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Am I Really Crazy!?​


When we have negative symptoms we feel crazy because we can’t be the us we want to be.

Problem is, we need to find out exactly what’s wrong. We all have some symptoms of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). The question is, do you fit the criteria enough for a diagnosis? Time restrictions are also considered. How long have you been suffering with this issue and how badly does it effect you. To be clinically diagnosed with a mental health disorder you must fit the required criteria, fit the time requirement, and these symptoms must also cause significant impairment in several areas of your life.

This information is not to replace a clinical evaluation but rather for personal education while professional consult is still recommended. Keep in mind that at one time during your life you may fit this criteria while during another you will not. With this being said you may not always have a mental health diagnosis throughout your entire life. Some factors need to be taken into consideration with these symptoms to include biological factors, family of origin, environmental issues, substance use, and current/past medications.

So, do you fit the criteria? Here are some brief explanations of three commonly diagnosed disorders that I assist my clients with:

Major Depressive Disorder (MDD)

Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks and significantly impaired function
: social, occupational, educational. These symptoms are not better explained by a different mental disorder.

Specific symptoms, at least 5 of these 9, present nearly every day:

  1. Depressed mood or irritable 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).
  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: Psychomotor agitation or retardation
  6. Fatigue or loss of energy
  7. Guilt/worthlessness: Feelings of worthlessness or excessive 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

Generalized Anxiety Disorder ( GAD)

The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive. Excessive worry means worrying even when there is nothing wrong, or in a manner that is disproportionate to the actual risk. This typically involves spending a high percentage of waking hours worrying about something. The worry may be accompanied by reassurance-seeking from others.

The anxiety and worry are associated with at least 3 of the following physical or cognitive symptoms:

  1. Edginess or restlessness.
  2. Tiring easily; more fatigued than usual.
  3. Impaired concentration or feeling as though the mind goes blank.
  4. Irritability (which may or may not be observable to others).
  5. Increased muscle aches or soreness.
  6. Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep).

The anxiety, worry, or associated symptoms make it hard to carry out day-to-day activities and responsibilities causing significantly impaired function: social, occupational, educational. These symptoms are unrelated to any other medical conditions and cannot be explained by the effect of substances including a prescription medication, alcohol or recreational drugs. These symptoms are not better explained by a different mental disorder.

Posttraumatic Stress Disorder (PTSD)

Diagnostic criteria for PTSD include a history of exposure to a traumatic event that meets specific stipulations and symptoms from each of four symptom clusters: • Intrusion, • Avoidance, • Negative alterations in cognition and mood, and • Alterations in arousal and reactivity. These symptoms cause significant impairment in your social, occupational, and/or educational activities and are not better explained by a different mental disorder. Duration of symptoms (in Criteria B, C, D, and E) for more than one month.

Criterion A: Stressor- The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required)

  1. Direct exposure to a traumatic incident.
  2. Indirect exposure to a traumatic incident.
  3. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties.

Criterion B: Intrusion symptoms-The traumatic event is persistently re-experienced in the following way(s): (one required)

  1. Recurrent, involuntary, and intrusive memories, traumatic nightmares.
  2. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness.
  3. Intense or prolonged distress after exposure to traumatic reminders.
  4. Marked physiologic reactivity after exposure to trauma-related stimuli.

Criterion C: Avoidance-Persistent avoidance of distressing trauma-related stimuli after the event: (one required)

  1. Trauma-related thoughts or feelings.
  2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations).

Criterion D: Negative alterations in cognition and mood-Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required)

  1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs).
  2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world
  3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.
  4. Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame).
  5. Markedly diminished interest in significant activities.
  6. Feeling alienated from others (e.g., detachment or estrangement).
  7. Constricted affect: persistent inability to experience positive emotions.

Criterion E: Alterations in arousal and reactivity-Arousal and reactivity that began or worsened after the traumatic event: (two required)

  1. Irritable or aggressive behavior
  2. Hyper-vigilance
  3. Self-destructive or reckless behavior
  4. Exaggerated startle response
  5. Problems in concentration
  6. Sleep disturbance

Note; Keep in mind that depression and anxiety symptoms can be ‘under the umbrella’ of PTSD. I always ask my clients what came first the traumatic event or the depression/anxiety.

Remember, even if you fit the criteria to have a mental health disorder this doesn’t mean that you are crazy. You are not alone and you can manage this issue. If you need further assistance we can set up an appointment or you can look on my website for other resources to help.

Nami is another great resource to look into for assistance. Click here to find out more.

-Jacqueline Campbell 


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