If I'm Not Bipolar, What Am I?

Eating Disorders

Anorexia -American Description

Diagnostic Criteria

1. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).
   
   
2. Intense fear of gaining weight or becoming fat, even though underweight.
   
   
3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
   
   
4. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)
   
   

Specify type:

Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)

Associated Features

1. Depressed Mood
   
2. Somatic/Sexual Dysfunction
   
3. Guilt/Obsession
   
4. Anxious/Fearful/Dependent Personality
   

Differential Diagnosis

General medical conditions; superior mesenteric artery syndrome; Major Depressive Disorder; Schizophrenia; Social Phobia; Obsessive-Compulsive Disorder; Body Dysmorphic Disorder

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Bulimia Nervosa: American Description

Diagnostic Criteria

A.Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:



1. eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
   
   
2. a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
   
   

B.Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.



C.The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.



D.Self-evaluation is unduly influenced by body shape and weight.



E.The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Specify type:

Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.



Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Associated Features

Depressed Mood

Somatic/Sexual Dysfunction

Addiction

Dramatic/Erratic/Antisocial Personality

Differential Diagnosis

Anorexia Nervosa; Binge-Eating/Purging Type; Kleine-Levin syndrome; Major Depressive Disorder, With Atypical Features; Borderline Personality Disorder.

For additional information on bulimia go here

Agoraphobia: European Description

F40.0 Agoraphobia -The term 'agoraphobia' is used here with a wider meaning than it has when originally introduced and as it is still used in some countries. It is now taken to include fears not only of open spaces but also of related aspects such as the presence of crowds and the difficulty of immediate easy escape to a safe place (usually home). The term therefore refers to an interrelated and often overlapping cluster of phobias embracing fears of leaving home: fear of entering shops, crowds, and public places, or of travelling alone in trains, buses, or planes. Although the severity of the anxiety and the extent of avoidance behaviour are variable, this is the most incapacitating of the phobic disorders and some sufferers become completely housebound; many are terrified by the thought of collapsing and being left helpless in public. The lack of an immediately available exit is one of the key features of many of these agoraphobic situations. Most sufferers are women and the onset is usually early in adult life. Depressive and obsessional symptoms and social phobias may also be present but do not dominate the clinical picture. In the absence of effective treatment, agoraphobia often becomes chronic, though usually fluctuating.

Diagnostic Guidelines:

All the following criteria should be fulfilled for a definite diagnosis:

1. the psychological or autonomic symptoms must be primarily manifestations of anxiety and not secondary to other symptoms, such as delusions or obsessional thoughts;
   
   
2. the anxiety must be restricted to (or occur mainly in) at least two of the following situations: crowds, public places, travelling away from home, and travelling alone; and
   
   
3. avoidance of the phobic situation must be, or have been, a prominent feature.
   
   

Differential Diagnosis:

It must be remembered that some agoraphobics experience little anxiety because they are consistently able to avoid their phobic situations. The presence of other symptoms such as depression, depersonalization, obsessional symptoms, and social phobias does not invalidate the diagnosis, provided that these symptoms do not dominate the clinical picture. However, if the patient was already significantly depressed when the phobic symptoms first appeared, depressive episode may be a more appropriate main diagnosis; this is more common in late-onset cases.

The present or absence of panic disorder in the agoraphobic situation on a majority of occasions may be recorded by means of a fifth character

Go here for research articles on agoraphobia.