My Neurological Spice Rack¹

Diagnostic Criteria 

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly attributable to another medical condition. 

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.) 

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). 

3. 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. (Note: In children, consider failure to make expected weight gain.) 

4. Insomnia or hypersomnia nearly every day. 

5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). 

6. Fatigue or loss of energy nearly every day. 

7. Feelings of worthlessness or excessive or inappropriate guilt (which may be  delusional) nearly every day (not merely self-reproach or guilt about being sick). 

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). 

9. 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. 

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

C. The episode is not attributable to the physiological effects of a substance or another medical condition. 

Diagnostic Criteria 

A. 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). 

B. The individual finds it difficult to control the worry. 

C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): Note: Only one item is required in children. 

1. Restlessness or feeling keyed up or on edge. 

2. Being easily fatigued. 

3. Difficulty concentrating or mind going blank. 

4. Irritability. 

5. Muscle tension. 

6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). 

D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.  

E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). 

F. The disturbance is not better explained by another mental disorder. 

Diagnostic Criteria

For a diagnosis of bipolar II disorder, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or past major depressive episode: 

Hypomanic Episode 

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. 

B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable), represent a noticeable change from usual behavior, and have been present to a significant degree: 

1. Inflated self-esteem or grandiosity. 

2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). 

3. More talkative than usual or pressure to keep talking. 

4. Flight of ideas or subjective experience that thoughts are racing.

5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. 

6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation. 

7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments). 

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. 

D. The disturbance in mood and the change in functioning are observable by others. 

E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. 

F. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition. 

Diagnostic Criteria 

A. Presence of obsessions, compulsions, or both: Obsessions are defined by (1) and (2): 

1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. 

2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion). Compulsions are defined by (1) and (2): 

1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. 

2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Note: Young children may not be able to articulate the aims of these behaviors or mental acts. 

B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. 

D. The disturbance is not better explained by the symptoms of another mental disorder. 

Diagnostic Criteria 

A. Recurrent skin picking resulting in skin lesions. 

B. Repeated attempts to decrease or stop skin picking. 

C. The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

D. The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies). 

E. The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in nonsuicidal self-injury). 

Diagnostic Criteria

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: 

1. Directly experiencing the traumatic event(s). 

2. Witnessing, in person, the event(s) as it occurred to others. 

3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. 

B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: 

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed. 

2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content. 

3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play. 

4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 

5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 

C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: 

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 

2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 

1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). 

2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”). 

3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 

4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). 

5. Markedly diminished interest or participation in significant activities. 

6. Feelings of detachment or estrangement from others. 

7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). 

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 

1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 

2. Reckless or self-destructive behavior. 

3. Hypervigilance. 

4. Exaggerated startle response. 

5. Problems with concentration.

6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). 

F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. 

G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 

A. The death ⁴, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least 6 months ago).  

B. Since the death, the development of a persistent grief response characterized by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) has occurred nearly every day for at least the last month: 

1. Intense yearning/longing for the deceased person. 

2. Preoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death). 

C. Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month: 

1. Identity disruption (e.g., feeling as though part of oneself has died) since the death. 

2. Marked sense of disbelief about the death. 

3. Avoidance of reminders that the person is dead (in children and adolescents, may be characterized by efforts to avoid reminders). 

4. Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death. 

5. Difficulty reintegrating into one’s relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future). 

6. Emotional numbness (absence or marked reduction of emotional experience) as a result of the death. 

7. Feeling that life is meaningless as a result of the death. 

8. Intense loneliness as a result of the death. 

D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

E. The duration and severity of the bereavement reaction clearly exceed expected social, cultural, or religious norms for the individual’s culture and context. 

F. The symptoms are not better explained by another mental disorder, such as major depressive disorder or posttraumatic stress disorder, and are not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 

¹ These statements are taken directly from THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION, TEXT REVISION (DSM-5-TR™) with the ²page numbers listed. These descriptions are meant to represent my own personal challenges ONLY and are, therefore, for informational purposes only, and not meant to represent, diagnose, or advise on the condition of any other person's mental health. However, if you do identify with these statements, I urge you to seek professional therapy. 

³ A new diagnoses called Complex PTSD is a variation on PTSD, except the trauma is not limited to one event, but rather a prolonged pattern of trauma, such as domestic violence and child abuse. This diagnoses has yet to be included in the DSM.

⁴ The "death" of a loved one, in my case isn't based on people actually dying, but the circumstances in which my narcissist ex-partner ended our relationship is more like a death to me than a break-up.