Other Conditions

Adjustment Disorder involves impairment in social or occupational functioning and unexpected severe emotional or behavioral symptoms occurring within 3 months after experiencing a specific identifiable stressful event, such as a divorce, business crisis, or family discord. Symptoms may include anxiety, depression, and conduct disturbances and tend to remit following elimination of the stressors or acquisition of new coping skills. In chronic adjustment disorder, symptoms last more than 6 months due to either the persistence or severity of the stressor. DSM–5 and DSM-5-TR reconceptualize it as a heterogeneous array of stress-response syndromes that occur after exposure to a distressing traumatic or nontraumatic event, rather than as a residual category for distress that does not meet criteria for a more discrete disorder (as in DSM–IV–TR).

Agoraphobia is an excessive, irrational fear of being in open or unfamiliar places, resulting in the avoidance of public situations from which escape may be difficult, such as standing in line or being in a crowd. In DSM–IV–TR, agoraphobia may accompany panic disorder (panic disorder with agoraphobia), in which an individual experiences unexpected panic attacks, or it may occur in the absence of panic disorder (agoraphobia without history of panic disorder), when an individual fears panic-like symptoms or limited symptom attacks but has not experienced full-blown panic attacks. In DSM–5 and DSM-5-TR, panic disorder and agoraphobia are treated as separate entities with separate criteria; their combined presence is considered two diagnoses.

Specific phobia is an intense, irrational fear of something that poses little or no actual danger. Although adults with phobias may realize that these fears are irrational, even thinking about facing the feared object or situation brings on severe anxiety symptoms.

OCD is a disorder characterized by recurrent intrusive thoughts (obsessions) that prompt the performance of neutralizing rituals (compulsions). Typical obsessions involve themes of contamination, dirt, or illness and doubts about the performance of certain actions. Common compulsive behaviors include repetitive cleaning or washing, checking, ordering, repeating, and hoarding. Obsessions and compulsions are time-consuming, cause significant distress, and interfere with functioning. OCD is classified under the category obsessive-compulsive and related disorders in DSM–5 and DSM-5-TR.

A panic attack is a sudden onset of intense apprehension and fearfulness in the absence of actual danger, accompanied by physical symptoms such as heart palpitations, difficulty breathing, chest pain or discomfort, choking or smothering sensations, sweating, and dizziness. The attack often involves fears of going crazy, losing control, or dying. Panic attacks may occur in the context of any anxiety disorder, other mental disorders (e.g., mood disorders, substance-related disorders), or some general medical conditions (e.g., hyperthyroidism). Also called anxiety attack.

Panic disorder is an anxiety disorder characterized by recurrent, unexpected panic attacks that are associated with persistent concern about having another attack, worry about the possible consequences of the attacks, significant behavior changes related to the attacks (e.g., avoiding situations, engaging in safety behaviors, not going out alone), or a combination of these. Panic disorder associated with significant avoidance is classified as panic disorder with agoraphobia. In DSM–5 and DSM-5-TR, panic disorder and agoraphobia are treated as separate entities with separate criteria; their combined presence is considered two diagnoses.

PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear is part of the body’s “fight-or-flight” response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most people recover from initial symptoms over time. Those who continue to experience problems may be diagnosed with PTSD.

Postpartum depression is a mood disorder that occurs during pregnancy and after childbirth. Symptoms can range from mild to severe. In rare cases, the symptoms are severe enough that a mother and her baby’s health and well-being may be at risk.

Most episodes of perinatal depression begin within 4−8 weeks after the baby is born. Women and other pregnant and postpartum people with perinatal depression experience extreme sadness, anxiety, and fatigue that may make it difficult to carry out daily tasks, including caring for themselves or others. Perinatal depression can be treated.

Prolonged grief disorder involves intense longing or preoccupation with the deceased, disrupting daily life. Diagnosis requires the loss to have occurred at least a year ago for adults, and at least 6 months ago for children and adolescents, with at least three of the following symptoms experienced nearly every day for at least the last month: identity disruption, disbelief about the death, avoidance of reminders, emotional pain related to the death, difficulty with reintegration, emotional numbness, feeling life is meaningless, intense loneliness, and bereavement lasting longer than expected. An estimated 7%-10% of bereaved adults experience prolonged grief disorder, with risk factors including older age, history of depression or bipolar disorder, caregiving, sudden or traumatic death. Prolonged grief disorder often co-occurs with PTSD, anxiety, or depression, and sleep problems are common. DSM-5-TR criteria help clinicians differentiate between normal and prolonged grief.

SAD is a type of depression characterized by a recurrent seasonal pattern, with symptoms lasting about 4−5 months out of the year. The signs and symptoms of SAD include those associated with depression as well as disorder-specific symptoms that differ for winter-pattern versus summer-pattern SAD. In most cases, SAD symptoms start in the late fall or early winter and go away during the spring and summer, known as winter-pattern SAD or winter depression. Other people experience depressive symptoms during the spring and summer months, known as summer-pattern SAD or summer depression. Summer-pattern SAD is less common.

Social anxiety is a fear of social situations in which embarrassment may occur (e.g., making conversation, meeting strangers, dating) or there is a risk of being negatively evaluated by others (e.g., seen as stupid, weak, or anxious). It involves apprehensiveness about one’s social status, role, and behavior. When the anxiety causes significant distress or impairment in functioning, a diagnosis of social phobia may be warranted.