تصوير لمجرة قديمة

https://www.nasa.gov/image-feature/goddard/2019/hubble-sees-a-galaxy-bucking-the-trend

وثيقة مكة رمضان 1440

https://www.skynewsarabia.com/middle-east/1255720-%D8%A7%D9%94%D9%83%D8%AB%D8%B1-%D8%A7%D9%94%D9%84%D9%81-%D8%B4%D8%AE%D8%B5%D9%8A%D8%A9-%D8%A7%D9%95%D8%B3%D9%84%D8%A7%D9%85%D9%8A%D8%A9-%D8%AA%D9%82%D8%B1-%D9%88%D8%AB%D9%8A%D9%82%D8%A9-%D9%85%D9%83%D8%A9-%D9%84%D9%84%D8%AA%D8%B9%D8%A7%D9%8A%D8%B4

GIS

https://www.elwatannews.com/news/details/4179824

شوف

http://www.seesaudi.sa/english/pages/default.aspx

نزل كتيبات لاصلاح السيارات

https://www.downloadworkshopmanuals.com/index.php

عن مخرج فيلم سوسبيريا الذي ارعبني

https://read.kinoscope.org/2017/10/02/dario-argento-a-dip-into-the-inferno/

معلومات عن معرض عماد الدين للسيارات

https://www.almrsal.com/post/808854

Sent from my Huawei Mobile

Books

https://www.simonandschuster.com/ebook-signup

بث الواحة اختفاء الثريا وتغير الطقس

الثريا تختفي مؤذنة بقرب انتهاء موسم الأمطار واقتراب مربعانية القيظ

رغم انه نزلت امطار فيضانات في جيزان وجنوب غرب السعودية

http://bth-alwaha.com/36555
بث الواحة: متابعات

قال الفلكي الدكتور خالد الزعاق أن غداً ستختفي الثريا عن الأنظار لدخولها حمرة شعاع الشمس غرباً.

وبين الزعاق أن اختفاء الثريا هو علامة على قرب نهاية موسم الأمطار الطبيعي
واقتراب دخول مربعانية القيظ كما بين أن سمك الزبيدي يبدأ التكاثرفي البحر وتبدأ الضبان بالتبييض بالبر.

وستبدأ الثريا بالشروق من جهة الشرق بعد أسبوعين قبيل شروق الشمس بالجهة الشرقية وهو موسم مربعانية القيظ حسب الدكتور الزعاق.


 

للمزيد حمل تطبيق بث الواحة

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Regards,

بث الواحة مشي

البلدية تحفز مشاية الكورنيش باللوحات الإرشادية
http://bth-alwaha.com/36601

بث الواحة: متابعات

انتهت بلدية محافظة القطيف من تركيب عدة لوحات إرشادية على طول كورنيش القطيف لتحفيز مرتادي الكورنيش على المشي وومارسة الرياضة.

وتشمل اللوحات التي ركبتها البلدية أرقام المسافات المقطوعة وعدد السعرات الحرارية التي تحتاجها هذه المسافة وبجانبها لوحة توعوية عن المشيء وممارسة الرياضة. 
 

للمزيد حمل تطبيق بث الواحة

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Regards,

بث الواحة سرعة الانتىنت

32 ميجا معدل سرعة الانترنت في المملكة حسب هيئة الاتصالات
http://bth-alwaha.com/36628

بث الواحة: متابعات

أطلقت هيئة الاتصالات وتقنية المعلومات مؤشرات تقرير مقياس للربع الأول من عام 2019م وذلك عبر تقرير يرصد المستوى العام لجودة خدمة الإنترنت المقدمة في المملكة موضحةً الشركات الأكثر تحسنًا في تقديم الخدمة.

وأوضحت الهيئة أن التقرير قد أظهر ارتفاعًا في المعدل العام لأداء سرعات الإنترنت المتنقل في المملكة خلال الربع الأول من عام 2019م حيث بلغ معدل سرعة التحميل 32.2 ميجابت في الثانية (Mbps) وذلك بزيادة تقدر ب 12.2% مقارنة بالربع الرابع من العام الماضي 2018م فيما بلغ معدل سرعة الرفع 13.1 ميجابت في الثانية (Mbps).

وبحسب القياسات التي قام بها مستخدمو الإنترنت في المملكة من خلال منظومة مقياس على شبكة الجيل الرابع (4G) فإن شركة الاتصالات السعودية (STC) حققت أعلى متوسط للأداء بلغ 38.0 ميجابت في الثانية بنسبة ارتفاع 8.0% بينما حققت كلاً من شركة الاتصالات المتنقلة السعودية (زين) وشركة اتحاد اتصالات (موبايلي) أفضل نسب تحسن بلغت 19.0% و 18.5% على التوالي بمتوسط سرعات 29.4 و 30.7 ميجابت في الثانية.

وعلى صعيد جودة بث الفيديو لموقع يوتيوب YouTube؛ أظهر تقرير مقياس أن النسبة الأعلى مما يتم بثه عبر موقع يوتيوب YouTube في المملكة من خلال شبكات الإنترنت المتنقل تتم بدقة الوضوح الكاملة Full HD مع وجود تباينٌ بين الشركات المقدمة للخدمة وهو ما يسلط التقرير الضوء عليه في سبيل تعزيز التنافسية بين الشركات لرفع الجودة بما يحقق رضا المستفيدين ويعود عليهم بالمنفعة. حيث أظهر التقرير أن قياسات مستخدمي شركة اتحاد اتصالات (موبايلي) على شبكة الجيل الرابع (4G) حققت أعلى نسبة بث على موقع يوتيوب YouTube يتم بدقة الوضوح الكاملة Full HD بلغت 71% تلتها شركة الاتصالات السعودية (STC) بنسبة 68% ثم شركة الاتصالات المتنقلة السعودية (زين) بنسبة 52%.

يذكر أن الهيئة قد دشنت مبادرة مقياس لرصد جودة تجربة استخدام الإنترنت في المملكة في عام 2017م داعيةً المهتمين من مستخدمي الإنترنت في جميع مناطق المملكة للمشاركة والتفاعل في عمل القياسات مما سيكون له أعمق الأثر في تحديد أوجه التحسين الممكنة والارتقاء بجودة خدمات الإنترنت المقدمة لهم.
لمزيد من المعلومات: (www.meqyas.sa).

 


للمزيد حمل تطبيق بث الواحة

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Regards,

32

32 ميجا معدل سرعة الانترنت في المملكة حسب هيئة الاتصالات
http://bth-alwaha.com/36628

للمزيد حمل تطبيق بث الواحة

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طرامات

مهرجان وسط العوامية السنوي للدراجات النارية لعام 1440 هـ http://bth-alwaha.com/36691 للمزيد حمل تطبيق بث الواحة http://bth-alwaha.com/app

نادي السلام السعودي بالعوامية ينظم : 

مهرجان وسط العوامية السنوي للدراجات النارية لعام 1440 هـ 

المشاركين فرق القطيف للدراجات النارية : 

- فريق مشاهير القطيف 

- فريق فنيكس رايدرز 

- فريق الصقور 

- فريق فرندز شب رايدرز 

- فريق الريشة بايكرز 

- فريق القطيف بايكرز 

- فريق أسود الشمال 

الإنطلاق : تجمع (9) إنطلاق (10)

البداية كورنيش الناصرة 

النهاية وسط العوامية 

يوم الجمعة 31/5/2019 الموافق 1440/09/26 هـ

من الساعة 10:30 إلى 1:00 

لم يقولوا صبح او ليل يمكن ليل

 

الزراعة المصرية الفاسدة

الزراعة ترفع حظر استيراد البصل المصري http://bth-alwaha.com/36710 للمزيد حمل تطبيق بث الواحة http://bth-alwaha.com/app

رغم كثرة من يدرسون بكليات الزراعة في مصر الا انها في منتهى الفقر والفساد

غضب من الله

بث الواحة: متابعات

أعلنت وزارة البيئة والمياه والزراعة رفع الحظر عن استيراد البصل من جمهورية مصر العربية بعد أن طبّق الجانب المصري عدداً من الإجراءات والشروط في منظومة الفحص والمتابعة التي تكفل ضمان سلامة صادرات الخضار والفاكهة المصدرة للمملكة.

 

جسوة العيد

💫جمعية العوامية الخيرية تعلن عن استقبال تبرعات كسوة العيد http://bth-alwaha.com/36720 للمزيد حمل تطبيق بث الواحة http://bth-alwaha.com/app

http://bth-alwaha.com/img/19056mpgOP.jpg

💫جمعية العوامية الخيرية تعلن عن استقبال تبرعات كسوة العيد

🌙بادر باغتنام الأجر والثواب قبل ختام شهر العطاء

تعلن جمعية العوامية الخيرية عن استقبالها تبرعات كسوة العيد للعام 1440هـ خلال ما تبقى من أيام شهر رمضان المبارك.


ويهدف هذا المشروع إلى توفير متطلبات العيد لهم و إدخال البهجة والفرح ورسم الابتسامة لجميع أفراد الأسر المحتاجة المسجلة لدى الجمعية من الفقراء والأيتام وإدخال جمال وأجواء العيد السعيد في نفوسهم.


وقد اعتمد مجلس الإدارة مؤخرا مبلغ وقدره ( 114.000 ريال ) يستفيد منه 380 فردا من مستفيدي اللجنة الاجتماعية.

💠حيث تقوم الجمعية بإيداع تبرعاتكم النقدية في حسابات هذه الأسر نهايـة شهر رمضان المبارك لذلك فإن جمعية العوامية تدعو المحسنين أن يساهموا في هذا المشروع المبارك ودعمه تعزيزًا لمبدأ التكافل الاجتماعي في هذا الشهر الكريم.

و تستقبل الجمعية التبرعات - بما تجود به أنفسكم المعطاءة- في مكتبها الجديد الكائن شمال العوامية على الشارع العام خلال أوقات الدوام الرسمي للجمعية :


من السبت إلى الخميس من الساعة 3.00 عصرا إلى 6.00 مساءا ومن الساعة 9.00 إلى 11.30 ليلا.

كما يمكن للمحسنين إيداع تبرعاتهم المالية على أرقام حسابات الجمعية التالية:

1⃣ مجموعة سامبا:

‏SA0240000000002604002906

2⃣البنك الأهلي:

‏SA1510000007218150000206

3⃣ البنك العربي:

‏SA4930400108001267130012

4⃣بنك الرياض:

‏SA3220000003061256689901

5⃣ البنك الفرنسي:

‏SA5655000000073872400289

6⃣ البنك الأول:

‏SA9150000000016065166005

7⃣ بنك البلاد:

‏SA6715000999124716530003

🔰في حالة تحويل المبلغ يرجى إرسال صورة عملية التحويل على رقم الجوال

0509712029

مع عبارة مشروع كسوة العيد والاسم الرباعي للمودع.

 

بث الواحة و الصفار

الشيخ الصفار يطلع على برامج جمعية مضر ويناقش التطوير
http://bth-alwaha.com/36740

للمزيد حمل تطبيق بث الواحة

http://bth-alwaha.com/app

Regards,

القبلة للكعبة

http://eqibla.com/

Prayer soft

http://zarrabi.info/

Undergraduate

https://en.wikipedia.org/wiki/Undergraduate_education

Skull and Bones Society

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Skull and Bones
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Not to be confused with Phi Kappa Sigma.
For other uses, see Skull and crossbones (disambiguation).
Skull and Bones is an undergraduate senior secret student society at Yale University in New Haven, Connecticut. The oldest senior class society at the university, Skull and Bones has become a cultural institution known for its powerful alumni and various conspiracy theories. The society's alumni organization, the Russell Trust Association, owns the organization's real estate and oversees the membership. The society is known informally as "Bones", and members are known as "Bonesmen".[1]

Skull and Bones

The emblem of Skull and Bones
Formation
1832
Type
Secret society
Headquarters
Yale University
Location
New Haven, Connecticut, United States
Region served
United States
Parent organization
Russell Trust Association
History
Edit
Skull and Bones was founded in 1832 after a dispute among Yale debating societies Linonia, Brothers in Unity, and the Calliopean Society over that season's Phi Beta Kappa awards. William Huntington Russell and Alphonso Taft co-founded "the Order of the Skull and Bones".[2][3] The first senior members included Russell, Taft, and 12 other members.[4]

The society's assets are managed by its alumni organization, the Russell Trust Association, incorporated in 1856 and named after the Bones' co-founder.[2] The association was founded by Russell and Daniel Coit Gilman, a Skull and Bones member.

The first extended description of Skull and Bones, published in 1871 by Lyman Bagg in his book Four Years at Yale, noted that "the mystery now attending its existence forms the one great enigma which college gossip never tires of discussing".[5][6] Brooks Mather Kelley attributed the interest in Yale senior societies to the fact that underclassmen members of then freshman, sophomore, and junior class societies returned to campus the following years and could share information about society rituals, while graduating seniors were, with their knowledge of such, at least a step removed from campus life.[7]

Skull and Bones selects new members among students every spring as part of Yale University's "Tap Day", and has done so since 1879. Since the society's inclusion of women in the early 1990s, Skull and Bones selects fifteen men and women of the junior class to join the society. Skull and Bones "taps" those that it views as campus leaders and other notable figures for its membership.

Facilities
Edit
Tomb
Edit
The Skull and Bones Hall is otherwise known as the "Tomb".


The tomb before the addition of a second wing
The building was built in three phases: the first wing was built in 1856, the second wing in 1903, and Davis-designed Neo-Gothic towers were added to the rear garden in 1912. The front and side facades are of Portland brownstone in an Egypto-Doric style. The 1912 tower additions created a small enclosed courtyard in the rear of the building, designed by Evarts Tracy and Edgerton Swartwout of Tracy and Swartwout, New York.[8] Evarts Tracy was an 1890 Bonesman, and his paternal grandmother, Martha Sherman Evarts, and maternal grandmother, Mary Evarts, were the sisters of William Maxwell Evarts, an 1837 Bonesman.


A 2009 view of the tomb from across High Street
The architect was possibly Alexander Jackson Davis or Henry Austin. Architectural historian Patrick Pinnell includes an in-depth discussion of the dispute over the identity of the original architect in his 1999 Yale campus history. Pinnell speculates that the re-use of the Davis towers in 1911 suggests Davis's role in the original building and, conversely, Austin was responsible for the architecturally similar brownstone Egyptian Revival Grove Street Cemetery gates, built in 1845. Pinnell also discusses the Tomb's aesthetic place in relation to its neighbors, including the Yale University Art Gallery.[8] In the late 1990s, New Hampshire landscape architects Saucier and Flynn designed the wrought iron fence that surrounds a portion of the complex.[9]

Deer Island
Edit
The society owns and manages Deer Island, an island retreat on the St. Lawrence River. Alexandra Robbins, author of a book on Yale secret societies, wrote:
The forty-acre retreat is intended to give Bonesmen an opportunity to "get together and rekindle old friendships." A century ago the island sported tennis courts and its softball fields were surrounded by rhubarb plants and gooseberry bushes. Catboats waited on the lake. Stewards catered elegant meals. But although each new Skull and Bones member still visits Deer Island, the place leaves something to be desired. "Now it is just a bunch of burned-out stone buildings," a patriarch sighs. "It's basically ruins." Another Bonesman says that to call the island "rustic" would be to glorify it. "It's a dump, but it's beautiful."


Bonesmen
Edit
Main article: List of Skull and Bones members

Yearbook listing of Skull and Bones membership for 1920. The 1920 delegation included co-founders of Time magazine, Briton Hadden and Henry Luce.
Skull and Bones's membership developed a reputation in association with the "power elite".[10] Regarding the qualifications for membership, Lanny Davis wrote in the 1968 Yale yearbook:

If the society had a good year, this is what the "ideal" group will consist of: a football captain; a Chairman of the Yale Daily News; a conspicuous radical; a Whiffenpoof; a swimming captain; a notorious drunk with a 94 average; a film-maker; a political columnist; a religious group leader; a Chairman of the Lit; a foreigner; a ladies' man with two motorcycles; an ex-service man; a negro, if there are enough to go around; a guy nobody else in the group had heard of, ever ...

— Lanny Davis, quoted by Alexandra Robbins
Like other Yale senior societies, Skull and Bones membership was almost exclusively limited to white Protestant males for much of its history. While Yale itself had exclusionary policies directed at particular ethnic and religious groups, the senior societies were even more exclusionary.[11][12] While some Catholics were able to join such groups, Jews were more often not.[12] Some of these excluded groups eventually entered Skull and Bones by means of sports, through the society's practice of tapping standout athletes. Star football players tapped for Skull and Bones included the first Jewish player (Al Hessberg, class of 1938) and African-American player (Levi Jackson, class of 1950, who turned down the invitation for the Berzelius Society).[11]

Yale became coeducational in 1969, prompting some other secret societies such as St. Anthony Hall to transition to co-ed membership, yet Skull and Bones remained fully male until 1992. The Bones class of 1971's attempt to tap women for membership was opposed by Bones alumni, who dubbed them the "bad club" and quashed their attempt. "The issue", as it came to be called by Bonesmen, was debated for decades.[13] The class of 1991 tapped seven female members for membership in the next year's class, causing conflict with the alumni association.[14] The trust changed the locks on the Tomb and the Bonesmen instead met in the Manuscript Society building.[14] A mail-in vote by members decided 368–320 to permit women in the society, but a group of alumni led by William F. Buckley obtained a temporary restraining order to block the move, arguing that a formal change in bylaws was needed.[14][15] Other alumni, such as John Kerry and R. Inslee Clark, Jr., spoke out in favor of admitting women. The dispute was highlighted on an editorial page of The New York Times.[14][16] A second alumni vote, in October 1991, agreed to accept the Class of 1992, and the lawsuit was dropped.[14][17]

Judith Ann Schiff, Chief Research Archivist at the Yale University Library, has written: "The names of its members weren't kept secret‍—‌that was an innovation of the 1970s‍—‌but its meetings and practices were."[18] While resourceful researchers could assemble member data from these original sources, in 1985, an anonymous source leaked rosters to Antony C. Sutton. This membership information was kept privately for over 15 years, as Sutton feared that the photocopied pages could somehow identify the member who leaked it. He wrote a book on the group, America's Secret Establishment: An Introduction to the Order of Skull and Bones. The information was finally reformatted as an appendix in the book Fleshing out Skull and Bones, a compilation edited by Kris Millegan and published in 2003.

Among prominent alumni are former president and Chief Justice William Howard Taft (a founder's son); former presidents and father and son George H. W. Bush and George W. Bush; Chauncey Depew, president of the New York Central Railroad System, and a United States Senator from New York; Supreme Court Justices Morrison R. Waite and Potter Stewart;[19] James Jesus Angleton, "mother of the Central Intelligence Agency"; Henry Stimson, U.S. Secretary of War (1940–1945); Robert A. Lovett, U.S. Secretary of Defense (1951–1953); William B. Washburn, Governor of Massachusetts; and Henry Luce, founder and publisher of Time, Life, Fortune, and Sports Illustrated magazines.[citation needed]

John Kerry, former U.S. Secretary of State and former U.S. Senator; Stephen A. Schwarzman, founder of Blackstone Group; Austan Goolsbee,[20] Chairman of Barack Obama's Council of Economic Advisers; Harold Stanley, co-founder of Morgan Stanley; and Frederick W. Smith, founder of FedEx, are all reported to be members.

In the 2004 U.S. Presidential election, both the Democratic and Republican nominees were alumni. George W. Bush wrote in his autobiography, "[In my] senior year I joined Skull and Bones, a secret society; so secret, I can't say anything more."[21] When asked what it meant that he and Bush were both Bonesmen, former presidential candidate John Kerry said, "Not much, because it's a secret."[22][23]

Lore
Edit
The number "322" appears in Skull and Bones' insignia and is widely reported to be significant as the year of Greek orator Demosthenes' death.[17][24][4] A letter between early society members in Yale's archives[25] suggests that 322 is a reference to the year 322 BC and that members measure dates from this year instead of from the common era. In 322 BC, the Lamian War ended with the death of Demosthenes and Athenians were made to dissolve their government and establish a plutocratic system in its stead, whereby only those possessing 2,000 drachmas or more could remain citizens. Documents in the Tomb have purportedly been found dated to "Anno-Demostheni".[26] Members measure time of day according to a clock 5 minutes out of sync with normal time, the latter is called "barbarian time".

One legend is that the numbers in the society's emblem ("322") represent "founded in '32, 2nd corps", referring to a first Corps in an unknown German university.[27][28]

Members are assigned nicknames (e.g., "Long Devil", the tallest member, and "Boaz", a varsity football captain, or "Sherrife" prince of future). Many of the chosen names are drawn from literature (e.g., "Hamlet", "Uncle Remus") religion, and myth. The banker Lewis Lapham passed on his nickname, "Sancho Panza", to the political adviser Tex McCrary. Averell Harriman was "Thor", Henry Luce was "Baal", McGeorge Bundy was "Odin", and George H. W. Bush was "Magog".[24]

Crooking
Edit
See also: Geronimo § Alleged theft of Geronimo's skull
Skull and Bones has a reputation for stealing keepsakes from other Yale societies or from campus buildings; society members reportedly call the practice "crooking" and strive to outdo each other's "crooks".[29]

The society has been accused of possessing the stolen skulls of Martin Van Buren, Geronimo, and Pancho Villa.[30][31]

Conspiracy theories
Edit
The group Skull and Bones is featured in conspiracy theories, which claim that the society plays a role in a global conspiracy for world control.[32] Theorists such as Alexandra Robbins suggest that Skull and Bones is a branch of the Illuminati, having been founded by German university alumni following the order's suppression in their native land by Karl Theodor, Elector of Bavaria with the support of Frederick the Great of Prussia,[27][dubious – discuss] or that Skull and Bones itself controls the Central Intelligence Agency.[33]

References in fiction
Edit
Skull and Bones has been satirized from time to time in the Doonesbury comic strips by Garry Trudeau, Yale graduate and Scroll and Key member. There are overt references, especially in 1980 and December 1988, with reference to George H. W. Bush, and again when the society first admitted women.[34]
The Skulls (2000) and The Skulls II (2002) films are based on the conspiracy theories surrounding Skull and Bones.[35] A third film, The Skulls III (2004), is based on the first woman to be "tapped" to join the society.
In Baz Luhrmann's film version of F. Scott Fitzgerald's novel The Great Gatsby, Nick Carraway calls Tom Buchanan Boaz. Tom in turn calls Nick Shakespeare. Nick has said earlier that he met Tom at Yale. It is thereby implied that they were in Skull and Bones together. In the novel, Yale is not explicitly mentioned (rather, they were in New Haven together) and it is only stated that they were in the same senior society.[36]
In The Good Shepherd (2006) the protagonist becomes a member of Skull and Bones while studying at Yale.
In The Simpsons season 28 episode "The Caper Chase", Mr. Burns visits the Skull and Bones society to meet with Bourbon Verlander about for-profit universities. In the episode “The Canine Mutiny” (season 8) after doing a secret handshake with a dog, Mr. Burns says: “I believe this dog was in Skull and Bones”.
In Season 1, Episode 33 of the 1966 Batman TV series, "Fine Finny Fiends" there is a gathering at Wayne Manor during which one guest points out a portrait of Bruce Wayne’s great-grandfather wearing a Yale sweater. He asks if it is true that Bruce’s ancestor was tapped for Skull and Bones, to which Aunt Harriet replies that he was not tapped for it, but “he FOUNDED Skull and Bones!”
References
Edit
^ Stevens, Albert C. (1907). Cyclopedia of Fraternities: A Compilation of Existing Authentic Information and the Results of Original Investigation as to the Origin, Derivation, Founders, Development, Aims, Emblems, Character, and Personnel of More Than Six Hundred Secret Societies in the United States. E. B. Treat and Company. p. 338. ISBN 978-1169348677. OCLC 2570157.
^ a b "Change In Skull And Bones.; Famous Yale Society Doubles Size of Its House — Addition a Duplicate of Old Building" (PDF). The New York Times. September 13, 1903. Retrieved November 5, 2011.
^ Niarchos, Nicolas; Zapana, Victor (December 5, 2008). "Yale's secret social fabric". Yale Daily News. Retrieved 5 November 2017.
^ a b Richards, David (May 2015). "The Origins of the Tomb". Yale Alumni Magazine. Retrieved 5 November 2017.
^ Schiff, Judith Ann. "How the Secret Societies Got That Way". Yale Alumni Magazine (September/October 2004). Archived from the original on April 4, 2005. Retrieved November 5, 2011.
^ Bagg, Lyman Hotchkiss (1871). Four Years at Yale. New Haven, C.C. Chatfield & Co. ISBN 978-1425569372. OCLC 2007757.
^ Yale: A History, Brooks Mather Kelley, (New Haven, Connecticut: Yale University Press, Ltd.), 1974.
^ a b Yale University 1999 Princeton Architectural Press, ISBN 1-56898-167-8 Google Books
^ "Scull and Bones". Saucierflynn.com. Archived from the original on 2007-09-18.
^ Leung, Rebecca (June 13, 2004). "Skull And Bones: Secret Yale Society Includes America's Power Elite". CBS News. Retrieved 2011-03-09.
^ a b Oren, Dan A. (1985). Joining the Club: A History of Jews and Yale. New Haven: Yale University Press. pp. 87–88, 162. ISBN 0-300-03330-3.
^ a b Karabel, Jerome (2005). The Chosen: The Hidden History of Admission and Exclusion at Harvard, Yale, and Princeton. Boston: Houghton Mifflin. pp. 53–36.
^ Robbins, pp. 152–159
^ a b c d e Andrew Cedotal, Rattling those dry bones, Yale Daily News, April 18, 2006.
^ "Yale Alumni Block Women in Secret Club". New York Times. September 6, 1991. Retrieved 2009-02-28.
^ Semple, Robert B., Jr. (April 18, 1991). "High Noon on High Street". New York Times. Retrieved 2009-02-28.
^ a b Hevesi, Dennis (October 26, 1991). "Shh! Yale's Skull and Bones Admits Women". New York Times. Retrieved 2009-02-28.
^ Yalealumnimagazine.com Archived April 4, 2005, at the Wayback Machine
^ Barron, James (July 25, 1991). "Male Fortress Falls at Yale: Bonesmen to Admit Women". New York Times. Retrieved 2009-02-28.
^ Aaron Bray (October 12, 2007). "Goolsbee '91 puts economics degree to use for Obama". Yale Daily News. Archived from the original on October 3, 2012.
^ Bush, George W. (1999). A Charge to Keep. William Morrow and Co. ISBN 0-688-17441-8.
^ Oldenburg, Don (April 4, 2004). "Bush, Kerry Share Tippy-Top Secret". The Washington Post. Retrieved November 5, 2011.
^ Meet the PressGoogle Video
^ a b Robbins, Alexandra (May 2000). "George W., Knight of Eulogia". The Atlantic Monthly. Retrieved 5 November 2017.
^ "Letter from a member of Skull and Bones Society to another member". Yale Manuscripts & Archives Digital Images Database. Yale University Library. 23 Mar 1860. Retrieved 5 November 2017.
^ Stevens, Albert C. (1907). Cyclopedia of Fraternities: A Compilation of Existing Authentic Information and the Results of Original Investigation as to the Origin, Derivation, Founders, Development, Aims, Emblems, Character, and Personnel of More Than Six Hundred Secret Societies in the United States. E. B. Treat and Company. p. 340. ISBN 978-1169348677. OCLC 2570157.
^ a b Robbins, Alexandra. Secrets of the Tomb: Skull and Bones, the Ivy League, and the Hidden Paths of Power. Back Bay Books, 2003.
^ "German postcard included in a Skull and Bones photograph album originally owned by Chester Wolcott Lyman, BA 1882" [Photograph albums of the Skull and Bones Society]. Yale University Library Manuscripts and Archives. 1882.
^ Lassila;Branch (2006). "Whose skull and bones?" (PDF). Yale Alumni Magazine: 20–22.
^ Greenburg, Zach O. (January 23, 2004). "Bones may have Pancho Villa skull". The Yale Herald. Archived from the original on December 20, 2008. Retrieved November 5, 2011.
^ Citro, Joseph A. (2005). Weird New England (illustrated ed.). Sterling Publishing Company, Inc. pp. 270–71. ISBN 1-4027-3330-5.
^ Stephey, MJ (Feb 23, 2009). "A Brief History of the Skull & Bones Society". Time.
^ Dempsey, Rachel (January 18, 2007). "Real Elis inspired fictional 'shepherd'". Yale Daily News. Archived from the original on October 22, 2012. Retrieved 2012-04-05.
^ Soper, Kerry (2008). Garry Trudeau: Doonesbury and the Aesthetics of Satire. University Press of Mississippi. pp. 25, 42. ISBN 1-934110-89-2.
^ Ebert, Roger. (2013-07-10) The Skulls Movie Review & Film Summary (2000) | Roger Ebert. Rogerebert.suntimes.com. Retrieved on 2013-07-15.
^ "The Great Gatsby". Publicbookshelf.com. Archived from the original on 2014-04-07.
Further reading
Edit
Hodapp, Christopher; Alice Von Kannon (2008). Conspiracy Theories & Secret Societies For Dummies. Hoboken, NJ: Wiley. ISBN 0-470-18408-6.
Klimczuk, Stephen & Warner, Gerald. Secret Places, Hidden Sanctuaries: Uncovering Mysterious Sites, Symbols, and Societies. Sterling Publishing, 2009, New York and London. ISBN 978-1-4027-6207-9. pp. 212–232 ("University Secret Societies and Dueling Corps").
Robbins, Alexandra. Secrets of the Tomb: Skull and Bones, the Ivy League, and the Hidden Paths of Power. Back Bay Books, 2003. ISBN 0-316-73561-2.
Sutton, Antony C. America's Secret Establishment: An Introduction to the Order of Skull & Bones. Walterville, OR: Trine Day, 2003. ISBN 0-9720207-0-5.
Sutton, Antony et al., Fleshing Out Skull & Bones Investigations Into America's Most Powerful Secret Society TrineDay LLC, 2003 ISBN 0-9720207-2-1 hardcover ISBN 0-9752906-0-6 softcover
External links
Edit
Wikimedia Commons has media related to Skull and Bones.
Wikinews has related news: Apaches accuse Prescott Bush of robbing Geronimo's grave
Yale University archives of Skull and Bones
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Melancholia

Melancholia
Melancholia (from Greek: , ), also lugubriousness, from the Latin lugere, to mourn; moroseness, from the Latin morosus, self-willed, fastidious habit; wistfulness, from old English wist: intent, or saturnine, was a concept in ancient and pre-modern medicine. Melancholy was one of the four temperaments matching the four humours. In the 19th century, "melancholia" could be physical as well as mental, and melancholic conditions were classified as such by their common cause rather than by their properties.

The name "melancholia" comes from the old medical belief of the four humours: disease or ailment being caused by an imbalance in one or other of the four basic bodily liquids, or humours. Personality types were similarly determined by the dominant humor in a particular person. According to Hippocrates and subsequent tradition, melancholia was caused by an excess of black bile, hence the name, which means "black bile", from Ancient Greek μέλας (melas), "dark, black", and χολή (kholé), "bile"; a person whose constitution tended to have a preponderance of black bile had a melancholic disposition. In the complex elaboration of humorist theory, it was associated with the earth from the Four Elements, the season of autumn, the spleen as the originating organ and cold and dry as related qualities. In astrology it showed the influence of Saturn, hence the related adjective saturnine.

Melancholia was described as a distinct disease with particular mental and physical symptoms in the 5th and 4th centuries BC. Hippocrates, in his Aphorisms, characterized all "fears and despondencies, if they last a long time" as being symptomatic of melancholia. When a patient could not be cured of the disease it was thought that the melancholia was a result of demonic possession.

In his study of French and Burgundian courtly culture, Johan Huizinga noted that "at the close of the Middle Ages, a sombre melancholy weighs on people's souls." In chronicles, poems, sermons, even in legal documents, an immense sadness, a note of despair and a fashionable sense of suffering and deliquescence at the approaching end of times, suffuses court poets and chroniclers alike: Huizinga quotes instances in the ballads of Eustache Deschamps, "monotonous and gloomy variations of the same dismal theme", and in Georges Chastellain's prologue to his Burgundian chronicle, and in the late fifteenth-century poetry of Jean Meschinot. Ideas of reflection and the workings of imagination are blended in the term merencolie, embodying for contemporaries "a tendency", observes Huizinga, "to identify all serious occupation of the mind with sadness".

Painters were considered by Vasari and other writers to be especially prone to melancholy by the nature of their work, sometimes with good effects for their art in increased sensitivity and use of fantasy. Among those of his contemporaries so characterised by Vasari were Pontormo and Parmigianino, but he does not use the term of Michelangelo, who used it, perhaps not very seriously, of himself. A famous allegorical engraving by Albrecht Dürer is entitled Melencolia I. This engraving has been interpreted as portraying melancholia as the state of waiting for inspiration to strike, and not necessarily as a depressive affliction. Amongst other allegorical symbols, the picture includes a magic square and a truncated rhombohedron. The image in turn inspired a passage in The City of Dreadful Night by James Thomson (B.V.), and, a few years later, a sonnet by Edward Dowden.

The most extended treatment of melancholia comes from Robert Burton, whose The Anatomy of Melancholy (1621) treats the subject from both a literary and a medical perspective. Burton wrote in the 17th century that music and dance were critical in treating mental illness, especially melancholia.

But to leave all declamatory speeches in praise of divine music, I will confine myself to my proper subject: besides that excellent power it hath to expel many other diseases, it is a sovereign remedy against despair and melancholy, and will drive away the devil himself. Canus, a Rhodian fiddler, in Philostratus, when Apollonius was inquisitive to know what he could do with his pipe, told him, "That he would make a melancholy man merry, and him that was merry much merrier than before, a lover more enamoured, a religious man more devout." Ismenias the Theban, Chiron the centaur, is said to have cured this and many other diseases by music alone: as now they do those, saith Bodine, that are troubled with St. Vitus's Bedlam dance.

In the Encyclopédie of Diderot and d'Alembert, the causes of melancholia are stated to be similar to those that cause Mania: "grief, pains of the spirit, passions, as well as all the love and sexual appetites that go unsatisfied."

During the later 16th and early 17th centuries, a curious cultural and literary cult of melancholia arose in England. In an influential 1964 essay in Apollo, art historian Roy Strong traced the origins of this fashionable melancholy to the thought of the popular Neoplatonist and humanist Marsilio Ficino (1433–1499), who replaced the medieval notion of melancholia with something new:

Ficino transformed what had hitherto been regarded as the most calamitous of all the humours into the mark of genius. Small wonder that eventually the attitudes of melancholy soon became an indispensable adjunct to all those with artistic or intellectual pretentions.

The Anatomy of Melancholy (The Anatomy of Melancholy, What it is: With all the Kinds, Causes, Symptomes, Prognostickes, and Several Cures of it... Philosophically, Medicinally, Historically, Opened and Cut Up) by Burton, was first published in 1621 and remains a defining literary monument to the fashion. Another major English author who made extensive expression upon being of an melancholic disposition is Sir Thomas Browne in his Religio Medici (1643).

Night-Thoughts (The Complaint: or, Night-Thoughts on Life, Death, & Immortality), a long poem in blank verse by Edward Young was published in nine parts (or "nights") between 1742 and 1745, and hugely popular in several languages. It had a considerable influence on early Romantics in England, France and Germany. William Blake was commissioned to illustrate a later edition.

In the visual arts, this fashionable intellectual melancholy occurs frequently in portraiture of the era, with sitters posed in the form of "the lover, with his crossed arms and floppy hat over his eyes, and the scholar, sitting with his head resting on his hand"—descriptions drawn from the frontispiece to the 1638 edition of Burton's Anatomy, which shows just such by-then stock characters. These portraits were often set out of doors where Nature provides "the most suitable background for spiritual contemplation" or in a gloomy interior.

In music, the post-Elizabethan cult of melancholia is associated with John Dowland, whose motto was Semper Dowland, semper dolens ("Always Dowland, always mourning"). The melancholy man, known to contemporaries as a "malcontent", is epitomized by Shakespeare's Prince Hamlet, the "Melancholy Dane".

A similar phenomenon, though not under the same name, occurred during the German Sturm und Drang movement, with such works as The Sorrows of Young Werther by Goethe or in Romanticism with works such as Ode on Melancholy by John Keats or in Symbolism with works such as Isle of the Dead by Arnold Böcklin. In the 20th century, much of the counterculture of modernism was fueled by comparable alienation and a sense of purposelessness called "anomie"; earlier artistic preoccupation with death has gone under the rubric of memento mori. The medieval condition of acedia (acedie in English) and the Romantic Weltschmerz were similar concepts, most likely to affect the intellectual.

Depression (mood)
Major depressive disorder
Melancholic depression
Mono no aware
Vapours (disease)
Weltschmerz
Melancholia is a specific form of mental illness characterized by depressed mood, abnormal motor functions, and abnormal vegetative signs. It has been identified in medical writings from antiquity and was best characterized in the 19th Century. In the 20th Century, with the interest in psychoanalytic writing, "major depression" became the principal class in psychiatric classifications. [See Taylor MA, Fink M: Melancholia for details of history.]
In 1996, Gordon Parker and Dusan Hadzi-Pavlovic described Melancholia as a specific disorder of movement and mood. [Melancholia" A Disorder of Movement and Mood, Cambridge UK: Cambridge University Press, 1996]. More recently, MA Taylor and M Fink crystallized the present image of melancholia as a systemic disorder that is identifiable by depressive mood rating scales, verified by the present of abnormal cortisol metabolism (abnormal dexamethasone suppression test), and validated by rapid and effective remission with ECT or tricyclic antidepressant agents. It has many forms, including retarded depression, psychotic depression and postpartum depression.
Source - Wikipedia

Mania

Mania
Mania is a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." Although mania is often conceived as a "mirror image" to depression, the heightened mood can be either euphoric or irritable; indeed, as the mania intensifies, irritability can be more pronounced and result in violence.

The nosology of the various stages of a manic episode has changed over the decades. The word derives from the Greek μανία (mania), "madness, frenzy" and the verb μαίνομαι (mainomai), "to be mad, to rage, to be furious".

The symptoms of mania are the following: heightened mood (either euphoric or irritable); flight of ideas and pressure of speech; and increased energy, decreased need for sleep, and hyperactivity. They are most plainly evident in fully developed hypomanic states; in full-blown mania, however, they undergo progressively severe exacerbations and become more and more obscured by other signs and symptoms, such as delusions and fragmentation of behavior.

Mania is a syndrome of multiple causes. Although the vast majority of cases occur in the context of bipolar disorder, it is a key component of other psychiatric disorders (as schizoaffective disorder, bipolar type) and may also occur secondary to various general medical conditions, as multiple sclerosis; certain medications, as prednisone; or certain substances of abuse, as cocaine or anabolic steroids. In current DSM-5 nomenclature, hypomanic episodes are separated from the more severe full manic episodes, which, in turn, are characterized as either mild, moderate, or severe, with specifiers with regard to certain symptomatic features (e.g. catatonia, psychosis). Mania, however, may be divided into three stages: hypomania, or stage I; acute mania, or stage II; and delirious mania, or stage III. This "staging" of a manic episode is, in particular, very useful from a descriptive and differential diagnostic point of view.

Mania varies in intensity, from mild mania (hypomania) to delirious mania, marked by such symptoms as disorientation, florid psychosis, incoherence, and catatonia. Standardized tools such as Altman Self-Rating Mania Scale and Young Mania Rating Scale can be used to measure severity of manic episodes. Because mania and hypomania have also long been associated with creativity and artistic talent, it is not always the case that the clearly manic bipolar person needs or wants medical help; such persons often either retain sufficient self-control to function normally or are unaware that they have "gone manic" severely enough to be committed or to commit themselves. Manic persons often can be mistaken for being on drugs.

Mixed states
In a mixed affective state, the individual, though meeting the general criteria for a hypomanic (discussed below) or manic episode, experiences three or more concurrent depressive symptoms. This has caused some speculation, among clinicians, that mania and depression, rather than constituting "true" polar opposites, are, rather, two independent axes in a unipolar—bipolar spectrum.

A mixed affective state, especially with prominent manic symptoms, places the patient at a greater risk for completed suicide. Depression on its own is a risk factor but, when coupled with an increase in energy and goal-directed activity, the patient is far more likely to act with violence on suicidal impulses.

Hypomania
Hypomania is a lowered state of mania that does little to impair function or decrease quality of life. It may, in fact, increase productivity and creativity. In hypomania, there is less need for sleep and both goal-motivated behaviour and metabolism increase. Though the elevated mood and energy level typical of hypomania could be seen as a benefit, mania itself generally has many undesirable consequences including suicidal tendencies, and hypomania can, if the prominent mood is irritable rather than euphoric, be a rather unpleasant experience. By definition, hypomania cannot feature psychosis, nor can it require psychiatric hospitalisation (voluntary or involuntary).

Associated disorders
A single manic episode, in the absence of secondary causes, (i.e., substance use disorder, pharmacologic, general medical condition) is sufficient to diagnose bipolar I disorder. Hypomania may be indicative of bipolar II disorder. Manic episodes are often complicated by delusions and/or hallucinations; should the psychotic features persist for a duration significantly longer than the episode of mania (two weeks or more), a diagnosis of schizoaffective disorder is more appropriate. Certain of "obsessive-compulsive spectrum" disorders as well as impulse control disorders share the name "mania," namely, kleptomania, pyromania, and trichotillomania. Despite the unfortunate association implied by the name, however, no connection exists between mania or bipolar disorder and these disorders. B deficiency can also cause characteristics of mania and psychosis.

Hyperthyroidism can produce similar symptoms to those of mania, such as agitation, elevated mood, increased energy, hyperactivity, sleep disturbances and sometimes, especially in severe cases, psychosis.

A manic episode is defined in the American Psychiatric Association's diagnostic manual as a "distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary)," where the mood is not caused by drugs/medication or a medical illness (e.g., hyperthyroidism), and (a) is causing obvious difficulties at work or in social relationships and activities, or (b) requires admission to hospital to protect the person or others, or (c) the person is suffering psychosis.

To be classed as a manic episode, while the disturbed mood and an increase in goal directed activity or energy is present at least three (or four if only irritability is present) of the following must have been consistently present:

Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feels rested after 3 hours of sleep.)
More talkative than usual or pressure to keep talking.
Flights of ideas or subjective experience that thoughts are racing.
Increase in goal directed activity, or psychomotor acceleration.
Distractibility (too easily drawn to unimportant or irrelevant external stimuli).
Excessive involvement in activities with a high likelihood of painful consequences.(e.g., extravagant shopping, sexual adventures or improbable commercial schemes).
Though the activities one participates in while in a manic state are not always negative, those with the potential to have negative outcomes are far more likely.

If the person is concurrently depressed, they are said to be having a mixed episode.

The World Health Organization's classification system defines a manic episode as one where mood is higher than the person's situation warrants and may vary from relaxed high spirits to barely controllable exuberance, accompanied by hyperactivity, a compulsion to speak, a reduced sleep requirement, difficulty sustaining attention and often increased distractibility. Frequently, confidence and self-esteem are excessively enlarged, and grand, extravagant ideas are expressed. Behavior that is out of character and risky, foolish or inappropriate may result from a loss of normal social restraint.

Some people also have physical symptoms, such as sweating, pacing, and weight loss. In full-blown mania, often the manic person will feel as though his or her goal(s) trump all else, that there are no consequences or that negative consequences would be minimal, and that they need not exercise restraint in the pursuit of what they are after. Hypomania is different, as it may cause little or no impairment in function. The hypomanic person's connection with the external world, and its standards of interaction, remain intact, although intensity of moods is heightened. But those who suffer from prolonged unresolved hypomania do run the risk of developing full mania, and indeed may cross that "line" without even realizing they have done so.

One of the most signature symptoms of mania (and to a lesser extent, hypomania) is what many have described as racing thoughts. These are usually instances in which the manic person is excessively distracted by objectively unimportant stimuli. This experience creates an absent-mindedness where the manic individual's thoughts totally preoccupy him or her, making him or her unable to keep track of time, or be aware of anything besides the flow of thoughts. Racing thoughts also interfere with the ability to fall asleep.

Manic states are always relative to the normal state of intensity of the afflicted individual; thus, already irritable patients may find themselves losing their tempers even more quickly and an academically gifted person may, during the hypomanic stage, adopt seemingly "genius" characteristics and an ability to perform and articulate at a level far beyond that which would be capable during euthymia. A very simple indicator of a manic state would be if a heretofore clinically depressed patient suddenly becomes inordinately energetic, cheerful, aggressive, or "over happy." Other, often less obvious, elements of mania include delusions (generally of either grandeur or persecution, according to whether the predominant mood is euphoric or irritable), hypersensitivity, hyper vigilance, hypersexuality, hyper-religiosity, hyperactivity and impulsivity, a compulsion to over explain, (typically accompanied by pressure of speech) grandiose schemes and ideas, and a decreased need for sleep (for example, feeling rested after only 3 or 4 hours of sleep); in the case of the latter, the eyes of such patients may both look and feel abnormally "wide" or "open," rarely blinking, and this often contributing to some clinicians’ erroneous belief that these patients are under the influence of a stimulant drug, when the patient, in fact, is either not on any mind-altering substances or is actually on a depressant drug, in a misguided attempt to ward off any undesirable manic symptoms. Individuals may also engage in out-of-character behavior during the episode, such as questionable business transactions, wasteful expenditures of money (e.g., spending sprees), risky sexual activity, abuse of recreational substances, excessive gambling, reckless behavior (as "speed driving" or daredevil activity), abnormal social interaction (as manifest via, for example, over familiarity and conversing with strangers), or highly vocal arguments. These behaviours may increase stress in personal relationships, lead to problems at work and increase the risk of altercations with law enforcement. There is a high risk of impulsively taking part in activities potentially harmful to self and others.

Although "severely elevated mood" sounds somewhat desirable and enjoyable, the experience of mania is ultimately often quite unpleasant and sometimes disturbing, if not frightening, for the person involved and for those close to them, and it may lead to impulsive behaviour that may later be regretted. It can also often be complicated by the sufferer's lack of judgment and insight regarding periods of exacerbation of characteristic states. Manic patients are frequently grandiose, obsessive, impulsive, irritable, belligerent, and frequently deny anything is wrong with them. Because mania frequently encourages high energy and decreased perception of need or ability to sleep, within a few days of a manic cycle, sleep-deprived psychosis may appear, further complicating the ability to think clearly. Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others.

Mania may also, as earlier mentioned, be divided into three “stages.” Stage I corresponds with hypomania and may feature typical hypomanic characteristics, such as gregariousness and euphoria. In stages II and III mania, however, the patient may be extraordinarily irritable, psychotic or even delirious. These latter two stages are referred to as acute and delirious (or Bell’s), respectively.

The biological mechanism by which mania occurs is not yet known. Based on the mechanism of action of antimanic agents (such as antipsychotics, valproate, tamoxifen, lithium, carbamazepine, etc.) and abnormalities seen in patients experiencing a manic episode the following is theorised to be involved in the pathophysiology of mania:

Dopamine D2 receptor overactivity (which is a pharmacologic mechanism of antipsychotics in mania)
GSK-3 overactivity
Protein kinase C overactivity
Inositol monophosphatase overactivity
Increased arachidonic acid turnover
Increased cytokine synthesis
Imaging studies have shown that the left amygdala is more active in women who are manic and the orbitofrontal cortex is less active. Pachygyria may be associated with mania also. During manic episodes decreased activity is found in the inferior frontal cortex.

Manic episodes may be triggered by dopamine receptor agonists, and this combined with increased VMAT2 activity support the role of dopamine in mania. Decreased cerebrospinal fluid levels of the serotonin metabolite 5-HIAA have been found in manic patients too, suggesting failure of serotonergic regulation and dopaminergic hyperactivity.

One proposed model for mania suggests that hyperactive fronto-striatal reward circuits result in manic symptoms.

Triggers
Various triggers have been associated with switching from euthymic or depressed states into mania. One common trigger of mania is antidepressant therapy. Studies show that the risk of switching while on an antidepressant is between 6-69% percent. Dopaminergic drugs such as reuptake inhibitors and dopamine agonists may also increase risk of switch. Other medication possibly include glutaminergic agents and drugs that alter the HPA axis. Lifestyle triggers include irregular sleep wake schedules and sleep deprivation, as well as extremely emotional or stressful stimuli.

Before beginning treatment for mania, careful differential diagnosis must be performed to rule out secondary causes.

The acute treatment of a manic episode of bipolar disorder involves the utilization of either a mood stabilizer (valproate, lithium, or carbamazepine) or an atypical antipsychotic (olanzapine, quetiapine, risperidone, or aripiprazole). Although hypomanic episodes may respond to a mood stabilizer alone, full-blown episodes are treated with an atypical antipsychotic (often in conjunction with a mood stabilizer, as these tend to produce the most rapid improvement).

When the manic behaviours have gone, long-term treatment then focuses on prophylactic treatment to try to stabilize the patient's mood, typically through a combination of pharmacotherapy and psychotherapy. The likelihood of having a relapse is very high for those who have experienced two or more episodes of mania or depression. While medication for bipolar disorder is important to manage symptoms of mania and depression, studies show relying on medications alone is not the most effective method of treatment. Medication is most effective when used in combination with other bipolar disorder treatments, including psychotherapy, self-help coping strategies, and healthy lifestyle choices.

Lithium is the classic mood stabilizer to prevent further manic and depressive episodes. A systematic review found that long term lithium treatment substantially reduces the risk of bipolar manic relapse, by 42%. Anticonvulsants such as valproate, oxcarbazepine and carbamazepine are also used for prophylaxis. More recent drug solutions include lamotrigine, which is another anticonvulsant. Clonazepam (Klonopin) is also used. Sometimes atypical antipsychotics are used in combination with the previous mentioned medications as well, including olanzapine (Zyprexa) which helps treat hallucinations or delusions, Asenapine (Saphris, Sycrest), aripiprazole (Abilify), risperidone, ziprasidone, and clozapine which is often used for people who do not respond to lithium or anticonvulsants.

Verapamil, a calcium-channel blocker, is useful in the treatment of hypomania and in those cases where lithium and mood stabilizers are contraindicated or ineffective. Verapamil is effective for both short-term and long-term treatment.

Antidepressant monotherapy is not recommended for the treatment of depression in patients with bipolar disorders I or II, and no benefit has been demonstrated by combining antidepressants with mood stabilizers in these patients.

In Electroboy: A Memoir of Mania by Andy Behrman, he describes his experience of mania as "the most perfect prescription glasses with which to see the world...life appears in front of you like an oversized movie screen". Behrman indicates early in his memoir that he sees himself not as a person suffering from an uncontrollable disabling illness, but as a director of the movie that is his vivid and emotionally alive life. "When I'm manic, I'm so awake and alert, that my eyelashes fluttering on the pillow sound like thunder". Many people who are artistic and do art in various forms have mania. Winston Churchill had periods of manic symptoms that may have been both an asset and a liability.

Source - Wikipedia

Malingering

Malingering
Malingering is the fabricating of symptoms of mental or physical disorders for a variety of "secondary gain" motives, which may include financial compensation (often tied to fraud); avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences; or simply to attract attention or sympathy. It is not a medical diagnosis. It falls under the broader scope of . Malingering is different from somatization disorder and factitious disorder. Failure to detect actual cases of malingering imposes a substantial economic burden on the health care system, and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. According to the Texas Department of Insurance, fraud that includes malingering costs the U.S. insurance industry approximately $150 billion each year. Other non-industry sources suggest it may be as low as $5.4 billion, ironically suggesting that insurance companies are over inflating the seriousness of the problem to divert more law enforcement towards health insurance fraud.

The symptoms most commonly feigned include those associated with mild head injury, fibromyalgia, chronic fatigue syndrome, and chronic pain. Generally, malingerers complain of psychological disorders such as anxiety. Malingering may take the form of complaints of chronic whiplash pain from automobile accidents. The psychological symptoms experienced by survivors of disaster (post-traumatic stress disorder) are also faked by malingerers.

Many dishonest methods are used by individuals feigning symptoms of malingering. Some of these include harming oneself, trying to convince medical professionals one has a disease after learning about its details (such as symptoms) in medical textbooks, taking drugs that provoke certain symptoms common in some diseases, performing excess exercise to induce muscle strain or other physical types of ailments, and overdosing on drugs.

According to the DSM-V, malingering may be suspected:

When a patient is referred for examination by an attorney
When the onset of illness coincides with a large financial incentive, such as a new disability policy
When objective medical tests do not confirm the patient's complaints
When the patient does not cooperate with the diagnostic work-up or prescribed treatment
When the patient has antisocial attitudes and behaviours (antisocial personality)
A formal assessment of malingering requires the explicit confession of the patient. Even in such cases, clinical guidelines do not exist for interrogation techniques and a physician may elicit a false confession. It is advised to avoid an assessment of malingering. Legally the term may be considered prejudicial and excluded on the basis of its probative value. No current research exists regarding the frequency, behaviour or detection of successful malingerers. No neuropsychological inventories exist that can be used to conclusively determine if a patient is malingering, or to exclude a determination of malingering. Genuine neurological and psychiatric conditions may return false positives. Testing inventories cannot distinguish between exaggeration and fabrication. Psychological inventories rely on naivety. Criminally, an assessment may lead to punishment enhancement, and medically, to denial of future treatment. The DSM-V criteria faces scrutiny for providing poor guidelines. As such physicians ultimately rely on their intuition and gut feeling for any assessment, which is subject to prejudice and cognitive dissonance, and which has been shown to be unreliable in synthetic tests.

Malingering presumes an exhaustive diagnostic procedure has been performed. Exhaustive diagnostics are neither practical nor economically viable or judged to be in the best interests of the patient's health. Radiological and invasive exploratory procedures can be necessary for an accurate diagnosis yet pose a health risk to the patient. Radiographic diagnostics expose the patient to radiation and surgical diagnostic procedures can carry a high risk of complications and mortality, such as a lumbar puncture, the only reliable diagnostic procedure for diagnosing rare terminal forms of parasitization, which the CDC reports as only being diagnosed post mortem 75% of the time. A physician invariably faces limitations in the realms of resources, time and liability. Because an assessment, formal or informal, of malingering ceases the medical process, it may seem an attractive option for the physician and help them to cope with cognitive dissonance over their failure to effectively diagnose and treat a patient within constraints.

Patients with unresolved illness may be adversarial towards physicians, attempting to game the triage system in order to receive specialist care. Such cases fit the criteria for malingering, yet the patient is still in need of medical care. For example, in a gatekeeper system, primary care physicians may restrict the availability of HIV testing to only patients who report high risk activity. A patient may then falsely report sexual and/or drug history and/or symptoms in order to elevate priority which can then go on to serve as diagnostically relevant history for an inaccurate path of further diagnosis.

Medical practitioners often believe that they can detect deception. In two studies, experienced medical practitioners including psychiatrists failed to perform better than chance when asked to detect lying and simulated patients. In 12 other studies, detection rates of simulated patients ranged between 0 and 25%. It's impossible to detect malingering from a clinical perspective.

The evaluative context (medical-legal and forensic) exerts distorting impact on the tendency of subjects to amplify or not the self-reported symptoms. This distorting effect is present also when subjects are truly suffering from mental pathology.

Antiquity
In the Hebrew Bible, King David feigns insanity to Achish, king of the Philistines (I Sam. 21:10-15). This is by many supposed not to have been feigned, but a real epilepsy or falling sickness, and the Septuagint uses words which strongly indicate this sense. Odysseus was stated to have also feigned insanity in order to avoid participating in the Trojan War. Malingering has been recorded historically as early as Roman times by the physician Galen (), who reported two cases. One patient simulated colic to avoid a public meeting, while the other feigned an injured knee to avoid accompanying his master on a long journey.

Renaissance
During the Renaissance, a treatise on feigned diseases () by , was published at Milan in 1595. Various phases of malingering () are well represented in the etchings and engravings of Jacques Callot (1592–1635). In his social-climbing manual, Elizabethan George Puttenham recommends that would-be courtiers have "sickness in his sleeve, thereby to shake off other importunities of greater consequence" and suggests feigning a "dry dropsy [...] of some such other secret disease, as the common conversant can hardly discover, and the physician either not speedily heal, or not honestly bewray."

Modern period
Lady Flora Hastings was accused of adultery stemming from court gossip following abdominal pain. Because she refused to be physically examined by a man for reasons of modesty befitting a lady in her position, the physician assumed her to be pregnant. She later died of stomach cancer.

General George S. Patton, in what became known as 'the Greek Incident', found a Soldier in a field hospital but with no wounds, claiming to be suffering from battle fatigue. Upon discovering this and believing that the patient was malingering, Patton flew into a rage, physically assaulted the patient, called him a coward and did not stop until he was physically restrained. The patient was later found to have contracted malaria and to be suffering from dysentery.

Antonio Damasio described a case study in Descartes' Error of his patient, 'Elliot.' He wrote, "Several professionals had declared that his mental faculties were intact-meaning that at the very best Elliot was lazy, and at the worst a malingerer." As a result, Elliot's disability benefits were withdrawn. Neuropsychological testing "revealed a superior intellect." Neuropsychological evaluations thought at that time to be sensitive such as the Wisconsin Card Sorting Test did not reveal impairment in function associated with the frontal lobes or brain damage and functional impairment in general. Elliot had previously had surgery to remove a meningioma "the size of a small orange." Following his surgery he had floundered into a series of poor decisions which ultimately resulted in divorce and bankruptcy from a previously "enviable position."

Few cases are as famous as Harold Garfinkel's study of Agnes Torres. In the 1950s, Agnes feigned symptoms and lied about almost every aspect of her medical history. Fearing doctors at UCLA would refuse her access to her desired sexual reassignment surgery, Garfinkel concluded that she had avoided every aspect of her case which would have indicated gender dysphoria so as to avoid being treated as an "effeminate homosexual" and psychiatric patient. She lied that she had not taken hormone therapy and her examining physicians concluded that it would be impossible for someone so young to have stumbled upon a therapy and instituted it at such a young age so as to produce such brilliant feminizing effects. As such they concluded that their patient had testicular feminization syndrome, legitimizing in their professional opinion the validity of her request for sexual reassignment surgery. While not evaluating the patient, Garfinkel commented that the complexity of the deception was of such intricate construction intended towards the singular goal of the particular desired medical intervention.

Because malingering was widespread throughout the Soviet Union to escape sanctions or coercion, physicians were limited by the state in the number of medical dispensations they could issue.

With thousands forced into manual labour, doctors were presented with four types of patients:

those who needed medical care;
those who thought they needed medical care (hypochondriacs);
malingerers; and
those who made direct pleas to the physician for a medical dispensation from work.
This dependence upon doctors by poor labourers altered the doctor-patient relationship to one of mutual mistrust and deception.

Malingering is a court-martial offense in the United States Armed Forces under Article 115 of the Uniform Code of Military Justice, which provides that:

     Any person subject to this chapter who for the purpose of avoiding work, duty, or service– (1) feigns illness, physical disablement, mental lapse or derangement; or (2) intentionally inflicts self-injury;      shall be punished as a court-martial may direct.

Hypochondriasis
Factitious disorder
Ganser syndrome
Insanity defense
Münchausen syndrome and Münchausen syndrome by proxy
Falsifiability
SIMS (Structured Inventory of Malingered Symptomatology)
Source - Wikipedia

Maladaptive daydreaming

Maladaptive daydreaming
Maladaptive daydreaming or excessive daydreaming is a psychological concept first introduced by Eli Somer to describe an extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning.

While there are many specific symptoms of a maladaptive daydreamer, someone with this disorder will not necessarily have all of them.

Often maladaptive daydreams are prompted by 'triggers' (stimuli which produce an emotional response) which may include conversational topics, sensory stimuli, or physical experiences. Maladaptive daydreamers may also experience trouble completing routine tasks or going to sleep, due to their desire to continue daydreaming. Oftentimes while maladaptive daydreamers are daydreaming, they will whisper, talk, make facial expressions, or do some sort of repetitive movements, such as pacing.

Maladaptive daydreamers can spend hours simply daydreaming. They may have elaborate fantasies within their minds, often comparable to a complete novel or movie. Many have more than one fantasy in their mind, each with its own characters, setting, plots, etc. Maladaptive daydreamers may become emotionally attached to their characters as well, though they know the characters are not real.

The Maladaptive Daydreaming Scale (MDS) is a 14-item self-report instrument designed to abnormal fantasizing. It is a statistically valid and reliable measure of MD that differentiates well between MDers and non-MDers. Mental health diagnoses are only determined based on clinician-administered structured interviews. Hence, no official diagnostic tool has been developed to diagnose MD.

Differential diagnosis
Maladaptive daydreaming is mistakenly and frequently misdiagnosed as schizophrenia which is defined as a mental disorder characterized by abnormal social behavior and failure to recognize what is real. Schizophrenia is considered a psychosis, whereas maladaptive daydreaming is not considered a psychosis because the Maladaptive Daydreaming Scale (MDS) has been shown to be poorly correlated with a psychosis measure. The fundamental difference between the two is that maladaptive daydreaming patients (MDers) are aware that their daydream characters are not real and they differentiate between what is real and what is not, whereas schizophrenia patients fail to recognize what is real and what is not. MDers do not hear voices or see people that are not real, whereas schizophrenia patients might.

Maladaptive daydreaming is not an official diagnosis, but people who suffer from it tend to agree that it is an intense and prolonged form of daydreaming interfering with their work, relationships, and general activities. People who have this form of daydream have difficulties shifting attention back to their desired task when immersing themselves into a thought. Symptoms reported have indicated a difficulty in attention shifting rather than difficulties in sustaining attention, since they seem to sustain their attention well enough to be immersed in a 3-hour daydream. Attention shifting is the ability to appropriately disengage and shift attention from one object/event to another. More concrete, redirecting one’s focus of attention away from one fixation (i.e. a daydream), towards a different focus of attention (i.e. the task needed to be done). These daydreams are many times reported as involuntary, highly immersive, and repetitive, so maladaptive daydreamers can experience something similar to perseveration seen in people with the Obsessive-compulsive disorder, and the attention shifting difficulties experienced by people with ADHD. Just like people with attention shifting problems do (i.e. ADHD), people who maladaptive daydream tend to constantly and involuntarily shift their attention inward during monotonous performances. The difference is that people who suffer from ADHD don't report having so highly immersive or prolonged daydreams lasting hours at a time, it is assumed due to their general shorter attention span. Maladaptive daydreamers appear to have the ability to maintain and engage attention (sustained attention) and so their inability to focus on an important task rather than their daydream may be due to a difficulty in directing one's attention span, back to the conscious and premeditated task (Attention shifting).

Because of its private nature, it is hard to form a generally agreed upon definition of daydreaming. Probably the single most common connotation is that daydreaming represents a shift of attention away from some primary physical or mental task we have set for ourselves, or away from directly looking at or listening to something in the external environment. Normal daydreaming or conscious fantasy seems most likely to occur under conditions relatively similar to those of night dreaming. A person who is alone in a situation, in which there is very little outside stimulation, perhaps most often just prior to going to sleep, is likely to find themselves engaged in an extensive reverie or interior monologue. Daydreaming has a lot to do with the concept of "mind wandering" and there are more studies done under this concept, than under daydreaming. In studies, most subjects were unaware of their own mind wandering, suggesting that mind wandering is most pronounced when it lacks meta-awareness. The takeaway of these studies was that conflict detection and cognitive control is needed to bring attention back, so people who have a high tendency to mind wander, might most likely have difficulties with this. More research is to be done around the neurobiological aspects that cause a person to daydream this way. We all obsess over things in varying degrees, there is real value in getting stuck on daydreams and being overfocused, but some people suffer from this to such degree that it interferes with their ability to function.

But most psychologists have never heard of maladaptive daydreaming, and it is not officially recognized as a disorder. Many scoff at the idea that a normal activity like fantasizing could cause such distress. So how can people who believe their daydreaming is out of to control receive help? Is maladaptive daydreaming a syndrome in itself, or is it just one manifestation of another affliction? Where does it come from, and how can it be cured? Most of all, how can the syndrome become better known so excessive fantasizers don’t feel like I did, the only person in the world to spend as much time as possible in my imaginary world?

Despite it not being an official recognized disorder or pathology, maladaptive daydreaming has received some attention from the media.

Attention deficit hyperactivity disorder
Derealization
Dissociative disorder
Fantasy prone personality
Obsessive compulsive disorder
Sluggish cognitive tempo
Source - Wikipedia

Major depressive episode

Major depressive episode
A major depressive episode is a period characterized by the symptoms of major depressive disorder: primarily depressed mood for two weeks or more, and a loss of interest or pleasure in everyday activities, accompanied by other symptoms such as feelings of emptiness, hopelessness, anxiety, worthlessness, guilt and/or irritability, changes in appetite, problems concentrating, remembering details or making decisions, and thoughts of or attempts at suicide. Insomnia or hypersomnia, aches, pains, or digestive problems that are resistant to treatment may also be present. The description has been formalised in psychiatric diagnostic criteria such as the DSM-5 and ICD-10.

Significant emotional pain and economic costs are associated with depression. In the United States and Canada, the costs associated with major depression are comparable to those related to heart disease, diabetes, and back problems and are greater than the costs of hypertension. According to the Nordic Journal of Psychiatry, there is a direct correlation between major depressive episode and unemployment.

Treatments for a major depressive episode include exercise, psychotherapy and antidepressants, although in more serious cases, hospitalization or intensive outpatient treatment may be required. There are many theories as to how depression occurs. One interpretation is that neurotransmitters in the brain are out of balance, and this results in feelings of worthlessness and despair. Magnetic resonance imaging shows that brains of people who have depression look different than the brains of people not exhibiting signs of depression. A family history of depression increases the chance of being diagnosed.

The criteria below are based on the formal DSM-IV criteria for a major depressive episode. A diagnosis of major depressive episode requires that the patient has—over a two-week period—experienced five or more of the symptoms below, and these must be outside the patient's normal behaviour. Either depressed mood or decreased interest or pleasure must be one of the five (although both are frequently present).

Mood, anhedonia and loss of interest
A person experiencing a major depressive episode may report depressed mood or may appear depressed to others. Often, interest or pleasure in everyday activities is decreased; this is referred to as anhedonia. These feelings must be present on an everyday basis for two weeks or longer to meet DSM-IV criteria for a major depressive episode. In addition, the person may experience one or more of the following emotions: sadness, emptiness, hopelessness, guilt, indifference, anxiety, tearfulness, pessimism, or irritability. Children and adolescents in particular may feel irritable. There may be a loss of interest in or desire for sex. Friends and family of the depressed person may notice that he/she has withdrawn from friends, or has neglected or quit doing activities that were once a source of enjoyment.

Depressed people may have feelings of guilt that go beyond a normal level or are delusional. Depressed people may think of themselves in very negative, unrealistic ways, such as manifesting a preoccupation with past failures, personalisation of trivial events, or believing that minor mistakes prove their inadequacy. They also may have an unrealistic sense of personal responsibility and see things beyond their control as being their fault. Additionally, self-loathing is common in clinical depression, and can lead to a downward spiral when combined with other symptoms.

Change in eating, appetite, or weight
A person experiencing a depressive episode may have a marked loss or gain of weight (such as 5% of their body weight in one month) or a change in appetite. Changes in appetite take on two manifestations: under- or over-eating. In the first instance, some people never feel hungry, can go long periods without wanting to eat, or may forget to eat; if they do eat, a small amount of food may be sufficient. In children, failure to make expected weight gains may be counted towards this criteria. Under-eating is often associated with a melancholic type of depression. In the second instance, some people tend toward an increase in appetite and may gain significant amounts of weight. They may crave certain types of food, such as sweets or carbohydrates. People with seasonal affective disorder (SAD) often crave foods high in carbohydrates. Over-eating is often associated with a type of depression called atypical depression.

Sleep
Nearly every day, the person may sleep excessively, known as hypersomnia, or not enough, known as insomnia. Insomnia is the most common type of sleep disturbance for people who are clinically depressed and is often associated with a melancholic type of depression. Symptoms of insomnia include trouble falling asleep, trouble staying asleep, and/or waking up too early in the morning. Hypersomnia is a less common type of sleep disturbance. It may include sleeping for prolonged periods at night or increased sleeping during the daytime. The sleep may not be restful, and the person may feel sluggish despite many hours of sleep. This impacts their everyday activities and ability to focus at home or work. According to the United States National Library of Medicine, people with seasonal affective disorder (SAD) may sleep longer during the winter months. Hypersomnia is often associated with an atypical depression. Hypersomnia is not as common as insomnia and up to 40% of people exhibit hypersomnia from time to time.

Motor activity
Nearly every day, others may see that the person's activity level is not normal. People suffering from depression may be overly active (psychomotor agitation) or be very lethargic (psychomotor retardation). If a person is agitated, they may find it difficult to sit still, may pace the room, wring their hands, or fidget with clothes or objects. Someone with psychomotor retardation tends to move sluggishly, may move across a room very slowly, avert their eyes, sit slumped in a chair and speak slowly, saying little. They might say that their arms and legs feel heavy. To meet diagnostic criteria, changes in motor activity must be so abnormal that it can be observed by others. Personal reports of feeling restless or feeling slow do not count towards the diagnostic criteria.

Fatigue and concentration
Nearly every day, the person will experience extreme fatigue, tiredness, or loss of energy. A person may feel tired without having engaged in any physical activity, and day-to-day tasks become increasingly difficult. Job tasks or housework become very tiring, and the patient finds that their work begins to suffer. The person may be indecisive or have trouble thinking or concentrating. Problems with memory and distraction are common. These issues cause significant difficulty in functioning for those involved in intellectually demanding activities, such as school and work, especially in difficult fields.

Thoughts of death and suicide
The person may have repeated thoughts about death (other than the fear of dying) or suicide (with or without a plan), or may have made a suicide attempt. The frequency and intensity of thoughts about suicide can range from believing that friends and family would be better off if one were dead, to frequent thoughts about committing suicide (generally related to wishing to stop the emotional pain), to detailed plans about how the suicide would be carried out. Those who are more severely suicidal may have made specific plans and decided upon a day and location for the suicide attempt.

Healthcare providers may screen patients for depression using a screening tool, such as the Patient Healthcare Questionnaire-2 (PHQ-2).

To diagnose a major depressive episode, a trained healthcare provider must make sure that:

The symptoms do not meet the criteria for a mixed episode.
The symptoms must cause considerable distress or impair functioning at work, in social settings or in other important areas in order to qualify as an episode.
The symptoms are not due to the direct physiological effects of a substance (e.g., abuse of a drug or medication) or a general medical condition (e.g., hypothyroidism).
Other than in the case of severe symptoms (severely impaired functioning, severe preoccupation with worthlessness, ideas of suicide, delusions or hallucinations or psychomotor retardation).
Depression is a treatable illness. Treatments for a major depressive episode may be obtained in one or more of the following settings: mental health specialists (i.e. psychologist, psychiatrists, social workers, counselors, etc.), mental health centers or organizations, hospitals, outpatient clinics, social service agencies, private clinics, peer support groups, clergy, and employee assistance programs. The treatment plan could include psychotherapy alone, antidepressant medications alone, or a combination of medication and psychotherapy.

For major depressive episodes of severe intensity (multiple symptoms, minimal mood reactivity, severe functional impairment), combined psychotherapy and antidepressant medications are more effective than psychotherapy alone. Patients with severe symptoms may require outpatient treatment or hospitalization.

Psychotherapy, also known as talk therapy, counseling, or psychosocial therapy, is characterized by a patient talking about their condition and mental health issues with a trained therapist. Different types of psychotherapy can be effective for depression. These include cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy, acceptance and commitment therapy, and mindfulness techniques.

Medications used to treat depression include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), norepinephrine-dopamine reuptake inhibitors (NDRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and atypical antidepressants such as mirtazapine, which do not fit neatly into any of the other categories. Different antidepressants work better for different individuals. It is often necessary to try several before finding one that works best for a specific patient. Some people may find it necessary to combine medications, which could mean two antidepressants or an antipsychotic medication in addition to an antidepressant. If a person's close relative has responded well to a certain medication, that treatment will likely work well for him or her.

Sometimes, people stop taking antidepressant medications due to side effects, although side effects often become less severe over time. Suddenly stopping treatment or missing several doses may cause withdrawal-like symptoms. Some studies have shown that antidepressants may increase short-term suicidal thoughts or actions, especially in children, adolescents, and young adults. However, antidepressants are more likely to reduce a person's risk of suicide in the long run.

If left untreated, a typical major depressive episode may last for about six months. About 20% of these episodes can last two years or more. About half of depressive episodes end spontaneously. However, even after the major depressive episode is over, 20% to 30% of patients have residual symptoms, which can be distressing and associated with disability.

Estimates of the numbers of people suffering from major depressive episodes and Major Depressive Disorder (MDD) vary significantly. In their lifetime, 10% to 25% of women, and 5% to 12% of men will suffer a major depressive episode. Fewer people, between 5% and 9% of women and between 2% and 3% of men, will have MDD, or full-blown depression. The greatest differences in numbers of men and women diagnosed are found in the United States and Europe. The peak period of development is between the ages of 25 and 44 years. Onset of major depressive episodes or MDD often occurs to people in their mid-20s, and less often to those over 65. Prepubescent girls and boys are affected equally. The symptoms of depression are the same in both children and adolescents though there is evidence that their expression within an individual may change as he or she ages.

In a National Institute of Mental Health study, researchers found that more than 40 percent of people with post-traumatic stress disorder suffered from depression 4 months after the traumatic event they experienced.

Cultural factors can influence the symptoms displayed by a person experiencing a major depressive episode. The values of a specific culture may also influence which symptoms are more concerning to the person or and their friends and family. It is essential that a trained professional knows not to dismiss specific symptoms as merely being the "norm" of a culture.

Women who have recently given birth may be at increased risk for having a major depressive episode. This is referred to as postpartum depression and is a different health condition than the baby blues, a low mood that resolves within 10 days after delivery.

Major depressive episodes may show comorbidity (association) with other physical and mental health problems. About 20-25% of individuals with a chronic general medical condition will develop major depression. Common comorbid disorders include: eating disorders, substance-related disorders, panic disorder, and obsessive-compulsive disorder. Up to 25% of people who experience a major depressive episode have a pre-existing dysthymic disorder.

Some persons who have a fatal illness or are at the end of their life may experience depression, although this is not universal.

Depressive personality disorder
Depression (differential diagnoses)
Major depressive disorder
Mental breakdown
Source - Wikipedia