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Common Symptoms and Diagnoses

A note of caution: The DSM IV is the manual that defines criteria for different diagnoses. The information here is intended to inform you about just a few broad categories, and perhaps to help you understand the diagnosis of a loved one, but it is not comprehensive or complete. The information here is not sufficient to diagnose yourself or anyone else.

The DSM Classification system of mental disorders reflects a consensus of current formulations of evolving knowledge in the field of psychology.  These descriptions enable clinicians to research and discuss, treat and study people with various mental health symptoms.

It is important to remember that symptoms that appear to be psychological could have a biological basis.

• For this reason it is critical to consult with your regular medical doctor and evaluate any possible organic causes for your symptoms. One example is thyroid disorder, which can present with symptoms of anxiety and/or depression.

• No amount of therapy will treat an underlying organic disorder. Prior to starting therapy, it is wise to have a complete physical with your regular medical doctor to rule out any possible medical causes for your symptoms.

• Symptoms may also be caused by the use, abuse, misuse, or withdrawal of medications, alcohol, caffeine, or illicit drugs. It is important to discuss and address any issues related to this with your treatment provider.

There is a good deal of overlap among the different diagnoses listed in the DSM IV. As with any medical diagnosis, rarely can a diagnosis be made without a pattern or cluster of symptoms.

• For example, Depression includes feelings of sadness, but anxiety can lead to sadness, as can phobias, psychosis, and many other disorders. Keep this in mind when reading about specific diagnoses or you may find yourself, like many medical school students, saying way too frequently "Oh my gosh, I have that!"

• Diagnoses can only be made by a clinician (e.g., psychologist or psychiatrist) who specializes in these areas and who understands the symptom patterns and idiosyncrasies of each disorder.

• If you feel you may have symptoms which are negatively affecting your life, please seek the advice and assistance of a professional.

DEPRESSION:

• Symptoms of depression include the following:
  1. depressed mood (such as feelings of sadness or emptiness)
  2. reduced interest in activities that used to be enjoyed
  3. sleep disturbances (either not being able to sleep well or sleeping too much)
  4. loss of energy or a significant reduction in energy level
  5. difficulty concentrating, holding a conversation, paying attention, or making decisions that used to be made fairly easily
  6. Suicidal thoughts or intentions.

• Major Depressive Disorder has a better prognosis than some other mood disorders in that treatment has been very successful in alleviating symptoms. However, many people with this disorder find that it can be episodic, and that periodic stressors can bring back symptoms.

• In this case, it is often helpful to have an ongoing relationship (with periodic “check ups”) with a mental health professional just as you would a physician if you had diabetes or high blood pressure.

  Treatment: Extensive research supports the use of talk therapy in the treatment of Depression. Many studies have validated the concurrent use of medications and therapy for a recovery with minimal relapses. In most cases, this is more effective than medication alone.

ANXIETY:

• Anxiety Disorders categorize a large number of disorders where the primary feature is abnormal or inappropriate anxiety. Everybody has experienced anxiety. Think about the last time a loud noise frightened you and remember the feelings inside your body.

• Chances are you experienced an increased heart rate, tensed muscles, and perhaps an acute sense of focus as you tried to determine the source of the noise. These are all symptoms of anxiety.

• They are also part of a normal process in our bodies called the “fight or flight” phenomenon. This means that your body is preparing itself to either fight to protect itself or to flee a dangerous situation. Sometimes, we react by “freezing” (the deer in the headlights experience).

• These symptoms become a problem when they occur without any recognizable stimulus or when the stimulus does not warrant such a reaction. In other words, inappropriate anxiety is when a person's heart races, breathing increases, and muscles tense without any reason for them to do so. Once a medical cause is ruled out, an anxiety disorder may be diagnosed and treated.

• PTSD (Post Traumatic Stress Disorder):

By definition, PTSD is an anxiety disorder. It may develop after a single or multiple traumatic events which cause intense fear, horror, and/or feelings of helplessness. Typically the symptoms develop shortly after the event, but sometimes symptoms develop months or years later.  While stress reactions are common, symptoms lasting at least a month could signal the possibility of PTSD. 

Vets who returned from World War II with symptoms such as these were described as “shell-shocked.” We now describe the collection of symptoms as PTSD.

Symptoms include re-experiencing the trauma through nightmares, obsessive thoughts, and flashbacks (feeling as if you are actually in the traumatic situation again). There is an avoidance component as well, where the individual avoids situations, people, and/or objects which remind him or her about the traumatic event (e.g., a person experiencing PTSD after a serious car accident might avoid driving or being a passenger in a car). Other avoidance symptoms might lead to “numbing the pain” with alcohol, drugs, or other behaviors that may become problematic. Finally, there is increased anxiety in general, possibly with a heightened startle response (e.g., very jumpy, easily startled).

Treatment: Psychological treatment, including the use of EMDR, is considered the most effective means to recovery from PTSD, although some medications (such as anti-anxiety meds) can help alleviate some symptoms during the treatment process.

• Obsessive Compulsive Disorder (OCD):

OCD is another anxiety disorder. Both biological and psychological causes have been found in OCD.

Symptoms: The key features of this disorder include obsessions (persistent, often irrational, and seemingly uncontrollable thoughts) and compulsions (actions which are used to neutralize the obsessions).

A good example of this would be an individual who has persistent, uncontrollable thoughts that he is dirty, infected, or otherwise unclean. In order to feel better, he washes his hands numerous times throughout the day, gaining temporary relief from the thoughts each time.

For these behaviors to constitute OCD, it must be disruptive to everyday functioning (such as compulsive checking before leaving the house making you extremely late for all or most appointments, washing to the point of excessive irritation of your skin, or inability to perform everyday functions like work or school because of the obsessions or compulsions).

Treatment: Medication may be prescribed for individuals with OCD. Psychotherapy (Cognitive Behavioral Therapy or “CBT”) can be helpful in learning ways to feel more in control, cope better with stressors, and explore the underlying issues associated with the obsessive thoughts.

ADJUSTMENT DISORDER:

• All of the disorders in this category relate to a significantly more difficult adjustment to a life situation than would normally be expected considering the circumstances.

• While it is common to need months and perhaps even years to feel normal again after a significant change in your life, when this adjustment causes suffering or impairment for an unusual length of time, it may be considered an adjustment disorder.

  Treatment: Talk therapy with the assistance and guidance of a trained psychologist will often provide the opportunity and pathway to change. Therapy may be short-term, often only a few sessions.