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The most common diagnosis is Major Depression, with or without
psychotic features.

Although the symptoms and presentation varies for different
individuals, lack of pleasure, sad mood, and lack of motivation top the
list. Suicidal ideation may be present with or without history of
attempts. Although there is a notion that addicts “treat themselves”
with street drugs, it is not clear whether addicts carry a diagnosis of
major depression more than the general population. Typically addicts
carry the burden of financial, legal and custody problems, more than
the average person. It may be argued that they are more disposed to
“situational depression” given how chaotic their lives may be. It is also
true that once an addict stops using stimulants, e.g. amphetamines, it
seems that they are more predisposed to weight gain, sleep problems,
poor concentration and attention. These cluster of symptoms are
commonly referred to as vegetative symptoms of depression.

It seems that major depression rarely exists in a pure form. Anxiety
and related disorders are seen up to 90% of the cases. There is a
debate whether these co-existing conditions are a cause of, a result of,
or just a related condition to depression. Common one is agoraphobia,
generalized anxiety disorder, panic attacks and post-traumatic stress
disorder.

In the last decade, there has been more emphasis on bipolar (manic-
depressive) disorder, and the fact that a patient can present with
psychosis as part of their manic-hypomanic states. Good psychiatric
skills are needed to decide what cause of psychosis is being faced
with. Bipolar disorder encompasses a wide variety of symptoms, with
life-long disabilities. Symptoms can be treated in an outpatient setting,
but more serious presentations may require hospitalizations and even
residential placements.

Mania is the extreme and dramatic presentation of this disorder.
Laymen can recognize the severity of this condition due to erratic and
dangerous actions these patients embark on. Manic patients require no
or limited sleep, are hypersexual, spend money foolishly and tend to
make long distance call at odd hours. They may disrobe, expose