Overdiagnosis: Examine the Assumptions, Anticipate New Bipolar Criteria, Complementary and Alternative Treatments for Autism Spectrum Disorder. seeing oneself from anothers perspective, being in a daze), Inability to remember at least one important aspect of the traumatic event, Avoids internal reminders of the trauma(s), Avoids external reminders of the trauma(s), Abnormal psychomotor behavior (e.g. I have revisited the trial of Hamlet in a class I teach with Professor Alan Dershowitz-Justice and Morality in the Plays of Shakespeare. Or as Isaac Ray and his colleagues did, they found their diagnostic categories and nosological theories confirmed by Shakespeare. Throughout the play, Hamlets mood changes happen within a matter of seconds. The Politics of the Family. 1984;12:209-219. 5: DO YOU BELIEVE IN MAGIC? Switching Antipsychotics: Why, When, and How? Actually, Hamlet describes himself as melancholic, but whether Halford got it right or wrong, he stands as an example of the profound influence medical commentators
I am told that forensic experts reviewing the testimony from their professional perspective considered that result inexplicable. Shakespeare W. Hamlet (Folger edition). Since Gertrudes marriage, Hamlet is continuously told not to be sad and get over King Hamlets death: How is it that the clouds still hang on you? (Act I, Scene II, 65) and Good Hamlet, cast thy knighted colour off, (Act I, Scene II, 67). C-SPAN Video Library. The soliloquies reveal the kind of insight, judgment, and reality testing we do not expect from patients with serious mental disorders. FOREWORD
He does not have dissociative identity disorder. Web. FOREWORD BY PACO UNDERHILL
Lower dosages may be required in children or older adults, patients with chronic disease, and those who are underweight. As Levin (1959) puts it, The Prince of Denmark has been identified with many other personalities, none of them bearing much resemblance to any of the others.. WebBipolar disorder (bipolar disorder / two-way disorder) can be divided into two main types: Type I bipolar disorder: If the patient has in the past, for at least one period, experienced mania, whether or not it includes a previous period of depression. This is a book that deserves to achieve a wide readership. He was asked about the character of Hamlet. Assessment is subjective and therefore can be erroneous. The U.S. Preventive Services Task Force recommends screening for depressive disorders for patients 12 years and older, including all pregnant patients in the perinatal period, in outpatient settings provided that systems are in place to support accurate diagnosis, psychotherapy, and follow-up. As a matter of fact, this method of diversifying the strategies on tackling Hamlet has enriches our understanding and appreciation of his character. Bipolar disorder, previously known as manic-depressive illness, involves alternating periods of intense mania (high energy and activity) and severe depression (low energy and mood). Having sampled Burtons Anatomy of Melancholy,7 I can only say that it defies modern diagnostic understanding.
Diagnosis: Hamlet does not have alters. continuum (Mitchell, 55). The magnitude or frequency as to which one is troubled can describe much about ones personality. Please refer to the attachment to answer this question. Web896 Words 4 Pages Open Document Sara Koziol Ms. Samsa AP Literature and Composition 9 May 2016 Bipolar Disorder in Hamlet There are several reasons why one would suspect Oliviers 1948 film version of Hamlet, emphasizing the mother-son sexual attraction, earned him Academy Awards for Best Picture and Best Actor. 2005;72(4):769-797. C. The anxiety and worry are associated with at least three of the following: C. The anxiety and worry are associated with marked avoidance of situations in which negative outcomes could occur, marked time and effort preparing for situations that might have a negative outcome, marked procrastination, difficulty making decisions due to worries, or repeatedly seeking reassurance due to worries. Torrey EF. They brought in psychoanalysts to help them think through all of the characters and their dynamic interactions. Among patients using pharmacotherapy, relapse occurs in up to 25% in the first year; the risk of relapse increases to 40% among patients who are untreated and to more than 70% of patients within five years, regardless of treatment approach.12,18,39 It is recommended that pharmacotherapy be continued indefinitely.12, Comanagement with a psychiatrist can aid the primary care physician in navigating diagnostic and therapeutic challenges, including relapse, treatment resistance, comorbid psychiatric conditions, and the risk of self-harm. He posited that all of the characters who died in the final scene by poisoning-Queen Gertrude, King Claudius, Laertes, and Hamlet-had all miraculously recovered. 7: WHY DID I CHOOSE YOU? This is the moment where he begins to dissociate himself from reality because as a rational character, seeing a supernatural being causes all sense of reality, everything that has been familiar, everything that, up to this point, was correct and rational, to go. Disabled peoples experiences of targeted violence and hostility As Hamlet progresses through the play he displays each of the three classifications of symptoms: positive, negative, and cognitive. Wikimedia Foundation, n.d. tasks. https://www.aafp.org/dam/AAFP/documents/patient_care/nrn/mood-disorder-questionnaire.pdf, https://mmcp.health.maryland.gov/pap/docs/Abnormal%20Involuntary%20Movement%20Scale.pdf, Systematic review of randomized controlled clinical trials regarding treatment generalized to screening, Manic or mixed feature episode with or without psychosis and/or major depression, Hypomanic episode with major depression; no history of mania, but can have a history of hypomania, Hypomanic and depressive symptoms that do not meet bipolar II disorder criteria, no major depressive episodes, occurring over two years, with no more than two months free of symptoms, Bipolar disorder, not otherwise specified, Does not meet criteria for major depression, bipolar I disorder, bipolar II disorder, or cyclothymia (e.g., less than one week of manic symptoms, without psychosis or hospitalization), Bipolar disorder, mixed features type or major depressive disorder, mixed features type, Mixed type, also known as mixed features, is a recent specifier that includes concurrent features of hypomania or mania and depression; patients who do not meet full criteria for bipolar disorders remain categorized as having unipolar depression, Substance-induced mania (include name of substance), Examples include steroids, alcohol, cocaine, or prescription antidepressants, Used for suspicion (e.g., in emergency department), Possible, depending on type of depression, Yes, when depressed only; otherwise, bipolar I disorder, Yes, can be triggered or worsened by the use of antidepressants, Yes, recovery from depression can manifest first with return of energy before mood improvement, which can look similar and is a vulnerable time for patients, Yes, often hypomania or mania triggered in the spring or with change in light or shift work, Yes, often hypomania triggered in the spring or with change in light or shift work, Yes, if it has a component of seasonal affective disorder, Atypical behaviors/depression (particularly in men): hypersomnia, increased appetite, psychosis, pathologic guilt, labile mood, Family history of multiple instances of suicide, incarceration, drug or alcohol abuse, Having a relative with a bipolar disorder, Intolerance of an antidepressant, steroid, or other medication, especially if the medication caused agitation or mania, Irregular mood changes from low to high in context of decreased need for sleep or periods of intense goal orientation, Irritability, impulsivity, irrationality (can be part of a mixed feature presentation), Multiple relatives with any of the following: anxiety, attention-deficit/hyperactivity disorder, depression, obsessive-compulsive disorder, panic disorder, No response to three or more antidepressant trials, Prior episodes of depression, especially with early onset (e.g., 13 years or younger), seasonal variability, Racing thoughts that prevent sleep initiation (can be part of a mixed feature presentation), Reduced need for sleep for a few days without feeling tired (in a hypomanic or manic phase), Sleep disruptions (e.g., shift work, childcare, travel, time change, change in season, especially spring and fall) that trigger a manic or hypomanic event, Consider if a patient taking valproic acid (Depakote) has mental status changes suggestive of delirium, Basic metabolic panel, more detailed evaluation of renal function (in patients with a history of renal disease), Establishes baseline sodium level and renal function in patients taking anticonvulsants, antidepressants, antipsychotics, or lithium, Rules out pernicious anemia and establishes baseline measurements in patients taking anticonvulsants, Complete physical examination, including neurologic evaluation, Evaluates for systemic illness; establishes baseline measurements of body mass index, blood pressure, and waist circumference, which are monitored in maintenance treatment of bipolar disorders; routine maintenance examination includes monitoring for medication adverse effects, including extrapyramidal effects, Electrocardiography (in patients older than 40 years, in others if indicated), Establishes baseline measurements in patients taking lithium, antipsychotics, or medications that can prolong the QTc interval (e.g., nonpsychiatric medications, such as proton pump inhibitors, carbamazepine [Tegretol], and prochlorperazine), Rules out diabetes mellitus, hyperlipidemia, and Cushing disease and establishes baseline measurements in patients taking any medication that can cause weight gain or hyperglycemia, Liver function tests, prothrombin time, and partial thromboplastin time (if electroconvulsive therapy is planned), May help rule out hepatitis, establishes baseline measurements in patients taking anticonvulsants and antipsychotics, Avoids use of teratogenic medications in pregnancy, Consider if patient has amenorrhea, galactorrhea, or gynecomastia because taking antipsychotics may increase prolactin level, Rules out primary or secondary thyroid disorders, establishes baseline measurements in patients taking lithium, To rule out other explanations for a mental status change in older patients, Rules out mood and thought disorders secondary to substance use disorders, Additional tests in patient with new-onset psychosis, Rules out occult seizure disorder, intracranial mass, other causes of secondary psychosis, Magnetic resonance imaging (preferred) or computed tomography, If indicated based on clinical suspicion: urine toxicology and studies for heavy metals, urine porphyrins, hepatitis C, and syphilis, 300 mg twice daily, titrated to a therapeutic level, Quetiapine (Seroquel) and quetiapine ER (Seroquel XR), Valproic acid (Depakote) or valproate (Depacon), Akathisia, dry mouth, extrapyramidal effects, hyperglycemia, hyperprolactinemia, neuroleptic malignant syndrome, orthostatic hypotension, sexual dysfunction, somnolence, tardive dyskinesia, weight gain, Lipid profile, fasting, baseline and annually; blood glucose level at baseline and as indicated; waist circumference, body weight, and CBC in patients with prior clinically significant leukopenia; measure at baseline and then as clinically indicated, Risperidone (Risperdal) and ziprasidone (Geodon) increase the risk of extrapyramidal effects, 2 to 5 mg intramuscularly for acute episode; may repeat every hour as needed until symptoms are controlled; switch to oral form as soon as feasible, Anxiety, blood dyscrasia, depression, extrapyramidal effects, headache, hyperprolactinemia, hypotension, insomnia, neuroleptic malignant syndrome, pneumonia, psychosis, QT prolongation, restlessness, sedation, seizures, tardive dyskinesia, weight gain, CBC (in patients with prior clinically significant leukopenia) at baseline and monthly in the first three months of therapy, Increased risk of death in older patients with dementia, 0.5 to 2 mg orally or intramuscularly, up to 4 mg per day, Agitation, anterograde amnesia, blood dyscrasia, cognitive impairment, depression, extrapyramidal effects, nausea, respiratory hyponatremia, sedation, syndrome of inappropriate antidiuretic hormone, Periodic CBC and liver function testing for patients on long-term therapy, Contraindicated in patients with myasthenia gravis or acute narrow-angle glaucoma, Ataxia; fatigue; headache; hyponatremia; leukopenia; nystagmus; rash, including Stevens-Johnson syndrome and toxic epidermal necrolysis, Serum carbamazepine levels every one to two weeks initially, then every three to six months or before and after dosage changes, Slower titration mitigates adverse effects, Target dosage: 1,000 to 3,000 mg orally per day. Email: At least 8 of the following symptoms began or worsened since the trauma and lasted 3 to 31 days: Diagnosis: The event experienced by Hamlet that qualifies as traumatic is that of his fathers death, and learning who killed him. New diagnostic criteria and specifiers with attention on mixed features and anxious distress aid the physician in recognizing episode severity and prognosis. Here you can choose which regional hub you wish to view, providing you with the most relevant information we have for your specific region. Scholars debate whether Shakespeare was Catholic or Protestant. catatonia), Negative symptoms (blunted affect, avolition, asocialty). Hamlet is near twenty years of age. It was a stunning performance. And Joel Klein assured me I would testify only for the state whose lawyers would argue that Hamlet was not insane. Despite all this, I now consider my certitude about Hamlet an example of hubris. These include lithium, valproic acid (Depakote), and antipsychotics. thinking, and combines comprehensive grammar review with an introduction to paragraph writing and composition. Diagnosis: Although we have no reference as to how Hamlet is everyday, since parts of the play jump from one day to the other, we can say that he may manifest four of the symptoms namely sad mood, feelings of worthlessness or excessive guilt, difficulty concentrating or making decisions, and recurrent thoughts of death and suicide. schizophrenia. Please contact the Research Team for further information about other Commission research reports, or visit our website: Research Team Equality and Human Rights Commission Arndale House The Arndale Centre Manchester M4 3AQ If he were alive in modern times, he would have been treated for these illnesses with a combination of therapy and medications. New York: international Universities Press; 1971. My friend, Fuller Torrey,15 likes to use the term anosognosia, suggesting a neural mechanism for the cardinal symptom of serious mental disorder. Garber M. Profiling Shakespeare. The episode is not attributable to the physiologic effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition. A PubMed Clinical Query was completed using the search terms bipolar disorder and bipolar disorder treatment. Does Hamlet have Bipolar Disorder? Akenside made no precise diagnosis, but he thought Hamlet could be forgiven because he was impaired by his own misfortunes: by the death of his father, the loss of expected sovereignty, and a sense of shame resulting from the hasty and incestuous marriage of his mother.4 Akensides compassionate understanding of the Prince of Denmarks emotional devastation and his perilous personal and political situation was unrivaled by succeeding psychiatric commentators who were so intent on finding a diagnosis for Hamlet that they lifted the character out of context. The eerie appearance of the ghost on the battlements of the castle to begin the first act left no doubt that this was a supernatural phenomenon, not Hamlets hallucination. New York: Routledge; 2008. 8.