Criteria:
Moving from Behavior to Symptom
We first look at behaviors – what a person does. If the behavior is severe enough it becomes a symptom. You
then need a set of symptoms to make a diagnosis.
Behavior to Symptom:
There are lots of things people do that are like symptoms that are just behaviors. Checking your locks a couple
times before you go to bed is one of my favorites. If you do it a couple of times and it relieves your anxiety and
you sleep well, it’s a behavior, it’s not a symptom. If you have thoughts that tell you to clean something, but it’s
not recurrent nor persistant, and it doesn’t become stronger when you try to push it away, then it’s just a little
nagging in your head, not a symptom of obsessive-compulsive disorder.
Brainstorm Criteria words and phrases:
“how long”, “how intense” are the two most common indicators of criteria.
recurrent
severity
interferes with major life functions
change from previous functioning
other cause (usually organic)
These criteria can be applied to all symptoms
Category: Mood Disorders - Depressive Episode Symptoms
Diagnosis: 5 of 9 symptoms for more than 2 weeks
Behaviors
Criteria
Symptoms
depressed mood
most of the time Indescribable, fog
Prozac, p. 2 “I call it a place because it is more than a feeling, it
is where I sit and cry and wish I had a real reason for being
there.”
Danquah p. 18 2nd ¶ “When the day ends…”
On waking up: it’s got to be a better day
general negative attitude a variety (change, “Why can’t I do anything right?”
interferes)
Danquah, 1st page – “nurturing a low grade melancholy”
Unholy Ghosts – between pose and reality made it worse
loss of interest or
all or almost all
The part that matters, that you enjoy.
pleasure in all or almost usual,
Have tried them and they aren’t working (slipping down)
all usual activities and
previous level of Boyd “2 ton phone - fun feels like w-o-r-k”
past times
functioning
not able to just mix with people, things of the world
Unholy Ghosts – loneliness only grew sharper in the presence of
others
- 2nd ¶ – I want to write, I can’t
Harris, p. 1 3rd ¶:
feelings of worthlessness sense it won't
Can’t describe a good day.
or guilt (helplessness,
change
the closer you get the worse it is
hopelessness)
if you really knew me, you wouldn’t like it
Boyd - Don’t return calls because I don’t have anything to say
Harris, p. 1 “I wanted the 1st line of my memoir to be brilliant”
Harris, p. 2 or 3 - Want to be released from all the loneliness,
feelings of shame and despair
Prozac
inability to think or
Inability
Keeping busy no longer works
concentrate
How unable?
The world seems unclear, hazy (not self)
Kaysen - "viscous"
Prozac – “I call it a place” go to a place where I can’t describe it
Prozac – “nothing is sharp or clean”
more inability…
Harris – 3rd para couldn’t explain
Prozac, p. 6 drug helps this. Dish analogy
constant feelings of
constant
e.g. wake up more tired than went to sleep
fatigue
exhausted from fight within self to do simplest thing, can grow
from within
Prozac p.2 “feel alone and hope no one will come and help me”
Prozac p. 2 “get up… get mean
Kaysen – later on – viscous and velocity look the same: dulled
or fascinated
Danquah, 1st & 2nd page (15,16)
Sleep change
previous level of Sleep, previously a respite, doesn’t hold it’s familiar comfort
functioning
Danquah, p. 18, 1st para
eating and weight
change
previous level of
functioning
disruption normal motor
activities
disruption
Food has lost its taste
Forget to eat
Not Depressed:
There’s movement, form from depressed mood to anger and other feelings
Responsive to poke
Hearing out loud changes, charges?
Category: Mood Disorders
Manic Episode Symptoms
For the diagnoses: 1st one,
plus 3 of others persisted and present to significant degree
Behaviors
1. mood - euphoric, expansive,
elevated
grandiose cognition, no limits, flight of
ideas (delusions)
flight of ideas or subjective experience
that thoughts are racing
Pressured speech
pressure to keep talking
motivational problems:
hyperactivity
increase in goal-directed activity or
psychomotor agitation
excessive involvement in pleasurable
activities that have a high potential for
painful consequences
reduced sleep - until exhaustion
distractibility
Criteria
Last at least a week
description
do not see these as a problem
(lack of insight)
Thoughts too fast for me
(distress)
more talkative than usual
keep talking
hyperactivity is "intrusive,
demanding, domineering, and
reckless
I have so many thoughts, I
can fill in your thoughts
Excessive
Potential
Painful
Irritated when blocked
until exhaustion?
feels rested after only 3 hours
of sleep
Too easily
Unimportant or irrelevant
Irritated when stopped or
redirected
"velocity"
answers, projects done
now. No sense of steps
toward goal
engaging in unrestrained
buying sprees, sexual
indiscretions, or foolish
bus. invest.
“I don’t need sleep”
…later describes problems
resulting from lack of
sleep
attention too easily drawn
to unimportant or
irrelevant external stimuli
Other criteria for Manic Episode:
Note the general criteria of dysfunction here:
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or
in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or
others, or there are psychotic features.