Bipolar I (bipolar II only hypomania)

The manic episode may have been preceded by and may be followed by hypo- manic or major depressive episodes.

manic episode:

During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms
(four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual
behavior: manic- (FOR ONE WEEK) hypomanic- 4 days
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g., feels rested after only3hoursofsleep).
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as
reported or observed.
6. Increase in goal-directed activity (either socially , at work or school, or sexually)or
psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful conse- quences (e.g.,
engaging in unrestrained buying sprees, sexual indiscretions, or
foolish business investments).

Major Depressive Episode

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad,
empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents,
can be irritable mood.)
2. Marked by diminished interest or pleasure in all, or almost all, activitiesmostofthe day, nearly every day (as
indicated by either subjective account or observation).

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. (Note: In children, consider failure to make
expected weight gain.)
3. Insomnia or hyper insomnia nearly every day.
4. Psychomotor agitation or retardation nearly every day (observable by others, not
merely subjective feelings of restlessness or being slowed down).
5. Fatigue or loss of energy nearly every day.
6. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
(not merely self-reproach or guilt about being sick).
7. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account
or as observed by others).
8. Recurrent thoughts of death (not just fear of dying),recurrent suicidal ideation with-
out a specific plan, or a suicide attempt or a specific plan for committing suicide.

MDD

5 or more symptoms present during same 2-week period

3. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad,
empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents,
can be irritable mood.)
4. Marked by diminished interest or pleasure in all, or almost all, activitiesmostofthe day, nearly every day (as
indicated by either subjective account or observation).
 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. (Note: In children, consider failure to make
expected weight gain.)
9. Insomnia or hyper insomnia nearly every day.
10. Psychomotor agitation or retardation nearly every day (observable by others, not
merely subjective feelings of restlessness or being slowed down).
11. Fatigue or loss of energy nearly every day.
12. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
(not merely self-reproach or guilt about being sick).
13. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account
or as observed by others).
14. Recurrent thoughts of death (not just fear of dying),recurrent suicidal ideation with-
out a specific plan, or a suicide attempt or a specific plan for committing suicide.

GAD

1. The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs
more often than not for at least six months and is clearly excessive.
2. The worry is experienced as very challenging to control. The worry in both adults and children may easily
shift from one topic to another.
3. The anxiety and worry are accompanied by at least three of the following physical or cognitive symptoms
(In children, only one of these symptoms is necessary for a diagnosis of GAD):
 Edginess or restlessness
 Tiring easily; more fatigued than usual
 Impaired concentration or feeling as though the mind goes blank
 Irritability (which may or may not be observable to others)
 Increased muscle aches or soreness
 Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying
sleep)

Anorexia
1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of
age, sex, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or
shape on self-evaluation, or denial of the seriousness of the current low body weight

PTSD

Criterion A: stressor (one required)

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened
sexual violence, in the following way(s):
 Direct exposure
 Witnessing the trauma
 Learning that a relative or close friend was exposed to a trauma
 Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first
responders, medics)
Criterion B: intrusion symptoms (one required)
The traumatic event is persistently re-experienced in the following way(s):
 Unwanted upsetting memories
 Nightmares
 Flashbacks
 Emotional distress after exposure to traumatic reminders
 Physical reactivity after exposure to traumatic reminders
Criterion C: avoidance (one required)
Avoidance of trauma-related stimuli after the trauma, in the following way(s):
 Trauma-related thoughts or feelings
 Trauma-related external reminders
Criterion D: negative alterations in cognitions and mood (two required)
Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):
 Inability to recall key features of the trauma
 Overly negative thoughts and assumptions about oneself or the world
 Exaggerated blame of self or others for causing the trauma
 Negative affect
 Decreased interest in activities
 Feeling isolated
 Difficulty experiencing positive affect
Criterion E: alterations in arousal and reactivity
Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):
 Irritability or aggression
 Risky or destructive behavior
 Hypervigilance
 Heightened startle reaction
 Difficulty concentrating
 Difficulty sleeping
Criterion F: duration (required)
Symptoms last for more than 1 month.
Criterion G: functional significance (required)
Symptoms create distress or functional impairment (e.g., social, occupational).
Criterion H: exclusion (required)
Symptoms are not due to medication, substance use, or other illness.