Information from Wikipedia with some examples from Damcho Pamo’s personal experience

Panic Attack

Inward experience

  • Intense fear including fear of loss of control
  • Intense feelings of foreboding
  • Chest pain

Outward signs

  • Palpitations
  • Profuse sweating
  • Shaking

Maximum degree of symptoms occur within minutes

Usually last about 30 minutes but can vary from seconds to hours.

Panic attacks in themselves are not dangerous


Inward experience

  • Unpleasant state of inner turmoil
  • Rumination, going over and over with particular thoughts without any constructive outcome
  • Feelings of dread over anticipated events
  • Expectation of future threat

Outward signs

  • Nervous behaviour such as pacing, repetitive non-functional actions such as pulling a zip back and forth
  • Somatic complaints such as headache, indigestion
  • Poor concentration
  • Overreaction to a situation that is only subjectively seen as menacing


Inward experience

  • Feelings such as sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, angry, ashamed
  • Feeling suicidal

Outward signs

  • Restlessness
  • Loss of interest in activities that are usually pleasurable
  • Eating disorders; loss of interest in food or over eating
  • Poor concentration
  • Poor decision making
  • Relationship difficulties
  • Excessive sleeping
  • Insomnia
  • Fatigue
  • Digestive disorders
  • Aches and pains
  • Attempt or commit suicide

Agitated Depression

This is a form of depression with some of the above characteristics but in which the person is physically restless all the time unable to sit still and may engage in pacing for long periods of time and may not be able to sleep at all. They very often lose a great deal of body weight during this illness. They may also be very irritable and talkative and may also exhibit some psychotic symptoms such as deluded thinking. It is thought to a be a mixed state of depression and mania (see below) showing aspects of each state.


Full Mania

Inward experience

  • heightened mood (either euphoric or irritable)
  • Inflated self-esteem
  • Grandiose feelings and thoughts
  • Flight of ideas
  • High energy
  • Racing thoughts

Outward signs

  • Hyperactive
  • Decreased need for sleep  – feels rested after 3 hours of sleep
  • Unusually talkative
  • Pressured speech
  • Deluded  thinking
  • Easily distracted –  too easily drawn to unimportant or irrelevant external stimuli eg a door key that has no relevance to the present situation
  • Excessive involvement in activities with a high likelihood of painful consequences.(e.g., extravagant shopping, sexual adventures or improbable commercial schemes)
  • Fearlessly engaging in risky behaviour eg jumping off a 12 foot wall onto the pavement


This is a milder version of mania and is not characterised by any psychotic symptoms such as delusions.

Inward experience

  • High energy
  • Flight of creative ideas

Outward signs

  • Talkative
  • Particularly self-confident
  • May engage in risky behaviour


Inward experience

  • Grandiose ideas eg  believing there is some kind of plan around you that is being formed by important people such as The Prime Minister and Archbishop of Canterbury.
  • Paranoia eg believing a newspaper, that gives details of terrorist acts, has been specially delivered to your house as a personal threat
  • Confused attribution eg at the same time feeling a phrase such as “yoga postures are  the tools of my trade” is just a neutral expression and also feeling it is has evil connotations and associations with the devil and evilness. Not being able to decide which you feel it is.
  • Hallucinations eg asking for a Bounty Bar in the train buffet which you see clearly displayed on the counter to find they don’t sell Bounty Bars!
  • Delusional thinking

Outward signs

  • Eating very little, loss of appetite for food
  • Non-sensical speech – word salad
  • Speaking in tongues , Glossolalia, fluid vocalizing of speech-like syllables that lack any readily comprehended meaning  eg responding to a tourist who was asking for directions and finding they ran away as you were talking in tongues though you felt you were producing speech normally.
  • Irrational behaviour eg. demanding hot chocolates in a cafe without being willing to pay

Psychological trauma

Psychological trauma is a type of damage to the mind that occurs as a result of a severely distressing event. Trauma is often the result of an overwhelming amount of stress that exceeds one’s ability to cope, or integrate the emotions involved with that experience. This trauma can have effects for weeks, years, or even decades as the person struggles to cope. It can eventually lead to serious, long-term negative consequences.

Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly (called “rituals”), or have certain thoughts repeatedly. People are unable to control either the thoughts or the activities for more than a short period of time. Common activities include, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the person’s daily life is negatively affected.  Often they take up more than an hour a day. Most adults realize that the behaviors do not make sense. The condition is associated with tics, anxiety disorder and an increased risk of suicide.