Depression is defined within the DSM-5 if you are experiencing five or more of the following symptoms throughout two weeks in conjunction with a depressed mood or loss of interest:

• Extended periods of depressed moods nearly every day.
• Diminished interest in most activities.
• You have experienced changes in your appetite leading to gain or loss of weight.
• You feel fatigued and lack energy most of the time.
• You struggle to focus or make choices.
• Feelings of negative self-worth or excessive remorse.
• Recurrent suicidal thoughts, planning, or attempted suicide.

Depression may manifest alone or in conjunction with other mental health conditions. Symptoms of physical discomfort, irritability, anxiety, or brooding can be signs of Depression.

People who are depressed might not be able or ready to recognize their symptoms immediately. Using expressions like “I just don’t feel well” or “I’m tired” can mask Depression. 

Other subtle signs are:

• Modifications in sleeping habits, such as insomnia
• Irresponsible actions
• Rejecting invitations or staying away from acquaintances and social gatherings
• Crying without an apparent cause 
• Unexpected soreness and pains

The DSM-5 defines anxiety disorders as having excessive fear or concern brought on by anticipating a danger, threat, or conflict. While anxiety is a normal facet of life, anxiety disorders can disrupt one’s functioning in day-to-day situations.

Some symptoms of anxiety are:

• Restlessness
• Fatigue
• Irritability
• Having trouble focusing and having racing ideas
• Sleeping problems and insomnia
• Hyper-vigilance

The physical health of the organism is also impacted by anxiety:

• Excessive sweating 
• Digestive issues
• Increased heart rate or palpitations
• Pains in the muscles and stomach
• Trouble breathing

Even though they may co-occur, panic attacks and panic disorders are distinct from anxiety disorders. However, the symptoms of panic and anxiety disorders may be similar, making them readily confused. The primary difference is that panic disorder involves sudden symptoms, often without apparent cause. Symptoms of a panic attack include:

• Heart palpitations
• Trembling or shaking 
• Difficulty breathing, shortness of breath
• Dizziness
• Chest pains
• Feeling numb or detached from reality
• Fear of impending death 

Similar to Depression, anxiety has a variety of underlying reasons, such as biochemical imbalances or traumatic experiences. When Depression and anxiety coexist, managing the conflicting feelings becomes impossible. 

Feeling anxious about achieving goals or others’ expectations may cause inaction, deepening Depression when one falls short. Struggling with fear of imminent death and suicidal ideation can leave one feeling like drowning and seeking ways to cope.

Often substance use is a symptom of underlying mental illness. Depression and anxiety are common among people living with substance use disorders. Using drugs and alcohol to escape the negative thoughts and emotions of these and other mental health disorders creates a vicious cycle with potentially deadly consequences. That is why concurrently treating co-occurring mental health and substance use disorders is vital.

Bipolar disorder frequently disrupts mood, energy, activity, sleep, cognition, behavior, and occupational and interpersonal functioning. Out of 328 diseases studied worldwide in 2016, bipolar disorder was the 23rd leading cause of years lived with disability. Pharmacotherapy within the context of a positive therapeutic alliance is central to managing morbidity and the risk of suicide. However, treatment following the onset of the disorder is typically delayed for years.

This topic reviews the clinical features of bipolar disorder in adults. Adult bipolar disorder assessment, diagnosis, and treatment are covered separately for adolescents and children, geriatric patients, and patients with rapid cycling (i.e., four or more mood episodes in 12 months).

Bipolar Manic Symptoms in Adults and Children

• An identifiable period of exceptionally elevated, expansive, or irritable mood and abnormally high activity or energy that lasts at least a week and is experienced almost daily (or for any length of time if hospitalization is required).
• Three (or more) of the following symptoms—or four if the mood is only irritable—are present to a significant extent during the time of mood disturbance and increased energy or activity and signify a discernible deviation from expected behavior:
  • Inflated self-esteem or grandiosity.
  • Decreased need for sleep (e.g., rested after only three hours).
  • More chatty than usual or under pressure to talk more.
  • Flight of thoughts or the feeling that one’s thoughts are rushing.
  • Distractibility (i.e., premature focus on unimportant or unrelated external stimuli), as reported or observed.
  • Increase goal-directed activity (socially, professionally, academically, or sexually) or psychomotor instability (i.e., purposeless non-goal-directed activity).
  • Excessive engagement in pursuits that carry a risk of unpleasant and painful outcomes (e.g., taking careless risks with your money, foolish business investments, or sexual indiscretions).
• If there are psychotic features, the mood disturbance is severe enough to impair social or occupational performance significantly or to require hospitalization to avoid harm to oneself or others.

Bipolar Hypomania Symptoms in Adults and Children

• A distinct episode of unusually elevated, expansive, or irritable mood and abnormally elevated activity or energy that lasts at least four days straight and is experienced nearly every day for the majority of the days.
• Four of the following symptoms—or three—have remained if the mood is only irritable, indicate an actual departure from normal behavior, and have been present to a significant degree during the time of mood disturbance and increased energy and activity:
  • Inflated sense of grandeur or grandiosity.
  • Lost the need for sleep (e.g., feels rested after only three hours of sleep).
  • More chatty than usual or under pressure to talk more.
  • Flight of thoughts or the feeling that one’s thoughts are rushing.
  • Distractibility (i.e., premature focus on unimportant or unrelated external stimuli, as reported or observed.
  • Intensification of goal-directed behavior (in social situations, at work or school, or during sexual activity) or psychomotor restlessness.
  • Excessive engagement in pursuits that risk unpleasant and painful outcomes (e.g., engaging in sexual indiscretions, foolish investments, or taking careless risks with your money).
• When the episode is not symptomatic, there is a clear shift in functioning that is uncharacteristic of the person.
• Others can see the mood disturbance and the difference in functioning.
• The episode wasn’t severe enough to significantly impair social or occupational performance or make hospitalization necessary. The incident is manic by definition if there are psychotic characteristics.
• The incident cannot be linked to a substance’s physiological effects. (e.g., abuse of medications, other treatments, or drugs).

Schizophrenia is no one’s fault. Schizophrenia affects 1.1% of the US population. While the exact cause is not known, experts think that a combination of family history (genetics), environmental factors, and specific chemical imbalances in the brain may be risk factors for developing Schizophrenia. People with Schizophrenia may have many different types of symptoms, including the ones described below:

• Hallucinations: This is when you see or hear things that aren’t there. You may see people or hear voices talking to you even when alone.
• Delusions: When you hold on to false beliefs even with proof that those beliefs are not true or logical.
  Disorganized Thinking: If you are finding it hard to organize thoughts, it can make it hard to talk clearly or tell people what you are thinking in a way they can understand.
• Social Withdrawal: You may not want to participate in every activity, like work, school, or social events.