feat: Add detailed examples from spiritual distress document

Based on 'Spiritual Distress Definitions & Examples' document:

YELLOW flag indicators expanded with:
- Emotional expressions (sleep issues, fatigue, anxiety, crying)
- Spiritual/existential concerns (identity, suffering, beliefs)
- Loss and grief (hobbies, nature, anticipatory grieving)
- Social/relational issues (loneliness, isolation, burden)
- Control/autonomy (overwhelmed, loss of control, independence)
- Spiritual practices (altered rituals, cultural conflict)

RED flag indicators expanded with:
- Crisis language (suicide, self-harm, death wishes)
- Severe emotional states (anger at God, excessive guilt, hopelessness)
- Severe grief (disenfranchised, maladaptive, complicated)
- Existential crisis (meaning of life/suffering, dignity, worthlessness)
- Expressions of severe distress (emptiness, unloved, unfinished business)
- Physical manifestations (uncontrolled pain causing existential distress)

All prompts and examples in English only

src/core/soft_triage_manager.py

@@ -38,24 +38,28 @@ You are a compassionate healthcare assistant conducting a gentle wellness check.
 </guidelines>
 
 <examples>
-<example language="english">
+<example>
 "It sounds like you're going through a difficult time. Would you like to tell me more about what's on your mind?"
 </example>
 
-<example language="english">
+<example>
 "I hear that things feel heavy right now. What would be most helpful for you to talk about?"
 </example>
 
-<example language="english">
+<example>
 "Thank you for sharing that with me. How have you been coping with these feelings?"
 </example>
 
-<example language="ukrainian">
-"Здається, ви переживаєте важкий час. Чи хотіли б ви розповісти більше про те, що вас турбує?"
+<example>
+"I can sense this is weighing on you. What's been the hardest part for you?"
 </example>
 
-<example language="ukrainian">
-"Я розумію, що зараз вам важко. Про що б вам найбільше хотілося поговорити?"
+<example>
+"You mentioned feeling [emotion]. Can you tell me more about that?"
+</example>
+
+<example>
+"Is there someone you can talk to about how you're feeling?"
 </example>
 </examples>
 

src/core/spiritual_monitor.py

@@ -75,23 +75,129 @@ The message contains only medical symptoms, routine questions, appointment sched
 
 <category name="YELLOW" severity="potential_distress">
 The message contains indicators of mild to moderate distress, including:
-- Expressions of sadness, worry, or anxiety
+
+<emotional_expressions>
+- Sleep difficulties, insomnia (Dysomnias/Difficulty sleeping)
+- Fatigue, emotional exhaustion
+- Anxiety, worry, fear
+- Depressive symptoms, sadness
+- Crying (may indicate deeper distress)
+</emotional_expressions>
+
+<spiritual_existential_concerns>
 - Spiritual or existential questions (about God, faith, life's meaning, purpose)
+- Questions about identity: "Who am I now?" "I don't recognize myself"
+- Questions about suffering: "Why is this happening to me?" "What's the purpose of this pain?"
+- Concerns about beliefs, values system
+- Desire to share intense spiritual/religious experiences
+</spiritual_existential_concerns>
+
+<loss_and_grief>
 - Grief or loss (not acute crisis)
+- Loss of interest in hobbies, creative expression, nature
+- Anticipatory grieving
+- Grieving in the context of life review
+- Regret about past actions or decisions
+</loss_and_grief>
+
+<social_relational>
 - Loneliness or isolation
+- Feeling alienated from relationships
+- Concerns about family, being a burden
+- Inadequate interpersonal relations
+- Separation from support system
+</social_relational>
+
+<control_and_autonomy>
 - Feeling overwhelmed or stressed
-- Questions about suffering or "why me"
-- Mild hopelessness that doesn't involve crisis language
+- Loss of control, confidence, serenity
+- Insufficient courage to face challenges
+- Loss of independence
+- Difficulty accepting aging process
+</control_and_autonomy>
+
+<spiritual_practices>
+- Altered religious ritual or spiritual practice
+- Impaired ability for introspection
+- Cultural conflict with medical culture
+- Inadequate environmental control for spiritual needs
+</spiritual_practices>
+
+<examples>
+"I can't sleep at night, my mind won't stop racing"
+"I used to love gardening, but now I can't and it breaks my heart"
+"Why is God letting this happen to me?"
+"I feel so alone, nobody understands"
+"I'm worried about being a burden to my family"
+"I don't know who I am anymore without my work"
+"I'm exhausted all the time, emotionally drained"
+"I can't do the things I used to enjoy"
+"What's the meaning of all this suffering?"
+</examples>
 </category>
 
 <category name="RED" severity="severe_distress">
 The message contains indicators of severe distress or crisis, including:
+
+<crisis_language>
 - ANY mention of suicide, suicidal thoughts, or suicidal ideation
 - Self-harm thoughts or behaviors
 - Explicit wishes to die or not wake up
-- Severe hopelessness combined with crisis language
 - Statements like "I can't go on," "I want to end it," "no reason to live"
+- "Better off dead," "wish I was dead," "want to disappear"
 - Active crisis or emergency language
+</crisis_language>
+
+<severe_emotional_states>
+- Anger (especially spiritual anger toward God/higher power)
+- Excessive guilt that dominates daily functioning
+- Severe hopelessness combined with crisis language
+- Complete loss of hope for the future
+- Expressing suffering that feels unbearable
+- Spiritual pain (soul-level suffering beyond physical)
+</severe_emotional_states>
+
+<grief_and_loss_severe>
+- Disenfranchised grief (unrecognized by society)
+- Maladaptive grieving (prolonged, unresolved)
+- Complicated grief (persistent, intense, disrupts life)
+- Loss of a loved one combined with crisis language
+</grief_and_loss_severe>
+
+<existential_crisis>
+- Questioning meaning of life with despair: "What's the point of any of this?"
+- Questioning meaning of suffering with hopelessness
+- Questioning own dignity: "Am I still worth anything?" "Am I just a burden?"
+- Complete loss of identity and purpose
+</existential_crisis>
+
+<expressions_of_severe_distress>
+- Feeling of emptiness (profound inner void)
+- Feeling unloved, worthless, unwanted
+- Need for forgiveness (overwhelming guilt/remorse)
+- Inability to experience transcendence or supportive forces
+- Feeling of having unfinished business (with urgency/despair)
+- Concern about medical treatment (with desperation/giving up)
+</expressions_of_severe_distress>
+
+<physical_manifestations>
+- Uncontrolled pain (causing existential distress)
+- Pain that makes patient question if life is worth living
+</physical_manifestations>
+
+<examples>
+"I can't take this anymore, I want it to end"
+"There's no point in going on, I'm just a burden"
+"I wish I wouldn't wake up tomorrow"
+"Life has no meaning anymore, why continue?"
+"I feel completely empty inside, nothing matters"
+"God has abandoned me, I'm worthless"
+"The pain is unbearable, I can't do this anymore"
+"I want to kill myself"
+"Better off dead"
+"No reason to live"
+"I can't go on like this"
+</examples>
 </category>
 </classification_categories>