Kerby Trevelus decapitated one of his sisters, stabbed another to death, and injured a third. Robert Stewart slaughtered eight people in a nursing home, and wounded another three. In the days leading up to the massacre of four police officers, Lovelle Mixon told relatives that he felt depressed and angry, an uncle noticing that he was emotionally withdrawn. Michael McLendon killed five family members and five other people before shooting himself.

In the days leading up to the massacre, he told a friend that he was depressed. Tim Kretschmer murdered fifteen people before shooting himself. Between April and September of 2008, Kretschmer had five outpatient “therapy” sessions for depression. Devan Kalathat shot to death six family members, wounded his wife, and committed suicide, Jiverly Voong gunning down fourteen people at an immigrant’s enter. Melissa Huckaby allegedly raped and murdered Sandra Cantu, and upon imprisonment was placed on a suicide watch. Raymond Clark allegedly strangled Annie Lee, and tried to conceal her body. Damon T. Thomson allegedly slashed the throat of a classmate, the police stating the motive for the attack was unknown. And now Jared Lee Loughner, 22, injured and killed several including Congresswoman Gabrielle Giffords in the recent Tucson shooting.
 
In the sixteenth century Portuguese travelers observed Javanese who would go out in the street and kill as many persons as they met, before others subdued or killed them, or they committed suicide. Malaysians called these people Amuco, amok meaning murderous frenzy or rage.

Amok was traditionally attributed to loss of face, shame, humiliation, jealousy, or provocation.  That amok is an expression of manic-depressive disorder is suggested by the preliminary symptoms: before the attack, the killer is typically preoccupied, withdrawn, brooding and apathetic – in other words, depressed. Following an amok, the perpetrator is often confused, with little or no memory of the event, and if not apprehended or killed, may commit suicide.

In his “Manic Depressive Insanity and Paranoia” (1921) Emil Kraepelin, suggested that amok is an expression of enraged mania, others referring to the attack as the outcome of switching from depression into manic agitation.

Recent mugshot of a smirking Jared Lee Loughner.

Dictionary com. deftly defines amok as “a psychic disturbance characterized by depression followed by a manic urge to murder.” While the motive and targets of amok are always investigated, an amok is indiscriminate, and biologically programmed to kill as many people as possible, as in battle. Manic depressive disorder has many variations, and a complex phenomenology,

Mood cycles have been observed in many species of domestic and wild animals, the vicious attacks of chimp Travis and killer whale Tikkun having the markings of amok. The savagery of shark attacks suggests that some could be an amok, rather than food seeking behavior.

In referring to an amok as “rampage,” media are at odds with the medical literature, which for hundreds of years has used the word “amok.” After an amok, it is essential to review the charts of all prior contacts with the mental health system and the law, to determine whether the diagnoses were correct, treatments appropriate, and whether “counseling,” rather than formal psychiatric examination, was imposed by the courts.

Melissa Huckaby was apparently taking Xanax, an agent capable of inducing mania.