DSM-5 Workshop Notes

5+ symptoms during the same 2-week period, most of the day, nearly every day; at least one of which is depressed mood or anhedonia.
Symptoms include:
- Depressed mood
- Anhedonia
- Change in appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Poor concentration or difficulty making decisions
- Recurrent thoughts of death
Symptoms cause significant distress/impairment.
Not due to other substance/disorder/medical condition.

Depressed mood for most of the day, more days than not, for at least two years.
2+ of the following symptoms while depressed:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
Never without symptoms for more than 2 months at a time during the 2-year period.
Never experienced a Manic or Hypomanic Episode, and criteria never met for Cyclothymic Disorder.
Symptoms cause significant distress/impairment.
Not due to other substance/disorder/medical condition.

Distinct period (at least several days) of abnormally/persistently elevated, expansive, or irritable mood and increased activity/energy.
3+ symptoms (4+ if mood is only irritable):
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative or pressure to keep talking
- Flight of ideas or racing thoughts
- Distractibility
- Increase in goal-directed activity
- Excessive involvement in high-risk activities
Symptoms cause significant distress/impairment.
Not due to other substance/disorder/medical condition.

Distinct period (at least 4 consecutive days) of abnormally/persistently elevated, expansive, or irritable mood and increased activity/energy.
3+ symptoms (4+ if mood is only irritable):
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative or pressure to keep talking
- Flight of ideas or racing thoughts
- Distractibility
- Increase in goal-directed activity
- Excessive involvement in high-risk activities
Represents an unequivocal change in functioning, uncharacteristic of the individual.
Disturbance in mood and change in functioning are observable by others.
Symptoms are not severe enough to cause marked impairment or necessitate hospitalization.
Not due to other substance/disorder/medical condition.

Excessive anxiety/worry more days than not for 6+ months about a number of events/activities.
Difficulty controlling the worry.
3+ symptoms associated with anxiety/worry:
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Anxiety/worry/physical symptoms cause significant impairment/distress.
Not due to other substance/disorder/medical condition.

Recurrent unexpected panic attacks with 4+ symptoms peaking within minutes:
- Palpitations, pounding heart, or accelerated heart rate
- Sweating
- Trembling or shaking
- Sensations of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, lightheaded, or faint
- Chills or heat sensations
- Paresthesia
- Derealization or depersonalization
- Fear of losing control or “going crazy”
- Fear of dying
1+ attack followed by 1 month of:
- Persistent concern/worry about additional attacks/consequences
- Significant maladaptive behavior change related to the attacks
Symptoms cause significant distress/impairment.
Not due to other substance/disorder/medical condition.

Marked fear/anxiety about 2+ of the following:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
Fear/avoidance due to thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms.
Agoraphobic situations almost always provoke fear/anxiety.
Situations are actively avoided or endured with intense fear/anxiety.
Fear/anxiety is out of proportion to the actual danger.
Persistent fear/anxiety/avoidance lasting 6+ months.
Causes significant impairment/distress.
Not attributable to other substance/disorder/medical condition.