Centers for the treatment of mental illness without medication. Treatment of mental illness. Supportive and preventive therapy

Treatment of mental illness in Moscow - clinic Transfiguration. More than 30 years of effective assistance to people in the most difficult situations. The treatment of mental illness in the hospital is carried out by the most experienced and competent specialists in the field of psychiatry, narcology and neurology. The clinic rightfully enjoys authority in the field of treatment of disorders of the nervous system.

Clinic Transfiguration is the first private psychiatric clinic in Russia. The history of the clinic begins in 1995. We provide services for the treatment of mental illness of varying complexity and are rightfully one of the best private psychiatric, psychotherapeutic and narcological clinics in Russia, providing paid medical services on an anonymous basis.

Call +7495 6320065 Around the clock, without holidays and weekends.

We will help even in the most difficult case!

The specialists of the clinic provide qualified and effective assistance even in the most difficult cases. The doctors of the clinic are engaged in the diagnosis and treatment of mental illnesses on an anonymous basis:

Treatment of mental illness in the clinic

1. Complete examination. Treatment in a hospital involves taking tests and undergoing diagnostics from specialists such as a psychiatrist, psychotherapist, clinical psychologist and neuropsychologist.

2. Round-the-clock supervision of specialists. Treatment is carried out under the full supervision of a doctor and nurses who regularly examine the patient and provide the necessary assistance.

3. Providing everything you need. Complete nutrition, modern medicines, diagnostic and medical equipment, a developed system of patient rehabilitation.

4. Comfortable single or double room. Each room has a bed with an orthopedic mattress, a refrigerator and a TV, a separate bathroom and a shower. For the convenience of patients, the wards are equipped with a call button for medical staff and a ventilation system.

Principles of treatment of mental illness in the clinic

At initial appointment of the patient entering the hospital, the main provisional diagnosis, the presence of concomitant diseases is clarified. Based on these data, a plan of examination and treatment is drawn up. The observation mode is specified (a special observation mode is established in patients with acute psychosis, patients with suicidal risk, somatically disadvantaged patients, patients with eating disorders).

The clinic uses 3 methods of treatment - biological therapy, psychotherapy, physiotherapy.

When prescribing the main drug therapy, preference is given to monotherapy (one antipsychotic, one antidepressant)

In addition to the main drug therapy(treatment with antipsychotics, antidepressants, mood stabilizers), most patients are prescribed complex neurometabolic therapy (vitamin, antioxidant, amino acid drugs), the purpose of which is to minimize side effects and increase the effectiveness of the main therapy.

Conducted daily checks physical condition patients, timely correction of side effects.

The intake of drugs by patients is monitored. In psychotic patients who tend to avoid taking drugs, preference is given to parenteral route administration of drugs (injections).

Treatment can be both outpatient and inpatient. This is determined depending on the condition of the patient, the possible consequences of the disease both for the patient himself and for those around him, and in some cases - the desire of the patient. With severe mental disorders, treatment is usually started in a hospital, and then, after the acuteness of the condition has passed, it is continued on an outpatient basis. The task of outpatient treatment in such cases is to stabilize the condition or further improve it and deepen remission. However, on an outpatient basis, not only maintenance therapy is possible, but also stopping or correcting a self-inflicted condition. Such a stopping treatment is prescribed for patients with erased mental episodes, reactive states that do not require hospitalization. Corrective therapy (psycho-correction) is carried out for mental disorders of the boundary circle (neurosis, psychopathy, neurotic reactions).

Biological therapy refers to methods of therapeutic action on the biological processes underlying mental disorders. It includes the use of psychotropic drugs (psychopharmacotherapy), shock methods of treatment (insulino-comatose and electroconvulsive therapy), as well as other means - hormones, vitamins, diet.

Psychopharmacotherapy. For a long time, various drugs have been used that affect the human psyche. The arsenal of such remedies was limited to some herbal preparations (opium, valerian, caffeine, ginseng) and minerals (bromine salts). Psychopharmacotherapy began to develop rapidly only from the beginning of the fifties, when chlorpromazine was discovered. Literally a new era began in the treatment and maintenance of the mentally ill. One after another, new groups of drugs were opened: tranquilizers, antidepressants, nootropics. Currently, the search for new, more effective drugs with minimal side effects and complications continues.

There are several groups of psychotropic drugs.

Antipsychotics (haloperidol, triftazin, stelazin, tizercin, chlorpromazine, etc.) - eliminate painful perception disorders (hallucinations), thinking (delusions), fear, agitation, aggressiveness.

It is the main remedy in the treatment of psychoses. Apply both inside and in injections. For outpatient maintenance therapy, drugs of prolonged (long-term) action are used. For example, Moditen-Depot is administered intramuscularly once every 3-4 weeks, Semap is given orally 1-2 times a week. When using antipsychotics, especially large doses, side effects and complications may occur. Of the side effects, the most commonly observed are: hand tremor, stiffness of movements, masking of the face, convulsive contraction of individual muscles (often chewing, swallowing muscles, muscles of the tongue, lips, eyes), restlessness (feeling of "restlessness" in the legs with the need to constantly move, "not finds a place." Even mild manifestations of these disorders require the appointment of special correctors (cyclodol, parkopan), the doses of which are selected individually. Antipsychotics such as eglonil, leponex do not cause the side effects described above and there is no need to prescribe correctors. Antipsychotics are very widely used in psychiatry: for the treatment of any psychotic conditions, including schizophrenia, involutional, alcoholic, reactive psychoses.

Tranquilizers (seduxen, elenium, phenazenem, tazepam, etc.) - have a calming effect, eliminate emotional tension, anxiety, excessive excitement, cause muscle relaxation, and promote falling asleep. Taking off emotional stress and anxiety, tranquilizers help normalize vegetative-vascular manifestations, in particular, reduce blood pressure, decrease in heart rate, removal of various "spasms" and associated respiratory and gastrointestinal disorders. Each tranquilizer has its own preferred spectrum of action. Some drugs have a more pronounced sedative effect, others have a relaxing effect along with a sedative, and others have a sleeping pill (hypnotic). This fact must be taken into account when prescribing treatment. If the patient suffers from insomnia, drugs such as radedorm, eunoctin, rohypnol are recommended, which help to fall asleep and deepen night sleep. In cases where it is necessary to obtain a calming effect without muscle relaxation and hypnotic action (for example, to relieve increased excitement during an exam, during an important meeting, a report), the so-called daytime tranquilizers (rudotel, stratium, grandaxin, uxepam) are used, which even have some stimulating action. Due to the wide spectrum of psychotropic activity, tranquilizers are used not only in psychiatric practice, in particular in the treatment of neurosis, neurotic reactions, pathocharacterological disorders, but also in many somatic diseases.

Antidepressants (amitriptyline, melipramine, gerfonal, azafen, ludiomil, pyrazidol, etc.) - increase painfully low mood, eliminate lethargy mental activity and motor activity. There are two groups of antidepressants - with stimulating and sedative (calming) action. The drugs of the first group (melipramine, nuredal) are prescribed in cases where, along with a depressed mood, there is a pronounced motor and speech retardation. Antidepressants of the second group (amitriptyline, triptizol) are used for severe anxiety and anxiety. During treatment with antidepressants, side effects may occur, such as dry mouth, constipation, palpitations, urinary retention or, conversely, salivation, diarrhea, slowing of the pulse, lowering blood pressure. However, these side effects are not life-threatening and can be managed with the help of a doctor.

Antidepressants are used in the treatment of depression of various origins: the depressive phase of manic-depressive psychosis, neurotic depression, depressive states in somatic diseases. Antidepressants, like other psychotropic drugs, are prescribed only by a doctor. It is not recommended to use these drugs on their own in order to avoid side effects and unpleasant complications.

Psychostimulants (sydnocarb, caffeine, cefedrin) - increase mental (thinking) and motor activity, relieve fatigue, lethargy, lethargy. The use of ah is limited to a certain range of disorders: severe asthenic conditions, apathy. Stimulants are prescribed by a psychiatrist. Possibly habituation.

Nootropics or metabolic drugs. This group consists of drugs different in chemical structure and mechanism of action (nootropil, piracetam, pyriditol, encephabol, gammalon, phenibut), united by the commonality of their effect. Nootropics increase mental performance, general tone, improve attention, memory, increase the protective properties of the body. The range of their application is very wide. Nootropics are used for many mental disorders, to relieve hangovers and intoxication syndrome in alcoholics, with atherosclerosis of cerebral vessels, with cerebrovascular accidents, with craniocerebral injuries, etc. Preparations of this group practically do not cause side effects. Rarely, mostly in patients old age, excitability, sexual desire increases, sleep is disturbed. It is recommended to use nootropics in the morning, given their activating effect.

Mood stabilizers (lithium salts) - eliminate painful mood swings, normalize excessively elevated mood. Used mainly for the prevention of depressive and manic attacks in patients with manic-depressive psychosis (cyclothymia), periodic schizophrenia. Treatment with lithium salts is carried out under the control of its content in the blood serum, for which patients periodically take blood for analysis. Side effects and complications usually appear with an overdose of the drug or in the presence of severe somatic diseases (diseases of the kidneys, heart and blood vessels, thyrotoxicosis, metabolic disorders). The most common are small hand tremors, muscle weakness, fatigue, nausea, which are easily eliminated by reducing the dosage of the drug.

Insulin shock therapy. This method is based on a non-specific stress effect on the body, which increases its defensive forces. In other words, as a result of shock therapy, adaptive capabilities increase so much that the body itself fights the disease. Treatment consists of daily administration of increasing doses of insulin until symptoms of hypoglycemia first appear (low blood sugar), and then - a coma (complete loss of consciousness). From the coma is removed by intravenous administration of glucose, as well as the intake of sugar syrup inside. The course of treatment is usually 20-30 com. Before treatment, the patient is carefully examined. Insulin-comatose therapy is carried out only for young, physically healthy individuals. Indications for the use of this method are currently limited. It is used to treat some forms of schizophrenia.

Electroconvulsive therapy (ECT). The method is to artificially call seizures by applying an alternating electric current. The mechanism of action of electroconvulsive treatment is still not well understood. The effect of this method is associated with the impact electric current on the subcortical brain centers, as well as on metabolic processes in the central nervous system.

ECT is used for endogenous (psychotic) depression within the framework of manic-depressive psychosis, schizophrenia. The course of treatment is 4-10 shocks. Abroad, this method is used quite often due to the rather quick effect and lower price compared to medical method treatment. Domestic psychiatrists use ECT quite rarely, only in cases of depression resistant to psychotropic drugs.

All methods of biological therapy are carried out in agreement with the patient or his relatives, if the patient is in acute psychosis and does not give an account of his actions.

Psychotherapy is a complex psychological impact of a doctor on the patient's psyche. The main tool of the doctor is the word. Psychotherapy in a broad sense covers the entire field of communication between the doctor and the patient. A doctor of any profile, communicating with the patient, has a psychological impact on him. Moreover, the ability to talk with the patient, in order to penetrate into his soul and gain confidence, is necessary for a psychiatrist.

The goal of psychotherapy is to eliminate painful symptoms, a change in attitude towards oneself, one's condition and the environment. The basis of all psychotherapeutic influences is suggestion and clarification, offered in various proportions and sequences.

Rational (explanatory) psychotherapy is a method of influencing the patient through a logically reasoned explanation. It is usually carried out in the form of a dialogue between the doctor and the patient. The purpose of such an interview is to explain the causes and nature of the disease, its possible outcomes, the need and expediency of the prescribed treatment, and to correct the patient's misconceptions about his illness. The doctor must have clarity and clarity of thinking, in order to inspire the patient with hope for recovery, inspire him, help overcome the false understanding of the disease and its consequences, using a scientific, logically constructed argument, in an accessible language. Before convincing the patient of something, the doctor must patiently and carefully listen to him, because this has great value to establish emotional contact between doctor and patient.

Suggestive therapy - the suggestion of various thoughts, including dislike and disgust (for example, to alcohol). The suggestion is accepted by the patient without logical processing and critical reflection. At the moment of suggestion, the patient perceives information passively, without reflection. The influence is mainly on emotional sphere. Suggestion is carried out both in the state of wakefulness and in the state of hypnotic sleep.

Suggestion in the waking state is carried out either individually or collectively. To carry out the suggestion, appropriate conditions are necessary: ​​a darkened room isolated from noise, comfortable chairs (so that the patient relaxes). Great importance has facial expressions, movements, speech of the doctor, his appearance.

Self-hypnosis is the suggestion to oneself of ideas, thoughts, feelings recommended by a doctor and aimed at eliminating painful phenomena and improving overall well-being. Self-hypnosis is realized through autogenic training, which the patient learns with the help of a psychotherapist.

Hypnosis is a therapeutic suggestion carried out in a state of hypnotic sleep. Before starting treatment, the essence of the method is explained to the patient so that he is not afraid, does not strain during the session. Each session consists of three stages: sleep, suggestion itself, exit from hypnosis. The number of sessions per course of treatment is 10-15. You can conduct hypnosis sessions with a group of patients. To do this, select patients with the same pathology and problems.

Collective and group psychotherapy - mutual therapeutic effect patients under the direction of a physician. In other words, this type of treatment involves not only the influence of the doctor on the patients, but also the members of the group on each other. It is very important that the group has an atmosphere of mutual understanding and trust, frankness, and interest in achieving a common goal.

Family psychotherapy is a therapeutic effect aimed at regulating interpersonal relationships in the patient's family. It is used for the prevention and treatment of neurosis, rehabilitation of the mentally ill after discharge from the hospital in order to create a favorable microclimate in the family.

Behavioral psychotherapy is a complex of psychotherapeutic techniques aimed at breaking pathological conditioned reflex connections and developing desirable forms of behavior. For example, this method is successfully used in the treatment of various fears (fear of the dark, water, subway). The patient, under the guidance of a doctor, through training, teaches himself to overcome the fear that arises in a traumatic situation.

Psychosis- a mental illness in which a person cannot adequately perceive the surrounding reality and respond to it appropriately. Psychoses are very diverse in their manifestations. They accompany many diseases such as schizophrenia, senile dementia, "delirious tremens" or may be an independent pathology.

So what is psychosis?

This is a mental disorder in which reality is so distorted in the mind of a person that this “picture” no longer has anything to do with what other people see. Being objective prevents a person from constant fear for his life, voices in his head that order him to do something, visions that are not available to anyone else ... These internal prisms change the patient's behavior. His reactions become completely inadequate: causeless laughter or tears, anxiety or euphoria. All patients with psychosis manifest differently. Some are sure that special services are hunting for them, others assure others of their superpowers, and still others persistently pursue the object of their love, groundlessly laying claim to it. It is impossible to list all the manifestations of psychosis, but psychiatrists managed to systematize them by combining them into groups.

Psychosis is not just a wrong train of thought. One should not think that the sick person is deluded or cannot keep his nerves under control. Do not argue and even more so condemn him. Psychosis is the same disease as diabetes mellitus. This is also a violation of metabolic processes, but only in the brain. You are not afraid of diabetics, you do not condemn them for their disease. You sympathize with them. Patients with neurosis deserve the same attitude. By the way, scientists have proven that mentally healthy people commit crimes more often than those with psychosis.

Don't label a person. Psychosis is not life sentence. It happens that after a period of illness, which can be quite difficult, the psyche is completely restored and problems never arise again. But more often the disease has a cyclical nature. In this case, after a long period of health, an exacerbation occurs: hallucinations and delusions appear. This happens if you do not strictly follow the recommendations of the attending physician. In severe cases, the disease becomes chronic, and mental health does not return.

Psychosis is a fairly common problem. According to statistics, 15% of patients in mental hospitals are patients with psychosis. And 3-5% of the total population suffers from psychosis caused by various diseases: asthma, cerebral atherosclerosis, etc. But there are still thousands of people whose psychosis is associated with external causes - drugs, alcohol, medicines. To date, doctors cannot calculate the exact number of patients with psychosis.

Psychosis affects both children and adults, both men and women. But some forms of the disease predominantly affect women. So, women suffer from manic-depressive syndrome 3-4 times more often. Psychoses are more likely to occur during menstruation, menopause, and after childbirth. This suggests that mental illness is associated with fluctuations in hormone levels in the female body.

If you or someone close to you has signs of psychosis, do not despair. Modern medicine successfully copes with this disease. And the notorious "accounting" was replaced by the consultation of the local psychiatrist - consultative and medical assistance. Therefore, the fact of treatment will not spoil your future life in any way. But attempts to cope with the disease on their own can lead to irreparable changes in the psyche and to disability.

Causes of psychosis

If the mitochondria are not producing ATP, then the pump is not working. As a result, cell activity is disrupted. This neuron remains “hungry” and experiences an oxygen deficiency, despite the fact that a person eats normally and gets enough fresh air.

Neurons in which the chemical balance is disturbed cannot form and transmit nerve impulses. They disrupt the entire central nervous system, leading to the development of psychosis. Depending on which parts of the brain are more affected, the manifestations of the disease depend. For example, lesions in the subcortical emotional centers lead to manic-depressive psychosis.

Factors and pathologies that lead to psychosis

1. Bad heredity.

   There is a group of genes that are passed from parents to children. These genes control the sensitivity of the brain to external influences and signal substances. For example, the neurotransmitter dopamine, which causes a feeling of pleasure. People with burdened heredity are more susceptible to the influence of negative factors, whether it be illness or psychological trauma. Psychosis develops in early age, quickly and severely.

   If both parents are sick, there is a 50% chance that the child will have psychosis. If only one of the parents is sick, then the risk for the child is 25%. If the parents did not suffer from psychosis, then their children may also face such a problem, having received " defective genes from past generations.

2. Brain Injuries:
   • injuries received by the child during childbirth;
   • bruises and concussions of the brain;
   • closed and open craniocerebral injuries.
   A mental disorder may occur hours or weeks after the injury. There is a pattern, the more severe the injury, the stronger manifestation psychosis. Traumatic psychosis is associated with increased intracranial pressure and has a cyclical nature - periods of manifestation of psychosis are replaced by periods of mental health. When the pressure rises, the symptoms of psychosis worsen. When the outflow of cerebrospinal fluid improves, then relief comes.
3. brain poisoning can be caused by various substances.
4. Diseases of the nervous system: multiple sclerosis, epilepsy, stroke, Alzheimer's disease, Parkinson's disease, temporal lobe epilepsy These diseases of the brain cause damage to the bodies of nerve cells or their processes. The death of the cells of the cortex and deeper structures of the brain causes swelling of the surrounding tissue. As a result, the functions for which the damaged areas of the brain are responsible are disrupted.
5. Infectious diseases: influenza, mumps (mumps), malaria, leprosy, Lyme disease. Living and dead microorganisms secrete toxins that poison nerve cells and cause their death. Intoxication of the brain negatively affects the emotions and thinking of a person.
6. brain tumors. Cysts, benign and malignant tumors compress the surrounding brain tissue, disrupt blood circulation, the transfer of excitation from one brain structure to another. Nerve impulses are the basis of emotions and thinking. Therefore, a violation of the passage of the signal manifests itself in the form of psychosis.
7. Bronchial asthma. Severe asthma attacks are accompanied by panic attacks and oxygen starvation of the brain. Lack of oxygen for 4-5 minutes causes the death of nerve cells, and stress disrupts the smooth functioning of the brain, leading to psychosis.
8. Diseases accompanied by severe pain Key words: ulcerative colitis, sarcoidosis, myocardial infarction. Pain is stress and anxiety. Therefore, physical suffering always has a negative impact on emotions and the psyche.
9. systemic diseases, associated with impaired immunity: systemic lupus erythematosus, rheumatism. Nervous tissue suffers from toxins released by microorganisms, from damage cerebral vessels from an allergic reaction that occurs when systemic diseases. These violations lead to the failure of the higher nervous activity and psychosis.
10. Lack of vitamins B1 and B3 that affect the functioning of the nervous system. They are involved in the production of neurotransmitters, ATP molecules, normalizes metabolism at the cellular level, positively affect the emotional background and mental abilities of a person. Vitamin deficiency makes the nervous system more sensitive to external factors that cause psychosis.
11. Violation electrolyte balance associated with deficiency or excess of potassium, calcium, sodium, magnesium. Such changes can be caused by persistent vomiting or diarrhea, when electrolytes are washed out of the body, prolonged diets, uncontrolled use mineral additives. As a result, the composition of the cytoplasm in nerve cells changes, which negatively affects their functions.
12. Hormonal disorders, caused by abortion, childbirth, ovarian dysfunction, thyroid gland, pituitary, hypothalamus, adrenal glands. Prolonged hormonal imbalance disrupts the brain. Between nervous system and glands internal secretion there is a direct relationship. Therefore, strong fluctuations in hormone levels can cause acute psychosis.
13. Mental trauma: severe stress, situations in which life was endangered, loss of a job, property or loved one, and other events that radically change future life. Nervous exhaustion, overwork and lack of sleep also provoke mental disorders. These factors disrupt blood circulation, the transmission of nerve impulses between neurons, metabolic processes in the brain and lead to the appearance of psychosis.

Risk factors for psychosis

Various psychoses manifest themselves in different period human life. For example, in adolescence, when a hormonal explosion occurs, the likelihood of schizophrenia is high.

Manic-depressive psychosis most often affects young active people. At this age, fateful changes occur, which are a heavy burden on the psyche. This is admission to a university, job search, creation of a family.

In the period of maturity, syphilitic psychoses occur. Since changes in the psyche begin 10-15 years after infection with syphilis.

In old age, the onset of psychosis is associated with menopause in women, age-related changes in blood vessels and nerve cells. Circulatory failure and destruction nervous tissue leads to senile psychosis.

gender factor

The number of men and women suffering from psychosis is about the same. But some types of psychosis can affect more members of the same sex. For example, manic-depressive (bipolar) psychosis in women develops 3 times more often than in men. And monopolar psychosis (attacks of depression without a period of excitement) has the same tendency: there are 2 times more female representatives among patients. Such statistics are explained by the fact that the female body often experiences hormonal surges that affect the functioning of the nervous system.

Men are more likely to develop psychosis chronic alcoholism, syphilitic and traumatic psychosis. These "male" forms of psychosis are not related to hormone levels, but to social role, behavioral characteristics of the representatives of the stronger sex. But early cases of psychosis in Alzheimer's disease in men are associated with genetic characteristics.

Geographic factor

It has been noticed that mental illnesses, including psychosis, more often affect residents of large cities. And those who live in small settlements and in countryside risk less. The fact is that life in megacities has a high pace and is full of stress.

Illumination, average temperature and daylight hours have little effect on the prevalence of diseases. However, some scientists note that people born in the northern hemisphere during the winter months are more prone to developing psychosis. The mechanism of development of the disease in this case has not been elucidated.

social factor

Psychosis often appears in people who have failed to realize themselves socially:

• women who did not marry did not give birth to a child;
• men who could not build a career, succeed in society;
• people who are not satisfied with their social status, have not been able to show their inclinations and abilities, have chosen a profession that does not correspond to their interests.

Psychophysiological constitution factor

Hippocrates described 4 types of temperament. He divided all people into melancholic, choleric, phlegmatic and sanguine. The first two types of temperament are considered unstable and therefore more prone to the development of psychosis.

Kretschmer singled out the main types of psychophysiological constitution: schizoid, cycloid, epileptoid and hysteroid. Each of these types is equally at risk of developing psychosis, but depending on the psychophysiological constitution, the manifestations will differ. For example, the cycloid type is prone to manic-depressive psychosis, and the hysteroid type is more likely to get hysteroid psychosis than others, and has a high tendency to attempt suicide.

How does psychosis manifest?

The main manifestations of psychosis

hallucinations. They can be auditory, visual, tactile, gustatory, olfactory. The most common are auditory hallucinations. The person seems to hear voices. They can be in the head, come from the body, or come from outside. The voices are so real that the patient does not even doubt their authenticity. He perceives this phenomenon as a miracle or a gift from above. Voices are threatening, accusing or commanding. The latter are considered the most dangerous, since a person almost always follows these orders.

You can guess that a person has hallucinations by the following signs:

• He suddenly freezes and listens to something;
• Sudden silence in the middle of a phrase;
• Conversation with oneself in the form of replicas to someone's phrases;
• Laughter or depression for no apparent reason;
• The person cannot concentrate on a conversation with you, stares at something.

1. Manifestations of depressive disorders:
   • A person sits in one position for a long time, he has no desire and strength to move or communicate.
   • Pessimistic attitude, the patient is dissatisfied with his past, present, future and the whole environment.
   • To alleviate anxiety, a person can constantly eat or vice versa, completely refuse food.
   • Sleep disturbances, early awakenings at 3-4 o'clock. It is at this time that mental suffering is most severe, which can lead to a suicide attempt.
2. Manic symptoms:
   • A person becomes extremely active, moves a lot, sometimes aimlessly.
   • Unprecedented sociability, verbosity appears, speech becomes fast, emotional, and may be accompanied by grimacing.
   • Optimistic attitude, a person does not see problems and obstacles.
   • The patient builds unrealizable plans, significantly overestimates his strength.
   • The need for sleep decreases, the person sleeps little, but feels vigorous and rested.
   • The patient may abuse alcohol, engage in promiscuity.

Delusion is a mental disorder that manifests itself in the form of an idea that does not correspond to reality. Distinctive feature delirium - you fail to convince a person with the help of logical arguments. In addition, the patient always tells his crazy ideas very emotionally and is firmly convinced that he is right.

Distinctive signs and manifestations of delirium

• Brad is very different from reality. Incomprehensible cryptic statements appear in the patient's speech. They may relate to his guilt, doom, or vice versa greatness.
• The patient's personality always takes center stage. For example, a person not only believes in aliens, but also claims that they flew in specifically to establish contact with him.
• Emotionality. A person very emotionally talks about his ideas, does not accept objections. He does not tolerate disputes about his idea, immediately becomes aggressive.
• Behavior obeys a delusional idea. For example, he may refuse to eat, fearing that they want to poison him.
• Unreasonable defensive actions. A person curtains windows, installs additional locks, fears for his life. These are manifestations of delusions of persecution. A person is afraid of the special services that follow him with the help of innovative equipment, aliens, "black" magicians who send damage to him, acquaintances who conspire around him.
• Delusions related to one's own health (hypochondriac). The person is convinced that he is seriously ill. He "feels" the symptoms of the disease, insists on numerous repeated examinations. Angry at the doctors who can't find the cause feeling unwell and do not confirm his diagnosis.
• Delusion of damage manifests itself in the belief that ill-wishers spoil or steal things, pour poison into food, act with the help of radiation, want to take away the apartment.
• Brad of invention. A person is confident that he has invented a unique device, a perpetual motion machine, or a way to deal with dangerous disease. He fiercely defends his invention, persistently trying to bring it to life. Since the patients are not mentally impaired, their ideas can sound quite convincing.
• Love delirium and delirium of jealousy. A person concentrates on his emotions, pursues the object of his love. He comes up with a reason for jealousy, finds evidence of betrayal where there is none.
• Brad of litigation. The patient floods various authorities and the police with complaints about his neighbors or organizations. Files numerous lawsuits.

1. Lethargy or stupor. A person freezes in one position, for a long time (days or weeks) remains without movement. He refuses food and communication.


2. Motor excitement. Movements become fast, jerky, often aimless. The facial expressions are very emotional, the conversation is accompanied by grimaces. Can mimic someone else's speech, imitate the sounds of animals. Sometimes a person is unable to perform simple tasks due to the fact that he loses control over his movements.

What to do if someone close to you has alarming symptoms?

Convince the person to seek psychiatric help. Explain that the doctor will prescribe medications that will help to calm down, it is easier to endure stressful situations.
Types of psychosis

The most common are manic and depressive psychoses - in an outwardly healthy person, signs of depression or significant arousal suddenly appear. Such psychoses are called monopolar - the deviation occurs in one direction. In some cases, the patient may alternately show signs of both manic and depressive psychosis. In this case, doctors talk about bipolar disorder - manic-depressive psychosis.

manic psychosis

depressive psychosis

Depressive psychosis is the opposite of manic psychosis. He also has triad of characteristic symptoms

1. pathologically depressed mood

   Thoughts are centered around your personality, your mistakes and your shortcomings. Concentration on one's own negative sides gives rise to the belief that everything was bad in the past, the present cannot please with anything, and in the future everything will be even worse than it is now. On this basis, a person with depressive psychosis can lay hands on himself.

   Since a person's intellect is preserved, he can carefully hide his desire for suicide so that no one violates his plans. At the same time, he does not show his depressed state and assures that he is already better. At home, it is not always possible to prevent a suicide attempt. Therefore, people with depression who are focused on self-destruction and their own low value are treated in a hospital.

   A sick person experiences unreasonable longing, it crushes and oppresses. It is noteworthy that he can practically show with his finger where the unpleasant sensations are concentrated, where the “soul hurts”. Therefore, this condition even received the name - precordial longing.

   Depression in psychosis has hallmark: the condition is worst early in the morning, and in the evening it improves. The person explains this by the fact that in the evening there are more worries, the whole family gathers and this distracts from sad thoughts. But with depression caused by neurosis, on the contrary, the mood worsens in the evening.

   Characteristically, in the acute period of depressive psychosis, patients do not cry. They say they would like to cry, but there are no tears. Therefore, crying in this case is a sign of improvement. Both patients and their relatives should remember this.

2. Mental retardation

   Mental and metabolic processes in the brain proceed very slowly. This may be due to a lack of neurotransmitters: dopamine, norepinephrine and serotonin. These chemicals ensure proper signal transmission between brain cells.

   As a result of a deficiency of neurotransmitters, memory, reaction, and thinking deteriorate. A person quickly gets tired, does not want to do anything, he is not interested in anything, does not surprise and does not please. From them you can often hear the phrase “I envy other people. They can work, relax, have fun. I'm sorry I can't."

   The patient constantly looks gloomy and sad. The look is dull, unblinking, the corners of the mouth are lowered, avoids communication, tries to retire. He slowly reacts to the appeal, answers in monosyllables, reluctantly, in a monotonous voice.

3. Physical retardation

   Depressive psychosis physically changes a person. Appetite falls, and the patient quickly loses weight. Therefore, weight gain with depression says that the patient is on the mend.

   A person's movements become extremely slow: a slow, uncertain gait, stooped shoulders, a lowered head. The patient feels a loss of strength. Any physical activity causes deterioration.

   At severe forms depressive psychosis a person falls into a stupor. He can sit for a long time without moving, looking at one point. If you try to read notations at this time; “get together, pull yourself together”, then only aggravate the situation. A person will have the thought: “I have to, but I can’t – that means I’m bad, good for nothing.” He cannot overcome depressive psychosis by an effort of will, since the production of norepinephrine and serotonin does not depend on our desire. Therefore, the patient needs qualified assistance and medical treatment.

   There are a number physical signs depressive psychosis: diurnal mood swings, early awakenings, weight loss due to poor appetite, menstrual irregularities, dry mouth, constipation, some people may develop insensitivity to pain. These signs indicate that you need to seek medical attention.

   Basic rules for communicating with patients with psychosis

   1. Do not argue or object to people if you see signs of manic arousal in them. This can provoke an attack of anger and aggression. As a result, you can completely lose trust and turn the person against you.
   2. If the patient shows manic activity and aggression, keep calm, self-confidence and goodwill. Take him away, isolate him from other people, try to calm him down during the conversation.
   3. 80% of suicides are committed by patients with psychosis in the stage of depression. Therefore, be very attentive to loved ones during this period. Don't leave them alone, especially in the morning. Pay special attention to signs warning of a suicide attempt: the patient talks about an overwhelming sense of guilt, about voices ordering to kill himself, about hopelessness and uselessness, about plans to end his life. Suicide is preceded by a sharp transition of depression into a bright, peaceful mood, putting affairs in order, drawing up a will. Do not ignore these signs, even if you think that this is just an attempt to attract attention to yourself.
   4. Hide all items that can be used in a suicide attempt: household chemicals, medicines, weapons, sharp objects.
   5. Eliminate the traumatic situation if possible. Create a calm environment. Try to keep the patient surrounded by loved ones. Reassure him that he is now safe and everything is over.
   6. If a person is delusional, do not ask clarifying questions, do not ask for details (What do aliens look like? How many are there?). This may make the situation worse. "Seize on" any non-delusional statement he utters. Develop the conversation in that direction. You can focus on the person's emotions by asking, “I see you're upset. How can I help you?"
   7. If there are signs that the person has experienced hallucinations, then calmly and confidently ask him what happened now. If he saw or heard anything unusual, then find out what he thinks and feels about it. To cope with hallucinations, you can listen to loud music in headphones, do something exciting.
   8. If necessary, you can firmly recall the rules of behavior, ask the patient not to scream. But do not ridicule him, argue about hallucinations, say that it is impossible to hear voices.
   9. Do not seek help from traditional healers and psychics. Psychosis is very diverse, and for effective treatment it is necessary to accurately determine the cause of the disease. For this, it is necessary to use high-tech diagnostic methods. If you lose time for treatment with non-traditional methods, you will develop acute psychosis. In this case, it will take several times more time to fight the disease, and in the future it will be necessary to constantly take medication.
   10. If you see that the person is relatively calm and ready to communicate, try to convince him to see a doctor. Explain that any symptoms of illness that are bothering him can be relieved with medication prescribed by the doctor.
   11. If your relative flatly refuses to go to a psychiatrist, persuade him to go to a psychologist or psychotherapist to deal with depression. These specialists will help convince the patient that there is nothing to worry about in a visit to a psychiatrist.
   12. The most difficult step for loved ones is to call an emergency team. psychiatric care. But this must be done if a person directly declares his intention to end his life, can injure himself or harm other people.

   Psychological treatments for psychosis

   In psychosis, psychological methods successfully complement drug treatment. A psychotherapist can help a patient:
   • reduce the symptoms of psychosis;
   • avoid relapses;
   • raise self-esteem;
   • learn to adequately perceive the surrounding reality, correctly assess the situation, one's condition and respond accordingly, correct behavioral errors;
   • eliminate the causes of psychosis;
   • improve the effectiveness of medical treatment.
   Remember, psychological treatments for psychosis are used only after the acute symptoms of psychosis have been relieved.

   Psychotherapy eliminates personality disorders that occurred during the period of psychosis, puts thoughts and ideas in order. Working with a psychologist and psychotherapist makes it possible to influence future events and prevent a recurrence of the disease.

   Psychological treatments are aimed at restoring mental health and at socializing a person after recovery in order to help him feel comfortable in the family, work team and society. This treatment is called psychosocialization.

   Psychological methods that are used to treat psychosis are divided into individual and group. During individual sessions, the psychotherapist replaces the personal core lost during the illness. It becomes an external support for the patient, calms him down and helps to correctly assess reality and adequately respond to it.

   group therapy helps to feel like a member of society. A group of people struggling with psychosis is led by a specially trained person who has managed to successfully cope with this problem. This gives patients hope for recovery, helps to overcome awkwardness and return to normal life.

   In the treatment of psychosis, hypnosis, analytical and suggestive (from Latin Suggestio - suggestion) methods are not used. When working with altered consciousness, they can lead to further mental disorders.

   Good results in the treatment of psychosis give: psychoeducation, addiction therapy, cognitive therapy behavior, psychoanalysis, family therapy, occupational therapy, art therapy, as well as psychosocial training: social competence training, metacognitive training.

   Psychoeducation is the education of the patient and his family members. The psychotherapist talks about psychosis, about the features of this disease, the conditions for recovery, motivates to take medication and lead healthy lifestyle life. Tells relatives how to behave with the patient. If you disagree with something or have questions, then be sure to ask them at the time specially allotted for discussions. It is very important for the success of the treatment that you have no doubts.

   Classes are held 1-2 times a week. If you visit them regularly, then you will form the right attitude towards the disease and drug treatment. Statistics say that thanks to such conversations, it is possible to reduce the risk of repeated episodes of psychosis by 60-80%.

   addiction therapy necessary for those people whose psychosis has developed against the background of alcoholism and drug addiction. Such patients always have an internal conflict. On the one hand, they understand that they should not use drugs, but on the other hand, there is a strong desire to return to bad habits.

   Classes are held in the form of an individual conversation. A psychotherapist talks about the relationship between drug use and psychosis. He will tell you how to behave in order to reduce the temptation. Addiction therapy helps build a strong motivation to abstain from bad habits.

   Cognitive (behavioral) therapy. Cognitive therapy is recognized as one of the best practices treatment of psychosis accompanied by depression. The method is based on the fact that erroneous thoughts and fantasies (cognitions) interfere with the normal perception of reality. During the sessions, the doctor will bring out these wrong judgments and the emotions associated with them. He will teach you how to be critical of them, and not let these thoughts influence your behavior, tell you how to look for alternative ways to solve the problem.

   To achieve this goal, a protocol of negative thoughts is used. It contains the following columns: negative thoughts, the situation in which they arose, the emotions associated with them, the facts “for” and “against” these thoughts. The course of treatment consists of 15-25 individual sessions and lasts 4-12 months.

   Psychoanalysis. Although this technique is not used to treat schizophrenia and affective (emotional) psychoses, its modern "supportive" version is effectively used to treat other forms of the disease. At individual meetings, the patient reveals his inner world to the psychoanalyst and transfers to him feelings directed at other people. During the conversation, the specialist identifies the reasons that led to the development of psychosis (conflicts, psychological trauma) and the defense mechanisms that a person uses to protect himself from such situations. The treatment process takes 3-5 years.

   Family Therapy - group therapy, during which the specialist conducts classes with family members where the patient with psychosis lives. Therapy is aimed at eliminating conflicts in the family, which can cause exacerbations of the disease. The doctor will talk about the features of the course of psychosis and the correct behavior in crisis situations. Therapy is aimed at preventing relapses and ensuring that all family members are comfortable living together.

   Ergotherapy. This type of therapy is most often group therapy. The patient is recommended to attend special classes where he can practice various types Activities: cooking, gardening, working with wood, textiles, clay, reading, writing poetry, listening and writing music. Such exercises train memory, patience, concentration, develop Creative skills, help to open up, to establish contact with other members of the group.

   The specific setting of tasks, the achievement of simple goals gives the patient confidence that he again becomes the master of his life.

   Art therapy - method of art therapy based on psychoanalysis. It is a “no-words” healing method that activates the possibilities for self-healing. The patient creates a picture expressing his feelings, an image of his inner world. Then the specialist studies it from the point of view of psychoanalysis.
   
   Social competence training. A group activity in which people learn and put into practice new forms of behavior in order to apply them in everyday life. For example, how to behave when meeting new people, when applying for a job or in conflict situations. In subsequent sessions, it is customary to discuss the problems that people encountered when implementing them in real situations.

   metacognitive training. Group training sessions that are aimed at correcting the thinking errors that lead to delusions: distorted attribution of judgments to people (he does not love me), hasty conclusions (if he does not love, he wants me dead), depressive way of thinking, inability to empathize , feel other people's emotions, painful confidence in memory impairment. The training consists of 8 sessions and lasts 4 weeks. At each module, the trainer analyzes thinking errors and helps to form new models of thoughts and behavior.

   Psychotherapy is widely used in all forms of psychosis. It can help people of all ages, but is especially important for teenagers. At a time when life attitudes and stereotypes of behavior are just being formed, psychotherapy can radically change life for the better.

   Drug treatment of psychoses

   Medicinal treatment of psychosis is a prerequisite for recovery. Without it, it will not be possible to get out of the trap of the disease, and the condition will only worsen.

   There is no single drug therapy for psychosis. The doctor prescribes drugs strictly individually, based on the manifestations of the disease and the characteristics of its course, gender and age of the patient. During treatment, the doctor monitors the patient's condition and, if necessary, increases or reduces the dose in order to achieve a positive effect and not cause side effects.

   Treatment of manic psychosis

   Drug group	The mechanism of the treated action	Representatives	How is it prescribed
   Antipsychotic drugs (neuroleptics)	They are used for all forms of psychosis. Block dopamine receptors. This substance is a neurotransmitter that promotes the transfer of excitation between brain cells. Thanks to the action of neuroleptics, it is possible to reduce the severity of delusions, hallucinations and thought disorders.	Solian (effective for negative disorders: lack of emotions, withdrawal from communication)	In the acute period, 400-800 mg / day is prescribed, up to a maximum of 1200 mg / day. Take with or without food. Maintenance dose 50-300 mg / day.
   		Zeldox	40-80 mg 2 times a day. The dose is increased over 3 days. The drug is administered orally after meals.
   		Fluanxol	The daily dose is 40-150 mg / day, divided into 4 times. Tablets are taken after meals. The drug is also produced in the form of a solution for injection, which is done 1 time in 2-4 weeks.
   Benzodiazepines	They are prescribed for acute manifestations of psychosis in conjunction with antipsychotic drugs. They reduce the excitability of nerve cells, have a calming and anticonvulsant effect, relax muscles, eliminate insomnia, and reduce anxiety.	Oxazepam	Take 5-10 mg twice or thrice a day. If necessary daily dose may be increased to 60 mg. The drug is taken regardless of food, drinking plenty of water. The duration of treatment is 2-4 weeks.
   		Zopiclone	Take 7.5-15 mg 1 time per day half an hour before bedtime, if psychosis is accompanied by insomnia.
   Mood stabilizers (normotimics)	Normalize mood, preventing the onset of manic phases, make it possible to control emotions.	Actinerval (derivative of carbamazepine and valproic acid)	The first week the daily dose is 200-400 mg, it is divided into 3-4 times. Every 7 days, the dose is increased by 200 mg, bringing up to 1 g. The drug is also canceled gradually so as not to cause a deterioration in the condition.
   		Contemnol (contains lithium carbonate)	Take 1 g per day once in the morning after breakfast, drinking plenty of water or milk.
   Anticholinergic drugs (anticholinergics)	Necessary to neutralize side effects after taking antipsychotics. Regulates the sensitivity of the nerve cells of the brain, blocking the action of the mediator acetylcholine, which ensures the transmission of nerve impulses between the cells of the parasympathetic nervous system.	Cyclodol, (Parkopan)	Initial dose 0.5-1 mg / day. If necessary, it can be gradually increased to 20 mg / day. Multiplicity of reception 3-5 times a day, after meals.

   Treatment of depressive psychosis

   Drug group	The mechanism of the treated action	Representatives	How is it prescribed
   Antipsychotic drugs	They make brain cells less sensitive to excess amounts of dopamine, a substance that promotes signaling in the brain. Drugs normalize thought processes, eliminate hallucinations and delusions.	Quentiax	During the first four days of treatment, the dose is increased from 50 to 300 mg. In the future, the daily dose may be from 150 to 750 mg / day. The drug is taken 2 times a day, regardless of food intake.
   		Eglonil	Tablets and capsules are taken 1-3 times a day, regardless of food intake. Daily dose of 50 to 150 mg for 4 weeks. The drug is not advisable to use after 16 hours, so as not to cause insomnia.
   		Rispolept Konsta	A suspension is prepared from microgranules and the solvent included in the kit, which is injected into the gluteal muscle 1 time in 2 weeks.
   		Risperidone	The initial dose is 1 mg 2 times a day. Tablets of 1-2 mg are taken 1-2 times a day.
   Benzodiazepines	It is prescribed for acute manifestations of depression and severe anxiety. Drugs reduce anxiety subcortical structures brain, relax muscles, relieve fear, calm the nervous system.	Phenazepam	Take 0.25-0.5 mg 2-3 times a day. The maximum daily dose should not exceed 0.01 g. Assign short courses so as not to cause dependence. After the onset of improvement, the dosage is gradually reduced.
   		Lorazepam	Take 1 mg 2-3 times a day. At severe depression the dose can be gradually increased to 4-6 mg / day. Cancel the drug gradually because of the risk of seizures.
   Normotimics	Drugs designed to normalize mood and prevent periods of depression.	lithium carbonate	Take orally 3-4 times a day. The initial dose is 0.6-0.9 g / day, gradually the amount of the drug is increased to 1.5-2.1 g. The drug is taken after meals to reduce irritant effect on the gastric mucosa.
   Antidepressants	Remedies to fight depression. Modern 3rd generation antidepressants reduce the uptake of serotonin by neurons and thereby increase the concentration of this neurotransmitter. They improve mood, relieve anxiety and longing, fear.	Sertraline	Take orally 50 mg, 1 time per day after breakfast or dinner. If there is no effect, the doctor may gradually increase the dose to 200 mg / day.
   		Paroxetine	Take 20-40 mg / day in the morning during breakfast. The tablet is swallowed without chewing and washed down with water.
   Anticholinergic drugs	Drugs that help eliminate the side effects of taking antipsychotics. Slowness of movement, muscle stiffness, trembling, impaired thinking, increased or absent emotions.	Akineton	2.5-5 mg of the drug is administered intravenously or intramuscularly. In tablets, the initial dose is 1 mg 1-2 times / day, gradually the amount of the drug is adjusted to 3-16 mg / day. The dose is divided into 3 doses. Tablets are taken during or after meals with liquid.

   
   Recall that any independent change in dose can have a very severe consequences. Reducing the dosage or refusing to take medication causes an exacerbation of psychosis. Increasing the dose increases the risk of side effects and addiction.

   Prevention of psychosis

   What should be done to prevent a relapse of psychosis?

   Unfortunately, people who have experienced psychosis are at risk of experiencing a relapse of the disease. A repeated episode of psychosis is a difficult test for both the patient himself and his relatives. But you can reduce your risk of relapse by up to 80% if you take your doctor's prescription medications.

   • Medical therapy- the main point of prevention of psychosis. If you find it difficult to take your medications every day, talk to your doctor about switching to a depot form of antipsychotic medication. In this case, it will be possible to make 1 injection in 2-4 weeks.

     It has been proven that after the first case of psychosis, the use of drugs for one year is necessary. With manic manifestations of psychosis, lithium salts and Finlepsin are prescribed at 600-1200 mg per day. And with depressive psychosis, Carbamazepine is needed at 600-1200 mg per day.

   • Regularly attend individual and group psychotherapy sessions. They boost your self-confidence and motivation to get well. In addition, a psychotherapist can notice signs of an approaching exacerbation in time, which will help adjust the dosage of drugs and prevent a recurrence.
   • Follow the daily routine. Train yourself to get up, take food and medicine at the same time every day. A daily schedule can help with this. From the evening, plan tomorrow. Make a list of all the things you need to do. Mark which of them are important and which are secondary. Such planning will help you not to forget anything, to be in time for everything and to be less nervous. When planning, set realistic goals.
   
   
   • Communicate more. You will feel comfortable around people who have managed to overcome psychosis. Communicate in self-help groups or on specialized forums.
   • Exercise daily. Suitable for running, swimming, cycling. It is very good if you do this in a group of like-minded people, then the classes will bring both benefit and pleasure.
   • Make a list of early symptoms of a coming crisis, the appearance of which must be reported to the attending physician. Pay attention to these signals:
     1. Behavior changes: frequent leaving the house, prolonged listening to music, unreasonable laughter, illogical statements, excessive philosophizing, conversations with people with whom you usually do not want to communicate, fussy movements, squandering, adventurism.
     2. Mood changes: irritability, tearfulness, aggressiveness, anxiety, fear.
     3. Feeling changes: sleep disturbance, lack or increased appetite, increased sweating, weakness, weight loss.
     What not to do?
     • Don't drink too much coffee. It can have a strong stimulating effect on the nervous system. Give up alcohol and drugs. They have a bad effect on the brain, cause mental and motor excitement, attacks of aggression.
     • Don't overwork. Physical and mental exhaustion can cause great confusion, incoherence of thought, and overreaction to external stimuli. These deviations are associated with a violation of the absorption of oxygen and glucose by nerve cells.
     • Do not sweat in the bath, try to avoid overheating. An increase in body temperature often leads to the appearance of delirium, which is explained by an increase in the activity of electrical potentials in the brain, an increase in their frequency and amplitude.
     • Don't conflict. Try to resolve conflicts constructively to avoid stress. Strong mental stress can become a trigger for a new crisis.
     • Don't refuse treatment. During an exacerbation, the temptation to refuse to take medication and visit a doctor is especially great. Do not do this, otherwise the disease will go into sharp shape and require hospital treatment.

     
     

     What is postpartum psychosis?

     postpartum psychosis quite rare mental illness. It develops in 1-2 out of 1000 women in labor. Signs of psychosis most often appear during the first 4-6 weeks after childbirth. Unlike postpartum depression, this mental disorder is characterized by delusions, hallucinations, and a desire to harm yourself or your baby.

     Manifestations of postpartum psychosis.

     The first signs of the disease are sharp drops mood, anxiety, severe anxiety, unfounded fears. Further delusions and hallucinations appear. A woman may claim that the child is not hers, that he is stillborn or crippled. Sometimes a young mother develops paranoia, she stops going for walks and does not let anyone near her child. In some cases, the disease is accompanied by megalomania, when a woman is confident in her superpowers. She can hear voices ordering her to kill herself or the child.

     According to statistics, 5% of women in a state of postpartum psychosis kill themselves, and 4% of their child. Therefore, it is very important for relatives not to ignore the signs of the disease, but to contact a psychiatrist in a timely manner.

     Causes of postpartum psychosis.

     The cause of mental disorders can be difficult childbirth, unwanted pregnancy, conflict with her husband, fear that the spouse will love the child more than her. Psychologists believe that psychosis can be caused by conflict between a woman and her mother. It can also be caused by damage to the brain as a result of injury or infection. A sharp decrease in the level of the female hormone estrogen, as well as endorphins, thyroid hormone and cortisol, can affect the development of psychosis.

     In about half of the cases, postpartum psychosis develops in patients with schizophrenia or manic-depressive syndrome.

     Treatment of postpartum psychosis.

     Treatment must be started as soon as possible because the woman's condition is rapidly deteriorating. If there is a risk of suicide, then the woman will be treated in a psychiatric ward. During the period while she is taking medicines, it is impossible to breastfeed the baby, since most of the drugs penetrate the mother's milk. But communication with the child will be useful. Caring for the baby (provided that the woman herself wants it) helps to normalize the state of the psyche.

     If a woman is depressed, then antidepressants are prescribed. Amitriptyline, Pirlindol are indicated if anxiety and fear predominate. Citalopram, Paroxetine have a stimulating effect. They will help in the case when psychosis is accompanied by stupor - a woman sits motionless, refuses to communicate.

     With mental and motor agitation and manifestations of a manic syndrome, lithium preparations (lithium carbonate, Micalit) and antipsychotics (Clozapine, Olanzapine) are necessary.

     Psychotherapy for postpartum psychosis is used only after the elimination of acute manifestations. It is aimed at identifying and resolving conflicts that led to a mental disorder.

     What is reactive psychosis?

     Reactive psychosis or psychogenic shock - a mental disorder that arose after a severe psychological trauma. This form of the disease has three features that distinguish it from other psychoses (Jaspers' triad):
     1. Psychosis begins after a severe emotional shock that is very significant for this person.
     2. Reactive psychosis is reversible. The more time has passed since the injury, the weaker the symptoms. In most cases, recovery occurs after about a year.
     3. Painful experiences and manifestations of psychosis depend on the nature of the trauma. Between them there is a psychologically understandable connection.
     Causes of reactive psychosis.

     A mental disorder occurs after a strong shock: a catastrophe, an attack by criminals, a fire, a collapse of plans, a career collapse, a divorce, illness or death of a loved one. In some cases, positive events that caused an explosion of emotions can also provoke psychosis.

     Particularly at risk of developing reactive psychosis are emotionally unstable people, those who have suffered a bruise or concussion, severe infectious diseases whose brain has been affected by alcohol or drug intoxication. As well as teenagers in puberty and women going through menopause.

     Manifestations of reactive psychosis.

     Symptoms of psychosis depend on the nature of the injury and the form of the disease. There are such forms of reactive psychosis:

     • psychogenic depression;
     • psychogenic paranoid;
     • hysterical psychosis;
     • psychogenic stupor.
     Psychogenic depression manifested by tearfulness and depression. At the same time, these symptoms may be accompanied by irascibility and quarrelsomeness. This form is characterized by the desire to cause pity, to draw attention to their problem. Which can end in a demonstrative suicide attempt.

     Psychogenic paranoid accompanied by delirium, auditory hallucinations and motor excitation. It seems to the patient that he is being persecuted, he fears for his life, is afraid of exposure and is fighting imaginary enemies. Symptoms depend on the nature of the stressful situation. The person is very excited, commits rash acts. This form of reactive psychosis often occurs on the road, as a result of lack of sleep, alcohol consumption.

     hysterical psychosis has several forms.

     1. delusional fantasies - crazy ideas that relate to greatness, wealth, persecution. The patient tells them very theatrically and emotionally. Unlike delirium, a person is not sure of his words, and the essence of statements changes depending on the situation.
     2. Ganser syndrome patients do not know who they are, where they are, what year it is. They answer simple questions incorrectly. They commit illogical actions (eat soup with a fork).
     3. pseudodementia - short-term loss of all knowledge and skills. A person cannot answer the simplest questions, show where his ear is, or count his fingers. He is naughty, grimaces, cannot sit still.
     4. Puerilism Syndrome - an adult has a child's speech, children's emotions, children's movements. May develop initially or as a complication of pseudodementia.
     5. Syndrome of "wildness" - human behavior resembles the habits of an animal. Speech is replaced by a growl, the patient does not recognize clothes and cutlery, moves on all fours. This condition, with an unfavorable course, can change puerilism.
     psychogenic stupor- after a traumatic situation, a person for some time loses the ability to move, speak and respond to others. The patient can lie in the same position for weeks until he is turned over.

     Treatment of reactive psychosis.

     The most important step in the treatment of reactive psychosis is the elimination of the traumatic situation. If you manage to do this, then the probability of a quick recovery is high.
     Medical treatment reactive psychosis depends on the severity of manifestations and characteristics of the psychological state.

     At reactive depression prescribe antidepressants: Imipramine 150-300 mg per day or Sertraline 50-100 mg 1 time per day after breakfast. Supplement therapy with tranquilizers Sibazon 5-15 mg / day or Phenazepam 1-3 mg / day.

     Psychogenic paranoid treated with neuroleptics: Triftazin or Haloperidol 5-15 mg / day.
     With hysterical psychosis, it is necessary to take tranquilizers (Diazepam 5-15 mg / day, Mezapam 20-40 mg / day) and neuroleptics (Alimemazine 40-60 mg / day or Neuleptil 30-40 mg / day).
     Psychostimulants can bring a person out of a psychogenic stupor, for example, Sydnocarb 30-40 mg / day or Ritalin 10-30 mg / day.

     Psychotherapy can save a person from excessive fixation on a traumatic situation and develop protective mechanisms. However, it is possible to proceed to consultations with a psychotherapist only after the acute phase of psychosis has passed, and the person has regained the ability to perceive the arguments of a specialist.

     Remember - psychosis is curable! Self-discipline, regular medication, psychotherapy and the help of loved ones guarantee the return of mental health.

   Mental disorders- in a broad sense, this is a disease of the soul, meaning a state of mental activity that is different from healthy. Their opposite is mental health. Individuals who have the ability to adapt to daily changing life conditions and resolve everyday problems are generally considered mentally healthy individuals. When this ability is limited, the subject does not master the current tasks of professional activity or the intimate-personal sphere, and is also unable to achieve the designated tasks, ideas, goals. In a situation of this kind, one can suspect the presence of a mental anomaly. Thus, neuropsychiatric disorders refers to a group of disorders that affect the nervous system and behavioral response of the individual. The described pathologies may appear as a result of deviations occurring in the brain of metabolic processes.

   Causes of mental disorders

   Due to the numerous factors that provoke them, neuropsychiatric diseases and disorders are incredibly diverse. Disorders of mental activity, whatever their etiology, are always predetermined by deviations in the functioning of the brain. All reasons are divided into two subgroups: exogenous factors and endogenous. The first ones are external influence, for example, the use of toxic substances, viral diseases, injuries, the second - immanent causes, including chromosomal mutations, hereditary and gene ailments, mental development disorders.

   Resistance to mental disorders depends on the specific physical characteristics and the general development of their psyche. different entities have various reactions for mental anguish and problems.

   There are typical causes of deviations in mental functioning: neurosis, depressive states, exposure to chemical or toxic substances, head injuries, heredity.

   Worry is considered the first step leading to exhaustion of the nervous system. People often tend to draw in their fantasy various negative developments of events that never materialize in reality, but provoke excessive unnecessary anxiety. Such anxiety gradually escalates and, as the critical situation grows, it can transform into a more serious disorder, which leads to a deviation in the mental perception of the individual and to dysfunctions in the functioning of various structures of internal organs.

   Neurasthenia is a response to prolonged exposure to traumatic situations. It is accompanied by increased fatigue and exhaustion of the psyche against the background of hyperexcitability and constant over trifles. At the same time, excitability and grumpiness are protective means against the final failure of the nervous system. Individuals are more prone to neurasthenic states, characterized by an increased sense of responsibility, high anxiety, people who do not get enough sleep, and are also burdened with many problems.

   As a result of a serious traumatic event, which the subject does not try to resist, hysterical neurosis occurs. The individual simply “runs away” into such a state, forcing himself to feel all the “charm” of experiences. This condition can last from two to three minutes to several years. At the same time, the longer the period of life it affects, the more pronounced the mental disorder of the personality will be. Only by changing the attitude of the individual to his own illness and attacks, it is possible to achieve a cure for this condition.

   In addition, people with mental disorders are prone to a weakening of memory or its complete absence, paramnesia, and a violation of the thought process.

   Brad is also frequent companion mental disorders. It is primary (intellectual), sensual (figurative) and affective. Primary delirium initially appears as the only sign of impaired mental activity. Sensual delirium is manifested in the violation of not only rational cognition, but also sensual. Affective delirium always occurs along with emotional deviations and is characterized by imagery. Also, overvalued ideas are distinguished, which mainly appear as a result of real-life circumstances, but subsequently take on a meaning that does not correspond to their place in the mind.

   Signs of a mental disorder

   Knowing the signs and characteristics of mental disorders, it is easier to prevent their development or to identify early stage occurrence of a deviation, rather than treating a neglected form.

   Signs of a mental disorder include:

   - the appearance of hallucinations (auditory or visual), expressed in conversations with oneself, in response to interrogative statements of a non-existent person;

   - unreasonable laughter;

   - difficulty concentrating when performing a task or a thematic discussion;

   - changes in the behavioral response of the individual in relation to relatives, often there is a sharp hostility;

   - in speech there may be phrases with delusional content (for example, “I myself am to blame for everything”), in addition, it becomes slow or fast, uneven, intermittent, confused and very difficult to perceive.

   People with mental disorders often seek to protect themselves, and therefore lock all the doors in the house, curtain the windows, carefully check every piece of food, or completely refuse meals.

   You can also highlight the signs of mental deviation observed in the female:

   - overeating leading to obesity or refusal to eat;

   - alcohol abuse;

   - violation of sexual functions;

   - depression of the state;

   - fast fatiguability.

   In the male part of the population, signs and characteristics of mental disorders can also be distinguished. Statistics show that the stronger sex is much more likely to suffer from mental disorders than women. In addition, male patients are characterized by more aggressive behavior. So, common signs include:

   - inaccurate appearance;

   - there is sloppiness in appearance;

   - can be avoided for a long time hygiene procedures(do not wash or shave);

   - quick mood swings;

   - mental retardation;

   - emotional and behavioral abnormalities in childhood age period;

   - personality disorders.

   More often, mental illnesses and disorders occur in the childhood and adolescence age period. Approximately 16 percent of children and adolescents have psychical deviations. The main difficulties children face can be divided into three categories:

   - a disorder of mental development - children, in comparison with their peers, lag behind in the formation of various skills, and therefore experience difficulties of an emotional and behavioral nature;

   - emotional defects associated with severely damaged feelings and affects;

   - expansive pathologies of behavior, which are expressed in the deviation of the baby's behavioral reactions from social norms or manifestations of hyperactivity.

   Neuropsychiatric disorders

   The modern high-speed life rhythm makes people adapt to various environmental conditions, sacrifice sleep, time, and energy in order to do everything. A person cannot do everything. The price of constant haste is health. The functioning of the systems and the coordinated work of all organs is directly dependent on the normal activity of the nervous system. Impact external conditions negative environments can cause mental disorders.
   Neurasthenia is a neurosis that arises against the background of psychological trauma or overwork of the body, for example, due to lack of sleep, lack of rest, prolonged hard work. The neurasthenic state develops in stages. At the first stage, aggressiveness and hyperexcitability, sleep disorder, inability to concentrate on activities. At the second stage, irritability is noted, which is accompanied by fatigue and indifference, decreased appetite, discomfort in epigastric region. Headaches, slowing or increased heart rate, and a tearful state may also be observed. The subject at this stage often takes "to heart" any situation. At the third stage, the neurasthenic state passes into an inert form: the patient is dominated by apathy, depression and lethargy.

   Obsessive states are one of the forms of neurosis. They are accompanied by anxiety, fears and phobias, a sense of danger. For example, an individual may be overly worried about the hypothetical loss of some thing or be afraid of contracting one or another ailment.

   Obsessive-compulsive disorder is accompanied by repeated repetition of the same thoughts that have no significance for the individual, a series of obligatory manipulations before any business, the appearance of absurd desires of an obsessive nature. At the heart of the symptoms is a feeling of fear to act contrary to inner voice even if his claims are absurd.

   Conscientious, fearful individuals who are unsure of their own decisions and subordinate to the opinion of the environment are usually subject to such a violation. Obsessive fears are divided into groups, for example, there is a fear of darkness, heights, etc. They are seen in healthy individuals. The reason for their origin is associated with a traumatic situation and the simultaneous impact of a specific factor.

   It is possible to prevent the appearance of the described mental disorder by increasing confidence in one's own significance, developing independence from others and independence.

   Hysterical neurosis or is found in increased emotionality and the desire of the individual to draw attention to himself. Often such a desire is expressed by rather eccentric behavior (deliberately loud laughter, affectation in behavior, tearful tantrums). With hysteria, there may be a decrease in appetite, fever, weight changes, nausea. Since hysteria is considered one of the most complex forms of nervous pathologies, it is treated with the help of psychotherapeutic agents. It occurs as a result of a serious injury. At the same time, the individual does not resist traumatic factors, but “runs away” from them, forcing him to feel painful experiences again.

   The result of this is the development of pathological perception. The patient likes being in a hysterical state. Therefore, such patients are quite difficult to get out of this state. The range of manifestations is characterized by scale: from stamping your feet to convulsing on the floor. By his behavior, the patient tries to benefit and manipulates the environment.

   The female sex is more prone to hysterical neuroses. Temporary isolation of people suffering from mental disorders is useful in preventing the onset of hysterical attacks. After all, as a rule, for individuals with hysteria, the presence of the public is important.

   There are also severe mental disorders that occur chronically and can lead to disability. These include: clinical depression, schizophrenia, bipolar affective disorder, identities, epilepsy.

   With clinical depression, patients feel depressed, unable to enjoy, work and conduct their usual social activities. Individuals with mental disorders caused by clinical depression are characterized by bad mood, lethargy, loss of habitual interests, lack of energy. Patients are not able to "pick up" themselves. They have insecurity, low self-esteem, increased guilt, pessimistic ideas about the future, appetite and sleep disorders, and weight loss. In addition, somatic manifestations can also be noted: dysfunction of the gastrointestinal tract, pain in the heart, head and muscles.

   The exact causes of schizophrenia are not known for certain. This disease is characterized by deviations in mental activity, logic of judgments and perception. Patients are characterized by detachment of thoughts: it seems to the individual that his worldviews were created by someone else and a stranger. In addition, withdrawal into oneself and into personal experiences, isolation from the social environment is characteristic. Often people with mental disorders provoked by schizophrenia experience ambivalent feelings. Some forms of the disease are accompanied by catatonic psychosis. The patient may remain immobile for hours, or express motor activity. With schizophrenia, emotional dryness can also be noted, even in relation to the closest.

   Bipolar affective disorder is called an endogenous ailment, expressed in phase changes of depression and mania. Patients experience a rise in mood and general improvement state, then a decline, immersion in the blues and apathy.

   A dissociative identity disorder is a mental pathology in which the patient has a "separation" of the personality into one or more components that act as separate subjects.

   Epilepsy is characterized by the occurrence of seizures, which are provoked by the synchronous activity of neurons in a certain area of ​​the brain. The causes of the disease can be hereditary or other factors: viral disease, traumatic brain injury, etc.

   Treatment of mental disorders

   The picture of the treatment of deviations in mental functioning is formed based on the anamnesis, knowledge of the patient's condition, and the etiology of a particular disease.

   For treatment neurotic states apply sedatives due to their calming effect.

   Tranquilizers are mainly prescribed for neurasthenia. Drugs in this group can reduce anxiety and relieve emotional tension. Most of them also reduce muscle tone. Tranquilizers are predominantly hypnotic rather than causing perceptual changes. Side effects are expressed, as a rule, in a feeling of constant fatigue, increased drowsiness, and disorders in remembering information. TO negative manifestations nausea, low blood pressure and decreased libido can also be attributed. Chlordiazepoxide, Hydroxyzine, Buspirone are more commonly used.

   Antipsychotics are the most popular in the treatment of mental pathologies. Their action is to reduce the excitation of the psyche, reduce psychomotor activity, reduce aggressiveness and suppress emotional tension.

   The main side effects of neuroleptics include a negative effect on skeletal muscles and the appearance of deviations in dopamine metabolism. The most commonly used antipsychotics include: Propazine, Pimozide, Flupentixol.

   Antidepressants are used in a state of complete depression of thoughts and feelings, a decrease in mood. Preparations of this series increase the pain threshold, thereby reducing the pain of migraines provoked by mental disorders, improve mood, relieve apathy, lethargy and emotional tension, normalize sleep and appetite, increase mental activity. TO negative impacts These drugs include dizziness, tremor of the limbs, confusion. The most commonly used as antidepressants Pyritinol, Befol.

   Normotimics regulate inadequate expression of emotions. They are used to prevent disorders that include several syndromes that manifest themselves in stages, for example, with bipolar affective disorder. In addition, the described drugs have an anticonvulsant effect. Side effect manifests itself in trembling of the limbs, weight gain, disruption of the digestive tract, unquenchable thirst, which subsequently entails polyuria. It is also possible the appearance of various rashes on the skin surface. The most commonly used salts of lithium, Carbamazepine, Valpromide.

   Nootropics are the most harmless among drugs that promote healing mental pathologies. They have a positive effect on cognitive processes, enhance memory, increase the resistance of the nervous system to the effects of various stressful situations. Sometimes side effects are expressed in the form of insomnia, headaches and digestive disorders. The most commonly used Aminalon, Pantogam, Mexidol.

   In addition, hypnotechniques, suggestion are widely used, less commonly used. In addition, the support of relatives is important. Therefore, if a loved one suffers from a mental disorder, then you need to understand that he needs understanding, not condemnation.