Mental disorder (mental illness; mental illness) - V in a broad sense- a mental state different from normal, healthy. The opposite of this term is Mental Health. However, it may have a more specific meaning in areas such as law, psychiatry and psychology.

Ideas about what is and is not a mental disorder change as science advances. For example, social phobia a couple of decades ago was not considered a mental disorder, and people who suffered from this illness were considered simply especially shy. Conversely, homosexuality several decades ago was considered a mental disorder requiring treatment, and according to the modern International Classification of Diseases, 10th revision, sexual orientation itself is not considered a disorder: only psychological problems, which may arise in connection with it (F 66. 66.), are classified as diseases.

Differences in the meaning of the term depending on the context

In jurisprudence

Under chronic mental disorder jurisprudence understands a long-term mental disorder, which can, however, occur in attacks (that is, with an improvement or deterioration of the mental state), but leave behind a persistent mental defect. Such mental illnesses include: schizophrenia, epilepsy, progressive paralysis, paranoia, manic-depressive psychosis and other mental illnesses.

Under temporary mental disorder jurisprudence understands mental illnesses that last a relatively short time and end with recovery. These include: pathological intoxication (delirium tremens), reactive symptomatic states, that is, mental disorders caused by severe mental shocks and experiences.

In psychiatry and clinical psychology

We can distinguish: organic mental disorders (that is, caused by organic disorders), personality disorders, behavioral disorders, emotional (affective) disorders, disorders associated (caused) by the use of psychoactive substances, post-traumatic stress disorder and others. Some of these groups may overlap.

In psychology

Examples

Notes

Literature

• // Encyclopedic Dictionary of Brockhaus and Efron: In 86 volumes (82 volumes and 4 additional ones). - St. Petersburg. , 1890-1907.

• Tiganov A. S., Snezhnevsky A. V., et al. Guide to Psychiatry / Ed. Academician of the Russian Academy of Medical Sciences A. S. Tiganov. - M.: Medicine, 1999. - T. in 2 volumes.
• Spasennikov B. A., Spasennikov S. B. Mental disorders and their criminal legal significance. - Moscow: Yurlitinform, 2011. - 270 p. - 1000 copies. - ISBN 978-5-93295-835-3
• Kuperman V. B., Zislin I. M. Simulation of psychosis: semiotics of behavior // Russian literature and medicine. Body, prescriptions, social practice. Collection of articles / Edited by K. A. Bogdanov, Yu. Murashov, R. Nicolosi. - Moscow: New publishing house, 2006. - P. 290-302. - 304 s. - (New materials and research on the history of Russian culture). - ISBN 5-98379-049-8

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See what “Mental disorder” is in other dictionaries:

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Mental illnesses that occur relatively quickly and end with recovery: pathological intoxication (delirium tremens), reactive symptomatic states, i.e. mental disorders caused by severe mental shock and... ... Legal Dictionary

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, delirium tremens, or can be an independent pathology.

So what is psychosis?

This is a mental disorder in which reality is so distorted in a person’s mind that this “picture” no longer has anything in common with what other people see. What prevents a person from being objective is constant fear for his life, voices in his head that order him to do something, visions that are no longer available to anyone... These internal prisms change the patient’s behavior. His reactions become completely inadequate: causeless laughter or tears, anxiety or euphoria. Psychosis manifests itself differently in all patients. Some are confident that the 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. There is no need to think that the sick person is mistaken or cannot keep his nerves under control. There is no point in arguing, much less condemning him. Psychosis is the same disease as diabetes. This is also a metabolic disorder, but only in the brain. You are not afraid of diabetics, you do not judge them for their disease. You sympathize with them. Patients with neurosis deserve the same treatment. By the way, scientists have proven that mentally healthy people commit crimes more often than people with psychosis.

You shouldn't put a mark on a person. Psychosis is not a life sentence. It happens that after a period of illness, which can be quite severe, the psyche is completely restored and problems never arise again. But more often the disease is cyclical. In this case, after a long period of health, an exacerbation occurs: hallucinations and delusional ideas appear. This happens if you do not strictly follow the recommendations of your doctor. In severe cases, the disease takes chronic nature, and mental health never returns.

Psychosis is a fairly common problem. According to statistics, 15% of patients in mental hospitals are patients with psychosis. And 3-5% of the entire 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 - taking drugs, alcohol, medications. To date, doctors cannot calculate the exact number of patients with psychosis.

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

If you or someone close to you shows signs of psychosis, do not despair. Modern medicine successfully copes with this disease. And the infamous “registration” was replaced by a consultation with a local psychiatrist - advisory and therapeutic assistance. Therefore, the fact of treatment will not ruin your future life. But attempts to cope with the disease on your own can lead to irreparable changes in the psyche and disability.

Causes of psychosis

If the mitochondria do not produce ATP, the pump does not work. As a result, the vital activity of the cell is disrupted. This neuron remains “hungry” and experiences oxygen deficiency, despite the fact that the person eats normally and spends enough time in the fresh air.

Neurons in which the chemical balance is disturbed cannot form and transmit nerve impulses. They disrupt the functioning of 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 on from parents to children. These genes control brain sensitivity external influences and signaling substances. For example, the neurotransmitter dopamine, which causes feelings of pleasure. People with a family history are more susceptible to the influence of negative factors than others, be it illness or psychological trauma. Psychosis develops in them early age, quickly and severely.

   If both parents are sick, the child has a 50% chance of developing 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 the same problem, having received “defective genes” from previous generations.

2. Brain injuries:
   • injuries received by the child during childbirth;
   • bruises and concussions;
   • closed and open craniocerebral injuries.
   Mental distress may occur hours or weeks after the injury. There is a pattern: the more severe the injury, the stronger the manifestations of psychosis. Traumatic psychosis is associated with increased intracranial pressure and has a cyclical nature - periods of manifestation of psychosis are replaced by periods mental health. When blood pressure rises, the symptoms of psychosis worsen. When the outflow of cerebrospinal fluid improves, relief comes.
3. Brain intoxication can be caused by various substances.
4. Nervous system diseases: multiple sclerosis, epilepsy, stroke, Alzheimer's disease, Parkinson's disease, temporal lobe epilepsy. These brain diseases cause damage to nerve cell bodies or their processes. The death of cells in 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 release toxins that poison nerve cells and cause their death. Brain intoxication negatively affects a person’s emotions and thinking.
6. Brain tumors. Cysts, benign and malignant tumors compress the surrounding brain tissue, disrupt blood circulation, and the transmission of excitation from one brain structure to another. Nerve impulses are the basis of emotions and thinking. Therefore, a violation of the signal transmission 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 coordinated work brain, leading to psychosis.
8. Diseases accompanied severe pain : ulcerative colitis, sarcoidosis, myocardial infarction. Pain is stress and anxiety. Therefore, physical suffering always has a negative impact on emotions and psyche.
9. Systemic diseases associated with impaired immunity: systemic lupus erythematosus, rheumatism. Nervous tissue suffers from toxins secreted by microorganisms, from damage cerebral vessels, from an allergic reaction that occurs with systemic diseases. These disorders lead to failure of 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, normalize metabolism at the cellular level, and have a positive effect on emotional background and human thinking abilities. Vitamin deficiency makes the nervous system more sensitive to external factors that cause psychosis.
11. Electrolyte imbalance associated with a 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, long-term diets, and uncontrolled use of mineral supplements. 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 gland, hypothalamus, adrenal glands. Long-term hormonal imbalances disrupt brain function. There is a direct relationship between the nervous system and the endocrine glands. 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 that place a heavy burden on the psyche. This means entering a university, finding a job, starting a family.

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

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

Gender factor

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

In men, psychosis due to chronic alcoholism, syphilitic and traumatic psychosis are more common. These “male” forms of psychosis are not related to hormone levels, but to social role, peculiarities of behavior of representatives of the stronger sex. But early cases of psychosis in Alzheimer's disease in men are associated with genetic characteristics.

Geographical factor

It has been noticed that mental illnesses, including psychosis, more often affect residents of large cities. And those who live in small populated areas and in rural areas take less risk. The fact is that life in big cities is fast paced and full of stress.

Illumination, average temperature and day length 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 psychosis. The mechanism of disease development in this case is not clear.

Social factor

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

• women who did not marry and did not give birth to a child;
• men who were unable to build a career or achieve success in society;
• people who are not happy with their social status, were unable to demonstrate their inclinations and abilities, and chose a profession that does not suit their interests.

Factor of psychophysiological constitution

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 identified 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 more often than others develops hysteroid psychosis and has a high tendency to attempt suicide.

How psychosis manifests itself

Main manifestations of psychosis

Hallucinations. They can be auditory, visual, tactile, gustatory, olfactory. Most often, auditory hallucinations occur. The person thinks he hears 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 can be 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 based on the following signs:

• He suddenly freezes and listens for something;
• Sudden silence mid-sentence;
• Conversation with oneself in the form of replicas to someone else’s phrases;
• Laughter or oppression without apparent reason;
• The person cannot concentrate on a conversation with you and is staring at something.

1. Manifestations of depressive disorders:
   • A person sits in one position for a long time; he has no desire or strength to move or communicate.
   • Pessimistic attitude, the patient is dissatisfied with his past, present, future and the entire environment.
   • To relieve anxiety, a person can eat constantly or, conversely, give up eating completely.
   • 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. Manifestations manic disorders:
   • The person becomes extremely active, moves a lot, sometimes aimlessly.
   • Unprecedented sociability and verbosity appear, speech becomes fast, emotional, and may be accompanied by grimacing.
   • An optimistic attitude; a person does not see problems or obstacles.
   • The patient makes unrealistic plans and significantly overestimates his strength.
   • The need for sleep decreases, the person sleeps little, but feels alert and rested.
   • The patient may abuse alcohol and engage in promiscuous sex.

Delusion is a thinking disorder that manifests itself in the form of ideas that do not correspond to reality. A distinctive feature of delusion is that you cannot convince a person using logical arguments. In addition, the patient always tells his delusional ideas very emotionally and is firmly convinced that he is right.

Distinctive signs and manifestations of delirium

• Delusion is very different from reality. Incomprehensible, mysterious statements appear in the patient’s speech. They may concern his guilt, doom, or, conversely, greatness.
• The patient's personality always takes center stage. For example, a person not only believes in aliens, but also claims that they arrived specifically to establish contact with him.
• Emotionality. A person talks about his ideas very emotionally and does not accept objections. He does not tolerate arguments about his idea and immediately becomes aggressive.
• Behavior is subordinated to a delusional idea. For example, he may refuse to eat, fearing that they want to poison him.
• Unreasonable defensive actions. A person curtains the windows, installs additional locks, and fears for his life. These are manifestations of delusions of persecution. A person is afraid of special services that monitor him with the help of innovative equipment, aliens, “black” magicians who send damage to him, acquaintances who weave conspiracies around him.
• Delusions related to one's own health (hypochondriacal). The person is convinced that he is seriously ill. He “feels” the symptoms of the disease and insists on numerous repeated examinations. He is angry with doctors who cannot find the cause of his poor health and do not confirm his diagnosis.
• Delirium of damage manifests itself in the belief that ill-wishers spoil or steal things, add poison to food, influence with radiation, or want to take away an apartment.
• Nonsense of invention. A person is confident that he has invented a unique device, a perpetual motion machine, or a method of combating dangerous disease. He fiercely defends his invention and persistently tries to bring it to life. Since patients are not mentally impaired, their ideas can sound quite convincing.
• Delirium of love and delirium of jealousy. A person concentrates on his emotions, pursues the object of his love. He comes up with reasons for jealousy, finds evidence of betrayal where there is none.
• Nonsense of litigiousness. The patient inundates 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 and remains motionless for a long time (days or weeks). He refuses food and communication.


2. Motor excitement. Movements become fast, jerky, and often aimless. Facial expressions are very emotional, the conversation is accompanied by grimaces. Can mimic other people's speech and imitate animal sounds. Sometimes a person is unable to perform simple tasks because he loses control of his movements.

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

Convince the person to seek help from a psychiatrist. Explain that the doctor will prescribe medications that will help you calm down and make it easier to endure stressful situations.
Types of psychoses

The most common are manic and depressive psychoses - an apparently healthy person suddenly shows signs of depression or significant agitation. Such psychoses are called monopolar - the deviation occurs in one direction. In some cases, the patient may alternately show signs of 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 low mood

   Thoughts are centered around your personality, your mistakes and your shortcomings. Concentrating on one’s own negative sides gives rise to the belief that everything was bad in the past, the present cannot please anyone, and in the future everything will be even worse than now. On this basis, a person with depressive psychosis can commit suicide.

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

   A sick person experiences causeless melancholy, it presses 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 a name - pre-cardiac melancholy.

   Depression in psychosis has a distinctive feature: the condition is worst early in the morning, and in the evening it improves. The person explains this by saying 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.

   It is characteristic that 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 gets tired quickly, doesn’t want to do anything, nothing interests him, doesn’t surprise or make him happy. You can often hear them say, “I envy other people. They can work, relax, have fun. It’s a pity that I can’t do that.”

   The patient always looks gloomy and sad. The gaze is dull, unblinking, the corners of the mouth are downcast, avoids communication, tries to retire. He reacts slowly to calls, answers in monosyllables, reluctantly, in a monotonous voice.

3. Physical inhibition

   Depressive psychosis physically changes a person. Appetite drops and the patient quickly loses weight. Therefore, weight gain during depression indicates that the patient is getting better.

   Human movements become extremely slow: slow unsure gait, hunched shoulders, lowered head. The patient feels a loss of strength. Any physical activity causes the condition to worsen.

   In severe forms of 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 notation at this time; “Get yourself together, pull yourself together,” then you will only make the situation worse. A person will have the thought: “I should, but I can’t - that means I’m bad, good for nothing.” He cannot overcome depressive psychosis by force of will, since the production of norepinephrine and serotonin does not depend on our desire. Therefore, the patient needs qualified help and drug treatment.

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

   Basic rules for communicating with patients with psychosis

   1. Don't argue or talk back to people if you see signs of manic excitement 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 exhibits manic activity and aggression, remain calm, self-confident and friendly. 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 your 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 feeling of guilt, about voices ordering him to kill himself, about hopelessness and uselessness, about plans to end his life. Suicide is preceded by a sharp transition from depression to a bright, peaceful mood, putting things in order, and drawing up a will. Don't ignore these signs, even if you think it's just an attempt to attract attention.
   4. Hide all items that could be used for a suicide attempt: household chemicals, medicines, weapons, sharp objects.
   5. If possible, eliminate the traumatic situation. Create a calm environment. Try to ensure that the patient is surrounded by close people. Reassure him that he is safe now and that everything is over.
   6. If a person is delusional, do not ask clarifying questions, do not ask about details (What do aliens look like? How many are there?). This may make the situation worse. “Get hold of” any nonsense statement he makes. Develop the conversation in this direction. You can focus on the person's emotions by asking, “I can 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 just happened. If he saw or heard something unusual, find out what he thinks and feels about it. To cope with hallucinations, you can listen to loud music on headphones or do something exciting.
   8. If necessary, you can firmly remind about the rules of behavior and ask the patient not to scream. But you shouldn’t make fun of him, argue about hallucinations, or say that it’s impossible to hear voices.
   9. Don't ask for help traditional healers and psychics. Psychoses are very diverse, and for effective treatment it is necessary to accurately determine the cause of the disease. To do this, it is necessary to use high-tech diagnostic methods. If you waste time on treatment with unconventional methods, acute psychosis will develop. In this case, it will take several times longer to fight the disease, and in the future it will be necessary to constantly take medications.
   10. If you see that a person is relatively calm and in the mood to communicate, try to convince him to see a doctor. Explain that all the symptoms of the disease that bother him can be eliminated with the help of medications prescribed by the doctor.
   11. If your relative flatly refuses to see a psychiatrist, persuade him to see a psychologist or psychotherapist to combat depression. These specialists will help convince the patient that there is nothing wrong with a visit to a psychiatrist.
   12. The most difficult step for loved ones is calling an emergency team psychiatric care. But this must be done if a person directly declares his intention to commit suicide, may injure himself or cause harm to other people.

   Psychological treatments for psychosis

   For psychosis psychological methods successfully complement drug treatment. A psychotherapist can help a patient:
   • reduce symptoms of psychosis;
   • avoid recurrent attacks;
   • increase self-esteem;
   • learn to adequately perceive the surrounding reality, correctly assess the situation, your condition and react accordingly, correct behavioral errors;
   • eliminate the causes of psychosis;
   • increase the effectiveness of drug treatment.
   Remember, psychological methods of treating psychosis are used only after it has been possible to remove acute symptoms psychosis.

   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 relapse of the disease.

   Psychological treatment methods are aimed at restoring mental health and socializing a person after recovery to help him feel comfortable in his 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 illness. It becomes an external support for the patient, calms him down and helps him correctly assess reality and respond adequately to it.

   Group therapy helps you 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 them overcome awkwardness and return to normal life.

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

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

   Psychoeducation– this is the education of the patient and his family members. The psychotherapist talks about psychosis, the characteristics of this disease, the conditions for recovery, motivates to take medications and lead healthy image life. Tells relatives how to behave correctly with the patient. If you disagree with something or have questions, be sure to ask them in the time designated for discussion. It is very important for the success of treatment that you have no doubts.

   Classes take place 1-2 times a week. If you visit them regularly, you will develop 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 who have developed psychosis 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 desire return to bad habits.

   Classes are conducted in the form individual conversation. A psychotherapist talks about the connection between drug use and psychosis. He will tell you how to behave to reduce temptation. Addiction therapy helps to create strong motivation to abstain from bad habits.

   Cognitive (behavioral) therapy. Cognitive therapy is recognized as one of the best methods of treating 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 identify these incorrect judgments and the emotions associated with them. It will teach you to be critical of them and not let these thoughts influence your behavior, and will tell you how to look for alternative ways to solve the problem.

   To achieve this goal, the Negative Thought Protocol is used. It contains the following columns: negative thoughts, the situation in which they arose, emotions associated with them, 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 defense mechanisms, which a person uses to protect himself from such situations. The treatment process takes 3-5 years.

   Family therapy – group therapy, during which a specialist conducts sessions with family members where the person 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 patterns in crisis situations. Therapy is aimed at preventing relapses and ensuring that all family members can live comfortably together.

   Occupational therapy. This type of therapy most often occurs in a group setting. The patient is advised to visit special classes, where he can engage in various activities: cooking, gardening, working with wood, textiles, clay, reading, composing poetry, listening and writing music. Such activities train memory, patience, concentration, and develop Creative skills, help to open up and establish contact with other members of the group.

   Specific setting of goals and achievement of simple goals gives the patient confidence that he again becomes the master of his life.

   Art therapy – art therapy method based on psychoanalysis. This is a “no words” treatment method that activates self-healing capabilities. The patient creates a picture that expresses his feelings, an image of his inner world. Then a specialist studies it from the point of view of psychoanalysis.
   
   Social competence training. A group lesson in which people learn and practice new forms of behavior so that they can then 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 classes, 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 thinking errors that lead to delusions: distorted attribution of judgments to people (he doesn’t love me), hasty conclusions (if he doesn’t love me, he wants me dead), depressive way of thinking, inability to empathize , feeling other people's emotions, painful confidence in memory impairment. The training consists of 8 lessons and lasts 4 weeks. At each module, the trainer analyzes thinking errors and helps to form new patterns of thoughts and behavior.

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

   Drug treatment of psychosis

   Drug 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 get worse.

   There is no single scheme drug therapy psychosis. The doctor prescribes medications 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 decreases the dose to achieve positive effect and not cause side effects.

   Treatment of manic psychosis

   Group of drugs	Mechanism of treated action	Representatives	How is it prescribed?
   Antipsychotic drugs(neuroleptics)	Used for all forms of psychosis. Block dopamine-sensitive 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, with a maximum of 1200 mg/day. Take regardless of meals. Maintenance dose 50-300 mg/day.
   		Zeldox	40-80 mg 2 times a day. The dose is increased over 3 days. The drug is prescribed orally after meals.
   		Fluanxol	The daily dose is 40-150 mg/day, divided into 4 times. The tablets are taken after meals. The drug is also available in the form of an injection solution, which is given once every 2-4 weeks.
   Benzodiazepines	Prescribed for acute manifestations of psychosis together 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, the daily dose can be increased to 60 mg. The drug is taken regardless of food, washed down sufficient quantity water. 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 (mood stabilizers)	They normalize mood, preventing the onset of manic phases, and make it possible to control emotions.	Actinerval (a derivative of carbamazepine and valproic acid)	The first week, the daily dose is 200–400 mg, divided into 3-4 times. Every 7 days, the dose is increased by 200 mg, bringing it to 1 g. The drug is also discontinued gradually so as not to cause a worsening of the condition.
   		Contemnol (contains lithium carbonate)	Take 1 g per day once in the morning after breakfast, with a sufficient amount of water or milk.
   Anticholinergic drugs (cholinergic blockers)	Necessary to neutralize side effects after taking antipsychotics. Regulates the sensitivity of nerve cells in the brain by blocking the action of the mediator acetylcholine, which ensures the transmission of nerve impulses between cells of the parasympathetic nervous system.	Cyclodol, (Parkopan)	The initial dose is 0.5-1 mg/day. If necessary, it can be gradually increased to 20 mg/day. Frequency of administration: 3-5 times a day, after meals.

   Treatment of depressive psychosis

   Group of drugs	Mechanism of treated action	Representatives	How is it prescribed?
   Antipsychotic drugs	Makes brain cells less sensitive to excess amounts of dopamine, a substance that promotes signal transmission in the brain. The drugs normalize thinking 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 can range from 150 to 750 mg/day. The drug is taken 2 times a day, regardless of meals.
   		Eglonil	Tablets and capsules are taken 1-3 times a day, regardless of meals. Daily dose from 50 to 150 mg for 4 weeks. It is not advisable to use the drug after 16 hours so as not to cause insomnia.
   		Rispolept Konsta	A suspension is prepared from microgranules and the included solvent, which is injected into the gluteal muscle once every 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	Prescribed for acute manifestations of depression and severe anxiety. The drugs reduce the excitability of the subcortical structures of the brain, relax muscles, relieve feelings of fear, and 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. Prescribed in short courses so as not to cause dependence. After improvement occurs, the dosage is gradually reduced.
   		Lorazepam	Take 1 mg 2-3 times a day. For severe depression, the dose can be gradually increased to 4-6 mg/day. The drug is discontinued gradually due to the risk of seizures.
   Normotimics	Medicines intended 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 medicine is taken after meals to reduce the irritant effect on the gastric mucosa.
   Antidepressants	Remedies to combat 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, melancholy, and fear.	Sertraline	Take 50 mg orally, 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 with breakfast. Swallow the tablet without chewing and wash it down with water.
   Anticholinergic drugs	Medicines that help eliminate the side effects of taking antipsychotics. Slowness of movements, 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 a day, gradually the amount of the drug is increased to 3-16 mg/day. The dose is divided into 3 doses. The tablets are taken during or after meals with liquid.

   
   Let us remember that any independent change in dose can have very serious consequences. Reducing the dosage or stopping taking medications causes an exacerbation of psychosis. Increasing the dose increases the risk of side effects and addiction.

   Prevention of psychosis

   What needs to be done to prevent another attack 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 ordeal for both the patient and his relatives. But you can reduce your risk of relapse by 80% if you take the medications prescribed by your doctor.

   • Drug therapy– the main point of prevention of psychosis. If you have difficulty taking your medications on a daily basis, talk to your doctor about switching to a depot form of your antipsychotic medications. In this case, it will be possible to give 1 injection every 2-4 weeks.

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

   • Regularly attend individual and group psychotherapy sessions. They will increase your self-confidence and motivation to get better. In addition, the psychotherapist can notice signs of an approaching exacerbation in time, which will help adjust the dosage of medications and prevent a recurrence of the attack.
   • Follow a daily routine. Train yourself to get up and take food and medications at the same time every day. A daily schedule can help with this. In the evening, plan for tomorrow. Add all necessary things to the list. Mark which ones are important and which ones are unimportant. Such planning will help you not to forget anything, get everything done and be less nervous. When planning, set realistic goals.
   
   
   • Communicate more. You will feel comfortable among people who have overcome psychosis. Communicate in self-help groups or specialized forums.
   • Exercise daily. Running, swimming, cycling are suitable. It’s 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 early symptoms approaching 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. Changes in health: sleep disturbance, lack or increased appetite, increased sweating, weakness, weight loss.
     What not to do?
     • Don't drink a lot of coffee. It can have a strong stimulating effect on the nervous system. Avoid alcohol and drugs. They have a bad effect on brain function, cause mental and motor agitation, and attacks of aggression.
     • Don't overwork yourself. Physical and mental exhaustion can cause severe confusion, inconsistent thinking, and increased responsiveness to external stimuli. These deviations are associated with a violation of the absorption of oxygen and glucose by nerve cells.
     • Do not take a steam bath, try to avoid overheating. An increase in body temperature often leads to 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. Severe mental stress can become a trigger for a new crisis.
     • Don't refuse treatment. During periods of exacerbation, the temptation to refuse to take medications and visit a doctor is especially great. Don't do this, otherwise the disease will turn into acute form and will require hospital treatment.

     
     

     What is postpartum psychosis?

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

     Manifestations of postpartum psychosis.

     The first signs of the disease are sudden mood swings, anxiety, severe restlessness, and unreasonable fears. Subsequently, 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 out for walks and does not allow anyone near the child. In some cases, the disease is accompanied by delusions of grandeur, when a woman is confident in her superpowers. She may hear voices telling her to kill herself or her child.

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

     Causes of postpartum psychosis.

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

     In approximately half of 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, the woman will be treated in a psychiatric department. While she is taking medications, she cannot breastfeed the baby, since most drugs penetrate into the mother's milk. But communication with the child will be useful. Taking care of the baby (provided that the woman herself wants it) helps to normalize the state of the psyche.

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

     For mental and motor agitation and manifestations of manic syndrome, lithium preparations (Lithium Carbonate, Micalite) and antipsychotics (Clozapine, Olanzapine) are needed.

     Psychotherapy for postpartum psychosis It is used only after acute symptoms have been eliminated. It is aimed at identifying and resolving conflicts that led to mental disorders.

     What is reactive psychosis?

     Reactive psychosis or psychogenic shock - a mental disorder that occurs after severe psychological trauma. This form of the disease has three characteristics that distinguish it from other psychoses (Jaspers triad):
     1. Psychosis begins after a severe emotional shock that is very significant for a given 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. There is a psychologically understandable connection between them.
     Causes of reactive psychosis.

     Mental disorders occur after a strong shock: a disaster, attack by criminals, fire, collapse of plans, career failure, divorce, illness or death of a loved one. In some cases, psychosis can also be triggered by positive events that cause an outburst of emotions.

     Emotionally unstable people, those who have suffered a bruise or concussion, severe infectious diseases whose brain has been damaged by alcohol or drug intoxication. As well as teenagers going through 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. The following forms of reactive psychosis are distinguished:

     • psychogenic depression;
     • psychogenic paranoid;
     • hysterical psychosis;
     • psychogenic stupor.
     Psychogenic depression manifests itself as tearfulness and depression. At the same time, these symptoms may be accompanied by short temper and grumpiness. This form is characterized by the desire to arouse pity and draw attention to one’s problem. Which could end in a demonstrative suicide attempt.

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

     Hysterical psychosis has several forms.

     1. Delusional fantasies – delusional ideas that relate to greatness, wealth, persecution. The patient tells them very theatrically and emotionally. Unlike delusion, a person is not sure of his words, and the essence of the statements changes depending on the situation.
     2. Ganser syndrome patients do not know who they are, where they are, or what year it is. They answer incorrectly simple questions. They perform illogical actions (eating soup with a fork).
     3. Pseudo-dementia – 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 capricious, grimaces, and cannot sit still.
     4. Puerilism syndrome – an adult develops childish speech, childish emotions, and childish movements. It may develop initially or as a complication of pseudodementia.
     5. The "feral" syndrome – human behavior resembles the habits of an animal. Speech gives way to a growl, the patient does not recognize clothes and cutlery, and moves on all fours. This condition, if unfavorable, can replace puerilism.
     Psychogenic stupor– after a traumatic situation, a person loses the ability to move, speak and react to others for some time. The patient may lie in the same position for weeks until he is turned over.

     Treatment of reactive psychosis.

     The most important stage in the treatment of reactive psychosis is the elimination of the traumatic situation. If you manage to do this, then there is a high probability Get well soon.
     Drug treatment reactive psychosis depends on the severity of manifestations and characteristics of the psychological state.

     At reactive depression antidepressants are prescribed: Imipramine 150-300 mg per day or Sertraline 50-100 mg once a day after breakfast. Therapy is supplemented with tranquilizers Sibazon 5-15 mg/day or Phenazepam 1-3 mg/day.

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

     Psychotherapy can free a person from excessive fixation on a traumatic situation and develop defense mechanisms. However, you can start consulting with a psychotherapist only after acute phase the psychosis has passed, and the person has again gained the ability to perceive the specialist’s arguments.

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

   characterized by disorders of mental and intellectual activity varying degrees severity and emotional disorders. Psychotic disorders are understood as the most striking manifestations mental illness, in which the patient’s mental activity does not correspond to the surrounding reality, a reflection real world consciousness is sharply distorted, which manifests itself in behavioral disorders, the appearance of abnormal pathological symptoms and syndromes.

   Covers psychoses and other mental disorders arising from trauma, brain tumors, encephalitis, meningitis, syphilis of the brain, as well as senile and presenile psychoses, vascular, degenerative and other organic diseases or lesions of the brain.

   Mental disorders include post-traumatic stress disorder, paranoia, and mental and behavioral disorders associated with reproductive function in women (premenstrual syndrome, pregnancy disorders, postpartum disorders - “birth blues”, postpartum depression, postpartum (puerperal) psychoses). Post-traumatic stress disorder is a disorder of mental activity due to psychosocial stress that is excessive in intensity.

   Causes of mental disorders

   Neuropsychiatric disorders due to the numerous causes that cause them are extremely diverse. These are depression, and psychomotor agitation, and manifestations of alcoholic delirium, withdrawal syndrome, and various types of delirium, and memory impairment, and hysterical attacks and much more. Let's look at some of these reasons.

   Neuroses

   The first step to exhaustion of the nervous system is basic anxiety. Agree, how often we begin to imagine incredible things, drawing various horrors, and then it turns out that all the worries are in vain. Then, as a critical situation develops, anxiety can develop into more serious nervous disorders, which leads to disturbances not only in a person’s mental perception, but also to failures various systems internal organs.

   Neurasthenia

   A mental disorder such as neurasthenia occurs in response to prolonged exposure to a traumatic situation and is accompanied by high human fatigue, exhaustion of mental activity against the background of excessive excitability and constant grumpiness over trifles. Moreover, excitability and irritability are protective methods against the final destruction of nerves. People with a sense of duty and anxiety, as well as those who do not get enough sleep and are burdened with many worries are especially prone to neurasthenia.

   Hysterical neurosis

   Hysterical neurosis occurs as a result of a strong traumatic situation, and a person does not try to resist it, but, on the contrary, “runs away” into it, forcing himself to experience the full severity of this experience. Hysterical neurosis can last from several minutes, hours to several years, and the longer the period it spreads, the stronger the mental disorder can be, and only by changing a person’s attitude towards his illness and seizures can the cessation of this disease be achieved.

   Depression

   Neurotic disorders also include depression, which is characterized by a lack of joy, a pessimistic perception of life, sadness and reluctance to change anything in one’s life. It may be accompanied by insomnia, refusal to eat, refusal of sexual intercourse, and lack of desire to do one’s business, including what one loves. Often the manifestation of depression is expressed in a person’s apathy to what is happening, melancholy; he seems to be in his own dimension, not noticing the people around him. For some, depression prompts them to turn to alcohol, drugs, and other substances that are harmful to their health. The worsening of depression is dangerous because the patient, losing criticality and adequacy of thinking, can commit suicide, unable to bear the burden of the severity of this disease.

   Chemical substances

   Also, the cause of such disorders can be various influences chemical substances, these substances can be some kind of medicines, food components, and industrial poisons. Lesions of other organs and systems (for example, endocrine system, vitamin deficiencies, exhaustion) cause the development of psychosis.

   Traumatic brain injuries

   Also, as a result of various traumatic brain injuries, transient, long-term and chronic mental disorders, sometimes quite severe, can occur. Brain oncology and other severe pathologies are almost always accompanied by one or another mental disorder.

   Toxic substances

   Toxic substances are another cause of mental disorders (alcohol, drugs, heavy metals and other chemicals). Everything listed above, all these harmful factors, under some conditions can cause a mental disorder, under other conditions - only contribute to the occurrence of the disease or its exacerbation.

   Heredity

   Also, family history increases the risk of developing mental illness, but not always. For example, some kind of mental pathology may appear if it occurred in previous generations, but it can also appear if it never existed. The influence of hereditary factors on the development of mental pathology remains far from being studied.