Common Psychiatric Diagnoses:
Struggling with symptoms? Unsure if you meet criteria for a psychiatric diagnosis? Our initial evaluations can get you started with a comprehensive plan of action to help you manage your symptoms and get the answers you are looking for.
DSM-5 Diagnostic Criteria for Major Depression Disorder (MDD):
Five (or more) of the following nine symptoms have been present during the same two-week period and represent a change from previous functioning. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Depressed mood most of the day.
Markedly diminished interest of pleasure in activities most of the day nearly every day.
Significant weight change, loss or gain.
Insomnia nearly every day.
Psychomotor agitation (restlessness or an inability to sit still) or retardation (slowed speech, decreased movement and impaired cognitive function) 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 concentration or indecisiveness nearly every day.
Recurrent thought of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
DSM-5 Diagnostic Criteria for Generalized Anxiety Disorder (GAD):
Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Worrying too much about different things
Trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen.
These GAD 7 criteria include A: Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance) and B: The person finds it difficult to control the worry.
DSM-5 Diagnostic Criteria for Panic Disorder:
Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
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, light-headed, or faint Chills or heat sensations
Paresthesias (numbness or tingling sensations)
Derealization (feelings of unreality) or depersonalization (being detached from oneself) Fear of losing control or “going crazy”
Fear of dying
At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”).
A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
The disturbance is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).
The disturbance is not better explained by another mental disorder (e.g., the panic attacks do not occur only in response to feared social situations, as in social anxiety disorder; in response to circumscribed phonic objects or situations, as in specific phobia; in response to obsessions, as in obsessive-compulsive disorder; in response to reminders of traumatic events, as in posttraumatic stress disorder; or in response to separation from attachment figures, as in separation anxiety disorder).
DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (OCD):
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
DSM-5 Diagnostic Criteria for Post Traumatic Stress Disorder (PTSD):
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person has been exposed to a traumatic event. The diagnostic criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR), and typically involve a combination of symptoms across several clusters, lasting for a significant period and causing distress or impairment.
A. Exposure to a Traumatic Event: The individual must have been exposed to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:
Directly experiencing the traumatic event(s).
Witnessing, in person, the event(s) as it occurred to others.
Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death, the event(s) must have been violent or accidental.
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). This does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related.
B. Intrusion Symptoms: The individual must experience one or more of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event occurred:
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
C. Avoidance Symptoms: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event occurred, as evidenced by one or both of the following:
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance of or efforts to avoid external reminders (e.g., people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
D. Negative Alterations in Cognitions and Mood: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event occurred, as evidenced by two or more of the following:
Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "No one can be trusted," "The world is completely dangerous").
Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
Markedly diminished interest or participation in significant activities.
Feelings of detachment or estrangement from others.
Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
E. Marked Alterations in Arousal and Reactivity: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event occurred, as evidenced by two or more of the following:
Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
Reckless or self-destructive behavior.
Hypervigilance.
Exaggerated startle response.
Problems with concentration.
Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
F. Duration: The duration of the disturbance (symptoms in Criteria B, C, D, and E) is more than 1 month.
G. Functional Significance: The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. Exclusion: The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
DSM-5 Diagnostic Criteria for Insomnia:
Insomnia is a common sleep disorder characterized by difficulty initiating or maintaining sleep, or experiencing non-restorative sleep, despite having adequate opportunity to sleep.
A. Predominant Complaint of Dissatisfaction with Sleep Quantity or Quality, Associated with One (or More) of the Following Symptoms:
Difficulty initiating sleep: Trouble falling asleep at the beginning of the night. In children, this may manifest as difficulty initiating sleep without caregiver intervention.
Difficulty maintaining sleep: Characterized by frequent awakenings or problems returning to sleep after awakening. In children, this may manifest as difficulty returning to sleep without caregiver intervention.
Early-morning awakening with inability to return to sleep: Waking up too early and being unable to go back to sleep.
B. The Sleep Disturbance Causes Clinically Significant Distress or Impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning. This can include:
Fatigue or malaise
Impaired attention, concentration, or memory
Impaired social, family, occupational, or academic performance
Mood disturbance or irritability
Daytime sleepiness
Behavioral problems (e.g., hyperactivity, impulsivity, aggression)
Reduced motivation, energy, or initiative
Increased errors or accidents
Concerns or dissatisfaction with sleep
C. The Sleep Difficulty Occurs at Least 3 Nights Per Week.
D. The Sleep Difficulty is Present for at Least 3 Months.
E. The Sleep Difficulty Occurs Despite Adequate Opportunity for Sleep. This means the person has enough time and a suitable environment for sleep, but still struggles to sleep.
F. The Insomnia is Not Better Explained by and Does Not Occur Exclusively During the Course of Another Sleep-Wake Disorder (e.g., narcolepsy, a breathing-related sleep disorder like sleep apnea, a circadian rhythm sleep-wake disorder, or a parasomnia).
G. The Insomnia is Not Attributable to the Physiological Effects of a Substance (e.g., a drug of abuse, a medication).
H. Coexisting Mental Disorders and Medical Conditions Do Not Adequately Explain the Predominant Complaint of Insomnia. While insomnia often coexists with other mental or medical conditions, the insomnia itself must be a distinct and primary concern, not merely a symptom fully explained by another condition.
DSM-5 Diagnostic Criteria for Attention Deficit Hyperactivity Disorder:
I. Persistent Pattern of Inattention and/or Hyperactivity-Impulsivity
This pattern must interfere with functioning or development and be characterized by symptoms from one or both of the following categories:
A. Inattention (6 or more symptoms for children up to age 16; 5 or more for adolescents aged 17 and older and adults, present for at least 6 months):
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
Often has difficulty sustaining attention in tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, gets sidetracked).
Often has difficulty organizing tasks and activities.
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted by extraneous stimuli (for older adolescents and adults, this may include unrelated thoughts).
Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
B. Hyperactivity and Impulsivity (6 or more symptoms for children up to age 16; 5 or more for adolescents aged 17 and older and adults, present for at least 6 months):
Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is expected.
Often runs about or climbs in situations where it is inappropriate (adolescents or adults may be limited to feeling restless).
Often unable to play or take part in leisure activities quietly.
Is often "on the go" acting as if "driven by a motor" (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
Often talks excessively.
Often blurts out an answer before a question has been completed (e.g., completes people's sentences, cannot wait for turn in conversation).
Often has difficulty waiting their turn.
Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people's things without asking or receiving permission).
II. Additional Diagnostic Criteria:
Onset before age 12: Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
Multiple settings: Several symptoms are present in two or more settings (e.g., at home, school/work, with friends or relatives, in other activities).
Functional impairment: There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
Exclusion of other disorders: The symptoms are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder) and do not occur exclusively during the course of schizophrenia or another psychotic disorder.
DSM-5 Diagnostic Criteria for Bipolar Affective Disorder (BPAD):
Bipolar Affective Disorder (previously known as Manic Depressive Disorder) is a mental health condition characterized by significant mood disturbances that include episodes of mania/hypomania and depression.
There are several types of Bipolar Disorder, the two primary ones being Bipolar I and Bipolar II.
Bipolar I Disorder
A. Manic Episode (Required for Diagnosis)
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy, lasting at least 1 week, present most of the day, nearly every day.
Must include 3 or more (4 if mood is irritable only) of the following:
Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after 3 hours)
More talkative than usual or pressure to keep talking
Flight of ideas or racing thoughts
Distractibility
Increase in goal-directed activity or psychomotor agitation
Excessive involvement in risky activities (e.g., spending sprees, sexual indiscretions)
B. The mood disturbance must be severe enough to:
Cause marked impairment in social or occupational functioning
Require hospitalization
Or involve psychotic features
C. Not due to substances or a medical condition
Note: A major depressive episode is common but not required for diagnosis.
Bipolar II Disorder
Requires:
At least one hypomanic episode
At least one major depressive episode
No history of a full manic episode
Hypomanic Episode
Same symptoms as mania, but:
Lasts at least 4 consecutive days
Not severe enough to cause marked impairment or hospitalization
No psychotic features
Major Depressive Episode
At least 5 of the following symptoms present during the same 2-week period, with at least one being depressed mood or loss of interest/pleasure:
Depressed mood
Markedly diminished interest or pleasure
Significant weight loss or gain
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Diminished ability to think/concentrate
Recurrent thoughts of death, suicidal ideation
DSM-5 Criteria for Borderline Personality Disorder (BPD):
A personality disorder characterized by a pervasive pattern of instability. More specifically, Borderline Personality Disorder is characterized by instability in relationships, self-image, emotions, and behavior (impulsivity). Borderline Personality
Disorder has a prevalence rate of 5.9% and is diagnosed in females at higher rates.
Borderline Personality Disorder is characterized by:
Intense difficulties in interpersonal relationships
An unstable self-concept
Impulsivity, disinhibition, and risk-taking behaviors
Difficulty managing painful emotions
To receive a diagnosis of Borderline Personality Disorder, these symptoms must:
1) Be present in multiple contexts (home and school or home and work)
2) Result in significant suffering or cause significant impairment in functioning
To meet the criteria for Borderline Personality Disorder, five of nine symptoms must be present. They must be present in multiple contexts and cause significant suffering or impairment in relationships and overall functioning. The nine criteria of Borderline Personality Disorder include:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of
idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two potentially self-damaging areas (e.g., spending, sex, substance abuse, reckless driving, binge eating).
5. Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually
lasting a few hours and rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
DSM-5 Criteria for Personality Disorders:
Personality disorders are enduring patterns of inner experience and behavior that deviate significantly from cultural norms and expectations. These patterns are pervasive, inflexible, and typically begin in adolescence or early adulthood, causing significant distress or impairment in various areas of functioning.
A pervasive pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
Cognition: Ways of perceiving and interpreting self, other people, and events.
Affectivity: The range, intensity, lability (rapid shifts), and appropriateness of emotional response.
Interpersonal Functioning: How a person relates to others.
Impulse Control: The ability to manage impulses.
The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. This means the problematic behaviors aren't limited to specific circumstances or relationships.
The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
5. The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.
6. The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, medication) or another medical condition (e.g., head trauma).
The DSM-5 categorizes personality disorders into three clusters based on descriptive similarities:
Cluster A (Odd or Eccentric): Paranoid, Schizoid, Schizotypal personality disorders.
Cluster B (Dramatic, Emotional, or Erratic): Antisocial, Borderline, Histrionic, Narcissistic personality disorders.
Cluster C (Anxious or Fearful): Avoidant, Dependent, Obsessive-Compulsive personality disorders.
Struggling with symptoms? Unsure if you meet criteria for a psychiatric diagnosis? Our initial evaluations can get you started with a comprehensive plan of action to help you manage your symptoms and get the answers you are looking for.