Holden’s Pocket DSM

(Diagnostic and Statistical Manual of Mental Disorders)

Bipolar Disorder
  • At least one major depressive episode and at least one hypomanic episode (but not a fully manic or mixed episode).
  • Symptoms cause distress or difficulty in some area of your life — such as relationships or work.
A manic episode is a distinct period of abnormally and persistently elevated, expansive, or irritable mood that lasts at least one week. Three of these traits persist:
  • Inflated self-esteem or grandiosity
  • Decreased need for sleep Unusual talkativeness
  • Racing thoughts; Distractibility
  • Increased goal-directed activity (either socially, at work or school, or sexually)
  • Doing things that have a high potential for painful consequences — for example, buying sprees, sexual indiscretions or foolish investments
A major depressive episode presents five (or more) of the following symptoms over a two-week period:
  • Depressed mood most of the day, nearly every day (feeling sad or empty)
  • Diminished interest or feeling no pleasure in almost all activities
  • Significant weight loss or weight gain
  • Insomnia or increased desire to sleep
  • Either restlessness or slowed behavior that can be observed by others
  • 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 or suicide, or a suicide attempt

Dysthymic Disorder
  • For an adult, depressed mood most of the day for two or more years
  • For a child, depressed mood or irritability most of the day for at least one year
In addition to that, you must have at least two of these symptoms, and they must cause distress or interfere with your ability to function in your daily life:
  • Poor appetite or overeating
  • Sleep problems
  • Tiredness or lack of energy
  • Low self-esteem
  • Hopelessness
  • Poor concentration
  • Trouble making decisions
/ Major Depression
Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
• Mood is changed from the person's baseline.
• Impaired function: social, occupational, educational.
• Specific symptoms, at least 5 of these 9, present nearly every day:
1. Depressed mood or irritable most of the day, nearly every day
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: agitation or slowing
6. Fatigue or loss of energy
7. Feelings of worthlessness or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan
Post Trauamatic Stress Disorder
  1. Trauma survivors must have been exposed to actual or threatened:
  • Death, serious injury, sexual violence
  1. The symptoms envelope ways that someone re-experiences the event:
  • Intrusive thoughts or memories; nightmares related to the traumatic event, flashbacks, feeling like the event is happening again; psychological and physical reactivity to reminders of the traumatic event, such as an anniversary
  1. Avoidant symptoms describe ways that someone may try to avoid anymemoryof the event, and must include one of the following:
  • Avoiding thoughts, feelings, people, or situations connected to the traumatic event
  1. Basically, there is a decline in someone’s mood or though patterns, which can include:
  • Memory problems that are exclusive to the event; negative thoughts or beliefs about one’s self or the world; distorted sense of blame for one’s self or others, related to the event, being stuck in severe emotions related to the trauma (e.g. horror, shame, sadness); severely reduced interest in pre-trauma activities; feeling detached, isolated or disconnected from other people
  1. Increased arousal symptoms are used to describe the ways that the brain remains “on edge,” wary and watchful of further threats. Symptoms include the following:
  • Difficulty concentrating; Irritability, increased temper or anger; difficulty falling or staying asleep; hypervigilance; being easily startled

Antisocial Personality Disorder
Diagnosed when a person’s pattern of antisocial behavior has occurred since age 15 and consists of the majority of these symptoms:
  • Failure to conform to social normswith 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
  • Impulsivityor failure to plan ahead
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  • Reckless disregardfor 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
/ Borderline Personality Disorder
A person with this disorder will also often exhibit impulsive behaviors and have a majority of the following symptoms:
  • Frantic efforts to avoid real/imagined abandonment
  • A pattern of unstable and intense interpersonal relationships between extremes of idealization and devaluation
  • Identity disturbance, such as a significant and persistent unstable self-image or sense of self
  • Impulsivityin 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
  • Emotional instabilitydue to significant reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxietyusually lasting a few hours to a few days)
  • Chronic feelings of emptiness
  • Inappropriate, intense angeror difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Transient, stress-related paranoid thoughtsor severe dissociative symptoms