Psychoneurological symptoms. Psychosis

Mental illnesses are a whole group of mental disorders that affect the state of the human nervous system. Today, such pathologies are much more common than is commonly believed. Symptoms of mental illness are always very variable and varied, but they are all associated with a disorder of higher nervous activity. Mental disorders affect a person’s behavior and thinking, his perception of the surrounding reality, memory and other important mental functions.

Clinical manifestations of mental diseases in most cases form entire symptom complexes and syndromes. Thus, a sick person may have very complex combinations of disorders, which need to be assessed to determine accurate diagnosis Only an experienced psychiatrist can.

Classification of mental illnesses

Mental illnesses are very diverse in nature and clinical manifestations. A number of pathologies may be characterized by the same symptoms, which often makes it difficult timely diagnosis diseases. Mental disorders can be short-term or long-term, caused by external and internal factors. Depending on the cause of occurrence, mental disorders are classified into exocogenous and exogenous. However, there are diseases that do not fall into either group.

Group of exocogenic and somatogenic mental diseases

This group is quite extensive. Does not include the most various disorders mental disorders, the occurrence of which is caused by the unfavorable influence of external factors. At the same time, factors of an endogenous nature may also play a certain role in the development of the disease.

Exogenous and somatogenic diseases of the human psyche include:

• drug addiction and alcoholism;
• mental disorders caused by somatic pathologies;
• mental disorders associated with infectious lesions located outside the brain;
• mental disorders arising from intoxication of the body;
• mental disorders caused by brain injuries;
• mental disorders caused by infectious lesions of the brain;
• mental disorders caused by cancer of the brain.

Group of endogenous mental diseases

The emergence of pathologies belonging to the group of endogenous ones is caused by various internal, primarily genetic, factors. The disease develops when a person has a certain predisposition and the participation of external influences. The group of endogenous mental illnesses includes diseases such as schizophrenia, cyclothymia, manic-depressive psychosis, as well as various functional psychoses characteristic of older people.

Separately in this group we can distinguish the so-called endogenous-organic mental diseases, which arise as a result of organic brain damage under the influence of internal factors. Such pathologies include Parkinson's disease, Alzheimer's disease, epilepsy, senile dementia, Huntington's chorea, atrophic brain damage, as well as mental disorders caused by vascular pathologies.

Psychogenic disorders and personality pathologies

Psychogenic disorders develop as a result of the influence of stress on the human psyche, which can arise against the background of not only unpleasant, but also joyful events. This group includes various psychoses characterized by a reactive course, neuroses and other psychosomatic disorders.

In addition to the above groups, in psychiatry it is customary to distinguish personality pathologies - this is a group of mental diseases caused by abnormal development personality. These are various psychopathy, oligophrenia (mental underdevelopment) and other defects of mental development.

Classification of mental illnesses according to ICD 10

In the international classification of psychoses, mental illnesses are divided into several sections:

• organic, including symptomatic, mental disorders (F0);
• mental and behavioral disorders arising from the use of psychotropic substances (F1);
• delusional and schizotypal disorders, schizophrenia (F2);
• mood-related affective disorders (F3);
• neurotic disorders caused by stress (F4);
• behavioral syndromes based on physiological defects (F5);
• mental disorders in adults (F6);
• mental retardation (F7);
• defects in psychological development (F8);
• behavioral and psychoemotional disorders in children and adolescents (F9);
• mental disorders of unknown origin (F99).

Main symptoms and syndromes

The symptoms of mental illness are so diverse that it is quite difficult to somehow structure their characteristic clinical manifestations. Since mental illnesses negatively affect all or virtually all nervous functions of the human body, all aspects of his life suffer. Patients experience disorders of thinking, attention, memory, mood, depressive and delusional states.

The intensity of symptoms always depends on the severity and stage of a particular disease. In some people, the pathology can occur almost unnoticed by others, while other people simply lose the ability to interact normally in society.

Affective syndrome

Affective syndrome is usually called a complex of clinical manifestations associated with mood disorders. There are two large groups affective syndromes. The first group includes conditions characterized by pathologically elevated (manic) mood, the second – conditions with depressive, that is, depressed mood. Depending on the stage and severity of the disease, mood swings can be either mild or very pronounced.

Depression can be called one of the most common mental disorders. Such conditions are characterized by extremely depressed mood, volitional and motor retardation, suppression of natural instincts such as appetite and the need for sleep, self-deprecating and suicidal thoughts. In particularly excitable people, depression may be accompanied by outbursts of rage. The opposite sign of a mental disorder can be called euphoria, in which a person becomes carefree and content, while his associative processes do not accelerate.

The manic manifestation of the affective syndrome is accompanied by accelerated thinking, rapid, often incoherent speech, unmotivated elevated mood, as well as increased motor activity. In some cases, manifestations of megalomania are possible, as well as increased instincts: appetite, sexual needs, etc.

Obsessiveness

Obsessive states are another one common symptom which is accompanied by mental disorders. In psychiatry, such disorders are designated by the term obsessive-compulsive disorder, in which the patient periodically and involuntarily experiences unwanted, but very obsessive ideas and thoughts.

This disorder also includes various unreasonable fears and phobias, constantly repeating meaningless rituals with the help of which the patient tries to relieve anxiety. A number of signs can be identified that distinguish patients suffering from obsessive-compulsive disorder. Firstly, their consciousness remains clear, while obsessions are reproduced against their will. Secondly, the occurrence of obsessive states is closely intertwined with a person’s negative emotions. Thirdly, intellectual abilities are preserved, so the patient realizes the irrationality of his behavior.

Impaired consciousness

Consciousness is usually called a state in which a person is able to navigate the world around him, as well as his own personality. Mental disorders very often cause disturbances of consciousness, in which the patient ceases to perceive the surrounding reality adequately. There are several forms of such disorders:

View	Characteristic
Amnesia	Complete loss of orientation in the surrounding world and loss of idea of ​​one’s own personality. Often accompanied by threatening speech disorders and increased excitability
Delirium	Loss of orientation in the surrounding space and one’s own personality, combined with psychomotor agitation. Often with delirium, threatening auditory and visual hallucinations
Oneiroid	The patient’s objective perception of the surrounding reality is only partially preserved, interspersed with fantastic experiences. In fact, this state can be described as half-asleep or a fantastic dream
Twilight stupefaction	Deep disorientation and hallucinations are combined with the preservation of the patient’s ability to perform purposeful actions. In this case, the patient may experience outbursts of anger, unmotivated fear, aggression
Outpatient automatism	Automated form of behavior (sleepwalking)
Turning off consciousness	Can be either partial or complete

Perception disorders

Typically, it is perception disorders that are easiest to recognize in mental illness. Simple disorders include senestopathy - a sudden unpleasant bodily sensation in the absence of an objective pathological process. Seneostapathy is characteristic of many mental diseases, as well as hypochondriacal delirium and depressive syndrome. In addition, with such disorders, the sensitivity of a sick person may be pathologically decreased or increased.

Depersonalization is considered a more complex disorder, when a person stops living his own life, but seems to be watching it from the outside. Another manifestation of pathology can be derealization - misunderstanding and rejection of the surrounding reality.

Thinking disorders

Thinking disorders are symptoms of mental illness that are quite difficult for the average person to understand. They can manifest themselves in different ways: for some, thinking becomes inhibited with pronounced difficulties when switching from one object of attention to another, for others, on the contrary, it becomes accelerated. A characteristic sign of a thinking disorder in mental pathologies is reasoning - repetition of banal axioms, as well as amorphous thinking - difficulty in orderly presentation of one's own thoughts.

One of the most complex forms of thinking disorders in mental illnesses is crazy ideas– judgments and conclusions that are completely far from reality. Delusional states can be different. The patient may experience delusions of grandeur, persecution, depressive delirium characterized by self-deprecation. There can be quite a lot of options for the course of delirium. In severe mental illness, delusional states can persist for months.

Violations of will

Symptoms of impaired will in patients with mental disorders are quite common. For example, in schizophrenia, both suppression and strengthening of will can be observed. If in the first case the patient is prone to weak-willed behavior, then in the second he will forcibly force himself to take any action.

A more complex clinical case is a condition in which the patient has some painful aspirations. This may be one of the forms of sexual preoccupation, kleptomania, etc.

Memory and attention disorders

Pathological increase or decrease in memory accompanies mental illness quite often. So, in the first case, a person is able to remember very large amounts of information, which is not typical for healthy people. In the second, there is a confusion of memories, the absence of their fragments. A person may not remember something from his past or prescribe to himself the memories of other people. Sometimes entire fragments of life fall out of memory, in which case we will talk about amnesia.

Attention disorders are very closely related to memory disorders. Mental illnesses are very often characterized by absent-mindedness and decreased concentration of the patient. It becomes difficult for a person to carry on a conversation or concentrate on something, or remember simple information, as his attention is constantly scattered.

Other clinical manifestations

In addition to the above symptoms, mental illness can be characterized by the following manifestations:

• Hypochondria. Constant fear of getting sick, increased concern about one’s own well-being, assumptions about the presence of some serious or even fatal disease. The development of hypochondriacal syndrome is associated with depressive states, increased anxiety and suspiciousness;
• Asthenic syndrome - chronic fatigue syndrome. Characterized by loss of the ability to conduct normal mental and physical activity due to constant fatigue and a feeling of lethargy that does not go away even after a night’s sleep. The patient’s asthenic syndrome manifests itself increased irritability, bad mood, headaches. It is possible to develop photosensitivity or fear of loud sounds;
• Illusions (visual, acoustic, verbal, etc.). Distorted perception of real-life phenomena and objects;
• Hallucinations. Images that appear in the mind of a sick person in the absence of any stimuli. Most often, this symptom is observed in schizophrenia, alcohol or drug intoxication, and some neurological diseases;
• Catatonic syndromes. Movement disorders, which can manifest themselves in both excessive excitement and stupor. Such disorders often accompany schizophrenia, psychosis, and various organic pathologies.

Suspect mental illness loved one possible by characteristic changes in his behavior: he stopped coping with the simplest everyday tasks and everyday problems, began to express strange or unrealistic ideas, and showed anxiety. Changes in your usual daily routine and diet should also be of concern. Signs of the need to seek help will include outbursts of anger and aggression, prolonged depression, thoughts of suicide, alcohol abuse or drug use.

Of course, some of the symptoms described above can be observed from time to time in healthy people under the influence of stressful situations, overwork, exhaustion of the body due to illness, etc. About mental illness we'll talk when pathological manifestations become very pronounced and negatively affect the quality of life of a person and his environment. In this case, the help of a specialist is needed, and the sooner the better.

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 topics that are problematic for them in the dialogue, emphasizing that everything is fine in their lives. But as soon as we start talking about 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. 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 in 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 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.

Mental disorders are a condition characterized by mental and behavioral changes in a destructive direction.

The term has several interpretations, both in the field of jurisprudence and in psychiatry or psychology, which introduces ambiguity into its meaning.

The ICD (International Classification of Diseases) does not distinguish this disorder as a mental or mental illness.

The term is rather a general assessment of various disorders of the human psyche.

Psychiatry notes that it is not always possible to identify biological, social or medical signs mental disorders. Few mental problems arise from a physical disorder in the body.

Risk factors

Each mental disorder of an individual can arise both due to changes in the structure and due to disruption of the normal functioning of the brain.

The reasons influencing this are divided into the following groups:

1. Exogenous. This category usually includes any external factor that affects a person: be it various industrial toxins, narcotic drugs, microorganisms or brain injuries, which could also be caused by a disease.
2. Endogenous. This category includes immanent factors that include chromosome disorders, gene diseases, and hereditary diseases.

There are still many mental disorders that cannot be explained scientifically. Every 4th person has a tendency to mental disorders and behavioral variability.

The main factors provoking the pathologies under consideration are usually considered to be biological and psychological impact environment.

The disorder can be genetically transmitted regardless of gender. Psychological factors combined heredity, as well as the influence of the environment, which can lead to personality disorders.

Raising children with false ideas about family values ​​increases the chances of developing mental disorders.

Mental pathologies most often manifest themselves among patients with diabetes mellitus, vascular diseases of the brain, infectious diseases, and those who have experienced a stroke.

Alcohol addiction can deprive a person of his sanity, disrupting the mental and physical functions of the body.

Symptoms of the disease may also appear in case of regular use of psychoactive drugs that affect the nervous system.

Autumn exacerbations or personal troubles can lead to any person mild depression. It is for this reason that it is recommended to take vitamins in the fall.

Classification

To make it easier to make a diagnosis, the World Health Organization has classified mental pathologies, which are usually grouped as follows:

1. A condition caused by various types of organic damage to the brain. This category includes disorders caused by brain injuries, strokes, or systemic diseases. Cognitive functions are impaired, and symptoms such as hallucinations, emotional variability, and delusions occur.
2. Persistent mental change caused by excessive use of alcohol or drugs. This group includes pathologies that were caused by the influence of psychoactive drugs, as well as sedatives, hypnotics, and hallucinogenic substances.
3. Schizophrenia and schizotypal disorders. Symptoms manifest themselves in the form of a sharp change in character, the commission of illogical and ridiculous actions, changes in interests and the emergence of uncharacteristic hobbies, and a decline in performance. An individual may completely lose the state of sanity and perception of the events surrounding him. If the symptoms are mild or borderline, the patient is diagnosed with schizotypal disorder.
4. Affective disorders are a group of disorders characterized by mood swings. The brightest representative of the category is considered to be bipolar disorder. This group also includes mania with various psychotic disorders and stable forms of these disorders are also considered
5. Phobias and neuroses. This group usually includes various neurotic disorders, including panic attack, paranoid state, neurosis, chronic stress, various phobias and somatized deviations. The classification includes specific and situational types of phobias.
6. Behavioral syndromes including physiological problems. This group includes various types of disorders associated with nutrition, sleep and sexual dysfunction..
7. Personality and behavior disorders. This group included many conditions, including problems of gender identification, sexual preferences, habits and attractions.

   Specific personality disorders include persistent changes in behavior as a reaction to a social or personal situation. Such conditions include paranoid, schizoid, and dissocial personality disorder symptoms.

8. Mental retardation. This category includes congenital conditions characterized by delay in mental development. These manifestations reduce intellectual functions, such as speech, thinking, attention, memory and social adaptation functions.

   The disorder can be mild, moderate, moderate or severe, which is characterized by obvious clinical manifestations. These conditions are based on possible injuries to the fetus during childbirth, developmental delays inside the womb, genetic predispositions, as well as attention deficits in early age.

9. Mental development disorders. This category included speech pathologies, delays in acquiring skills, learning, motor functions and problems of psychological development. The condition begins in childhood and is often caused by brain damage. It proceeds evenly, without deterioration or remission.
10. Disorders that involve activity and attention. This group also includes hyperkinetic pathologies. Symptoms appear in adolescents or children as problems with attention. Children show hyperactivity, disobedience, and sometimes aggression.

Symptoms

Mental pathologies have the following symptoms, divided into groups of signs.

1. Group 1 - hallucinations

   Hallucinations include imaginary perceptions that are not caused by external object. Such perceptions may be verbal, visual, tactile, gustatory and olfactory.

   • Verbal (auditory) hallucinations manifest themselves in individual words, songs, music, phrases that the patient hears. Often words can be in the nature of a threat or an order that is difficult to resist.
   • Visual can manifest itself in the appearance of silhouettes, objects, pictures and full-fledged films.
   • Tactile hallucination is perceived as the sensation of foreign beings or objects on the body, as well as their movement along the body and limbs.
   • Taste hallucination characterized by a feeling of taste as if the patient had bitten something.
   • Olfactory hallucination manifested by a sense of aromas that usually cause disgust.

They can manifest themselves in a wide variety of cases and are a symptom of psychosis. They can occur both in schizophrenia and in case of poisoning with alcohol or other toxic substances. It may also occur in cases of brain damage or senile psychosis.

2. Group 2 - symptoms of thinking disorder

   This group of symptoms includes pathologies of thought processes, it includes: obsessive, delusional and overvalued ideas.

   • Obsessions include conditions that occur against the patient's will. The patient evaluates the standing critically and tries to cope with it. Obsessive thoughts are characterized by inconsistency with the patient’s worldview. An obsession occurs in cases of neurosis or schizophrenia.
     • obsessive doubt manifests itself as regular uncertainty in actions and actions taken, and exists contrary to reasonable logic;
     • the patient can repeatedly check whether electrical appliances are turned on and whether the doors are locked;
     • obsessive memory is manifested by regular reminders to oneself about an unpleasant fact or event;
     • an obsessive abstract idea is manifested by scrolling through thoughts of incoherent concepts, numbers and operations with them.
   • Super valuable ideas. They manifest themselves as logically supported beliefs based on realistic situations that are related to personal characteristics and emotionally charged. Such ideas push the patient to narrowly focused actions, which often contributes to his maladjustment. At the same time, critical thinking is maintained, so ideas can be adjusted.
   • Crazy ideas. They mean a false idea that arises against the background of mental disorders and does not correspond to reality. Such judgments are not criticized, therefore they are fully immersed in the patient’s consciousness, changing the activity and reducing the patient’s social adaptation.
3. Group 3 - signs of emotional disturbance
   

   Various types of emotional disorders are grouped here, reflecting the human attitude towards reality and oneself personally.

   The human body has a close connection with the external environment, which leads to constant exposure irritants from outside.

   Such an impact can be either emotionally positive or negative or cause uncertainty. Emotions can be newly emerged (hypothymic, hyperthymic and parathymic) or lost.

   1. Hypotymia manifested by a decrease in mood in the form of anxiety, fears, feelings of melancholy or confusion.
      • Yearning is a condition that depresses any mental processes of a person. The entire environment is painted in dark tones.

        Activity decreases, there is a strong expression of doom. There is a feeling that life is meaningless.
        There is a high risk of suicide. Melancholy manifests itself in cases of neurosis and manic-depressive psychosis.

      • Anxiety- internal anxiety, tightness and excessive tension in the chest. Usually accompanied by a feeling of impending disaster.
      • Fear is a condition that causes fear for one’s own life and well-being. The patient may, at the same time, not realize what he is really afraid of and be in a state of expectation that something bad will happen to him.

        Some will strive to escape, others will become depressed, freezing in place. Fear can have certainty. In this case, the person realizes the cause of fear (cars, animals, other people).

      • Confusion. In this state, there is variability in the emotional background along with the manifestation of bewilderment.
   2. Hypothymic states are not specific and can occur in various conditions.
   3. Hyperthymia - excessive good mood . Such conditions manifest themselves euphoria, complacency, ecstasy, anger.
      • - causeless joy, happiness. In this state, there is often a desire to do something. Manifests itself when using alcohol or drugs, as well as in manic-depressive psychosis.
      • Ecstasy is characterized by the highest degree of mood enhancement. It appears in patients with schizophrenia or epilepsy.
      • Complacency is a state of carelessness with a lack of desire for action. Most often occurs with senile dementia or atrophic processes in the brain.
      • Anger. The condition is irritability highest level, anger with the manifestation of aggressive, destructive activity. When combined with sadness it is called dysphoria. The condition is typical for patients with epilepsy.

   All types of emotional states described above can occur in a completely healthy person in everyday life: the main factor here is the number of manifestations, intensity and impact on further activities.

4. Group 4 - symptoms of memory impairment
   

The fourth group contains symptoms of memory problems. These include a decrease in memory function or their complete loss, the inability to remember, retain and reproduce individual events or information.

They are divided into paramnesia (memory deception) and amnesia (memory loss)

5. Group 5 - signs of impaired volitional activity

   TO volitional disorders include such types of violations as hypobulia (expressed as a weakening of volitional activity), (lack of activity), and also parabulia (perversion of volitional acts).

   1. Hypobulia is characterized by a decrease in the intensity and number of activities that encourage activity. It can manifest itself as suppression of individual instincts, for example, food, sexual or defensive, which leads to anorexia, decreased libido and lack of protective actions against a threat, respectively. Usually observed in neuroses, depressive states. More persistent conditions occur in some cases of brain damage, as well as schizophrenia and dementia.
   2. The opposite symptom is hyperbulia, which is expressed by a painful increase in volitional activity. A similar unhealthy desire for activity occurs in the case of manic-depressive psychosis, dementia and some types of psychopathy.
6. Group 6 - signs of attention disorder

The sixth group of symptoms includes signs of absent-mindedness, distractibility, exhaustion and stiffness.

1. Absent-mindedness. In this state, a person is unable to concentrate on one type of activity.
2. Exhaustibility. Such a violation of attention leads to a weakening of concentration on a specific process. As a result, it becomes impossible to do work productively.
3. Distractibility. Such a manifestation leads to frequent and unreasonable changes in activity, and as a result, to a loss of productivity.
4. Stiffness. It becomes difficult for a person to switch attention from one object to another.

The pathologies described almost always occur in cases of mental illness.

Public reaction

Most people tend to avoid contact with people suffering from mental disorders, most often the reason for this is stereotypes.

At the same time, there are many variants of deviations that create problems for the patient, but not for the people around him. Only some pathologies lead to antisocial behavior and violation of laws. In this case, the person is declared insane and sent to compulsory therapy.

Old stereotypes cultivate complexes in people that do not allow them to visit psychotherapists, as is common in Western culture. No one can be immune from mental disorders, so you should not ignore specialists who can help overcome a psychological problem.

With timely provision of proper medical care, the severe and sometimes irreversible impact of mental illness on a person can be avoided.

Documentary film on the topic: “Psyche and mental disorders. Genius or disease."

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

So what is psychosis?

This 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 a 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 long period health, an aggravation 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 never returns.

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

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

If you or someone close to you is showing 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 compounds act as an electrical current for a special sodium-potassium pump. It pumps into the neuron the chemical elements necessary for its operation: 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 of the brain. Lack of oxygen for 4-5 minutes causes the death of nerve cells, and stress disrupts the smooth functioning of the brain, leading to psychosis.
8. Diseases accompanied by severe pain: 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 an allergic reaction that occurs when systemic diseases. These disorders lead to failure of higher nervous activity and psychosis.
10. Lack of vitamins B1 and B3 that affect the functioning of the nervous system. They are involved in the production of neurotransmitters, ATP molecules, normalize metabolism at the cellular level, and have a positive effect on a person’s emotional background and mental abilities. Vitamin deficiency makes the nervous system more sensitive to external factors that cause psychosis.
11. Electrolyte imbalance associated with a deficiency or excess of potassium, calcium, sodium, magnesium. Such changes can be caused by persistent vomiting or diarrhea, when electrolytes are washed out of the body, long-term diets, and uncontrolled use of mineral supplements. As a result, the composition of the cytoplasm in nerve cells changes, which negatively affects their functions.
12. Hormonal disorders caused by abortion, childbirth, ovarian dysfunction, thyroid gland, pituitary gland, hypothalamus, adrenal glands. Long-term hormonal imbalances disrupt brain function. There is a direct relationship between the nervous system and the endocrine glands. Therefore, strong fluctuations in hormone levels can cause acute psychosis.
13. Mental trauma: severe stress, situations in which life was endangered, loss of a job, property or loved one and other events that radically change future life. Nervous exhaustion, overwork and lack of sleep also provoke mental disorders. These factors disrupt blood circulation, the transmission of nerve impulses between neurons, metabolic processes in the brain and lead to the appearance of psychosis.

Psychiatrists believe that psychosis does not occur in “one fine moment” after suffering a 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

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

Manic-depressive psychosis most often affects young, active people. At this age, fateful changes occur that place a heavy burden on the psyche. This means entering a university, finding a job, starting a family.

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

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

Gender factor

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

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

Geographical factor

It has been observed that mental illness, including psychosis, more often affects residents major 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 in 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, have failed to demonstrate their inclinations and abilities, and have chosen a profession that does not suit their interests.

In such a situation, a person is constantly pressed by the burden 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 around him, 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 depression for no 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, refuse food 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 of 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. Distinctive feature nonsense - you are unable to 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. Angry at doctors who can't find the cause feeling unwell 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, perpetual motion machine or a way to fight a dangerous disease. He fiercely defends his invention and persistently tries to bring it to life. Since patients are not mentally impaired, their ideas can sound quite convincing.
• Delirium of love and delirium of jealousy. A person concentrates on his emotions, pursues the object of his love. He comes up with reasons for jealousy, finds evidence of betrayal where there is none.
• Nonsense of litigiousness. The patient inundates various authorities and the police with complaints about his neighbors or organizations. Files numerous lawsuits.

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 the external side of the disease. 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. Focus on your own negative aspects gives rise to the belief that in the past everything was bad, 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 the condition to worsen.

   At severe forms Depressive psychosis causes a person to fall 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 assistance and drug treatment.

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

   Basic rules for communicating with patients with psychosis

   1. Don't argue or talk back to people if you see signs of manic excitement in them. This can provoke an attack of anger and aggression. As a result, you can completely lose trust and turn the person against you.
   2. If the patient exhibits manic activity and aggression, remain calm, self-confident and friendly. Take him away, isolate him from other people, try to calm him down during the conversation.
   3. 80% of suicides are committed by patients with psychosis in the stage of depression. Therefore, be very attentive to your loved ones during this period. Don't leave them alone, especially in the morning. Pay special attention to signs warning of a suicide attempt: the patient talks about an overwhelming feeling of guilt, about voices ordering him to kill himself, about hopelessness and uselessness, about plans to end his life. Suicide is preceded by a sharp transition from depression to a bright, peaceful mood, putting things in order, and drawing up a will. Don't ignore these signs, even if you think it's just an attempt to attract attention.
   4. Hide all items that could be used to attempt suicide: 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, you will develop acute psychosis. 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 psychiatric team. 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 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 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 the patient’s external support, calms him down and helps him correctly assess reality and respond adequately to it.

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

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

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

   Psychoeducation– this is the education of the patient and his family members. The psychotherapist talks about psychosis, the characteristics of this disease, the conditions for recovery, motivates to take medications and lead a healthy lifestyle. 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 treatment of psychosis accompanied by depression. The method is based on the fact that erroneous thoughts and fantasies (cognitions) interfere with the normal perception of reality. During the sessions, the doctor will 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 lessons 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 talk about the peculiarities of the course of psychosis and the correct models of 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 engage in various activities: cooking, gardening, working with wood, textiles, clay, reading, composing 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 expressing his feelings, an image of him 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. At a time when life attitudes and behavioral stereotypes are just being formed, psychotherapy can radically change life for the better.

   Drug treatment of psychosis

   Drug treatment 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 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 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. They reduce the excitability of nerve cells, have a calming and anticonvulsant effect, relax muscles, eliminate insomnia, and reduce anxiety.	Oxazepam	Take 5-10 mg twice or thrice a day. If necessary, the daily dose can be increased to 60 mg. The drug is taken regardless of food, washed down 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)	They normalize mood, preventing the onset of manic phases, and make it possible to control emotions.	Actinerval (a derivative of carbamazepine and valproic acid)	The first week, the daily dose is 200–400 mg, divided into 3-4 times. Every 7 days, the dose is increased by 200 mg, bringing it to 1 g. The drug is also discontinued gradually so as not to cause a worsening of the condition.
   		Contemnol (contains lithium carbonate)	Take 1 g per day once in the morning after breakfast, with a sufficient amount of water or milk.
   Anticholinergic drugs (cholinergic blockers)	Necessary 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 fear, and calm the nervous system.	Phenazepam	Take 0.25-0.5 mg 2-3 times a day. The maximum daily dose should not exceed 0.01 g. Prescribed in short courses so as not to cause dependence. After improvement occurs, the dosage is gradually reduced.
   		Lorazepam	Take 1 mg 2-3 times a day. For severe depression, the dose can be gradually increased to 4-6 mg/day. The drug is discontinued gradually due to the risk of seizures.
   Normotimics	Medicines intended to normalize mood and prevent periods of depression.	Lithium carbonate	Take orally 3-4 times a day. The initial dose is 0.6-0.9 g/day, gradually the amount of the drug is increased to 1.5-2.1 g. The medicine is taken after meals to reduce the irritant effect on the gastric mucosa.
   Antidepressants	Remedies to combat depression. Modern 3rd generation antidepressants reduce the uptake of serotonin by neurons and thereby increase the concentration of this neurotransmitter. They improve mood, relieve anxiety, melancholy, and fear.	Sertraline	Take 50 mg orally, 1 time per day after breakfast or dinner. If there is no effect, the doctor may gradually increase the dose to 200 mg/day.
   		Paroxetine	Take 20-40 mg/day in the morning with breakfast. Swallow the tablet without chewing and wash it down with water.
   Anticholinergic drugs	Medicines that help eliminate the side effects of taking antipsychotics. Slowness of movements, muscle stiffness, trembling, impaired thinking, increased or absent emotions.	Akineton	2.5-5 mg of the drug is administered intravenously or intramuscularly. In tablets, the initial dose is 1 mg 1-2 times a day, gradually the amount of the drug is increased to 3-16 mg/day. The dose is divided into 3 doses. The tablets are taken during or after meals with liquid.

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

   Prevention of psychosis

   What needs to be done to prevent another attack of psychosis?

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

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

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

   • Regularly attend individual and group psychotherapy sessions. They will increase your self-confidence and motivation to get better. In addition, the psychotherapist can notice signs of an approaching exacerbation in time, which will help adjust the dosage of medications and prevent a recurrence of the attack.
   • Follow a daily routine. Train yourself to get up and take food and medications at the same time every day. A daily schedule can help with this. In the evening, plan for tomorrow. Add all 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 responsiveness to external stimuli. These deviations are associated with impaired 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 activity electrical potentials in the brain, increasing 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 anxiety, 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. 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 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 medicines You cannot breastfeed your baby, as 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.

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

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

     What is reactive psychosis?

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

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

     Emotionally unstable people, those who have suffered a bruise or concussion, severe infectious diseases, 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 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 simple questions incorrectly. They perform illogical actions (eating soup with a fork).
     3. Pseudo-dementia – short-term loss of all knowledge and skills. A person cannot answer the simplest questions, show where his ear is, or count his fingers. He is capricious, grimaces, and cannot sit still.
     4. Puerilism syndrome – an adult develops childish speech, childish emotions, and childish movements. It may develop initially or as a complication of pseudodementia.
     5. The "feral" syndrome – human behavior resembles the habits of an animal. Speech gives way to a growl, the patient does not recognize clothes and cutlery, and moves on all fours. This condition, if unfavorable, can replace puerilism.
     Psychogenic stupor– after a traumatic situation, a person loses the ability to move, speak and react to others for some time. The patient may lie in the same position for weeks until he is turned over.

     Treatment of reactive psychosis.

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

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

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

     Psychotherapy can free a person from excessive fixation on a traumatic situation and develop defense mechanisms. However, it is possible to begin consultations with a psychotherapist only after the acute phase of psychosis has passed and the person has regained the ability to accept the specialist’s arguments.

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

   Asthenia is a whole complex of disorders that characterize the initial stage of a mental disorder. The patient begins to quickly get tired and exhausted. Performance decreases. There is general lethargy, weakness, and mood becomes unstable. Frequent headaches, sleep disturbances and a constant feeling of fatigue require detailed consideration. It is worth noting that asthenia is not always the main sign of a mental disorder and rather refers to a nonspecific symptom, as it can also occur with somatic diseases.
   

   Suicidal thoughts or actions are a reason for emergency hospitalization of the patient in a psychiatric clinic.

   A state of obsession. The patient begins to have special thoughts that cannot be gotten rid of. Feelings of fear, depression, uncertainty and doubt increase. The state of obsession may be accompanied by certain rhythmic actions, movements and rituals. Some patients wash their hands thoroughly and for a long time, others repeatedly check whether the door is closed, the lights are turned off, the iron is turned off, etc.

   Affective syndrome is the most common first sign of mental disorder, which is accompanied by persistent change moods. Most often, the patient has a depressed mood with a depressive episode, much less often - mania, accompanied by an elevated mood. When a mental disorder is effectively treated, depression or mania is the last thing to go away. Against the background of affective disorder, a decrease is observed. The patient has difficulty making decisions. In addition, depression is accompanied by a number of somatic symptoms: indigestion, feeling hot or cold, nausea, heartburn, belching.

   If affective syndrome accompanied by mania, the patient has an elevated mood. Pace mental activity speeds up many times over, leaving you with minimal time to sleep. Excess energy can be replaced by severe apathy and drowsiness.
   

   Dementia – last stage mental disorder, which is accompanied by a persistent decline in intellectual functions and dementia.

   Hypochondria, tactile and visual hallucinations, delusions, abuse psychoactive substances and – all this accompanies a mental disorder. Close relatives of the patient do not always immediately understand what is happening, so they seek psychiatric help when the disorder becomes pronounced.

   Timely treatment of mental disorders is a guarantee of success

   Modern medicine has in its arsenal quite effective means for treating mental disorders. The sooner treatment is started, the higher the chance of success.