The G Bitch Spot

Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do note [sic] include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood 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). Note: In children and adolescents, can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Major Depressive Disorder

Single Episode
A. Presence of a single Major Depressive Episode

B. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition.

Recurrent
A. Presence of two or more Major Depressive Episodes
Note: To be considered separate episodes, there must be an interval of at least 2 consecutive months in which criteria are not met for a Major Depressive Episode.

B. The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.

C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects or a general medical condition.

Specify (for current or most recent episode):
Severity/Psychotic/Remission Specifiers
Chronic
With Catatonic Features
With Atypical Features
With Postpartum Onset

Specify
Longitudinal Course Specifiers (With and Without Interepisode Recovery)
With Seasonal Pattern

1. A history of subjection to totalitarian control over a prolonged period (months to years). Examples include hostages, prisoners of war, concentration-camp survivors, and survivors of some religious cults. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering, childhood physical or sexual abuse, and organized sexual exploitation.
   
   
2. Alterations in affect regulation, including:
   • persistent dysphoria
   • chronic suicidal preoccupation
   • self-injury
   • explosive or extremely inhibited anger (may alternate)
   • compulsive or extremely inhibited sexuality (may alternate)
   
   
3. Alterations in consciousness, including:
   • amnesia or hypermnesia for traumatic events
   • transient dissociative episodes
   • depersonalization/derealization
   • reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation
   
   
4. Alterations in self-perception, including:
   • sense of helplessness or paralysis of initiative
   • shame, guilt, and self-blame
   • sense of defilement or stigma
   • sense of complete difference from others (may include sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)
   
   
5. Alterations in perception of perpetrator, including:
   • preoccupation with relationship with perpetrator (includes preoccupation with revenge)
   • unrealistic attribution of total power to perpetrator (caution: victim's assessment of power realities may be more realistic than clinician's)
   • idealization or paradoxical gratitude
   • sense of special or supernatural relationship
   • acceptance of belief system or rationalizations of perpetrator
   
   
6. Alterations in relations with others, including:
   • isolation and withdrawal
   • disruption in intimate relationships
   • repeated search for rescuer (may alternate with isolation and withdrawal)
   • persistent distrust
   • repeated failures of self-protection
   
   
7. Alterations in systems of meaning:
   • loss of sustaining faith
   • sense of hopelessness and despair

Do you have old thumb drives (otherwise known as USB Memory Sticks) at your office or home that you don't use anymore?

We'd love to collect these drives and share them with the organizations we work with. They can be used in 100's of useful ways by:

• Students
• Aid Workers
• Small Business Entrepreneurs

More than 2.5 billion people live in rural and remote areas of developing countries where access to communications is severely limited due to availability or affordability. For these rural communities, access to Information and Communications Technologies (ICTs) can transform their lives in simple, yet profound ways.

But chillingly, trauma has a second, even more covert mechanism. It can affect children and adults directly, as in primary trauma, or it can function vicariously, make a long, stealthy leap from one person's mind to another person's, across space and time. Secondary trauma, the vicarious sort, is a term used most often by psychotherapists, to refer to the fact that a person (such as a psychotherapist) can begin to show significant symptoms of post-traumatic stress disorder merely from hearing repeated stories about the traumatic experiences of other people (such as trauma patients). Secondary trauma quietly and pervasively occurs even in the lives of those who are not psychotherapists and who do not treat trauma patients, for the simple reason that, in a world where too many children have never even slpet on a mattress, extreme human misery is not far removed from any of us.

The man for the job: New Orleans recovery czar