A. Currently (or most recently) in a Mixed Episode.
- i. The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period. This has been going on since she was sixteen. Patrick always wrote it off as mood swings, not wanting Charley to know that she was taking after her mother's condition. Charley hates her mother and would be repulsed at the idea.
ii. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. Charley is always engaging in damaging activities such as sex, spending, and self-mutilating behavior. She has lost several jobs because of this.Charley does not do drugs, though she loves to drink, and has experimented with weed, she is in no way an addict.
B. There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.
- i. Criteria for Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). Charley's manic periods usually last a few days, rarely longer than two week without a break in her mood.
B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
(1) inflated self-esteem or grandiosity Charley -knows- she looks good and can get whatever she wants. Be it men, success, fame, or trinkets. She knows what she wants and how to get it.
(2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) When she's manic, Charley often stays up all night, either partying or sleeping around.
(3) more talkative than usual or pressure to keep talking Charley never shuts up. Like, ever.
(4) flight of ideas or subjective experience that thoughts are racing It's often difficult to understand what Charley is talking about, because her thoughts leap from one subject to the next. When she was a kid, her teachers thought she had ADD, but she was never tested for it.
(5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) Again, when she was a child, they thought she had ADD. Charley is easily distracted by things she finds attractive or shiney.
(6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation When she is manic, she finds strange sexual goals... like trying to seduce a priest.
(7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) Obviously the sex, but she has also been known to spend upwards of 3000 dollars in one shopping spree (on her brother's tab, no less)
D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. Charley has been hospitalized around fifteen times for severe cuts to her wrists, and twice having her stomach pumped for alcohol and pills. These issues became more frequent with age. Charley has never had a solid relationship, she gets distracted too easily and often ends up cheating.
E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). See above reference to drugs
ii. Criteria for 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. Both 1 and 2 have occured. Charley has quit plays mid-production, quit jobs she's loved, quit relationships, all so she could do nothing other than lay around and pity herself.
Note: Do not 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. Charley feels sad because she feels her life is going no where. She cries often, worried that she'll never find the right person, and that she'll never have a successful job. She's also terrified of becoming her mother.
(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) See above
(4) Insomnia or Hypersomnia nearly every day Charley often has a hard time sleeping, and calls her brother in tears, instead.
(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) Only her brother really notices this, but Charley moves slowly and takes forever to do things when she's depressed, and is almost "catatonic" in her activities.
(6) fatigue or loss of energy nearly every day Not much more to say about that
(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) See above statement of how she feels about being like her mother
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) Which is why she often quits plays/jobs
(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 She has been hospitalized several times for suicide attempts
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. See above reference to same topic
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). See above reference to same topic
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. Symptoms have been going on since about the time she was fifteen or sixteen, unprovoked.
C. The mood episodes in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
Profile
![[info]](http://l-stat.livejournal.com/img/userinfo.gif)
amp_charlotte_j- Charley Johnson