious is not always a bad thing. Overdoing it is. As the Tree of Life teaches, the middle path is the best.
Here are some symptom summaries I picked up from the internet. Please visit the websites for even more information.
This one describes a possible source of where depression comes from. The writing is from the
Journal of the American Academy of Child and Adolescent Psychiatry
Symptoms of depression in adolescents with epilepsy.
Author/s: David W. Dunn
Issue: Sept, 1999
It is the negative evaluation of stress that leads to negative evaluation of self and thus depression. Our study hypothesized that the reformulated theory of learned helplessness, in which the combination of apparently uncontrollable adverse events and the individual's negative perceptions and attributions results in depression.
We hypothesize that family factors and mother and child perceptions will be significantly associated with depression in children.
We have demonstrated an association between the adolescent's negative evaluation of family relationships and the risk of depression.
Our findings support the learned helplessness model of depression with its subsequently reformulated attributional model in which the combination of uncontrollable adverse events and the individual's negative perceptions and attributions result in depression.
OK. I thought you'd like to know something of what researchers are finding about where depression comes from. It is interesting to me that we can each work our way out of feeling helpless and possibly cure depression. Knowing things can work out and help us have a better life. Of course, there really are some people who are helpless and fortunately in our world, there are a lot of people who protect and support such helpless individuals. Nice place to be.
Here is a directory to get you around quicker:
Major Depression symptoms
Bipolar Disorder
Manic Episode
hypomanic Episode
Schizoaffective disorder
Schizophrenia
Delusional Disorder
Antisocial Personality Disorder
Avoidant Personality Disorder
Borderline Personality Disorder
Dependent Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Obsessive-Compulsive Personality Disorder
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Attention Deficit Disorder
Generalized Anxiety Disorder
Panic Disorder
SYMPTOMS OF MAJOR DEPRESSION.
A person who suffers from a major depressive disorder must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition. Major depressive disorder cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder.
This disorder is characterized by the presence of the majority of these symptoms:
markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
insomnia or hypersomnia nearly every day
psychomotor agitation or retardation nearly every day
fatigue or loss of energy nearly every day
feelings of worthlessness or excessive or inappropriate guilt nearly every day
diminished ability to think or concentrate, or indecisiveness, nearly every day
recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Check here for a great article on depression to gain more understanding.
Bipolar disorder is often not recognized by the patient, relatives, friends, or even physicians. An early sign of manic-depressive illness may be hypomania--a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior.
Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.
In its early stages, bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.
If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged mania and clinical depression.
One of the usual differential diagnoses for bipolar disorder is that the symptoms (listed below) are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
And as with nearly all mental disorder diagnoses, the symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
http://mentalhelp.net/disorders/sx20.htm
A manic episode is not a disorder in and of itself, but instead is a part of other disorders, most usually bipolar disorder.
It is characterized by a time period of an elevated, expansive or notably irritable mood, lasting for at least one week. This disorder must be sufficiently severe to cause difficulty or impairment in occupational, social, educational or other important functioning and can not be better explained by a mixed episode. Symptoms also can not be the result of substance use or abuse (alcohol, drugs, medications) or caused by a general medical condition. A majority of the following symptoms is also present:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
attention is easily drawn to unimportant or irrelevant items
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
inflated self-esteem or grandiosity
decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
more talkative than usual or pressure to keep talking
flight of ideas or subjective experience that thoughts are racing
distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic.
The disturbance in mood and the change in functioning are observable by others.
The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.
The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
This disorder is characterized by the presence of one of the following:
Major Depressive Episode (must include depressed mood)
Manic Episode
Mixed Episode
as well as the presence of at least two of the following symptoms, for at least one month:
delusions
hallucinations
disorganized speech (e.g., frequent derailment or incoherence)
grossly disorganized or catatonic behavior
negative symptoms (e.g., affective flattening, alogia, avolition)
(Only one symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.)
The occurrence of the delusions or hallucinations must be in the absence of any serious mood symptoms for at least 2 weeks. The mood disorder, however, must be present for a significant minority of the time. The symptoms of this disorder also can not be better explained by the use or abuse of a substance (alcohol, drugs, medications) or a general medical condition (stroke).
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
This disorder consists of at least two of the following symptoms, for at least one month:
Delusions
Hallucinations
Disorganized speech (e.g., frequent derailment or incoherence)
Grossly disorganized or catatonic behavior
Negative symptoms (e.g., affective flattening, alogia, avolition; see below)
(Only one symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.)
For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).
Schizoaffective Disorder and Mood Disorder With Psychotic Features have been considered as alternative explanations for the symptoms and have been ruled out.
The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).
"Positive" Symptoms
Delusions
Disorganized thinking
Lack of drive or initiative
Apathy
"Negative" Symptoms
Hallucinations
Agitation
Social withdrawal
Emotional unresponsiveness
Different Types of Schizophrenia:
Paranoid schizophrenia
a person feels extremely suspicious, persecuted, grandiose, or experiences a combination of these emotions.
Disorganized schizophrenia
a person is often incoherent but may not have delusions.
Catatonic schizophrenia
a person is withdrawn, mute, negative and often assumes very unusual postures.
Residual schizophrenia
a person is no longer delusion or hallucinating, but has no motivation or interest in life. These symptoms can be most devastating.
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
This disorder is characterized by the presence of non-bizarre delusions which have persisted for at least one month. Non-bizarre delusions typically are beliefs of something occurring in a person's life which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a government agent, etc. All of these situations could be true or possible, but the person suffering from this disorder knows them not to be (e.g., through fact-checking, third-person confirmation, etc.).
People who have this disorder generally don't experience a marked impairment in their daily functioning in a social, occupational or other important setting. Outward behavior is not noticeably bizarre or objectively characterized as out-of-the-ordinary.
The delusions can not be better accounted for by another disorder, such as schizophrenia, which is also characterized by delusions (which are bizarre). The delusions also cannot be better accounted for by a mood disorder, if the mood disturbances have been relatively brief.
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Antisocial Personality Disorder
This disorder is characterized by a long-standing pattern of a disregard for other people's rights, often crossing the line and violating those rights. This pattern of behavior has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder) and consists by the presence of the majority of these symptoms:
failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
impulsivity or failure to plan ahead
irritability and aggressiveness, as indicated by repeated physical fights or assaults
reckless disregard for safety of self or others
consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Avoidant Personality Disorder
This disorder is characterized by a long-standing and complex pattern of feelings of inadequacy, extreme sensitivity to what other people think about them, and social inhibition. It typically manifests itself by early adulthood and includes a majority of the following symptoms:
avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Borderline Personality Disorder
A person who suffers from this disorder has labile interpersonal relationships characterized by instability. This pattern of interacting with others has persisted for years and is usually closely related to the person's self-image and early social interactions. The pattern is present in a variety of settings (e.g., not just at work or home) and often is accompanied by a similar lability (fluctuating back and forth, sometimes in a quick manner) in a person's affect, or feelings. Relationships and the person's affect may often be characterized as being shallow. A person with this disorder may also exhibit impulsive behaviors and exhibit a majority of the following symptoms:
frantic efforts to avoid real or imagined abandonment.
a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
identity disturbance: markedly and persistently unstable self-image or sense of self
impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
transient, stress-related paranoid ideation or severe dissociative symptoms
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Dependent Personality Disorder
This personality disorder is characterized by a long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life. This pervasive fear leads to "clinging behavior" and usually manifests itself by early adulthood. It includes a majority of the following symptoms:
has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
needs others to assume responsibility for most major areas of his or her life
has difficulty expressing disagreement with others because of fear of loss of support or approval.
has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
urgently seeks another relationship as a source of care and support when a close relationship ends
is unrealistically preoccupied with fears of being left to take care of himself or herself
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Histrionic Personality Disorder
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) is uncomfortable in situations in which he or she is not the center of attention
(2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
(3) displays rapidly shifting and shallow expression of emotions
(4) consistently uses physical appearance to draw attention to self
(5) has a style of speech that is excessively impressionistic and lacking in detail
(6) shows self-dramatization, theatricality, and exaggerated expression of emotion
(7) is suggestible, i.e., easily influenced by others or circumstances
(8) considers relationships to be more intimate than they actually are
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Obsessive-Compulsive Personality Disorder
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
(3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
(5) is unable to discard worn-out or worthless objects even when they have no sentimental value
(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
(7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
(8) shows rigidity and stubbornness
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Paranoid Personality Disorder
A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
reads hidden demeaning or threatening meanings into benign remarks or events
persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
Schizoid Personality Disorder
A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
neither desires nor enjoys close relationships, including being part of a family
almost always chooses solitary activities
has little, if any, interest in having sexual experiences with another person
takes pleasure in few, if any, activities
lacks close friends or confidants other than first-degree relatives
appears indifferent to the praise or criticism of others
shows emotional coldness, detachment, or flattened affectivity
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
ideas of reference (excluding delusions of reference)
odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations)
unusual perceptual experiences, including bodily illusions
odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
suspiciousness or paranoid ideation
inappropriate or constricted affect
behavior or appearance that is odd, eccentric, or peculiar
lack of close friends or confidants other than first-degree relatives
excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
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Attention deficit disorder (with or without hyperactivity) is known by a cluster of co-occurring behavioral symptoms. Check to see if any of these sound familiar to you.
ADHD or ADD is characterized by a majority of the following symptoms being present in either category (inattention or hyperactivity). These symptoms need to manifest themselves in a manner and degree which is inconsistent with the child's current developmental level. That is, the child's behavior is significantly more inattentive or hyperactive than that of his or her peers of a similar age.
Symptoms of Inattention:
often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
often has difficulty sustaining attention in tasks or play activities
often does not seem to listen when spoken to directly
often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
often has difficulty organizing tasks and activities
often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
is often easily distracted by extraneous stimuli
is often forgetful in daily activities
Symptoms of Hyperactivity:
often fidgets with hands or feet or squirms in seat
often leaves seat in classroom or in other situations in which remaining seated is expected
often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
often has difficulty playing or engaging in leisure activities quietly
is often "on the go" or often acts as if "driven by a motor"
often talks excessively
Symptoms of Impulsivity:
often blurts out answers before questions have been completed
often has difficulty awaiting turn
often interrupts or intrudes on others (e.g., butts into conversations or games)
Symptoms must have persisted for at least 6 months. Some of these symptoms need to have been present as a child, at 7 years old or younger. The symptoms also must exist in at least two separate settings (for example, at school and at home). The symptoms should be creating significant impairment in social, academic or occupational functioning or relationships.
Criteria summarized from:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
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Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It's chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety.
People with GAD can't seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.
Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.
Usually the impairment associated with GAD is mild and people with the disorder don't feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don't characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.
GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It's more common in women than in men and often occurs in relatives of affected persons. It's diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.
Specific Symptoms of this Disorder:
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
The person finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children don't need to meet as many criteria).
restlessness or feeling keyed up or on edge
being easily fatigued
difficulty concentrating or mind going blank
irritability
muscle tension
sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
Additionally, the anxiety or worry is not about having a Panic Attack, being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), being away from home or close relatives (as in Separation Anxiety Disorder), gaining weight (as in Anorexia Nervosa), having multiple physical complaints (as in Somatization Disorder), or having a serious illness (as in Hypochondriasis), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder (PTSD).
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Developmental Disorder.
References:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)
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People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can't predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.
When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you're having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.
Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age--in children or in the elderly--but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder-- for example, many people have one attack but never have another. For those who do have panic disorder, though, it's important to seek treatment. Untreated, the disorder can become very disabling.
Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you're riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.
Some people's lives become greatly restricted -- they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs. When people's lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.
Specific Symptoms of this Disorder:
The person experiences recurrent unexpected Panic Attacks and at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
persistent concern about having additional attacks
worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
a significant change in behavior related to the attacks
Presence or absence of Agoraphobia.
The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).
References:
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)
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