According to the DSM-V-TR (2022),  “Obsessive-compulsive and Related Disorders include obsessive compulsive disorder (OCD), body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation (skin picking) disorder, substance/medication-induced obsessive-compulsive and related disorder, obsessive-compulsive and related disorder due to another medical condition, other specified obsessive-compulsive and related disorder (nail biting, lip biting, cheek chewing, obsessional jealousy, olfactory reference [disorder of factory reference syndrome bracket parentheses, and unspecified obsessive compulsive and related disorder.”

Signs and Symptoms

“People with OCD and related disorders may have obsessions, compulsions, or both. Obsessions are repeated thoughts, urges, or mental images that are intrusive, unwanted, and make most people anxious. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to the rules that must be applied rigidly.” (DSM-V-TR, 2022)

Symptoms may include:

• Unable to control obsessions or compulsions even when the person knows they are excessive

• Spend more than 1 hour a day on obsessions or compulsions.

• Feel temporary from anxiety caused by obsession or compulsions but does not enjoy the actions themselves (nimh.nih.gov, 2022)

• Having unwanted thoughts, impulses, or images that occur over and over and which cause anxiety or distress.

• Skin picking, hair pulling, body focused repetitive behaviors, hoarding (DSM-V-TR, 2022)

• Having to think about or say something over and over (for example, counting, or repeating words over and over silently or out loud)

• Having to do something over and over (for example, handwashing, placing things in a specific order, or checking the same things over and over, like whether a door is locked) (cdc.gov, 2023)

Impact

• Experience disruptions to daily life and/or relationships because of obsessions and compulsions

• Impacts daily life in a negative way

• Experience relief from anxiety when performing a compulsion but don’t get any pleasure out of the activity (mcleanhospital.org, 2023)

• Can interfere with school and work 

• Can disrupt relationships

• Lead to self harm

• Cause low self esteem (thesohocenter.com, 2024)

Need

• Obtain an official diagnosis

• Therapy (CBT)

• Psychotherapy

• Exposure and Response Prevention Therapy

• Repetitive Transcranial Magnetic Stimulation (rTMS)

• Deep Brain Stimulation (surgery)

• Medication

• Support

(nimh.nih.gov, 2022)

According to the DSM-V-TR (2022), Trauma and stressor-related disorders include disorders in which exposure to a traumatic or stressful event is listed explicitly as a diagnostic criterion. These disorders include reactive attachment disorder, disinhibited social engagement disorder, post-traumatic stress disorder (PTSD), acute stress disorder, adjustment disorders, and prolonged grief disorder.

Signs and Symptoms

According to Mentalhealthgetaway.org (2024), trauma and stressor-related disorders have characteristic symptoms:

• Intrusion symptoms are recurrent, involuntary, and distressing memories, thoughts, and dreams of the traumatic event. This can include flashbacks, a dissociative experience in which they feel or act as if the traumatic event is reoccurring.

• Avoidance symptoms include efforts to avoid internal (memories, thoughts, feelings) and/or external (people, places, situations) reminders of the traumatic event. Preoccupation with avoiding trauma-related feelings and stimuli can become a central focus of the individual’s life.

• Negative alterations in cognition and mood include problems remembering important aspects of the traumatic event, depression, fear, guilt, shame, and feelings of isolation from others.

• Hyper-arousal symptoms include being jumpy and easily startled, irritability, angry outbursts, self-destructive behavior, problems concentrating, and difficulty sleeping.

Impact

Having a trauma and stressor-related disorder can impact the client's life in many ways, such as:

 -medical and mental health problems

 -depression

 -anxiety

-substance abuse

-attempted and completed suicide 

-difficulties with self-regulation, attention, concentration, impulse control

-negative self-image

-aggression/risk-taking 

-somatization 

-attachment or conduct/oppositional defiant disorder

-sexual interest/activity/avoidance, and/or hypersexuality

(Virginia.gov, 2017)

Need

Treatment for these disorders will most likely include medication and a form of psychotherapy.

Medication: Selective serotonin reuptake inhibitors or SSRIs are mostly prescribed to people with a trauma or stressor-related disorder. These antidepressants help regulate mood, anxiety, sleep, appetite, and other bodily functions (W. Alexander, 2012)

Psychotherapy:

According to Psychologytoday.com (2022), Trauma -Focused CBT- there are 5 main features of TF-CBT:

• Psychoeducation- teaches the client about normal reactions to traumatic experiences. This can help them reduce feelings of guilt or culpability for what happened.

• Coping skills- this includes deep breathing, mindfulness, acceptance, identifying and redirecting thoughts, and other relaxation methods.

• Gradual exposure- involves gradually re-introducing the patient to memories of their traumatic experience. The goal is to recondition their response to triggers and ease emotional distress.

• Cognitive processing- includes developing skills to recontextualize unhelpful feelings and thoughts, and regulate emotions.

• Caregiver involvement- includes rebuilding trusting adult relationships for the child and training the caregiver in how to best be a resource for the child.

Bipolar and related disorders are a bridge between schizophrenia spectrum/psychotic disorders and depressive disorders. They are similar in the ways of symptoms, family history, and genetics. 

Signs and symptoms (DSM-V-TR, 2022)

Bipolar I

-One manic episode is required

-Hypomanic episodes can occur but are not required

-Major depressive episode can occur but is not required

Bipolar II

-One hypomanic episode and one major depressive episode are required

-There has never been a manic episode

Cyclothymic

-for at least 2 years:

-hypomanic symptoms that do not meet the criteria for a hypomanic episode

-numerous drpressive symptoms that do not meet the criteria for a major depressive episode

Substance/Medication-Induced Bipolar and Related Disorders

Symptoms of bipolar and related disorders appear soon after a substance or medication is ingested. 

Manic episodes are defined in the DSM-V-TR (2022), as “a period of abnormally and persistently elevated expansive or irritable mood and abnormally and persistently increased activity or energy lasting at least one week and persistent most of the day nearly every day.”

Symptoms include:

-inflated sense of self

-overly talkative

-lack of sleep

-flight of ideas

-distracted

-engaging in risky behaviors

Depressive episodes are defined in the DSM-V-TR (2022) as “periods of either depressed mood or loss of interest. Symptoms must be present during the same two-week period and present a change from previous functioning.”

Symptoms include:

-depressed mood most of the day, every day

-irritability

-significant weight loss

-loss of interest in pleasurable activities

-insomnia/hypersomnia

-psychomotor agitation/retardation

-fatigue

-feeling inappropriate guilt

-inability to think clearly/concentrate

-indecisiveness

-thought of death/suicidal ideation

Hypomania can be described as a milder version of a manic episode. Symptoms do not last as long and are not as intense.

Impact

Bipolar and related disorders can impact someone's daily life significantly. They are most likely impaired in the areas of:

-work

-school

-legal issues

-financial issues

-relationships

-cognitive functioning

These impairments can lead to lower socioeconomic status, strained interpersonal relationships, and legal trouble. 

Need (mayoclinic.org, 2022)

Bipolar and related disorders cannot be cured but can be managed with medication, therapy, and lifestyle changes. 

Medications

-Mood stabilizers

-Anticonvulsants

-Antipsychotics

-Antianxiety

Therapy

-psychotherapy

-psychoeducation

-CBT

-Interpersonal and social rhythm therapy (IPSRT)

-electroconvulsive therapy (ECT)

-family-focused therapy

Hospitalization

-Inpatient or outpatient treatment

According to the DSM-V-TR, 2022, signs of Neurodevelopmental disorders typically begin in the developmental stages. They can be characterized by a spectrum of developmental deficits or differences in the brain that produce impairments. Deficits can range from very specific learning disabilities or control of executive functioning to global impairments of social skills or intellectual

ability.

Signs and symptoms

-not meeting developmental milestones

-developmental delays or regression

-co-occurring

-academic deficits

-inhibited motor activity

-poor memory

-abnormal body movements

-distractibility

-communication problems

-disorganized thoughts

Communication disorders include global developmental delay, intellectual disability, language disorder, speech sound disorder, stuttering, social communication disorder, and unspecified.

Signs and Symptoms:

-deficits in general mental abilities: reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience

-impairments of adaptive functioning

-failure to meet standards of personal independence at home and/or community settings

-impairments in social participation, academic or occupational functioning 

-failure to meet developmental milestones 

These deficits can be classified as mild, moderate, severe, or profound.

Autism Spectrum Disorder is defined as persistent deficits in social communication and social interaction across multiple scenarios. People with autism may display the following traits:

-avoiding eye contact

-difficulties with communication

-repetitive movements such as flapping or spinning

-rigid thinking

-emotional dysregulation

-abnormal affect

-socially awkward

-fixation on specific topics

ADHD presents as high levels of inattention, disorganization, and/or hyperactivity-impulsivity to the point of impairment. Other signs and symptoms include:

-distractibility

-off task 

-impulsivity

-constant fidgeting

-trouble multitasking

-forgetfulness

Learning Disabilities include deficits in reading (word reading accuracy, reading rate or fluency, reading comprehension) also known as Dyslexia, written expression (spelling accuracy, grammar and punctuation accuracy, clarity or organization of written expression), mathematics (number sense, memorization of math facts, accurate or fluent calculation, accurate math reasoning) also known as dyscalculia.

These deficits can be classified as mild, moderate, or severe. 

Motor disorders include developmental coordination disorder, stereotypic movement disorder, and tic disorders. Signs and symptoms:

-lack of coordination

-unstable

-stiffness

-falling frequently

-problems with speech

-limited mobility in limbs

Impact

-impairments of personal, social, academic, or occupational functioning

-limitations in learning 

-impairments of social skills 

-higher risk of experiencing ACEs

-higher risk of CS involvement

-higher risk of abuse

Need

-special education assistance in school

-504 plan

-some may need a lifetime caregiver

-physical therapy

-occupational therapy

-support from their families and the community

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

What are Depressive Disorders?

Depressive Disorders include Disruptive Mood Dysregulation Disorder, Major Depressive Disorder, Persistent Depressive Disorder, Premenstrual Dysphoric Disorder, Depressive Disorder Due to Another Medical Condition, Other Specified Depressive Disorder, Unspecified Depressive Disorder, and Unspecified Mood Disorder.

Characteristics of depressive disorders include:

-major depressive episodes

-prolonged sadness

-poor concentration

-irritability

-somatic and cognitive changes

Disorders all differ in duration, timing, or presumed etiology.

Disruptive Mood Dysregulation Disorder:

-chronic, severe irritability

-temper outbursts

-aggression

-occurs at least 3x a week

Major Depressive Disorder

-at least one major depressive episode

symptoms lasting at least 2 weeks 

-loss of interest in all or nearly all activities for most of the day

nearly every day

-changes in appetite or weight 

-disrupted sleep patterns

-decreased energy

-feelings of worthlessness or guilt

-distractability

-thoughts of death or suicidal ideation

Severity can be mild, moderate, severe, and with psychotic features

Additional specifiers include anxious distress, mixed features, melancholic features, atypical features, mood-congruent psychotic features, mood-incongruent psychotic features, catatonia, peripartum onset, or seasonal pattern

Persistent Depressive Disorder

-depressed mood for most of the day every day for at least 2 years

-poor appetite or overeating

-insomnia or hypersomnia

-low energy/fatigue

-low sense of self-worth

-distractability

-hopelessness

Severity can be mild, moderate, severe

Additional specifiers include  anxious distress, atypical features, partial remission, full remission, early onset, late onset, pure dysthymic syndrome, persistent major depressive episode, intermittent major depressive episodes, with or without current episode

Premenstrual Dysphoric Disorder

-mood swings

-sudden feelings of sadness 

-increased sensitivity

- feelings of irritability or anger 

-depressed mood, feelings of hopelessness, or self-deprecating thoughts

-feelings of anxiety/ tension

-loss of interest in usual activities 

-distractability

-fatigue

-change in appetite

-hypersomnia or insomnia

-sense of being overwhelmed

-breast tenderness or swelling

-bloating or weight gain

-symptoms occur in menstrual cycles from the preceding year.

-symptoms cause clinically significant distress or interference with daily functioning

Impact

-disrupted interpersonal relationships

-severe social disruption

-loss of interest in activities

-suicidal ideation

Needs

-psychotherapy

-CBT

-medication: antidepressants, SSRIs, mood stabilizers

-coping strategies

-support

-self care

-psychoeducation

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Centers for Disease Control and Prevention. (2023). Obsessive-compulsive disorder in children. Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/ocd.html 

Everything you need to know about OCD. OCD: Everything You Need to Know | McLean Hospital. (2024). https://www.mcleanhospital.org/essential/ocd 

Learning/modeling. WorryWiseKids.org | Learning/Modeling. (2024). https://www.worrywisekids.org/node/17 

Mayo Foundation for Medical Education and Research. (2022). Bipolar disorder. Mayo Clinic.https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961 

Sussex Publishers. (2022). Trauma-focused cognitive behavior therapy. Psychology Today. https://www.psychologytoday.com/us/therapy-types/trauma-focused-cognitive-behavior-therapy#how-it-works 

Trauma and stress-related disorders. Mental Health Gateway. (2024). https://mentalhealthgateway.org/trauma-and-stress-related-disorders/ 

U.S. Department of Health and Human Services. (2022). Obsessive-compulsive disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd 

Understanding OCD and how it can affect your daily life. Understanding OCD and How it Can Affect Your Daily Life: The Soho Center for Mental Health Counseling: Psychotherapists. (2024). https://www.thesohocenter.com/blog/understanding-ocd-and-how-it-can-affect-your-daily-life 

Virginia. (2017). https://vcoy.virginia.gov/documents/collection/018%20Trauma2.pdf