Depression, varying from low mood to clinical depression • • • • • Emotional flatness/blunting – loss of ability to have any ‘feelings’ Emotional lability (mood swings) Hopelessness Social withdrawal; loss of initiation of activity or ideas; apathy; lethargy Major depression Anger, ranging from irritability to full blown rage • • • • Irritability and hostility, Poor impulse control Outbursts of physical and verbal violence against others, self and objects Unprovoked anger, sometimes manifesting as rage Cognitive disturbances, ranging from lack of concentration to confusional states • • • • Short attention span Poor concentration Poor memory Confused thought processes; disorientation. Perceptual distortions, ranging from hypersensitivity to hallucinations • • • • • Hypersensitivity to noises and smells Distortions of sensation (e.g. walls closing in) Disorientation in time and space Depersonalisation/derealisation Hallucinations affecting all five senses, visual, auditory, tactile, olfactory and gustatory (e.g. hallucinations of objects or people appearing in the cell, or hearing voices when no-one is actually speaking). Paranoia and Psychosis, ranging from obsessional thoughts to full blown psychosis • • • 16 Recurrent and persistent thoughts (ruminations) often of a violent and vengeful character (e.g. directed against prison staff ) Paranoid ideas – often persecutory Psychotic episodes or states: psychotic depression, schizophrenia. Sourcebook on solitary confinement: The health effects of solitary confinement