Facing the Demon: Facing the Demon

Originally published in Blog Them Out of the Stone Age on June 5, 2005

But besides the achievement of this functional and corporate aim, the rote-learning and repetitive form and the categorical, reductive quality of officer-training has an important and intended -- if subordinate -- psychological effect. Anti-militarists would call it de-personalizing and even de-humanizing. But given -- even if they would not give -- that battles are going to happen, it is powerfully beneficial. For by teaching the young officer to organize his intake of sensations, to reduce the events of combat to as few and as easily recognizable a set of elements as possible, to categorize under manageable headings the noise, blast, passage of missiles and confusion of human movement which will assail him on the battlefield, so that they can be described -- to his men, to his superiors, to himself -- as "incoming fire, "outgoing fire," "airstrike," "company-strength attack," one is helping him to avert the onset of fear or, worse, of panic and to perceive a face of battle which, if not familiar, need not, in the event, prove wholly petrifying.

-- John Keegan, The Face of Battle

Diagnostic Criteria for Major Depressive Episode

For a diagnosis of a major depressive episode, these are the signs and symptoms doctors are looking for:

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.

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.

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)

3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: in children, consider failure to make expected weight gains.

4. insomnia or hypersomnia nearly every day.

5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness of being slowed down)

6. fatigue or loss of energy nearly every day

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)

8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

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.

B. The symptoms do not meet criteria for a Mixed Episode [i.e., a Mixed Bipolar Episode in which manic and depressive features are simultaneously present].

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

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).

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.

Reference: These criteria are excerpts from Diagnostic and Statistical Manual of Mental Disorders, DSM-IV, p. 327, © 1994, American Psychiatric Association.

Adapted from HealthyPlace.com