Mental disorder (mental illness; mental illness) - in a broad sense - a state of mind, different from normal, healthy. The opposite of this term is Mental health. However, it may have more particular significance in fields such as law, psychiatry, and psychology.

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

What is a mental disorder called? Mental abnormalities: signs and symptoms of the disease

A PHOTO Getty Images

It is not easy for anyone whose close relative, family member has suddenly changed, has become a different person, to accept this change. For many, the first reaction is denial, which manifests itself in reproaches, harsh demands and irritation, followed by fear and misunderstanding. Both the patient himself and his relatives do not recognize the changes for a long time. A person can suffer from the disease for several months and even years before turning to specialists. The first manifestations of mental illness sometimes occur in youth and go unnoticed. Symptoms of depression are attributed to melancholy, anxiety to shyness, thinking disorders to a philosophical mindset, behavioral disorders are explained by a complex character.

How to recognize the disease?

Mental disorder is a general concept for various disorders of the psyche and behavior. Among them are anxiety disorder (every fourth suffers from it), depression (every eighth). Schizophrenia is diagnosed in one in a hundred people. Each specific mental disorder is accompanied by a violation of the key function of the psyche and characteristic behavior, which is the first to be noticed by relatives and others. Some examples.

Cognitive disorders(most characteristic - dementia, age-related dementia): a marked decrease in memory and other cognitive abilities, such as counting, understanding, judgment, concentration, up to their partial or complete loss. A person forgets names, cannot remember details from the past, but is also unable to absorb new information. He loses the ability to rational and critical thinking, cannot plan and comprehend his actions.

Mood disorders(most characteristic - depression): decreased mood, loss of interest and excessive fatigue, accompanied by guilt, lack of motivation, sleep and appetite disturbances. Or, on the contrary, mania is an excessively elevated or irritable mood, with a reduced need for sleep and food. The person is too talkative, easily distracted, commits rash, risky acts. Mood disorders also include anxiety, fears, neuroses. They are expressed in sudden, causeless (panic) or, conversely, due to a specific factor (metro, altitude) attacks of fear. At such moments, breathing becomes difficult, the heartbeat quickens, dizziness appears, a feeling of loss of control over the situation. There may also be constant and excessive anxiety for a variety of reasons.

Disorders of consciousness(most characteristic - delirium): confused consciousness, disorientation, overexcitation, hallucinations, delirium. As a rule, it worsens in the evening. The most common causes are diseases of the central nervous system, complications of somatic disorders, alcohol and drug intoxication and abuse. The so-called "white tremens" just refers to the latter.

Disorders of thinking and perception(most characteristic - schizophrenia): delusions in the form of megalomania or persecution, illogical, obsessive, extremely poor thinking, fast, incomprehensible speech. Intrusive thoughts such as fear of contamination, contamination, fear of harming oneself or others. Intrusive thoughts are often accompanied by compulsive acts or rituals, such as washing hands frequently, putting things in order. Visual, auditory, rarely olfactory or tactile hallucinations. illusory experiences.

Conduct disorders(most of them first appear in childhood or adolescence): hyperactivity, social isolation, aggression, suicidal attempts. Almost all personality disorders, such as dissocial, paranoid, emotionally unstable, are accompanied by one or another behavioral disorder.

However, sudden mood swings, strange emotional reactions and physiological manifestations do not in themselves speak of illness. Our psyche is arranged in such a way that emotions, feelings and behavior are vulnerable to various factors. They can change at the moment when the body adapts to a stressful situation. And they pass when a person copes with it.

What distinguishes illness from short-term stress?

1. Duration of changes. Each mental disorder has its own duration: symptoms of depression should be observed for at least two weeks, panic disorder and schizophrenia - a month, post-traumatic disorder can be diagnosed in a few days.

2. Persistence of symptoms is one of the main criteria. Symptoms should occur every day or at high intervals.

3. Serious deterioration in capacity and quality of life. If changes interfere with a person's social contacts, limit his physical activity, reduce the standard of living, cause suffering - this is certainly a reason to see a doctor.

4. Set of specific symptoms is the most important criterion. Only a psychiatrist can determine it.

How serious is this?

Even with an obvious clinical picture, relatives of patients are trying to convince themselves that this will pass and you just need to pull yourself together. Patients, not understanding or not knowing what is happening to them, tend to hide their mental problems so as not to burden others or avoid unpleasant and, as it seems to them, unnecessary conversations. In fact, with mental disorders, stable and sometimes irreversible changes occur in the human brain: those structures and those neurochemical systems that are responsible for regulating mood, emotions, thinking, perception, and behavioral stereotypes are disrupted. That is, changes in mental state and behavior are biologically determined. In this sense, any psychiatric disorder is no easier than a physical illness, such as hypertension or diabetes. And to count on the fact that “everything will resolve itself”, unfortunately, is not necessary. The longer the course of the disease, the less assistance provided to the patient, the more serious and extensive the disturbances in his brain. The risk of recurrence of depression after the first depressive episode is 50%, after the second - already 70%, after the third - 90%. Moreover, each new episode reduces the chance of recovery.

What to do?

Realize that the correct diagnosis can only be made by a doctor, a psychiatrist. And it is better to dispel doubts from a specialist than to start the disease.
Act in the interests of the life and health of a loved one and those around him. It can be expected that the sick person himself is unlikely to want to see a doctor. Legally, no one has the right to require him to seek help and accept treatment. But there are conditions, such as acute psychosis, that still require inpatient treatment. In the event that a person close to you poses a danger to yourself or others, it is still necessary to call a psychiatric ambulance team: perhaps this will save the family from tragic consequences.
Look for a good specialist. Many of us still have a very strong fear of psychiatric hospitals and dispensaries, many are afraid to leave there in an even worse condition. But in addition to neuropsychiatric dispensaries, in Russia there are neurosis rooms at district clinics, where people with anxiety and depressive disorders turn much more readily. It is appropriate to ask the attending physician about his actions, plans and duration of treatment, about therapeutic and side effects. The only reason why the attending physician may not provide comprehensive information on treatment is his lack of professionalism. In search of a good doctor, you can take into account the recommendations on forums and other Internet resources. But the priority should not be reviews, but more specialist experience in a particular psychiatric disorder. Of course, good psychiatrists feel confident and competent in any area of psychiatry, but in practice they prefer to deal with only a limited range of disorders. Scientific works, thematic publications, research, academic position along with clinical practice - all this is also a sure sign of professionalism.

Unfortunately, most of those who suffer from psychiatric disorders face lifelong treatment. But, realizing this, it is important to understand something else: the support of loved ones, a sensitive attitude improves their condition. And it will take more effort from the patients themselves to learn to live in harmony with themselves than it was before the disease. But this, perhaps, is the call of the soul, to which one must be able to heed.

Eduard Maron, psychiatrist, MD, professor of psychopharmacology at the University of Tartu (Estonia), honorary lecturer at Imperial College London. He has been practicing for 15 years, including five years in a London clinic. Eduard Maron is the author of the novel "Sigmund Freud" (AST, 2015), under the pseudonym David Messer.

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 causes are divided into two subgroups: exogenous factors and endogenous. The former include external influences, for example, the use of toxic substances, viral diseases, injuries, and the latter include 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 subjects have different reactions to 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.

Delirium is also a frequent companion of 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 deviations at an early stage than to treat an advanced 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, in connection with which they 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 long time avoid hygiene procedures (do not wash or shave);

- quick mood swings;

- mental retardation;

- emotional and behavioral deviations in the 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 mental disabilities. 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. The impact of external environmental conditions of a negative orientation 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 increased excitability, sleep disturbance, inability to concentrate on activities are observed. At the second stage, irritability is noted, which is accompanied by fatigue and indifference, decreased appetite, discomfort in the 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 are not significant for the individual, a series of mandatory 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 the inner voice, even if its requirements 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 feet to rolling in convulsions 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. Persons 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 have either a rise in mood and a general improvement in their condition, or a decline, immersion in spleen 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.

Sedatives are used to treat neurotic conditions 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. Negative manifestations also include nausea, low blood pressure and decreased libido. 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 pain in migraines provoked by mental disorders, improve mood, relieve apathy, lethargy and emotional tension, normalize sleep and appetite, increase mental activity. The negative effects of 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 effects are manifested 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 help cure 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.

D001523

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, however, can proceed and paroxysmal (that is, with an improvement or worsening 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 illness that lasts a relatively short time and ends in recovery. These include: pathological intoxication (delirium tremens), reactive symptomatic conditions, that is, mental disorders caused by severe mental upheavals and experiences.

In psychiatry and clinical psychology

We can distinguish: organic mental disorders (that is, due to 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). - St. Petersburg. , 1890-1907.

Tiganov A. S., Snezhnevsky A. V., and others. 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 law 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. - S. 290-302. - 304 p. - (New materials and research on the history of Russian culture). - ISBN 5-98379-049-8

Wikimedia Foundation. 2010 .

See what "Mental disorder" is in other dictionaries:

Law Dictionary

Ex., number of synonyms: 3 mental illness (15) mental illness (7) ... Synonym dictionary

Mental disorder- A general term indicating that a person's mental state warrants psychiatric intervention. The term also implies. that normal behavior is due to factors similar to those that can cause somatic ... Great Psychological Encyclopedia

Mental disorder- see Mental illness ... Encyclopedia of Law

mental disorder- a term introduced in the Criminal Code of the Russian Federation instead of the outdated concept of mental illness. It includes a temporary mental disorder, a chronic mental disorder (disease), dementia, and other morbid conditions. The presence of P.s. is… … Big Law Dictionary

Mental disorder- (mental disorder) - the concept refers to a number of serious mental dysfunctions. The Mental Health Act 1983 defines a mental disorder as a MENTAL ILLNESS, mental retardation, or other mental disorder such as … Social Work Dictionary

MENTAL DISORDER- A more neutral term than mental illness, and many prefer to use it, because hell does not imply a medical model of clinical phenomena, although it is still assumed that the mental sphere is at the same time an analogue ... ... Explanatory Dictionary of Psychology

MENTAL DISORDER- - see Mental illness ... Soviet legal dictionary

Chronic mental illness, i.e. long-term mental disorder. Sometimes they are paroxysmal (i.e., with an improvement or deterioration in the condition), but they are able to leave behind a persistent mental defect. To such diseases ... ... Law Dictionary

Mental illnesses that proceed relatively quickly and end in recovery: pathological intoxication (delirious tremens), reactive symptomatic states, i.e. mental disorders caused by severe mental shocks and ... ... Law 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 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 a 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 suffer 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, 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

mechanism of psychosis. At the heart of psychosis are violations of the brain cells (neurons). Inside the cell there are components - mitochondria, which provide cellular respiration and give it energy for activity in the form of ATP molecules. These compounds act as an electrical current for a special sodium-potassium pump. It pumps into the neuron the chemical elements necessary for its work: potassium, sodium, calcium.

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 happens to be in the fresh air enough.

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

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. Their psychosis develops at an early age, quickly and in severe form.
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.
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 the manifestations of psychosis. Traumatic psychosis is associated with an increase in 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.
brain poisoning can be caused by various substances.
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.
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.
brain tumors. Cysts, benign and malignant tumors compress the surrounding brain tissues, disrupt blood circulation, and 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.
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.
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.
systemic diseases, associated with impaired immunity: systemic lupus erythematosus, rheumatism. The nervous tissue suffers from toxins secreted by microorganisms, from damage to the cerebral vessels, from an allergic reaction that occurs with systemic diseases. These disorders lead to a failure of higher nervous activity and psychosis.
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.
Electrolyte imbalance 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 of mineral supplements. As a result, the composition of the cytoplasm in nerve cells changes, which negatively affects their functions.
hormonal disorders, caused by abortion, childbirth, disruption of the ovaries, thyroid gland, pituitary gland, hypothalamus, adrenal glands. Prolonged hormonal imbalance disrupts the brain. There is a direct relationship between the nervous system and the endocrine glands. Therefore, strong fluctuations in hormone levels can cause acute psychosis.
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.

Psychiatrists believe that psychosis does not occur at "one fine moment" after suffering a nervous shock. Each stressful situation undermines the brain and prepares the ground for the emergence of psychosis. Each time, the person's reaction becomes a little stronger and more emotional until psychosis develops.

Risk factors for psychosis

age factor

Different psychoses manifest themselves in different periods of a person's 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, finding a job, starting 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 appearance of psychosis is associated with menopause in women, age-related changes in blood vessels and nerve cells. Violation of blood circulation and destruction of 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.

In men, psychosis due to chronic alcoholism, syphilitic and traumatic psychosis are more common. These "male" forms of psychosis are not associated with the level of hormones, but with the social role, the behavior 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 towns and in rural areas are less at risk. 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.

In such a situation, a load of negative emotions constantly presses on a person, and this prolonged stress depletes the safety margin of the nervous system.

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 develop hysteroid psychosis than others, and has a high tendency to attempt suicide.

How does psychosis manifest?

The manifestations of psychosis are very diverse, since the disease causes disturbances in behavior, thinking, and emotions. It is especially important for patients and their relatives to know how the disease begins and what happens during an exacerbation in order to start treatment in a timely manner. You may notice unusual behavior, refusal of food, strange statements, too emotional reaction to what is happening. The opposite situation also happens, a person ceases to be interested in the world around him, nothing touches him, he is indifferent to everything, does not show any emotions, moves and talks little.

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.

Affective or mood disorders. They are divided into depressive and manic.

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.
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.

Crazy ideas.

Delusion is a mental disorder that manifests itself in the form of an idea that does not correspond to reality. A hallmark of delusions is that you can't convince a person with 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 protective 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 doctors who can't find the reason for feeling unwell and don't 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 fight a 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.

Movement disorders. During periods of psychosis, two variants of deviations occur.

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

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.

Personality traits always show up in the symptoms of psychosis. The inclinations, interests, fears that a healthy person has are intensified during an illness and become the main goal of his existence. This fact has long been noticed by doctors and relatives of patients.

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

If you notice such manifestations, then talk to the person. Find out what is bothering him, what is the reason for the changes in his behavior. At the same time, it is necessary to exercise maximum tact, avoid reproaches and claims, and not raise your voice. One carelessly spoken word can lead to a suicide attempt.

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 psychoses

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

Manic psychosis - a severe mental disorder that causes the appearance of three characteristic symptoms: elevated mood, accelerated thinking and speech, noticeable motor activity. The periods of excitation last from 3 months to one and a half years.

depressive psychosis

depressive psychosis is a disease of the brain, and psychological manifestations are the external side of the disease. Depression begins slowly, imperceptibly for the patient himself and for others. As a rule, good, highly moral people fall into depression. They are tormented by a conscience that has grown to pathological dimensions. Confidence appears: “I am bad. I am not doing my job well, I have not achieved anything. I'm bad at raising kids. I am a bad husband. Everyone knows how bad I am and they talk about it." Depressive psychosis lasts from 3 months to a year.

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

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 in the past everything was bad, the present cannot please 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 unpleasant sensations are concentrated, where “the soul hurts”. Therefore, this condition even received the name - precordial longing.
Depression in psychosis has a distinguishing feature: the condition is worst in the early morning, and by 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.
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.

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 worsens the condition.

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 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 of physical signs of 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

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.
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.
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 commit suicide. 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.
Hide all items that can be used in a suicide attempt: household chemicals, medicines, weapons, sharp objects.
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.
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?"
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 with headphones, do something exciting.
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.
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 on treatment with non-traditional methods, then acute psychosis will develop. 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.
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.
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.
The most difficult step for loved ones is to call the psychiatric emergency team. 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 the 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 are given by: psychoeducation, addiction therapy, cognitive behavior therapy, psychoanalysis, family therapy, occupational therapy, art therapy, as well as psychosocial trainings: 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 them to take medication and lead a healthy lifestyle. 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 treatments for 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 engage in various activities: cooking, gardening, working with wood, textiles, clay, reading, writing poetry, listening to and writing music. Such activities train memory, patience, concentration, develop creative abilities, help open up, 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 psychosis

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, the daily dose can be increased to 60 mg. The drug is taken regardless of food, drinking plenty of water. The duration of treatment is 2-4 weeks.
Benzodiazepines		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.
Mood stabilizers (normotimics)		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)	The initial dose is 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. The drugs reduce the excitability of the subcortical structures of the brain, relax the muscles, relieve the feeling 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. Assign short courses so as not to cause dependence. After the onset of improvement, the dosage is gradually reduced.
Benzodiazepines		Lorazepam	Take 1 mg 2-3 times a day. With 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 the irritating 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.
Antidepressants		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 can 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 very serious 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 psychoses

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 impending exacerbation in time, which will help adjust the dosage of drugs and prevent a relapse.
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 extreme confusion, inconsistent thinking, 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 become acute and hospital treatment will be required.
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 oneself or the baby.
Manifestations of postpartum psychosis.
The first signs of the disease are sudden mood swings, anxiety, severe anxiety, unreasonable 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 medications, it is impossible to breastfeed the baby, since most drugs penetrate into 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 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.
Especially at risk of developing reactive psychosis are emotionally unstable people, those who have suffered a bruise or concussion, severe infectious diseases, whose brain has suffered from 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.
Drug treatment of reactive psychosis depends on the severity of the 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.
In 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.

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

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

Mental disorders include post-traumatic stress disorder, paranoia, as well as mental and behavioral disorders associated with reproductive function in women (premenstrual syndrome, pregnancy disorders, postpartum disorders - "birth blues", postpartum depression, postpartum (puerperal) psychosis). Post Traumatic Stress Disorder- a disorder of mental activity due to psychosocial stress, excessive in its intensity.

Causes of mental disorders

Neuropsychiatric disorders due to the multitude of causes that cause them are extremely diverse. These are depressions, and psychomotor agitations, and manifestations of alcoholic delirium, withdrawal symptoms, 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 the exhaustion of the nervous system is elementary 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 result in more serious nervous disorders, which leads to violations not only of a person’s mental perception, but also to failures of various systems of internal organs.

Neurasthenia

Such a mental disorder as neurasthenia occurs in response to prolonged exposure to a traumatic situation and is accompanied by a person’s high 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 arises 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 it spreads, the stronger the mental disorder can be, and only by changing a person’s attitude to his illness and seizures, you can stop this disease.

Depression

Neurotic disorders also include depression, which is characterized by a lack of joy, a pessimistic perception of life, sadness and unwillingness to change anything in one's life. It can be accompanied by insomnia, refusal to eat, from sexual intercourse, lack of desire to do one's own business, including one's favorite thing. Often the manifestation of depression is expressed in a person's apathy to what is happening, sadness, he seems to be in his own dimension, does not notice the people around him. For some, depression motivates them to turn to alcohol, drugs, and other unhealthy drugs. The aggravation of depression is dangerous because the patient, losing criticality and adequacy of thinking, can commit suicide, unable to withstand the burden of the severity of this disease.

Chemical substances

Also, the cause of such disorders can be exposure to various chemicals, these substances can be some drugs, and food components, and industrial poisons. Damage to other organs and systems (eg, endocrine system, vitamin deficiencies, malnutrition) causes the development of psychosis.

Traumatic brain injury

Also, as a result of various traumatic brain injuries, passing, long-term and chronic mental disorders, sometimes quite severe, can occur. Oncology of the brain and its other gross pathology 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). All that is listed above, all these harmful factors, under certain conditions can cause a mental disorder, under other conditions - only contribute to the onset of the disease or its exacerbation.

Heredity

Also burdened heredity increases the risk of developing mental illness, but not always. For example, some kind of mental pathology may appear if it was encountered in previous generations, but it may also appear if it never existed. The influence of the hereditary factor on the development of mental pathology remains far from being studied.

What is a mental disorder called? Mental abnormalities: signs and symptoms of the disease

How to recognize the disease?

What distinguishes illness from short-term stress?

How serious is this?

What to do?

Causes of mental disorders

Signs of a mental disorder

Neuropsychiatric disorders

Treatment of mental disorders

Differences in the meaning of the term depending on the context

In jurisprudence

In psychiatry and clinical psychology

In psychology

Examples

Notes

Literature

See what "Mental disorder" is in other dictionaries:

Causes of psychosis

Risk factors for psychosis

How does psychosis manifest?

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

manic psychosis

depressive psychosis

Psychological treatments for psychosis

Drug treatment of psychosis

Treatment of manic psychosis

Treatment of depressive psychosis

Prevention of psychoses

What is postpartum psychosis?

What is reactive psychosis?

Causes of mental disorders

neuroses

Neurasthenia

Hysterical neurosis

Depression

Chemical substances

Traumatic brain injury

Toxic Substances

Heredity