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Dictionary of Symptoms and Terms


This symptom list is not to be used to make a self-diagnosis and is presented only for explanatory usage. Consultation with your General Practitioner, Psychologist or Psychiatrist, should always be made to assist with a diagnoses, or to answer questions about these symptoms.

Agoraphobia
Bereavement
Burnout
Depression
Obsessive-Compulsive Disorder
Panic Attack
Panic Disorder
Posttraumatic Stress Disorder (PTSD)
Social Phobia Symptoms
Specific Phobia Symptoms


Agoraphobia Symptoms

Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.

The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.

See also Panic Disorder Symptoms.

References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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Bereavement Symptoms

This category can be used when the focus of clinical attention is a reaction to the death of a loved one. As part of their reaction to the loss, some grieving individuals present with symptoms characteristic of a Major Depressive Episode (e.g., feelings of sadness and associated symptoms such as insomnia, poor appetite, and weight loss). The bereaved individual typically regards the depressed mood as "normal," although the person may seek professional help for relief of associated symptoms such as insomnia or anorexia. The duration and expression of "normal" bereavement vary considerably among different cultural groups.

The diagnosis of Major Depressive Disorder is generally not given unless the symptoms are still present 2 months after the loss. However, the presence of certain symptoms that are not characteristic of a "normal" grief reaction may be helpful in differentiating bereavement from a Major Depressive Episode. These include:

1. guilt about things other than actions taken or not taken by the survivor at the time of the death;
2. thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person;
3. morbid preoccupation with worthlessness;
4. marked psychomotor retardation (e.g., rapid speech, irritability, pacing, jittery)
5. prolonged and marked functional impairment; and
6. hallucinatory experiences other than thinking that he or she hears the voice of, or transiently sees the image of, the deceased person.

Criteria summarized from: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association.

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Burnout Symptoms

The classic symptoms of job burnout include pessimism, increased dissatisfaction, absenteeism and inefficiency at work. A growing number of North American workers report that their job causes them stress. A 1985 study conducted by the National Center for Health Statistics (U.S.) found that more than half of the workers surveyed experienced 'a lot' to 'moderate' stress in their jobs in the last two weeks. Job stress accounts for a tremendous amount of personal misery and billions of dollars lost annually in productivity, wages, and medical bills.

Criteria summarized from: Hatfield, M. O. (1990). Stress and the American worker. American Psychologist, October 1990, p. 1162-1164. Maslach, 1982. Shinn, M., Rosario, M., Morch, H., & Chestnut, D.E. (1984). Coping with job stress and burnout in the human services. Journal of Personality and Social Psychology, 46, 864-876

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Depression Symptoms

Major Depression
Symptoms

A person who suffers from a major depressive disorder must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2-week period. This mood must represent a change from the person's normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition. Major depressive disorder cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed mood is better accounted for by schizo affective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder.

This disorder is characterized by the presence of a majority of these symptoms:

depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
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.
insomnia or hypersomnia nearly every day
psychomotor agitation or retardation nearly every day
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 (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Criteria summarized from: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association.

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Obsessive-Compulsive Disorder Symptoms

Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3), and (4):

1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
2. the thoughts, impulses, or images are not simply excessive worries about real-life problems
3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions as 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 person 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 distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

-AND-

At some point during course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.

Note: This does not apply to children.

The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

If another disorder is present, the content of the obsessions or compulsions is not restricted to it.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Criteria summarized from: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association.

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Panic Attack Symptoms

A panic attack is a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

palpitations, pounding heart, or accelerated heart rate
sweating
trembling or shaking
sensations of shortness of breath or smothering
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded, or faint
derealization (feelings of unreality) or depersonalization (being detached from oneself)
fear of losing control or going crazy
fear of dying
paresthesias (numbness or tingling sensations)
chills or hot flushes

See also Panic Disorder symptoms.

References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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Panic Disorder

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can't predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. In between times there is a persistent, lingering worry that another attack could come any minute.

When a panic attack strikes, most likely your heart pounds and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control. You may genuinely believe you're having a heart attack or stroke, losing your mind, or on the verge of death. Attacks can occur any time, even during nondream sleep. While most attacks average a couple of minutes, occasionally they can go on for up to 10 minutes. In rare cases, they may last an hour or more.

Panic disorder strikes between 3 and 6 million Americans, and is twice as common in women as in men. It can appear at any age, in children or in the elderly, but most often it begins in young adults. Not everyone who experiences panic attacks will develop panic disorder-- for example, many people have one attack but never have another. For those who do have panic disorder, though, it's important to seek treatment. Untreated, the disorder can become very disabling.

Panic disorder is often accompanied by other conditions such as depression or alcoholism, and may spawn phobias, which can develop in places or situations where panic attacks have occurred. For example, if a panic attack strikes while you're riding an elevator, you may develop a fear of elevators and perhaps start avoiding them.

Some people's lives become greatly restricted -- they avoid normal, everyday activities such as grocery shopping, driving, or in some cases even leaving the house. Or, they may be able to confront a feared situation only if accompanied by a spouse or other trusted person. Basically, they avoid any situation they fear would make them feel helpless if a panic attack occurs. When people's lives become so restricted by the disorder, as happens in about one-third of all people with panic disorder, the condition is called agoraphobia. A tendency toward panic disorder and agoraphobia runs in families. Nevertheless, early treatment of panic disorder can often stop the progression to agoraphobia.

Specific Symptoms of this Disorder: The person experiences recurrent unexpected Panic Attacks and at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

persistent concern about having additional attacks
worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
a significant change in behavior related to the attacks

Presence or absence of Agoraphobia.

The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stress or), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

References: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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Posttraumatic Stress Disorder Symptoms

Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. PTSD, once referred to as shell shock or battle fatigue, was first brought to public attention by war veterans, but it can result from any number of traumatic incidents. These include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as a mugging, rape, or torture, or being held captive. The event that triggers it may be something that threatened the person's life or the life of someone close to him or her. Or it could be something witnessed, such as mass destruction after a plane crash.

Whatever the source of the problem, some people with PTSD repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feeling detached or numb, or being easily startled. They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent. Seeing things that remind them of the incident may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often very difficult.

PTSD can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety. Symptoms may be mild or severe. People may become easily irritated or have violent outbursts. In severe cases they may have trouble working or socializing. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person, such as a rape, as opposed to a flood.

Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and reenact the event for a period of seconds or hours or, very rarely, days. A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.

Not every traumatized person gets full-blown PTSD, or experiences PTSD at all. PTSD is diagnosed only if the symptoms last more than a month. In those who do have PTSD, symptoms usually begin within 3 months of the trauma, and the course of the illness varies. Some people recover within 6 months, others have symptoms that last much longer. In some cases, the condition may be chronic. Occasionally, the illness doesn't show up until years after the traumatic event.

Specific Symptoms of this Disorder:

The person has been exposed to a traumatic event in which the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and the person's response involved intense fear, helplessness, or horror.

The traumatic event is persistently reexperienced in one (or more) of the following ways:

recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
recurrent distressing dreams of the event.
acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated).
intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

The individual also has persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

efforts to avoid thoughts, feelings, or conversations associated with the trauma
efforts to avoid activities, places, or people that arouse recollections of the trauma
inability to recall an important aspect of the trauma
markedly diminished interest or participation in significant activities
feeling of detachment or estrangement from others
restricted range of affect (e.g., unable to have loving feelings)
sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

difficulty falling or staying asleep
irritability or outbursts of anger
difficulty concentrating hypervigilance
exaggerated startle response

The disturbance, which has lasted for at least a month, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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Social Phobia Symptoms

Social phobia is an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people. It often runs in families and may be accompanied by depression or alcoholism. Social phobia often begins around early adolescence or even younger."

If you suffer from social phobia, you tend to think that other people are very competent in public and that you are not. Small mistakes you make may seem to you much more exaggerated than they really are. Blushing itself may seem painfully embarrassing, and you feel as though all eyes are focused on you. You may be afraid of being with people other than those closest to you. Or your fear may be more specific, such as feeling anxious about giving a speech, talking to a boss or other authority figure, or dating. The most common social phobia is a fear of public speaking. Sometimes social phobia involves a general fear of social situations such as parties. More rarely it may involve a fear of using a public restroom, eating out, talking on the phone, or writing in the presence of other people, such as when signing a check.

Although this disorder is often thought of as shyness, the two are not the same. Shy people can be very uneasy around others, but they don't experience the extreme anxiety in anticipating a social situation, and they don't necessarily avoid circumstances that make them feel self-conscious. In contrast, people with social phobia aren't necessarily shy at all. They can be completely at ease with people most of the time, but particular situations, such as walking down an aisle in public or making a speech, can give them intense anxiety. Social phobia disrupts normal life, interfering with career or social relationships. For example, a worker can turn down a job promotion because he can't give public presentations. The dread of a social event can begin weeks in advance, and symptoms can be quite debilitating.

People with social phobia are aware that their feelings are irrational. Still, they experience a great deal of dread before facing the feared situation, and they may go out of their way to avoid it. Even if they manage to confront what they fear, they usually feel very anxious beforehand and are intensely uncomfortable throughout. Afterwards, the unpleasant feelings may linger, as they worry about how they may have been judged or what others may have thought or observed about them.

Specific Symptoms of this Disorder:

A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.

Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.

The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.

The feared social or performance situations are avoided or else are endured with intense anxiety or distress.

The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

In individuals under age 18 years, the duration is at least 6 months.

The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder.

If a general medical condition or another mental disorder is present, the fear in the first criteria is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.

References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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Specific Phobia Symptoms

Many people experience specific phobias, intense, irrational fears of certain things or situations, dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren't just extreme fear; they are irrational fear. You may be able to ski the world's tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.

Specific phobias strike more than 1 in 10 people. No one knows just what causes them, though they seem to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias; only about 20 percent of adult phobias vanish on their own. When children have specific phobias, for example, a fear of animals, those fears usually disappear over time, though they may continue into adulthood. No one knows why they hang on in some people and disappear in others.

Specific Symptoms of this Disorder:

Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).

Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.

The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.

The phobic situation(s) is avoided or else is endured with intense anxiety or distress.

The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.

In individuals under age 18 years, the duration is at least 6 months.

The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.

References: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, transcript revised. Washington, DC: American Psychiatric Association. National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)

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