Mental Disorders and Symptoms

This video from AL Dept of Health looks at mental illness as a function of the brain. It includes ways to “stay well.”

The disorders listed below (a partial list from hundreds of disorders) are diagnosed based upon commonly referred to criteria. The criteria are found in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM5)². The DSM is the leading professionally developed and endorsed medical collection of universally recognized disorders in the United States. It has undergone a number of revisions due to emerging literature and research. Increasingly, however, diagnosis is being brought into question by experts in research, psychiatry and in eclectic mental health paradigms. Mental illness in the US is a very real phenomena, to be sure; it may not be as common as many people think; diagnosis can be a part of insurance billing in order to meet the medical necessity standard.

The information found on this page regarding symptoms of mental disorders comes from the DSM. The symptoms listed are paraphrased, and include dominant features—rule out variables are not included here. None of the symptoms listed address the possibility that professional interpretations might vary among different mental health practitioners and among practice specialists.

The DSM contains family patterns, onset, cultural factors, rule out considerations, prevalence, gender differences, age differences, and symptomology.

It also addresses medically induced disorders. The DSM provides other factors to consider in diagnosis. It is important to consider that not all professionals use the PIE perspective in their assessment, even as this might be a comprehensive view of a person, and to know that there are other ways to get accurate diagnoses. Diagnosis is one aspect to a treatment plan trajectory, just as is nutrition, exercise, getting away from it all, and a myriad of considerations that should be built into your intake and your consultation.

Diagnosis is commonly made during a subjective assessment process—that is, interpretations are made based upon the perspectives and beliefs of the professional doing the assessment. Subjective beliefs are usually rooted in what is known as practice wisdom, and when assessment occurs with the use of psychometric instruments, practice wisdom can be less subjective. For more about the impact of bias in care see my article on specialization vs eclectic mental healthcare.

The Department of Health and Human Services reports that about 44 million people a year experience a mental disorder¹. Research indicates that one in every five children experience mental disorders. Many will be treated in school settings as opposed to clinics of mental health.

If you believe you (or someone you love) is experiencing symptoms of a mental disorder remember that a diagnosis can only be made by a licensed mental health professional—and some offer free initial consultations. Treatment ideas and options, as well as professionals you might contact follow the few disorders listed below.

Users are advised that this list is based on a criterion reference based paradigm of “known” mental illness symptoms, commonly accepted as reasonable and valid in the US and users are advised that the life cycle may include some symptoms however these may not be sufficient to meet the overall diagnosis. And where a disorder has no biological evidence (brain scans, urinalysis, blood work correlated to psychometric testing and correlated to licensed provider interviewing) the key to all disorders is an inability to function in day to day life. LaRose argues that if a person has met some or even most criteria for a disorder, yet is functioning at a normative level in bio-psycho-social-sexual health, a disorder may not be evident as in nothing may be actually wrong (to see more about diagnosis problems and alternative perspective, see the eclectic reference here and elsewhere on this page ….)

While the criteria for diagnosis has changed in the DSM from various versions, much of the criteria listed below is largely unchanged in what identifies symptoms of illness. This list is a combination of DSM criteria in two versions along with over 14 years of practice wisdom in working with a diverse population of clients.

USERS ARE DIRECTED TO AVOID SELF DIAGNOSIS AND WHERE THERE IS ROOM FOR CONCERN TO SEE A LICENSED PROFESSIONAL FOR HELP.

Alcoholism (Alcohol Use Disorder)

► Craving—a strong drive to use.
► Frequent / Recurrent Use—throughout the day, in the morning, etc.
► Withdrawal (after use)—sleep disturbance, anxiety, tremors, sweats, shakes.
► Tolerance— Increased amounts are needed to get intoxicated.
► Use continues—in spite of negative consequences.
► Unable to maintain limits—uses more than what was planned or agreed.
► Activities central to use—they are centered around being able to use.
► Isolation—form activities or hobbies that no longer involve use.

Note by LaRose: Alcohol abuse is no longer a diagnosis and nor is the illegality of use a criteria for alcohol or other substance use disorders. Alcohol and substance use disorder are also a flag of potential trauma and trauma responses. Trauma may be a culprit in self medication such that these overlapping disorders are somewhat difficult distinguish until the trauma is resolved (and depending on substance use interferes with treatment progress). A good bit of science has been published related to addictions. 12 step programs are one version of recovery and so it the life satisfaction model.

Generalized Anxiety Disorder

► Excessive anxiety or worry—more days than not (at least 6 months).
► Inability to Control the Worry—it is difficult for the person to stop.
► Anxiety / Worry
► Restlessness or “edgy,” easily fatigued, inability to concentrate
► Going blank, irritability, muscle tension, or sleep disturbance
► Anxiety / worry significantly limits a person’s ability to function, day to day.

NOTE by LaRose: panic disorder and phobias have other symptoms that are not listed here. Anxiety disorders can be a suspect of past trauma, such that the overlapping symptoms must be considered in the context of a “hyperactive amygdala” mechanism. Trauma triggering responses may be sourced in an HPA axis impact, a repetitive and ongoing adrenaline/cortisol/epinephrine impact, as well as the very common psychosomatic features at play with anxiety disorders. Serotonin, melatonin, blue light, adrenal fatigue (ie: extreme athleticism) and sleep deprivation are other considerations in this/these disorders as well.

Major Depressive Disorder

► Five or more of the following symptoms have been present during a 2 week period and it is a change from prior functioning; one symptom is either depressed or loss of interest/pleasure (and not due to a medical condition)
► Depressed mood most of the day, almost everyday (in children may appear as irritability)
► Marked diminished interest or pleasure in nearly all activities, most of the day
► Significant weight loss when not dieting (5% in 30 days) or a decrease in appetite nearly every day (in children can be failure to make gains).
► Insomnia or hypersomnia nearly every day
► Psychomotor agitation/retardation nearly every day
► Fatigue or loss of energy nearly every day
► Feelings of worthlessness, excessive/inappropriate guilt (nearly every day)
► Diminished concentration, or indecisiveness (nearly every day)
► Recurrent thoughts of death, recurrent suicidal ideation without a plan, or a suicide attempt or a plan
► The symptoms do not meet the Mixed Episode criteria
► The symptoms are not due to effects of substances (or a general medical condition)
► The symptoms are not due to bereavement, the symptoms last longer than 2 months, include marked impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms or psychomotor retardation.

NOTE by LaRose: Depression is complex in treatment due to a common factor related to lacking motivation and finding joy and pleasure as reported by clients. Suicidal ideation is pretty common in depression (thoughts about suicide) and if these occur it can increase the need for a medication consideration. Suicidal ideation associated to a way of killing oneself (now the thoughts have moved to how it might happen) is much more serious and suggests being seen in an emergency situation in needed as soon as possible. Where acting upon thoughts can occur in depressed clients, this likely indicates a need for inpatient hospitalization and being seen now (see 911 in mental health for resources and ways of looking at when to get to the ER). Depression that lasts longer than 2 years would change to a different disorder – Dysthymia.

Post Traumatic Stress Disorder

► Exposure to actual and threated death scenarios or sexual violence either directly, witnessing it, learning of it happening to a loved one and experiencing repeated extreme exposure to the events
► Frequent / Recurrent Intrusive Thoughts and distressing memories
► Recurrent nightmares, night terrors where these are related to the trauma event(s)
► Dissociation, depersonalization, derealization, flashbacks and re-experiencing the events (reliving it)
► Exaggerated Emotional Responses (hyper and hypo) internally or externally triggered
► Recreating traumatic scenarios in acting out (children and adults do this) often is dissociation.
► The avoidance of triggers to the degree it negatively impacts a person ability to reasonably live.
► Memory decline, memory loss, memory fog and in other scenarios flashbulb memory limited to certain details
► Isolation from intimate relationships and an inability to enjoy them (or to enjoy other life events/activities)
► Sleep disturbance
► Symptoms are evident at least 6 months after the event (if less than 6 months then acute stress disorder is evident)

NOTE by LaRose: Symptoms are not generally related to exposure of violence in media outside of real life exposure for PTSD. PTSD is diagnosed a bit differently in children under the age of 6 (everyone else has the same symptom set to consider). Interestingly not only do victims of tragic accidents or violence experience PTSD, but so do batterers, law enforcement, medical doctors, patients in care, retirees, and some people have trauma responses without any life threatening variable taking place at all. PTSD is often misdiagnosed in thought disorders, bipolar, anxiety, addictions and depression before it is accurately identified.

Attention Deficit Disorder

► Fails to give attention to details, difficulty sustaining attention, doesn’t listen when spoken to, fails to complete tasks, inability to organize, avoids structured tasks, loses things, easily distracted, or forgetful.
► Fidgets or squirms, unable to stay seated, runs/climbs excessively, inability to engage in activities quietly, acts as if “driven by a motor,” talks excessively, blurts out / interrupts often, inability to take turns, or intrudes on others.
► Above symptoms existed prior to age seven.
► Above symptoms are present in two or more settings.
► Symptoms impair social, academic or occupational functioning.
► The symptoms are not better accounted for by another disorder.

NOTE by LaRose: ADD and ADHD are best accounted for in the impact that stimulants have on the person believed to have ADD/ADHD and along with this consideration it is key that a full clinical battery of psychological testing (clinical psychologists) is done where a conglomerate of as many as 15 or more other disorders are first ruled out. The impact of ever changing screens and even one study that looked at the effect of a famous child’s TV show (unnamed intentionally) is correlated with the “symptoms” of ADD/ADHD.

BiPolar I Disorder

► Manic Episodes Exist
► Persistent elevated/irritable mood lasting at least 1 week
► During the mood disturbance there is inflated self-esteem, decreased need for sleep, talkative, flighty ideas
► The person is easily distracted, intense goal-directed actions, excessive involvement via high motivation interests
► Absorption in pleasurable (yet risky) behaviors (shopping sprees, poor investments, sexual acting out).
► Causes significant impairment in social/academic/occupational/familial functioning and often requires hospitalization. (safety)
► There are at times some forms of psychotic features

NOTE by LaRose: Bipolar disorder is one of the more serious and in my view complex mental health conditions in so far as prognosis is concerned. If accurately diagnosed and other rule outs or related symptom sets are resolved, and the biploar features remain often a lifelong treatment trajetory will be needed, up to maintenance and stabilization support. Bipolar is best treated with a medications assisted model and for talk therapy to be most effective, and coordination of care between the prescribing doctor and therapist is recommended. Bipolar disorder has overlapping symptoms with addictive disorders, thought disorders and trauma.

BiPolar II Disorder

► Hypomanic Episodes Exist
► Persistent elevated/irritable mood lasting at least 4 days & unlike non-depressed moods
► During the mood disturbance there is a combination of inflated self-esteem, decreased need for sleep, talkative, flighty ideas
► The person is easily distracted, engages in intense goal-directed actions, with excessive involvement in these actions
► The person spends a good bit of time in pleasurable (yet risky) behaviors (shopping sprees, poor investments, sexual acting out).
► Causes significant impairment in social/academic/occupational/familial functioning and may require hospitalization.
► Presence (or hx) of Major Depressive Episode(s)
► At least one Hypomanic episodes
► There has never been a Manic Episode or a Mixed Episode
► Causes significant impairment in social/academic/occupational functioning ( and usually this disorder occurs w/out hospitalization or psychotic features).

NOTE by LaRose: Prior to 2013 it was generally not possible to diagnose minors under the age of 16 years old with BiPolar, even as the practice of doing so occurred, usually consistent with a symptom set meeting criteria. Post 2013 in a new DSM version children were/are identified as having criteria for the disorder. Here, as in the other bipolar, the complexity of overlapping symptoms and the impact of trauma (even more complex when dealing with children).

Substance Use Disorder

► A maladaptive pattern of use, leading to clinical impairment, as manifest in three or more criteria occurring during any 12 month period
► Tolerance (increased or decreased)
► Withdrawal Syndrome (varies usually by substance type)
► Substance is taken in larger amounts than intended, over a longer period of time
► Persistent desire or unsuccessful efforts to cut down or control use
► A great deal of time is spent to obtain, use, and recover from use
► Important social activities are given up or reduced for use
► Substance use continues in spite of knowledge of mental/physical problems exacerbated by use

NOTE by LaRose: Drug Dependency is labeled specific to the substances used (Alcohol, Opioids, Nicotene, Caffeine, PCP, Benzodiazapines, Cocaine, Cannabis, Amphetamines, etc. etc.), but in general it can include physical or psychological dependence or both. Dependency can include prescription medications as well. When physical dependence is evident it is necessary to include medical doctors in the trajectory of care to prevent a dangerous withdrawal process. Increasingly addictions are being treated with a number of interventions looking at dopamine, life satisfaction models and older abstinence only models.

Eating Disorders

Bulimia can be a purging and a non-purging type

► There are recurrent episodes of binge eating, characterized by both of the following
► 1) Eating in a discrete period of time (within any 2 hour period) an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances and
► 2) a sense of lack of control over eating during the episode (a feeling of not being able to stop or a feeling of not being to control the amount).
► Recurrent inappropriate compensatory behavior to prevent weight gain
► The binges and the compensatory behavior both occur at least 2 time a week in a three month period
► Self evaluation is unduly influenced by body shape and weight
► The disturbance does not occur exclusively during episodes of anorexia nervosa

Anorexia Nervosa can have a “restricting type” or a “binge/purge type.”

► Refusal to maintain body weight (for age & height) with gains/losses at 85% of what is expected.
► Intense fear of gaining weight or becoming “fat” even though underweight
► Disturbance in the way one body weight/shape is experienced, with undue influence placed on weight/shape, or denial of seriousness of current low body weight
► In postmenarcheal females, amenorrhea, such as the absence of 3 consecutive cycles

Note by LaRose: The above is more consistent with a bulimia type label, but binge and anorexia are in this category as well. The insidious nature of the eating disorder is often so subtle that a client and a therapist can be in collusion without either of them knowing it – sometimes for weeks, months and even years. Collusion is not intentional it is an enabling mechanism; the subtlety of the eating disorder pattern may not be apparent until an ER visit produces labs that indicate malnutrition, damage to the back of the throat, teeth, esophagus and even the stomach lining – or worse – heart, liver and kidney dysfunction. The brilliance of the eating disorder client in explaining (often using mental health jargon and assertions) and justifying how some other problem is at play is powerful whether under eating, over eating, over exerting, purging or binging. Weight issues can be seen as body image problems (dysmorphia) whereby this diagnosis may overlook the eating disorder – making treatment even more complex. Many times it is ideal when eating disorder clients seek care that a medical doctor clear them as healthy enough to engage in outpatient treatment, depending on the severity of the disorder(s).

Treatment Ideas and Where to Begin

The list of professionals you might see can be a bit overwhelming. Increasingly specialization makes the field of providers seemingly vast. You can begin here to get some help in narrowing down who to see.

Learn more here about treating:

In the treatment of various disorders there are also populations to consider. In the context of populations there may or may not actually be a disorder at all. A couple may need couples counseling and they may not be ill. If insurance is billed, at least one person in the couple will have a diagnosed mental illness, however. The same is true with children, aging populations and LGBTQ; the area of treatment focus by population may not have a mental illness at all, yet still need treatment.

Populations of treatment interest, focus or specialty may inherently include disorders due to matters of severity yet as group there is not one specific disorder to use or maybe the DSM doesn’t have a single diagnosis. In the case of some conditions there may be a category identified even so, where treatment is most certainly indicated:

Increasingly as holistic health is about treating the whole person mental health providers are adding exercise, nutrition, sleep hygiene, the impact of everyday life events (divorce, the death of a loved one, job changes and even matters of faith) into the clinical picture:

And what about the unconventional approaches? A licensed professional would still provide the interventions in more non-traditional models of care or in more uncommon settings for care.

| Clinical Hypnosis
| Online Therapy
| Onsite Rural Health
| Onsite School Counseling and Child Welfare
| Retreat Get Away

In an age of specialization there are as many types of experts emerging, maybe as there are professional groupings. A psychiatrist is mainly a presriber of medication and certain more invasive treatments (ECT, TMS, brain scans, sleep studies) – and this type of an MD is an expert in this regard (and required if these treatments are sought or needed). A psychologist is not a presriber but is an expert in psychometric testing. A masters level therapist is a talk therapist and covers a wide range of training areas: mental health counselors, clinical social workers, marriage and family therapists (all can provide talk therapy if and according to licensing laws and most can bill health insurance too). Learn more here about other experts in the field …

Have A Question About What You Might Think is a Symptom?

For more information please contact us today!

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More disorders and links to come as this page is updated from time to time…

Page history original transfer incomplete to/with BV 10/2018 to 2/2019. Page Rev. 7/15, 8/13/19