DSM 5

The following are definitions for the mental illnesses I will reference most often. I’ll add the DSM 5 definitions when I finish my paper.

Eating Disorders                                                                                              eatingdisorders.org

Anorexia Nervosa (“AN”)

  1. Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for age, sex, developmental trajectory, and physical health) .
  2. Either an intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain (even though significantly low weight).
  3. Disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.                                                        Subtypes:
    Restricting type
    Binge-eating/purging type

Atypical Anorexia Nervosa

  1. All criteria are met, except despite significant weight loss, the individual’s weight is within or above the normal range. I may slip and call it “EDNOS” because that was its name in the DSM IV.

Bulimia Nervosa (“BN”)

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  2. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  3. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  4. Self-evaluation is unduly influenced by body shape and weight.
  5. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Binge Eating Disorder (“BED”)

  1. Recurrent episodes of binge eating. An episode of binge eating is characterised by both of the following:
    • Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  2. The binge eating episodes are associated with three or more of the following:
    • eating much more rapidly than normal
    • eating until feeling uncomfortably full
    • eating large amounts of food when not feeling physically hungry
    • eating alone because of feeling embarrassed by how much one is eating
    • feeling disgusted with oneself, depressed or very guilty afterward
  3. Marked distress regarding binge eating is present
  4. Binge eating occurs, on average, at least once a week for three months
  5. Binge eating not associated with the recurrent use of inappropriate compensatory behaviours as in Bulimia Nervosa and does not occur exclusively during the course of Bulimia Nervosa, or Anorexia Nervosa methods to compensate for overeating, such as self-induced vomiting.

Anxiety Disorders                                                                                              PsychCentral, Anxiety and Depression Association of America, Generalized Anxiety Disorder

Social Anxiety Disorder (“Social Phobia”)

  1. A 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 embarrassing and humiliating.
  2. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.
  3. The person recognizes that this fear is unreasonable or excessive.
  4. The feared situations are avoided or else are endured with intense anxiety and distress.
  5. 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.
  6. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
  7. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.                                                                      

Generalized Anxiety Disorder

  1. Excessive anxiety about a number of events or activities, occurring more days than not, for at least 6 months.
  2. The person finds it difficult to control the worry.
  3. The anxiety and worry are associated with at least three of the following six symptoms (with at least some symptoms present for more days than not, for the past 6 months):
    • Restlessness or feeling keyed up or on edge
    • Being easily fatigued
    • Difficulty concentrating or mind going blank
    • Irritability
    • Muscle tension
    • Sleep disturbance
  4. The focus of the anxiety and worry is not confined to features of an Axis I disorder, being embarrassed in public (as in social phobia), being contaminated (as in obsessive-compulsive disorder), being away from home or close relatives (as in separation anxiety disorder), gaining weight (as in anorexia nervosa), having multiple physical complaints (as in somatization disorder), or having a serious illness (as in hypochondriasis), and the anxiety and worry do not occur exclusively during posttraumatic stress disorder.
  5. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social or occupational functioning.
  6. The disturbance does not occur exclusively during a mood disorder, a psychotic disorder, pervasive developmental disorder, substance use, or general medical condition.

Depressive Disorders

Persistent Depressive Disorder (Chronic Major Depression and/or Dysthymia) Wikipedia, PsychCentral

Chronic Major Depression and Dysthymia were two separate depressive disorders in the DSM-IV-TR. Now they are categorized as the same disorder. Apparently, there are no scientifically meaningful difference between Dysthymia and Chronic Major Depression. Dysthymia was a persistent lighter version of depression and Chronic Major Depression was a persistent full-force version of depression, as opposed to episodic versions where the depression goes away at times. The types of depression where the symptoms seem to go away at random are called “single” or “episodic”, there is also depression, which comes and goes with the seasons (formerly called Seasonal Affective Disorder, “SAD”). Only rarely will I distinguish between any of these. Depression is awful; when your inside it, the length of time seems eternal.

  1. For the better part of nearly every day, the patient reports a depressed mood or appears depressed to others.
  2. or most of nearly every day, interest or pleasure is markedly decreased in nearly all activities (noted by the patient or by others)
  3. Although not dieting, there is a marked loss or gain of weight (such as 5% in one month) or appetite is markedly decreased or increased nearly every day.
  4. Changes in appetite take on two manifestations: under- or over-eating
    • Some people never feel hungry, can go long periods without wanting to eat, may forget to eat, or if they do eat a small amount of food may be sufficient.
    • Other people tend toward an increase in appetite and may gain significant amounts of weight. They may tend to crave certain types of food such as sweets or carbohydrates.
  5. Nearly every day the patient sleeps excessively, known as hypersomnia, or not enough, known as insomnia
  6. Nearly every day others can see that the patient’s activity is agitated or slow.
  7. Nearly every day the person experiences extreme fatigue.
  8. Nearly every day the patient feels worthless or inappropriately guilty. These feelings are not just about being depressed, they may be delusional.
  9. Noted by the patient or by others, nearly every day the patient is indecisive or has trouble thinking or concentrating.
  10. The patient has had repeated thoughts about death (other than the fear of dying), suicide (with or without a plan) or has made a suicide attempt.
  11. Caveats:
    • These symptoms must cause clinically important distress, or impair work, social or personal functioning, and they should not fulfill the criteria for a mixed episode.
    • The symptoms are not due to the direct physiological effects of a substance (e.g., abuse of a drug or medication) or a general medical condition.

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