Sometimes it's not easy to tell if you should seek out care from a mental health professional. Below are some common signs and symptoms for three common psychological conditions: drug and alcohol dependence, clinical depression, and anxiety. These signs and symptoms are derived from the Diagnostic and Statistical Manual (DSM-VI) of the American Psychiatric Association. Please note that there are many other psychological conditions which can affect people and which also may warrant consultation with a mental health professional.
If you feel that you may be experiencing mental health concerns, please seek out appropriate treatment and care. Start however you're able, maybe by talking to a knowledgeable friend or family member, your primary care physician, a member of the clergy, or a community-based agency such as Body Positive. See the "Body Positive Mental Health Roundtable" article in this issue for suggestions about how to make contact with sources of help, or call the toll-free Body Positive telephone Helpline (1-800-566-6599) between Monday and Friday from 10 am to 9 pm.
Drug and Alcohol Dependence
If you have had three or more of the following symptoms in the past twelve months, you should seriously consider seeking professional assistance for possible drug and/or alcohol dependence.
- Do you find that you have developed "tolerance" for the substance(s) you use? Tolerance means either that you need a greatly increased amount to get as high as earlier or that using the same amounts produces less of an effect.
- Have you experienced "withdrawal" symptoms (i.e., physical reactions to the absence of the substance) or have you used other substances to relieve or avoid withdrawal?
- Are you using more alcohol or drugs or using them over a longer period than you intended?
- Do you persistently try, or try and find yourself unable, to cut down or control your use?
- Do you spend a great deal of time obtaining the substance, using it, or recovering from its effects?
- Are you reducing, or giving up important social, occupational, or recreational activities because of substance use?
- Do you continue using alcohol or drugs even though you know they are causing physical or psychological problems for you?
If you have experienced four or more of the following symptoms during the same two week period, you should seriously consider seeking professional assistance for possible clinical depression. This is particularly the case if you think that the symptoms are not clearly related to HIV or some other physical condition.
- Has your mood been depressed most of the day, nearly every day, during a two week period? This can be either in terms of how you feel or in terms of what others have commented on.
- Have you had markedly less interest or pleasure in all, or almost all, activities most of the day, nearly every day, during a two week period? Again, this can be either in terms of how you feel or in terms of what others have commented on.
- Have you experienced significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or the decrease or increase of your appetite nearly every day?
- Have you been sleeping too little or too much?
- Have you felt unusually restless or sluggish?
- Have you felt fatigued or had a loss of energy nearly every day?
- Have you had feelings of worthlessness or excessive guilt every day?
- Have you had trouble thinking or concentrating, or felt unable to make up your mind about things, nearly every day?
- Have you had thoughts of death (not just fear of dying) or of suicide?
If you have experienced the following symptoms either over a long period (such as over six months) or for a shorter duration with greater intensity, you should seriously consider seeking professional assistance for possible problems relating to anxiety. This is particularly the case if you think that the symptoms are not clearly related to HIV or some other physical condition.
- Have you felt excessive anxiety and worry, occurring more days than not, about a number of events or activities?
- Do you find it hard to control the worry?
- Do you feel at least three of the following symptoms: restlessness or feeling keyed up; being tired easily; having trouble concentrating or feeling your mind go blank; being irritable; feeling tense; having difficulty falling or staying asleep or having restless, unsatisfying sleep?