What causes acute mental disorders. How to find out that your interlocutor is crazy: simple signs that can help identify mental disorders

WHO, depression is the most common mental illness: it affects more than 300 million people worldwide. With depression, there is a persistent decrease in mood and self-esteem, loss of interest in life and previous hobbies, pessimism, sleep and appetite disorders.

The speech of a depressed person has its own characteristics:

• Quiet voice.
• Lack of desire to have a conversation.
• Long thought before answering, inhibition, careful choice of words.
• Frequent use In an Absolute State: Elevated Use of Absolutist Words Is a Marker Specific to Anxiety, Depression, and Suicidal Ideation words with a negative connotation (“lonely”, “sad”, “unhappy”), the pronoun “I” and words expressing totality (“always”, “nothing”, “entirely”).

In addition, there is the concept of masked depression, when a person hides his problems and tries to appear happy. Recognizing the disorder in this case is not easy: the interlocutor will always deny all life’s difficulties. May make jokes about suicide.

Masked depression is more difficult to recognize. Such patients will try not to touch upon problematic topics for them in the dialogue, emphasizing that everything is fine in their lives. But as soon as we start talking about the areas where they are experiencing difficulties, we will see despondency on their faces and hear the phrases: “What is the hurry for me? I’ll have time for everything, I have my whole life ahead of me.”

Lyutsina Lukyanova, psychotherapist, chief physician medical center "Happiness"

Bipolar affective disorder (BD)

Bipolar affective disorder, or manic-depressive psychosis, is another mental illness associated with mood changes. I'm suffering Mental disorders about 60 million people in the world. The life of such people passes in two modes: mania (or hypomania - its lighter form) and depression. The duration of each period is individual and unpredictable; it can range from several days to several months.

A characteristic feature is a change of phases: increased mood or desire to move, do something, create, commit and depression, apathy, despondency, powerlessness, indifference. The moment when the phase change occurs is impossible to predict.

Alexandra Shvets, Candidate of Medical Sciences, neurologist at the Ekaterininskaya Clinic

The manic phase is characterized by an incredible increase in mood and strength, increased activity, including sexual activity. There is so much energy that a person stops sleeping and eating, he is busy all the time. The speech of a patient in a manic phase is characterized by the following features:

• Excessive talkativeness. The person is excited, jumping from one thought to another.
• Boasting, self-confidence and the feasibility of one’s plans. The man says that he is ready to move mountains and complete many different projects.
• Delusional ideas (manifest in special cases). For example, a patient may say that everyone is jealous of him and wants to harm him.

The depressive phase is accompanied by a loss of strength, self-esteem, sexual desire, loss of interest in previous hobbies and life in general. The person is depressed, inhibited, and does not want to communicate with anyone. In severe cases, plans suicide.

Generalized anxiety disorder

Susceptible to this disease Epidemiology of anxiety disorders in the 21st century a third of the planet's population. A person constantly experiences anxiety and suffers from unpleasant sensations in the body: trembling, sweating, dizziness, discomfort in the solar plexus area. Anxiety is usually caused by a variety of fears related to the future.

Among the features of communication:

• Stories about your own fears. A person is afraid to either fly on a plane, or get into an elevator, or communicate, or go into unfamiliar places.
• Constant indignation and complaints, including about health conditions.

Often these are lonely people who have not achieved success in their personal lives and work. They are often outraged by something: the leadership of the country or company where they work, the situation in the state or at home - everything they encounter in life.

Lyutsina Lukyanova

Obsessive-compulsive disorder (OCD)

Another disease associated with anxiety. With it, the patient has obsessive, frightening thoughts that he is unable to fight. To get rid of anxiety, a person performs some kind of ritual: spits over his left shoulder, checks all the locks in the house, washes his hands, and so on. These actions may seem pointless, but they help the patient to relieve the condition for a short time.

A person with OCD can be recognized by the same speech characteristics as those with generalized anxiety disorder. These are complaints, suspiciousness, repeated conversations about fears. However, it will be much more effective to observe his behavior and track the ritual. A typical OCD patient is the American inventor Howard Hughes, about whose life the film “The Aviator” was filmed. He constantly washed his hands because he was afraid of catching an infection.

It is very difficult to identify patients with OCD by phrases in speech, the exception is if the person himself wants to tell you about what is bothering him. It’s not difficult to notice them if you watch people in the park, for example.

Lyutsina Lukyanova

Post-traumatic stress disorder (PTSD)

The disorder can occur after a traumatic situation, most often associated with a threat to life. The sick are victims of sexual or other violence, terrorist attacks, or participants in military operations. They try to avoid conversations, places and situations that may remind them of the events they experienced, but memories constantly return them there. In especially severe cases, the patient may displace the event from memory, as if to forget.

Patients with PTSD suffer from both depressive and anxiety symptoms, so in their speech you can find the same signs as in patients with depression or anxiety disorder.

It is difficult to notice anything from their statements, because they try not to communicate with anyone, living in their own experiences. But if the dialogue does take place, then you will not hear a word about happiness, joy or love. The interlocutor with PTRS will either be laconic or devote his story to the misfortune that happened to him.

Lyutsina Lukyanova

Schizophrenia

According to WHO Mental disorders, schizophrenia affects 23 million people worldwide. This is a serious mental illness that is accompanied by disturbances in thinking, perception of reality, emotions, speech and behavior. Patients do not have a critical attitude towards their condition; in most cases they are confident that they are healthy. A typical example is a mathematician and Nobel laureate in economics John Nash, about whose life the film “A Beautiful Mind” was filmed.

Schizophrenia can be recognized by the following signs:

• Suspiciousness and paranoia. A person may be sure that they are being persecuted or want to harm him.
• Grand ideas and plans.
• Crazy ideas. The patient may think that the world has long been taken over by aliens.
• Inability to conduct dialogue and formulate thoughts. They either break off somewhere in the middle of a sentence (sperrung) or consist of a jumbled collection of words (verbal okroshka).

One of the most striking manifestations of schizophrenia in speech is delusional symptoms of persecution. The patient will be sure that they are putting a spoke in his wheels and that he is being watched. He will whisper his guesses in your ear, looking around.

Lyutsina Lukyanova

Remember: it is impossible to make a diagnosis based on speech and communication style alone. However, if you think that your loved one’s behavior has changed, then be observant. If you have the described symptoms, it is better to show it to your doctor.

All over the world people suffer from mental illness of one kind or another. According to other data, every fifth person in the world has a mental or behavioral disorder.

In total, there are about 200 clinically diagnosable diseases, which can be divided into five types: mood disorders, anxiety disorders, schizophrenia and psychotic disorders, disorders eating behavior, dementia.

Depression is the most common mental illness. The World Health Organization estimates that by 2020, depression will become the second leading cause of disability worldwide, after cardiovascular disease. Slightly less common general anxiety, bipolar disorder, schizophrenia and anorexia, as well as eating inedible objects.

How to recognize the first signs of the disease

This is fine. But as soon as emotions begin to spoil life, they become a problem that indicates a possible mental disorder.

Signs of mental illness are fairly easy to spot. When we feel so anxious that we cannot go to the store, call the phone, or talk without panic attacks. When we are so sad that we lose our appetite, there is no desire to get out of bed, and it is impossible to concentrate on the simplest tasks.

Simon Wessely, President of the Royal College of Psychiatrists and Lecturer at King's College London

Looking at yourself in the mirror for too long, becoming obsessed with yourself appearance They can also talk about health problems. No less a serious signal There should be changes in appetite (both increase and decrease), sleep patterns, indifference to interesting pastimes. All this may indicate depression.

Voices in your head are signs of much more serious problems. And, of course, not everyone who suffers from mental illness hears them. Not everyone who is depressed will cry. Symptoms are always variable and may vary depending on age and gender. Some people may not notice changes in themselves. But, if changes indicating illness are obvious to people around you, then you should consult a psychiatrist.

What causes mental illness

The causes of mental illness combine natural and social factors. However, some diseases, such as schizophrenia and bipolar personality disorder, may be due to a genetic predisposition.

Mental illness occur twice as often after natural Disasters and disasters. This is also affected by changes in a person’s life and physical health. However, the clear causes of the disorder are currently unknown.

How to make a diagnosis

Of course, you can do self-diagnosis and look for a description of the problems on the Internet. This can be useful, but such results should be trusted with great caution. It is best to contact a specialist to receive qualified assistance.

Medical diagnosis can take a very long time, perhaps years. Getting a diagnosis is the beginning, not the end. Each case proceeds individually.

How to be treated

The concept of “mental illness” has changed over time. Today, electrotherapy is prohibited, like many other forms of treatment, so they try to help patients with drugs and psychotherapy. However, therapy is not a panacea, and drugs are most often insufficiently studied due to low funding and the impossibility of conducting mass studies. It is impossible to treat such diseases according to a template.

Is a cure possible?

Yes. People can fully recover from acute illness and learn to overcome chronic conditions. The diagnosis can change, and life can get better. After all, the main goal of treatment is to give a person the opportunity to live the life he wants.

Although many people believe that mental illness is rare, this is actually not the case. Each year, approximately 54 million Americans experience mental health problems or illnesses. Mental disorders affect 1 in 4 people worldwide at some stage in their lives. Many of these diseases can be treated with medications and psychotherapy, but if left unattended, they can easily get out of control. If you think you may be experiencing signs of a mental disorder, seek help from a qualified professional as soon as possible.

Steps

Part 1

Mental illness concept

Understand that mental illness is not your fault. Society often stigmatizes mental illness and those who suffer from it, and it is easy to believe that the reason you have a problem is because you are worthless or don't try hard enough. It is not true. If you have a mental illness, it is the result of a medical condition, not personal failure or anything else. An experienced physician or mental health professional should never make you feel like you are to blame for your illness. Neither those around you nor yourself are to blame.

Let's consider possible biological risk factors. There is no single cause of mental illness, but there are many biological factors that are known to interfere with mental illness. chemical reactions brain and contribute to hormonal imbalance.

• Genetic predisposition. Some mental illnesses, such as schizophrenia, bipolar disorder, and depression, are deeply linked to genetics. If someone in your family has been diagnosed with mental illness, you may be more susceptible to developing one simply due to your genetic makeup.
• Physiological disorder. Injuries such as severe head trauma or exposure to viruses, bacteria or toxins in utero lead to mental illness. Also, abuse of illicit drugs and/or alcohol can cause or worsen mental illness.
• Chronic diseases. Chronic illnesses such as cancer or other long-term illnesses increase the risk of developing mental disorders such as anxiety and depression.

1. Understanding possible environmental risk factors. Some mental illnesses, such as anxiety and depression, are directly related to your personal environment and sense of well-being. Turmoil and lack of stability can cause or worsen mental illness.

   • Difficult life experiences. Extremely emotional and exciting life situations can cause mental illness in a person. They may be concentrated in a moment, such as the loss of a loved one, or prolonged, such as a history of sexual or physical abuse. Participation in combat or as part of an emergency response team can also contribute to the development of mental illness.
   • Stress. Stress can worsen existing mental health conditions and cause mental illnesses such as depression or anxiety. Family quarrels, financial difficulties and problems at work can all be a source of stress.
   • Loneliness. Lack of reliable connections for support, a sufficient number of friends and a lack of healthy communication contributes to the onset or exacerbation of a mental disorder.

2. How to recognize warning signs and symptoms. Some mental illnesses appear at birth, but others appear over time or occur quite suddenly. The following are symptoms that may be warning signs of mental illness:

   • Feeling sad or irritable
   • Confusion or disorientation
   • Feeling apathetic or lack of interest
   • Increased anxiety and anger/hostility/violence
   • Feelings of fear/paranoia
   • Inability to control emotions
   • Difficulty concentrating
   • Difficulty in taking responsibility
   • Reclusion or social withdrawal
   • Sleep problems
   • Illusions and/or hallucinations
   • Weird, pompous, or unrealistic ideas
   • Alcohol or drug abuse
   • Significant changes in eating patterns or sex drive
   • Thoughts or plans about suicide

3. Identify physical warning signs and symptoms. Sometimes physical signs can serve as warning signs that a mental illness is present. If you have symptoms that do not go away, contact medical care. Warning symptoms include:

   • Fatigue
   • Back and/or chest pain
   • Cardiopalmus
   • Dry mouth
   • Digestive problems
   • Headache
   • Excessive sweating
   • Significant changes in body weight
   • Dizziness
   • Serious sleep disturbances

4. Determine how severe your symptoms are. Many of these symptoms occur in response to everyday events and therefore do not necessarily indicate that you are mentally ill. You should have cause to worry if they persist and, more importantly, if they negatively impact your daily functioning in life. Never be afraid to seek medical help.

   Make connections for support. It is important for everyone, especially those dealing with mental illness, to have friends who accept and support them. For starters, this could be friends and family. In addition, there are many support groups. Find a support group in your area or online.

   Consider meditation or cultivating self-awareness. Although meditation cannot replace qualified professional help and/or drug treatment, it can help manage the symptoms of certain mental illnesses, especially those associated with addiction and substance use or anxiety. Mindfulness and meditation emphasize acceptance and presence, which can help relieve stress.

   Keep a diary. Keeping a journal of your thoughts and experiences can help you different ways. Writing down negative thoughts or worries can help you stop focusing on them. Keeping track of what causes certain experiences or symptoms will help your mental health provider provide you with optimal treatment. It will also allow you to explore your emotions in a safe way.

5. Maintain a healthy diet and routine physical activity. Although diet physical exercise may not prevent mental illness, but they can help you manage your symptoms. In cases of severe mental illness, such as schizophrenia or bipolar disorder, it is especially important to stick to a regular routine and get enough sleep.

   • If you suffer from an eating disorder such as anorexia, bulimia or binge eating, you may need to be especially careful with your diet and exercise routine. Consult a professional to make sure you are eating a healthy diet.

The first signs of a mental disorder are changes in behavior and disturbances in thinking that go beyond existing norms and traditions. Basically, these signs are associated with the complete or partial insanity of a person and make a person incapable of performing social functions.

Such disorders can occur in men and women, regardless of age and nationality.

The pathogenesis of many mental disorders is not completely clear, but scientists have come to the conclusion that their formation is influenced by a combination of social, psychological and biological factors.

How do you know if you have a mental disorder? To do this, you should undergo an examination by a professional psychotherapist and answer questions as honestly and frankly as possible.

As the disease progresses, symptoms appear that are noticeable, if not to the patient himself, then to his loved ones. The main signs of a mental disorder are:

• emotional symptoms();
• physical symptoms(pain, );
• behavioral symptoms (medication abuse, aggression);
• perceptual symptoms (hallucinations);
• cognitive symptoms (memory loss, inability to formulate thoughts).

If the first symptoms of the disease are persistent and interfere with normal activities, it is recommended to undergo diagnostics. There are border mental states personalities that are present in many mental and somatic diseases or ordinary fatigue.

Asthenia

Asthenic syndrome is manifested by nervous exhaustion, fatigue, and low performance. The female psyche is more vulnerable and therefore such disorders are more typical for the weaker sex. They experience increased emotionality, tearfulness and

The male psyche reacts to asthenic syndrome with outbursts of irritation and loss of self-control over trifles. With asthenia, severe headaches, lethargy and disturbances in night sleep are also possible.

Obsessions

This is a condition in which an adult persistently has various fears or doubts. He cannot get rid of these thoughts, despite recognizing the problem. A patient with mental pathology can spend hours checking and counting something, and if he is distracted at the time of the ritual, start counting again. This category also includes claustrophobia, agoraphobia, fear of heights and others.

Depression

This painful condition for any person is characterized by a persistent decrease in mood, depression, depression. The disease can be detected by early stage, in this case the condition can be quickly normalized.

Severe cases of depression are often accompanied by suicidal thoughts and require hospital treatment.

Often the appearance of delusional ideas is preceded by depersonalization and derealization.

Catatonic syndromes

These are conditions in which movement disorders: complete or partial inhibition or, on the contrary, excitement. With catatonic stupor, the patient is completely immobilized, silent, and the muscles are toned. The patient freezes in an unusual, often awkward and uncomfortable position.

For catatonic excitement, repetition of any movements with exclamations is typical. Catatonic syndromes are observed both with darkened and clear consciousness. In the first case, this indicates a possible favorable outcome disease, and in the second - on the severity of the patient’s condition.

Blackout

In an unconscious state, the perception of reality is distorted, interaction with society is disrupted.

There are several types of this condition. They are united by common symptoms:

• Disorientation in space and time, depersonalization.
• Detachment from the environment.
• Loss of ability to logically comprehend a situation. Sometimes incoherent thoughts.
• Memory loss.

Each of these signs sometimes occurs in an adult, but their combination may indicate confusion. They usually go away when clarity of consciousness is restored.

Dementia

With this disorder, the ability to learn and apply knowledge is reduced or lost, and adaptation to the outside world is disrupted. There are congenital (oligophrenia) and acquired forms of decreased intelligence, which occur in older people or patients with progressive forms of mental disorders.

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 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 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 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 reasons– taking drugs, alcohol, medicines. 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 is 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

The mechanism of psychosis. Psychosis is based on dysfunction of brain cells (neurons). Inside the cell there are components - mitochondria, which ensure cellular respiration and give it energy for activity in the form of ATP molecules. These connections play a role electric current for a special sodium-potassium pump. It pumps into the neuron what is necessary for its operation. chemical elements: potassium, sodium, calcium.

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. Their psychosis develops at an early age, quickly and in severe form.

   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 brain. Lack of oxygen for 4-5 minutes causes the death of nerve cells, and stress disrupts the coordinated functioning of the 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 to cerebral vessels, from allergic reaction, which occurs when systemic diseases. These violations 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 nervous system more sensitive to external factors causing 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 violations hormonal levels 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 interfere with blood circulation, transmission nerve impulses between neurons, metabolic processes in the brain lead to psychosis.

Psychiatrists believe that psychosis does not occur at “one fine moment” after an experience. nervous shock. Every 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 at 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 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. Circulatory impairment and destruction nerve 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 the level of hormones, but to the social role and behavioral characteristics of the stronger sex. And here early cases psychosis in Alzheimer's disease in men is 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 towns and rural areas are at less risk. The fact is that life in big cities is fast paced and full of stress.

Illumination, average temperature and daylength 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.

In such a situation, a person is constantly pressed by a load of negative emotions, and this long-term stress depletes the safety margin of the nervous system.

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

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 begin treatment in a timely manner. You may notice unusual behavior, refusal to eat, strange statements, or an overly emotional reaction to what is happening. The opposite situation also happens, a person ceases to be interested in the world, nothing touches him, he is indifferent to everything, does not show any emotions, moves and talks little.

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.

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

1. Manifestations 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 and 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.

Crazy ideas.

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 the patients are not impaired mental capacity, their ideas may 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.

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

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.

Personality characteristics always manifest themselves in symptoms of psychosis. The inclinations, interests, and fears that a healthy person has intensify during illness and become the main purpose 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 and what is the reason for the changes in his behavior. In this case, it is necessary to show maximum tact, avoid reproaches and claims, and not raise your voice. One carelessly spoken word can cause a suicide attempt.

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

Manic psychosis – severe mental disorder that causes three characteristic symptoms: elevated mood, accelerated thinking and speech, noticeable motor activity. Periods of excitement last from 3 months to one and a half years.

Depressive psychosis

Depressive psychosis is a disease of the brain, and psychological manifestations are outer side diseases. Depression begins slowly, unnoticed by the patient and those around him. As a rule, good, highly moral people fall into depression. They are tormented by a conscience that has grown to pathological proportions. Confidence appears: “I am bad. I'm not doing my job well, I haven't achieved anything. I'm bad at raising children. I'm a bad spouse. 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

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.

   A person’s movements become extremely slow: a slow, uncertain gait, hunched shoulders, a lowered head. The patient feels a loss of strength. Any physical activity causes deterioration of 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 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 through willpower, 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, 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. Please contact Special attention for signs warning of a suicide attempt: the patient talks about an overwhelming feeling of guilt, 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. You should not turn to traditional healers and psychics for help. 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

   In 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 behavior therapy, psychoanalysis, family therapy, occupational therapy, art therapy, as well as psychosocial trainings: 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 a strong desire to return to bad habits.

   Classes are conducted in the form of 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 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 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 tell you about the characteristics of the course of psychosis and correct models behavior 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 recommended to attend special classes where he can practice various types Activities: cooking, gardening, working with wood, textiles, clay, reading, writing poetry, listening and writing music. Such activities train memory, patience, concentration, develop creative abilities, 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 in order to achieve a 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. Reduces the excitability of nerve cells, has a calming and anticonvulsant effect, relax muscles, eliminate insomnia, reduce anxiety.	Oxazepam	Take 5-10 mg twice or thrice a day. If necessary daily dose may be increased to 60 mg. The drug is taken regardless of food, washed down with a sufficient amount of 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)	Normalize mood, preventing the onset of manic phases, 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 for neutralization 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. 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. Repeated episode of psychosis - ordeal both for the patient himself and for 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 the 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 reaction 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 levels of the 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, the baby cannot be breastfed, since most drugs pass into 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.

     With mental and motor excitation and manifestations manic syndrome lithium preparations (lithium carbonate, Micalite) and antipsychotics(Clozapine, Olanzapine).

     Psychotherapy for postpartum psychosis applies only after elimination acute manifestations. 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 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. There is a psychologically understandable connection between them.
     Causes 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, or whose brains have been damaged by alcohol or drug intoxication are especially at risk of developing reactive psychosis. 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 “feralization” 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 of a quick recovery.
     Drug treatment of 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.