There was a psychosis. Acute psychosis: symptoms, causes, treatment

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Psychotic disorders and their types

By definition psychoses there are pronounced manifestations of mental disorders, in which a sick person's perception and understanding of the world around him is distorted; behavioral reactions are disturbed; various pathological syndromes and symptoms appear. Unfortunately, psychotic disorders are a common pathology. Statistical studies show that the incidence of psychotic disorders is up to 5% of the total population.

A person may develop a transient psychotic state due to the use of certain drugs or drugs; or due to the impact of severe mental trauma ( "Reactive" or psychogenic psychosis).
Mental trauma is a stressful situation, illness, job loss, natural disasters, a threat to the life of loved ones and relatives.

Sometimes there are so-called somatogenic psychoses ( developing due to serious somatic pathology, for example, due to myocardial infarction); infectious ( caused by complications after an infectious disease); and intoxicating ( e.g. alcoholic delirium).

The manifestations of psychotic syndromes are very extensive, which reflects the richness of the human psyche. The main signs of psychosis are:

• Mood disorders.
• Delusional judgments and ideas.
• Movement disorders.

Hallucinations

Hallucinations differ depending on the analyzer involved: gustatory, auditory, tactile, olfactory, visual. They are also differentiated into simple and complex. The simple ones include seeming calls, noises, sounds. To complex - voices, speech. The most common hallucination is auditory: a person hears voices inside his head or from outside that can order, accuse, threaten. Sometimes the voices are neutral.

The most dangerous are the commanding voices, since the sick most often absolutely obey them and are ready to follow all orders, even those that threaten the life and health of other people. Sometimes, due to illness, the main psychological mechanisms are turned off, for example, the instinct of self-preservation. In this case, a person under the influence of voices can harm himself. It is not uncommon for patients in psychiatric clinics to try to commit suicide because the voice ordered it.

Mood disorders

Mood disorders are manifested in patients with manic or depressive conditions. A depressive state is distinguished by a triad of main symptoms, from which all the rest follow: a decrease in mood, a decrease in activity, a decrease in libido. Depressed mood, melancholy, motor retardation, decreased cognitive abilities, ideas of guilt and self-blame, pessimism, suicidal ideas - all these characterize the depressive state.

A manic state is manifested by the opposite symptoms: increased libido, increased activity, increased mood. A person who is in a manic stage shows increased ability to work. He may not sleep at night, and at the same time look active, cheerful, cheerful and tireless. He makes plans, shares with the surrounding fantastic projects. Disinhibition of the sphere of drives is especially characteristic of a manic state: a person begins to lead a promiscuous sex life, drinks a lot, and abuses drugs.

All of the above manifestations of psychotic disorders belong to the range of disorders called "positive". This name was given to them because the symptoms that appeared during the illness, relatively speaking, are added to the painful behavior and state of the human psyche.

Sometimes a person who has suffered a psychotic disorder, despite the apparent disappearance of symptoms, manifests itself negative disorders. They have such a name because the patient's character undergoes changes, in which everything that was characteristic of him is violated: behavior, habits, personal qualities. To put it simply, much disappears from the totality of his behavior and his inherent habits. Negative disorders can lead to even more severe social consequences than positive ones.

Patients with negative disorders become uninitiative, lethargic, apathetic, passive. Their energy tone decreases, dreams and desires, aspirations and motives disappear, and emotional dullness grows. Such people are fenced off from the outside world, do not enter into any social contacts. Previously inherent in them such good traits as sincerity, kindness, responsiveness, benevolence are replaced by aggression, irritability, rudeness, scandalousness. In addition, they develop disorders of cognitive functions, in particular, thinking, which becomes rigid, amorphous, unfocused, meaningless. Because of this, sick people lose their labor qualifications and work skills. Such inability to professional activity is a direct road to disability.

Crazy ideas

Delusional judgments, various ideas and inferences of patients with psychotic syndrome do not lend themselves to correction through clarification and persuasion. They take over the mind of a sick person so strongly that critical thinking is completely turned off. The content of delusional obsessions is very diverse, but most often there are ideas of persecution, jealousy, external influence on the mind, hypochondriacal ideas, ideas of harm, reformism, litigation.

The delusion of persecution is characterized in the conviction of patients that the special services are chasing them, that they will certainly be killed. Delirium of jealousy is more typical for men than for women, and it lies in ridiculous accusations of treason and attempts to extract a confession about it. Delirium of influence on the mind is characterized by assurances of patients that they are affected by radiation, conjure that aliens are trying to telepathically penetrate their minds.

Hypochondriacal patients claim that they are sick with an incurable terrible disease. Moreover, their psyche is so convinced of this that the body "adjusts" to this conviction, and a person can actually show symptoms of various diseases that he is not sick with. The delusion of damage consists in damage to the property of other people, often those who live in the same apartment with a sick person. It can go as far as adding poison to food or stealing personal items.

Reform delirium consists in the constant production of impossible projects and ideas. However, a sick person does not try to bring them to life, as soon as he comes up with one thing, he immediately throws this idea and takes on another.

Litigation delirium is constant complaints to all instances, filing claims in court and much more. Such people create a lot of problems for others.

Movement disorders

Two options for the development of movement disorders: agitation or lethargy ( that is, stupor). Psychomotor agitation forces patients to be in active movement all the time, to talk incessantly. They often mimic the speech of the people around them, grimace, imitate the voices of animals. The behavior of such patients becomes impulsive, sometimes silly, sometimes aggressive. They can commit unmotivated acts.

Stupor is immobility, freezing in one position. The patient's gaze is directed in one direction, he refuses to eat and stops talking.

The course of psychosis

Most often, psychotic disorders are paroxysmal. This means that outbreaks are observed during the disease process acute attacks psychosis and periods of remission. Seizures can occur seasonally ( that is, predictably) and spontaneously ( not predictable). Spontaneous outbreaks occur under the influence of various psychotraumatic factors.

There is also a so-called one-off course, which is most often observed at a young age. Patients endure one long attack and gradually recover from the psychotic state. Their working capacity is fully restored.

In severe cases, psychosis can turn into a chronic continuous stage. In this case, symptoms are partially manifested throughout life, despite supportive therapy.

In non-started and uncomplicated clinical cases, treatment in psychiatric hospital lasts about one and a half - two months. During the stay in the hospital, doctors select the optimal therapy and relieve psychotic symptoms. If the symptoms are not relieved by the selected drugs, then the treatment algorithms have to be changed. Then the terms of stay in the hospital are delayed up to six months or even more.

One of the most important factors that affect the prognosis of psychotic disorder therapy is the early initiation of treatment and the effectiveness of drugs in combination with non-drug rehabilitation methods.

People with psychotic disorder and society

For a long time, a collective image of mentally ill people has been formed in society. Unfortunately, many people still believe that a person with mental disorders is something aggressive and insane, threatening other people with their presence. They are afraid of sick people, they do not want to keep in touch with them, and even their relatives sometimes refuse them. Indiscriminately they are called maniacs, murderers. It is believed that people with psychotic disorders are absolutely incapable of any meaningful action. Not so long ago, during the USSR, when the treatment of such patients did not differ in diversity and humanity ( they were often treated and tamed with electric shock), mental illness was considered so shameful that they were carefully hidden, fearing public opinion and condemnation.

The influence of Western psychiatric luminaries in the past 20 years has changed this opinion, although some prejudices against patients with psychosis remain. Most people think that they are already normal and healthy, but schizophrenics are sick. By the way, the incidence of schizophrenia is no more than 13 people per 1000. In this case, it is statistically justified to believe that the other 987 people are healthy, but 13 who are out of the general count are sick. However, not a single psychologist and psychiatrist in the world can give an exact definition: what is normal and what is abnormal?
The boundaries of normality change all the time. Even 50 years ago, the diagnosis of "autism" in children was a sentence. And now many doctors consider this condition as a different way of a child's relationship with society. As evidence, the facts of the phenomenal memory of such children, their abilities for music, drawing, and chess are cited.

Social rehabilitation involves the use of a whole range of corrective measures and skills for teaching rational behavior. Learning social skills for communication and interaction with the environment helps to adapt to everyday aspects of life. If necessary, daily skills such as shopping, distributing finances, and using public transport are developed with the patient.

Psychotherapy enables people with mental disorders to better understand themselves: to accept themselves as they are, to love themselves, to take care of themselves. It is especially important to undergo psychotherapy for those who experience shame and feelings of inferiority from realizing their illness, and therefore vehemently denies it. Psychotherapeutic methods help to master the situation and take it into their own hands. Communication in groups is valuable, when patients who have undergone hospitalization share with other people who just got to the hospital, their problems and personal ways to solve them. Communication in a close circle, implicated in common problems and interests, brings people closer and gives them the opportunity to feel support and their own need.

All these rehabilitation methods, when used correctly, greatly increase the effectiveness drug therapy, although not able to replace it. Most mental disorders cannot be cured once and for all. Psychoses tend to recur, therefore, after treatment, patients require preventive observation.

Treatment of psychotic disorders with antipsychotics

Antipsychotic drugs ( or antipsychotics) are the main, basic drugs used in psychiatric and psychotherapeutic practice.
Chemical compounds that stop psychomotor agitation, eliminate delusions and hallucinations were invented in the middle of the last century. An effective and very powerful treatment for psychosis has emerged in the hands of psychiatrists. Unfortunately, it was the excessive use of these drugs, as well as unjustified experiments with their dosages, that led to the fact that Soviet psychiatry received a negative image.
She was called "punitive" because of the use of shock therapy. But besides shock therapy, doctors used antipsychotics such as stelazine, chlorpromazine and haloperidol... This is very powerful tools, but they only affected positive symptoms and did not affect negative ones in any way. Yes, the patient got rid of hallucinations and delusions, but at the same time he was discharged from the hospital passive and apathetic, unable to fully interact with society and engage in professional activities.

In addition, classic antipsychotics gave side complication - drug parkinsonism. This complication appeared due to the drugs affecting the extrapyramidal structures of the brain.
Symptoms of drug-induced parkinsonism: tremor, muscle stiffness, convulsive twitching of the limbs, sometimes - a feeling of intolerance to being in one place. Such patients constantly move and cannot sit in one place. To eliminate this symptomatology, additional therapy with corrector drugs was required: akinetone, cyclodol.

In addition to extrapyramidal disorders, in some severe cases, vegetative disorders... In addition to tremor, the patient could have observed: dry mouth, increased salivation, diuretic disturbances, constipation, nausea, frequent heartbeat, fainting, surges in blood pressure, decreased libido, abnormalities of ejaculation and erection, increased body weight, amenorrhea, galactorrhea, decreased cognitive functions, fatigue, lethargy.

Antipsychotics are effective means therapy, especially when combined with other methods of mental rehabilitation, however, according to statistics, 30% of people with psychotic disorders who received antipsychotic therapy did not respond well to treatment.

One of the reasons for the ineffectiveness of treatment may be the fact that some patients who deny their illness violate the doctor's recommendations ( for example, they hide the pills behind the cheek, so that they can spit it out when the medical staff will not see it). In such cases, of course, any therapeutic tactic will be ineffective.

Over the past several decades, new generation antipsychotics have been discovered - atypical antipsychotics... They differ from classical antipsychotics in their selective neurochemical action. They act only on certain receptors, so they are better tolerated and more effective. Atypical antipsychotics do not produce extrapyramidal disturbances. The main drugs in this group are azaleptin, seroquel, rispolept and etc.
Rispolept is the drug of the first order, and azaleptin is used when the ineffectiveness of the previous treatment is revealed.

In the treatment of the acute stage of psychosis, atypical antipsychotics have the following advantages:

• The effectiveness of treatment is precisely negative symptoms, and not only positive ones.
• Good tolerance, and as a consequence, the permissibility of using these drugs in debilitated patients.

Preventive and maintenance therapy for psychosis

Psychoses tend to recur, and patients with such a diagnosis require regular preventive monitoring. Therefore, the international psychiatric conventions give clear recommendations on the duration of the main treatment, as well as preventive and maintenance.

Those patients who have had their first episode of acute psychosis need to take small doses of antipsychotics for two years as preventive therapy. If they have a repeated exacerbation, then the period of preventive therapy is increased by 2 to 3 years.

With the continuous course of the disease, supportive therapy is carried out, the terms of which are established by the attending physician.

Practicing psychiatrists believe that during the initial hospitalization of a patient with acute psychosis, treatment regimens should be covered as extensively as possible and full-fledged, long-term social and psychological rehabilitation measures should be carried out in order to reduce the risk of relapse of the disease.

Reducing the risk of recurrence of psychosis

To reduce the risk of an exacerbation of a psychotic disorder, medical advice should be followed:

• A measured, orderly lifestyle.
• Healthy physical activity, gymnastics.
• A balanced diet and avoiding alcohol and smoking.
• Regular use of prescribed maintenance drugs.

Any changes in the usual rhythm of wakefulness and sleep can lead to a relapse. The first signs of relapse: poor appetite, insomnia, irritability. Such signs require examination of the patient by the attending physician.
Before use, you must consult with a specialist.

Psychosis is a deviation from the normal state of the psyche, which has severe symptoms. Often this word is used not in a medical, but in an everyday sense, when we want to describe behavior that does not correspond to the situation, sharp and unexpected manifestations of emotions. The word "psychosis" at the everyday level means behavior that is not adequate to the current moment.

This everyday definition has a lot in common with the medical one. Soviet physiologist I.P. Pavlov, familiar to everyone from school from experiments aimed at studying conditioned reflexes, defined this disorder as a mental disorder in which a person's reactions grossly contradict reality.

Causes of psychosis

There can be many reasons for the disorder. This condition can be triggered by the use of alcohol, amphetamines, cocaine and other psychoactive substances. Long-term use of antidepressants can also lead to this disorder. Cancellation of some drugs (when the person stops taking the drug to which they are used to) can have the same result.

The diagnosis of psychosis can be made not only for the above reasons. There are a number of social factors that create fertile ground for this disorder. Poverty comes first. It has been proven that psychosis is more common in people whose financial situation is at a low level.

The second factor is violence. The disorder can be triggered by physical abuse, including sexual abuse, experienced in childhood or later in life. Violence can be more than just physical. The disorder can result from emotional abuse (bullying, boycotting, isolation, etc.).

Another common cause in children is hospitalization. It can be difficult for a child to experience separation from home, being in unfamiliar conditions. In this case, hospital treatment can be perceived as violence.

In addition, psychosis can be triggered by repeated trauma. If a child is abused as a child and re-encounters it in adulthood, this can become the basis of a mental disorder.

Types of psychoses

Exists different classifications this disease. From the point of view of the cause of the onset of psychosis, they are divided into endogenous and exogenous. Endogenous translated from Latin means "generated by internal factors, intra-born." The causes of such disorders are associated with metabolic disorders in the brain. This type includes bipolar personality disorder and depressive psychosis.

The next type is exogenous. Translated from Latin means "generated by external factors." A striking example is psychosis caused by the use of psychoactive drugs (drugs, alcohol). In addition to psychoactive drugs, external factors include psychosocial causes: stressful situations, depression, violence, severe emotional experiences.

In addition, there are organic psychoses. They occur against the background or as a consequence of somatic diseases, for example, after a heart attack, infectious and other diseases.

Stages of psychosis

The stages of psychosis are called phases. There are 4 main phases: prodromal (initial), untreated psychosis, acute and residual. How long each phase lasts depends on the individual characteristics and predispositions of the person. However, it should be remembered that this disease is long-term. Taking into account all phases (not only acute), its course is measured in years or even decades.

The prodromal phase is characterized by the appearance of mild symptoms at first, which then become more pronounced. By the end of the stage, they become fully identifiable. At this stage, the most striking manifestations can occur - hallucinations and delusions. The duration of the phase varies from 2 to 5 years.

The untreated phase of psychosis begins when symptoms persist and ends when treatment is started.

In the state of the acute phase, a person may not understand what is happening to him, and not realize that he is sick. At this stage, the symptoms are most pronounced. This is delirium, hallucinations, disrupted thinking.

After the completed course of treatment, the residual phase begins (from the English residue). This stage is characterized by residual symptoms. The residual phase is extended for an indefinite period. It can last until the end of the patient's life.

At the same time, symptoms suppressed with the help of drug treatment may worsen after a while. The period of exacerbation may come again. The possibility of relapse is the specificity of the residual phase.

Signs of psychosis

Psychosis can be recognized by initial stage development. For this, it is necessary to carefully analyze the harbingers of the disease. These are subtle manifestations of symptoms, which are often confused with signs of puberty, attributed to bad temperament or uncommunicativeness.

Harbingers include: anxiety, irritability, sensitivity, anger. The disease leaves an imprint on a person's thinking: there are problems with memory, building logical connections. Symptoms also manifest themselves during appearance... Such a person can be called neglected, unkempt. A clear sign is sleep disorder, which is expressed in drowsiness or, conversely, in insomnia. A person may lose their appetite and fall into apathetic state.

Manifestations of psychosis in women

A feature of the female form is the rapid course of the disease and acute symptoms. Mild manifestations of the disorder are mood swings, which are often attributed to hormonal changes associated with childbirth or menopause.

The cause of the disease can be schizophrenia, thyroid disorders, pregnancy, childbirth, menopause, lesions nervous system... The disease can develop against the background of postpartum depression. External causes include: alcohol consumption, stress, depression.

A woman in a state of psychosis behaves agitated, anxious, or, conversely, is in a state of euphoria. Such states alternate. Often they are accompanied by thoughts out loud (the patient speaks to herself or to imaginary interlocutors). At the same time, speech is distinguished by incoherence and confusion of thoughts. A person may experience visual and auditory hallucinations, which are often described as the presence of a certain voice that can give orders, direct the person's actions.

Moreover, all patients are characterized by a lack of understanding of their condition.

Symptoms of psychosis in men

The specificity of the disease in men is that aggression is added to the female symptoms. It is typical for women, but to a lesser extent.

Substances act less on men than on women and are less likely to cause psychosis. This is due to the fact that a man's body weight is, on average, greater than a woman's. Therefore, the toxic effect of alcohol in the case of men is not as dangerous as in the case of women.

In addition, when alcohol is consumed, the adrenal glands begin to produce male hormones. For men, this is not dangerous, except for sexual arousal. In the case of a woman, this leads to irreversible hormonal changes.

Therefore, more often the cause of the disease in men is not alcohol, but social factors: problems with employment, low social status, the need to compete and compete with colleagues and business partners. This social pressure creates feelings of hopelessness.

All this leads to irritability, gloomy and withdrawn behavior, apathy, depression. These symptoms often translate into aggression.

Treatment of psychosis

How to get rid of psychosis, you can ask a specialist. Do not self-diagnose and self-medicate. The disease is associated with abnormalities in the functioning of the brain, therefore, for an accurate diagnosis, it is necessary to do a CT or MRI. However, an experienced psychiatrist can establish the presence of a problem with the help of tests that show a lack of connection with reality, illogical thinking and other mental disorders.

Patients are prescribed antidepressants and tranquilizers (sedatives). Such drugs work better in combination with physiotherapy procedures, physiotherapy exercises, which have a general strengthening effect and help the patient to relax and get distracted.

High efficiency in the treatment of the disease is demonstrated by cognitive therapy or psychoanalysis. With its help, the doctor determines the cause of the disorder and adjusts the composition of the drug treatment.

Prevention of psychosis

Treatment of psychosis at home is not possible. However, there are a number of recommendations that will help you choose the right line of communication with loved ones suffering from such a disorder.

The patient must be listened to, no matter how delusional his thoughts would seem, but you should not enter into a dialogue and try to defend your point of view. One should agree with the patient in everything. This is due to the fact that such a person may not understand what he is saying. During an exacerbation, the dispute can provoke the patient to aggressive actions. In such situations, you need to call an ambulance.

It should be remembered that psychosis is divided into manic and depressive. In the first case, antidepressants are contraindicated. Therefore, you should not choose the treatment yourself. If symptoms are found, you should immediately consult a doctor.

Possible consequences of untreated psychosis

It is impossible to completely cure psychosis. However, the treatment of symptoms can provide a lasting remission, that is, a condition without relapses of the disease. If the patient is not helped, the disease will surely return. In advanced cases, the disease returns in an aggravated form. An extreme manifestation in such cases can be suicide.

Article author: Maria Barnikova (psychiatrist)

Psychosis: causes, types, signs and treatments for the disorder

06.04.2017

Maria Barnikova

Psychosis is a pronounced severe disorder of the psychotic level. Causes, types, symptoms and methods of psychosis treatment.

In modern psychiatry, the term means deep, severe, pronounced mental disorder. In psychosis, the reactions shown to the patient clearly contradict the real situation, which manifests itself in a gross violation of the perception of the surrounding reality, a strong disorganization of the patient's behavior.

Psychoses are characterized by the occurrence of abnormal, incomprehensible, illogical phenomena, such as: hallucinations, delusional components, psychomotor dysfunction, affective defects. With psychosis, a person loses the ability to adequately perceive the real picture of the world, he cannot interpret the situation objectively, he is deprived of the opportunity to conduct a logical analysis. A psychotic patient completely loses the ability to critically assess his condition and cannot comprehend the existence of the problem.

Disorders from the psychotic group are fairly common diseases. According to the World Health Organization, about 2% of the entire human population suffers from some type of psychosis. So, according to the Russian Institutes of Psychiatry, the prevalence of schizophrenia alone is 2 cases per 1000 population. However, it is difficult to provide accurate data on the incidence of psychosis due to the existence of various diagnostic approaches, the rather low quality of the work of Russian psychiatric services, personality traits patients and the existing misconception in many people regarding psychotic disorders.

Also, due to the existing variety of psychoses, it is rather difficult to indicate the age range corresponding to the maximum number of cases of these disorders. It should be borne in mind that any person can get sick with psychosis, regardless of gender, age, level of education, financial situation, social status. It was found that about 20% of patients who were diagnosed with a disease of the group of psychosis had a fairly early onset of the disorder - from 15 to 25 years. However, there are also such forms of psychosis that are more characteristic of elderly and senile people.

Psychosis: types and classification

There are several different approaches to classifying the types of psychosis. The most accurate systematization of these disorders is based on the principle of dividing them into groups depending on the etiological causes and conditions of their occurrence, the pathogenetic mechanisms of the development of the disease. So, the resulting psychoses are classified into types:

• endogenous - conditions that developed with damage, defects, diseases internal organs in the absence of brain damage;
• exogenous - ailments that manifested as a result of negative impact external factors, for example: intoxication.

Endogenous types of psychoses include:

• manic-depressive, also referred to as bipolar affective disorder or endogenous depression;
• senile - acute disturbance of mental activity in elderly people;
• schizophrenic - a deep personality disorder characterized by a significant distortion of thinking and impaired perception with the presence of a feeling of the influence of extraneous forces in the patient;
• cycloid, characterized by a constant sharp change in mood, a rapid change in motor activity;
• symptomatic - conditions caused by the progression of the underlying somatic ailment.

There is also a syndromic classification of psychoses - the division of disorders in sight, depending on the dominant symptoms in the patient. According to this subdivision, the most common forms of psychosis are paranoid, hypochondriacal, depressive, manic, depressive-paranoid, depressive-hypochondriacal disorders.

It is also customary to subdivide psychoses into types:

• organic - disorders that started after traumatic brain damage, neuroinfections and other painful conditions of the structures of the skull, including neoplasms;
• functional - states that have arisen under the influence of external traumatic factors.

According to the intensity of symptoms and the rate of their development, psychiatrists distinguish types of psychoses:

• reactive - a reversible pathology of the psyche, which started as a result of exposure to intense long-term psycho-traumatic factors;
• acute - pathological mental defects that developed suddenly and rapidly.

Within the framework of this article, it is not possible to describe all the existing and studied types of psychotic disorders that have specific symptoms and arise for established natural reasons. However, we point out that the most common types of psychoses are:

• metal alcoholic, which are subdivided into delirium (delirium tremens), hallucinosis (acute, subacute, chronic), delusional states (delusions of persecution and paranoia), encephalopathy (Gaia-Wernicke, Korsakov's psychosis, pseudoparalysis) and pathological intoxication (epileptoid) and paranoid forms
• disorders that have formed as a result of the use of drugs and substance abuse, such as: hashish psychotic disorders with manic, hallucinatory-paranoid, depressive-hypochondriacal content; psychotic episodes with the use of LSD, phenamine; cocaine, amphetamine psychosis and others;
• traumatic - mental disorders that occur in the acute, distant and late period after trauma to the cranial structures or damage to the central nervous system;
• senile - gross changes in the mental sphere that occur in elderly people;
• manic-depressive - an anomaly, which is characterized by the presence of depressive inclusions and episodes of mania;
• epileptic –ictal, postictal and interictal types;
• postpartum mental disorders;
• vascular - psychopathological conditions associated with pathogenic vascular processes;
• schizophrenic - abnormal states of the psyche, which are subdivided into affective, delusional, hallucinatory (more often pseudo-hallucinatory), hebephrenic, catatonic, oneroid stupefaction;
• hysterical - disorders, subdivided into the syndrome of delusional fantasizing, pseudodementia (false dementia), mental regression syndrome (the phenomenon of "wildness"), puerilism (manifestation of childishness in adult patients), psychogenic stupor, Ganser's syndrome ("mimicry" syndrome).

Psychosis: causes of the disorder

The rapid development of medicine has led to the fact that today a lot of theories have been formulated and enough hypotheses about the causes of psychosis have been considered. However, at present, neither genetic, nor physiological, nor social, nor psychological studies can indicate the exact true reason why psychotic disorders arise and develop in all people without exception.

That is why the world's leading psychiatrists recognize the multifactorial system of mechanisms that gives rise to psychotic disorders. This model assumes that the same type of psychosis can start in different people according to various reasons... Moreover, most often the disease develops due to the existence and layering of several predisposing and provoking factors (biological prerequisites and psychosocial causes).

One of such systems is the model conventionally called "stress - vulnerability". This theory is based on the following: there are certain genetic factors that predispose to the formation of psychotic disorders in an individual. The presence of such a conditioned tendency to psychosis, coupled with a specific characterological portrait of the personality, is the basis for a high susceptibility of a person to the effects of stress factors, both a positive spectrum and a negative color. At certain stages of life, for example: during puberty or during pregnancy, the subject becomes especially vulnerable to the onset of traumatic events due to his tendency to excessive mental reactions and inability to withstand stress. It is this moment that is the countdown for the formation of psychosis. At the same time, not always factors that have a protective effect (for example: a person's financial stability and a happy marriage) can counteract traumatic circumstances. In some situations, when the intensity of stressors is too high, such "defenders" only postpone the moment of development of psychosis, soften the severity of the symptoms shown.

If we consider each of the versions proposed by scientists separately, we should highlight the most proven theories describing the causes of the development of psychosis.

Reason 1. Biological (chemical)

One of the leading causes of any psychotic disorder is a failure in the production and exchange of neurotransmitters, one of the functions of which is to ensure the transfer of information between the structural units of the nervous system. A special role in the neurotransmitter system is assigned to catecholamine dopamine, tryptamine serotonin, 2-aminopentanedioic (glutamic) acid.

Thus, excessive dopamine activity in the mesolimbic tract provokes an increase in the positive (productive) symptoms of psychosis, for example: the appearance of motor affective reactions, the emergence of delusional judgments and hallucinations. On the contrary, a decline in dopamine activation in the mesocortical system gives rise to the development and aggravation of negative (deficient) symptoms of psychosis, provoking apathy, speech poverty, attention deficit, and a lack of working memory.

Reason 2. Genetic

A familial predisposition to psychotic reactions is one of the leading causes of psychosis. Individuals with close relatives suffering from schizophrenia, bipolar disorder have a high risk of developing psychosis.

If both the mother and the father suffered from psychotic disorders, then the probability of developing psychosis in their offspring is 50%. If only one parent has symptoms of mental disorders, then the risk of developing psychotic reactions for the child reaches the level of 25%.

Reason 3. Personal constitution

Character traits and certain personality traits can cause psychosis. For example, individuals with schizophrenic psychosis are often introverted. They are distinguished by egocentrism. So, a person of the cycloid type is prone to manic-depressive psychosis. In a person with a hysterical constitution, hysterical disorders are most often recorded.

Reason 4. Social factors

A person's stay in a negative emotional climate is one of the leading causes of psychosis. Regular stress, frequent traumatic situations are the basis for the emergence of psychotic disorders. Certain life circumstances also push to psychosis: low economic status, poor social status, inability to pay off loan obligations, lack of own housing, poor family relationships.

The social reasons for the development of psychosis also include an unfavorable period of growing up - a situation when a child was brought up in an incomplete or problematic family, excessive severity or complete inattention of parents. Psychiatrists point out that the risk of developing psychosis in adulthood is very high in those people who have experienced sexual , physical or mental abuse. People who have been treated inappropriately and cruelly in childhood are at risk of developing psychotic disorders. A high degree of development of psychosis is present in children abandoned by their parents and underwent “street education”. Very often, the victims of psychosis are persons who in childhood were rejected or suffered bullying from their peers.

Reason 5. Biological (anomalies of intrauterine development)

The factors predisposing the appearance of psychosis include the problems of intrauterine development of a person. Infectious diseases of the mother, poor-quality or inadequate nutrition during pregnancy, alcohol abuse, drug use have a negative impact on the development and functioning of the central nervous system of the unborn baby. Prematurity, oxygen starvation, which arose during childbirth, are the cause of the formation of various psychotic disorders, including psychoses.

Reason 6. Anatomical

A common cause of psychotic conditions is anomalies in the structures of the brain, resulting from trauma to the structures of the skull, due to vascular pathologies, infectious diseases with the predominant localization of the focus of the disease in the central nervous system.

Brain contusions and concussions, closed and open craniocerebral trauma can trigger a cascade of psychotic reactions both a few hours later and several months after the injury. Moreover, the more severe the damage to the skull, the stronger the symptoms of psychosis.

Psychosis is often a companion or a consequence of:

• chronic autoimmune disease - multiple sclerosis;
• epilepsy;
• acute disturbance of cerebral blood supply - stroke;
• senile dementia of the Alzheimer's type - Alzheimer's disease;
• tremor paralysis - Parkinson's disease.

Psychotic reactions can occur in the presence of cysts, benign and malignant tumors in the structures of the cranium. The cause of psychosis can be bronchial asthma with severe debilitating attacks.

It can be argued that any somatic pathology accompanied by an intense pain syndrome is a source of severe stress for a person, as a result of which psychosis can start.

Reason 7. Intoxication

A common cause of psychosis is abuse alcoholic beverages, uncontrolled intake of pharmacological agents, substance abuse. Quite often, psychotic disorders are a consequence of cannabinoid use in adolescence. The development of some symptoms of psychosis provokes reception:

• nMDA receptor antagonists such as ketamine, dextromethorphan and phencyclidine;
• anticholinergic drugs such as the alkaloids atropine, scopolamine and hyoscyamine;
• glucocorticoids such as cortisol;
• adrenocorticotropic hormone;
• dopamine agonists such as tubazide;
• non-steroidal anti-inflammatory drugs, for example: dicloberla;
• sympathomimetics such as ephedrine;
• antidepressants such as Prozac
• antipsychotics, for example: haloperidol.

Reason 8. Perceptual-cognitive and neuropsychological factors

It has been found that psychoses are very often recorded in people with problems in neuropsychological development and with a low coefficient of intellectual potential. In such patients, the processing of visual and spatial information is quite often impaired, sensory-motor dysfunctions are determined, associative thinking is weakened, the ability to recognize presented stimuli is impaired.

Psychosis: symptoms of the disorder

Due to the existing variety of psychotic disorders, it is impossible to describe in one publication all the symptoms demonstrated in psychosis. It can be argued that the manifestations and signs of psychosis are limitless, as the human psyche is multifaceted and unique. However, symptoms have been studied and described that may indicate the onset and development of a psychotic disorder.

You should know that the first symptoms of the disease can be determined in a person long before the onset of psychosis. Such conditioned signals include any changes occurring in a person's mental activity, which arose spontaneously and unexpectedly in the absence of adequate reasons. The harbingers of psychosis include:

• excessive nervousness, unreasonable irritability of a person;
• a sudden and dramatic change in mood, its fluctuations from a state of deep sadness to euphoria;
• psychomotor agitation and motor restlessness;
• significant slowness of reactions, lethargy of the subject;
• the appearance of problems with sleep;
• a sharp change in eating behavior;
• significant decline in working capacity, inability to fulfill the usual professional duties;
• the appearance of irrational fears and illogical anxiety;
• a sudden change in habits;
• voluntary isolation of a person from society;
• groundless change of interests and hobbies.

All symptoms of psychosis are divided into two conditional categories: positive signs and negative signs.

Positive symptoms of psychosis

Among positive symptoms of psychotic disorder include:

• Verbal, visual, olfactory, gustatory, vestibular, visceral, tactile hallucinations of simple and complex forms. Most often, an individual hears "voices" coming from outside. Bright and distinct sounds can come from the patient's head. The perceived message from the "voices" may have a neutral color, but most often the patient is threatened, humiliated or accused, ordered to perform some action. When verbal hallucinations occur, the subject can talk to himself. A person can suddenly become alert, begin to listen carefully to something. He may start crying a lot or laughing for no reason.
• Delusional inclusions - versatile ideas, reasoning, conclusions, inferences that do not reflect the really existing picture of reality, do not lend themselves to correction with the help of beliefs and explanations. The most common type is the delusion of persecution, when a person is sure that he is being watched, intrigues are being woven against him, there are conspiracies with the aim of maiming or killing him. The delusion of influence is also widespread - a phenomenon when a patient is convinced that he is being influenced by some otherworldly forces or other structures, for example: special services, using secret technology.
• A common symptom of psychosis is damage maniacharacterized by a person's conviction that they want to harm him. Also, the symptoms of psychosis include hypochondriacal delirium - a phenomenon when the subject is sure that he is sick with some incurable disease. No less common is another symptom of psychosis - delirium of jealousy, when an individual is sure that the other half is cheating on him. There may be other delusional ideas, for example: megalomania.
• Movement disorders of akinetic-rigid types and hyperkinetic forms, manifested in diametrically opposite phenomena - in the form of stupor (lethargy) or motor excitement. In the first case, the individual looks sedentary, his body takes on a static and unnatural position, he seems to freeze in one position. A person can be motionless for hours, staring at one point. He does not respond to appeals addressed to him, stops giving answers to questions. In the case of psychomotor agitation, the subject cannot be motionless. His actions are chaotic and inconsistent, impulsive and unmotivated. His speech is verbose and illogical. An increase in gesticulation is noticeable, the person vigorously waves his arms, grimaces.
• Mood disorders are mood instability in the form of depressive episodes and manic states. Symptoms of a depressive nature in psychosis are a melancholy mood, depression, a pessimistic outlook on life, the emergence of ideas of self-accusation, suicidal behavior. Symptoms of a manic state are an overly elevated mood, an indefatigable thirst for activity, an overestimation of one's own capabilities, disinhibition of drives and impulses.

Negative symptoms of psychosis

The negative signs of psychotic disorders include such phenomena, which are characterized by a global change in the character and personal qualities of a person, the loss from the mental sphere of a huge part of the processes that were previously inherent in it. The negative symptoms of psychosis are:

• decline in human energy potential;
• decrease and subsequent complete disappearance of desires;
• lack of motivation, impulses, aspirations;
• the emergence and growth of dullness of the emotional response;
• social isolation of a person, voluntary isolation from society, unwillingness to contact in the human community;
• the disappearance of moral and ethical norms, the appearance of rudeness, vulgarity, aggressiveness;
• impoverishment of speech and thinking;
• behavior that is dangerous for the patient himself and others;
• rigidity, empty thinking, lack of purposefulness;
• loss of work skills and the ability to self-service.

It is worth pointing out that mentally ill people cannot, by force of will or by compulsion, eliminate the symptoms of psychosis. Therefore, it is extremely important for them to understand and support loved ones, it is vitally necessary to consult a doctor and subsequent treatment.

Psychosis: phases of disorder

As a rule, psychoses have a periodic course with sudden or regular seizures. However, psychotic pathologies can also become chronic, acquiring a continuous course with a constant demonstration of symptoms.

The phases of any type of psychosis include:

• prodromal stage - the period from the manifestation of single symptoms to their subsequent constant demonstration;
• the stage of untreated psychosis - the interval from the onset of constant demonstration of psychosis symptoms until the beginning of treatment for the disease;
• acute phase - a stage for which the peak of the disease is characteristic and the maximum intensity of the symptoms of the disorder is observed;
• the residual phase is a stage of decrease in the intensity of psychosis symptoms, lasting several years.

Psychosis: treatments

All people who notice the symptoms of psychotic disorders and people who suspect that relatives have problems should visit the hospital as soon as possible. It should be remembered: in these days, a visit to a psychiatrist is not fraught with publicity and does not have any unpleasant consequences. The visit to the doctor remains voluntary and anonymous. Therefore, a timely visit to a doctor is the only chance for choosing the right program for treating psychosis and getting rid of a person from the painful symptoms of the disorder.

You need to know: psychotic symptoms succumb successful treatment exclusively through pharmacological therapy. No miraculous herbs, visits to healers, psychological convictions can help to overcome a serious illness of the mental sphere.

How to respond if a close relative has symptoms of psychotic disorders? It is important to observe the following:

• Do not ask, do not clarify, do not be interested in details regarding the details of his hallucinations.
• Do not try to figure out the essence of his delusional statements.
• Do not enter into debates with the patient.
• Do not prove that his beliefs are false and illogical.
• You need to try to calm him down, switch his attention.
• If a person is inclined to talk, you need to listen carefully.
• The patient should be motivated to see a psychiatrist.
• If there is a suspicion that the person has decided on, it is necessary to call the medical team as an emergency.
• In cases of demonstrating aggressive socially dangerous behavior, you must immediately apply for medical help, since acute symptoms of psychosis can be stopped only in a hospital setting.

Although psychoses are a very large and difficult group of disorders to overcome, the principles of drug treatment for all diseases of this series are the same. However, when carrying out drug therapy, an unconventional, purely individual approach to the choice of a treatment program for each specific patient is required. Before prescribing drug treatment, the doctor takes into account a number of various factors, such as: age, gender, general health of the patient, the presence of somatic ailments, peculiarities of the course of psychosis, existing risks and contraindications.

The basis of pharmacological therapy for the treatment of psychosis is drugs from the group of antipsychoticsotherwise referred to as antipsychotics... The main property of antipsychotics is their ability to have an effective effect on the productive symptoms of psychosis. In addition, some atypical antipsychotics are often used to treat symptomatic deficits.

There are two types of antipsychotics used in modern psychiatry: atypical and typical antipsychotics. Atypical antipsychotics are highly active against productive disorders. Typical antipsychotics include:

• from sedative effect, which has a clear inhibitory effect;
• with a strong incisive (antipsychotic) effect, eliminating persistent personality changes, delusions, hallucinations, mania, increasing interest in the environment;
• with disinhibiting properties, showing an activating effect.

Prescribing antipsychotics should be accompanied by a guarantee that appropriate treatment and control measures are taken due to the high risk of developing extremely life-threatening side effects.

The psychosis treatment program can also include benzodiazepine tranquilizers. Drugs of this class have a sedative effect, eliminate anxiety and help restore sleep.

The treatment of affective disorders also involves normotimics - mood stabilizers. These drugs exhibit tranquilizing properties, reduce the feeling of anxiety, improve the mental health and mood of patients with psychosis.

In the presence of depressive inclusions in the treatment program, include antidepressants.However, the use of antidepressants to treat bipolar disorder is associated with a high risk of phase inversion - the development of a hypomanic or manic state.

For elimination side effectscaused by the intake of antipsychotics can be treated with anticholinergics. These drugs eliminate extrapyramidal disorders, dyskinesia, akinesia caused by treatment with neuroleptics.

To increase the effectiveness of drug therapy, it is advisable to conduct parallel rehabilitation of a psychological nature. The most commonly used methods are cognitive behavioral therapy - a short, intensive treatment aimed at altering painful thinking and behavior patterns. A variety of training programs help psychosis patients develop other adequate responses to environmental phenomena.

To prevent recurrence of psychotic disorders and to avoid the formation of any disease, everyone should lead an orderly lifestyle. Allocate time for regular physical activity... Receive reasonable and quality rest in sufficient volume. Stably follow the schedule. Eat regularly and in a balanced way. A complete rejection of drugs and alcoholic beverages is required.

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Like many other medical terms, the word "psychosis" is of Greek origin: "psyche" means "soul," and "osis" means a morbid condition, disorder. Psychosis is a symptom of certain mental problems, but not the diagnosis itself. That is, psychosis is not a separate disease and encompasses a number of related disorders: schizophrenia, bipolar disorder, schizoaffective disorder, and others.

Such disorders most often occur during late adolescence or early adolescence. Among children, there are 1.6-1.9 cases of psychosis per 100 thousand people, and after 14 years, this figure rises sharply.

Irina, 22 years old: “The first time happened when I was 18 at all: I looked at myself in the mirror and realized that in my life I had never seen a more ugly, disgusting person whom everyone I met hated (and deservedly so). Nothing pleased me anymore. I spent over an hour looking at myself and studying meticulously. The gap between the teeth seemed huge, hare, the eyes were disproportionately different, the cheeks were huge, the scar on the forehead was bright white, as if crossing the entire face, but the nose - even the witch did not have such a nose in the worst fairy tales. I remember that I began to cry from the realization of a terrible ugliness both inside and outside, and then only the pain and the sound of broken glass. This was probably one of the episodes that convinced him to seek help. "

Psychotic episodes can seriously interfere with the adolescent's social life or education. Frequently psychotic adolescents are not only bullied and severely stigmatized, but also at risk of violation of their rights.

Psychoses in adolescents are difficult to treat in comparison with adults, since they disrupt the process of social and mental development.

Many people mistakenly think that the word psychotic means dangerous. The media often shows that people with psychosis behave aggressively. But in fact, very few people suffering from this ailment carry a threat to strangers - mainly the psychotic himself is the main victim of this condition.

What is psychosis

Psychosis is a state of confusion that can happen both to a person who has a diagnosis (schizophrenia, bipolar affective disorder, etc.) and to a person who never knew anything about the disorder.

This state does not arise by itself, just like that. Almost always, psychosis is preceded by a period (of varying duration), during which a person has common features mental problems. When a person loses touch with reality, this is called a psychotic episode. Those who have experienced this often refer to this state as loss of control, insanity, or describe it as a feeling when everything explodes - this is perhaps the best description!

Vera, 18 years old:“It all started as a panic attack, I had a fight with a classmate and burst into tears during the training.
She began to choke, then anger began.
I threw myself in a manic direction.
In fact, mixed.
Subjectively, it's like jumping with a parachute and not being sure if it will open up.
Don't remember if you took it at all. I don’t know how to convey.
You are not so sure of yourself that it goes beyond the boundaries of good and evil.
You don't understand what is real and what is not.
Hospitalization helped only with the selection of primary drugs.
No more.
The main thing is just to find a good doctor who doesn't care.
And about antipsychotics. Sometimes you get so nailed that you don't even know if you are sleeping now or not and stuff like that. Everything is either marshmallow or plush.
But this effect doesn't last long. So far, I cannot find a suitable circuit.
A lot of side effects.
Most of the time I'm depressed.
And to be honest, it's hard for me to say which is worse.
I don’t want to live with it, but I don’t know who I am without it. ”

Many of those who have experienced more than one episode of psychosis can generally live well - provided they receive appropriate support, the degree of which is always individual.

What are the causes of psychosis

Doctors don't know exactly what causes psychosis, but.

Symptoms of confusion due to mental illness are slightly more common among people with family history of mental illness due to genetic vulnerability. If a person has had at least one episode of psychosis, then this means that he is sick, and he can be diagnosed depending on the specific symptomatology.

Stress can trigger the onset of psychosis. Our ability to deal with different kinds stress depends on our personality type and previous experience: not everyone can easily experience stress, problems in relationships or at work. Psychotic symptoms during periods of stress can occur with personality disorders or post-traumatic stress disorder.

For many people, psychosis is a rather painful experience. A person may feel misunderstood or abandoned if they do not feel the support of others. Often there may be a feeling that they do not trust him and that everyone is trying to harm. The psychotic state causes fear, panic, anxiety, horror.

The good news is that the experience of psychosis can prepare us to recognize the first signs of such conditions in the future, draw up an anti-crisis intervention plan in advance and seek help in a timely manner.

If you find symptoms of psychosis

If you or loved ones notice symptoms of psychosis, then you should soon seek help from a psychiatrist at your place of residence at the PND (neuropsychiatric dispensary) or to a private clinic where a psychiatrist is receiving. It is important to do this as early as possible so that the condition does not have time to affect work, school, and your relationships with others.

Frequent or prolonged symptoms of psychosis mean that something serious is happening to the person's brain. In addition, problems in thinking and perceiving the world can have a big impact on a person's life, relationships, school, or career. The longer the problems continue, the more serious the consequences will be, and the more they will affect the future of this person.

Early intervention - the best way prevent future problems. Effective treatment can make a huge difference to a speedy recovery.

How others can help someone with psychosis:

• There are clinics for the first psychotic episode, for example, on the basis of the Alekseev Psychiatric Clinical Hospital No. 1 in Moscow. Institutions of this type can be contacted without a referral. It is enough to call and explain the situation.
• Call 112, dial 3 in tone mode, tell them you need an ambulance and give the address. Stay with the patient until the arrival of the doctors.
• Encourage the sufferer to go to.

It is necessary to tell the doctors about what you observed, saw, heard and what alerted you in the patient's behavior. Stay close to the patient during the arrival of doctors, support him and say that nothing threatens his life.

Irina, 22 years old:“My first hospitalization saved me. The first time I got there was not quite voluntarily, after a suicide attempt, caused just by psychosis. Two months spent in almost complete silence, tranquility, and to be honest, under haloperidol, were generally the first impetus to the realization that there are problems and they must be solved. Our hospital is located on the shores of the White Sea, and I remember how my neighbor and I ran off just to get some fresh air and feed the birds. Combined with daily therapy, pills, and silence is quite a good treatment.

I have been taking antipsychotics for a long time, most often I change one for another, depending on the phase. I cannot explain, but one helps better in a mixed one, the other in a depressive one. The first month of admission, I was afraid that I would remain sleepy and do not understand anything. I was afraid that nothing would remain of my personality, that I would become a vegetable. But no - I'm still the same, it's just that now, with the slightest suspicion, I don't get into a fight and don't run into trouble. I'm still the same, but calmer and more judicious. Overall, the hospitalization helped me. "

There are other ways to help a suffering person:

• Psychosis is very frightening to the patient. It is important to create a calm, quiet environment, if possible.
• Sit next to the person, not in front of them. Keep it simple and clear.
• Don't argue with the person about their thoughts or experiences. Instead, focus on how he is feeling and how scary it must be for him.
• Be alert. If the person becomes very anxious or aggressive, make sure you take steps to keep yourself and others safe. If the patient is aggressive, the police and an ambulance can be called. This will help protect others and the patient from self-harm.

If the patient does not want to be treated, read our "What to do if there is a mentally ill person in the family and he denies treatment."

Where is better to be treated

Along with state hospitals, there are private clinics, where there is also a hospital. There is an opinion that “free” means poor quality, but this is not the case. In state hospitals there are professionals in their field, doctors who are sincerely ready to help.

Yes, in private clinics, conditions are more free. For example, a patient is allowed to stay with a relative, you can freely use a tablet, a phone in a hospital. The person feels cared for, the staff, as a rule, are friendly, attentive to each patient. Paid clinics have good doctors, but the financial side of the issue is a priority there - not everyone can afford it, but this does not mean that there are no other options. Both in private and in state clinic can help.

It is important to stay with the patient during the hospitalization process. If he cannot adequately answer the doctor's questions, you need to state the facts about his condition clearly and clearly.

Maria, 30 years old: “Of course, the hospitalization helped. And yes, it was dumb, because the methods used to calm mania can be cruel. Professionally burnt-out people work there (IMPORTANT: not all!), And they very much hit their pride with their attitude. All three times that I was there, I, of course, regretted that I had made the decision to come there and sign the documents, that I allow me to be treated as the doctor sees fit.

They do not say what they are treating, they do not say when they will be discharged, in general, no one cares deeply about everyone, with the exceptions that confirm the rule.

I was lying on mating - it is really humiliating and painful. Perhaps, yes, I was behaving violently, but when it finally dawned on me where I was, I simply began to look for open doors, for which I received a blow to the head and binding. It was more than dumb. Therefore, with all my heart I wish those who suffer from mental disorders to be treated and never get there. "

Hospitalization can be quite traumatic for a patient if it happens suddenly.

In such an environment, it is important to calm a person down and explain to him consistently all his actions. Of course, this does not always work, so it is important to stay in contact with the patient, speak in a calm voice and explain the need for a doctor's examination without criticism. In extreme cases, you can give out a visit to a doctor for a planned medical examination.

Olga, 23 years old: “I was struck by the attitude of the doctors when I came with an acute psychosis. First, my then doctor said that the condition had become “a little worse”. Wow, a little! All my spheres of activity were disrupted, I was kicked out of my job, but for him it is "a little". In the day hospital they tell me: “And we are only writing it down for a month in advance!” I explain to them that I have an exacerbation, I feel terrible. The doctor comes and says: “Yes, I don't care that you have an aggravation! It is said that a month in advance means a month in advance! "Another doctor told me:" It's just autumn, well, wait there, "- this is when I told him that I have been terribly bad since April."

How is psychosis treated?

A multidisciplinary team is involved in the treatment of psychosis on the basis of a hospital: psychiatrist, psychotherapist, psychologist, social worker. Specialists are working on the treatment and adaptation of the patient after suffering psychosis. Psychiatrist and psychologist conduct psychoeducational sessions where patients are informed about symptoms, causes and secondary prevention psychosis. Specialists of helping professions conduct classes in art therapy, occupational therapy, bibliotherapy to maximize patient adaptation.

During treatment, the psychiatrist may prescribe antipsychotic medications (pills, liquids, or shots) to reduce symptoms and recommend inpatient treatment.

When the condition is stabilized, cognitive behavioral therapy is used. It allows you to understand the experience of experiencing psychosis and consider strategies for overcoming the disease state. Improving psychological literacy will help you recognize if what you see and hear is real or imaginary. This type of therapy also highlights the importance of antipsychotic medication and adherence to treatment.

Art therapy can help express feelings that may be overwhelming. It uses paints, plasticine, dance, music and other means to express emotions. Such therapy can be helpful if the person has difficulty talking about their experiences.

Side effects of medications

Antipsychotics can have side effects, although not everyone will experience them, and the severity will differ depending on the individual.

Side effects can include:

• drowsiness;
• trembling limbs;
• weight gain;
• restlessness;
• muscle twitching and spasms;
• blurred vision;
• dizziness;
• constipation;
• loss of sex drive (libido);
• dry mouth.

You should inform your doctor if side effects become particularly unpleasant. The doctor will prescribe an alternative antipsychotic medication that has fewer side effects, or suggest correctors to reduce uncomfortable symptoms.

Olga, 23 years old: “I have been taking risperidone for a long time. At first it seemed to help, but then, at his mono reception, I felt terribly bad and derealization intensified. Then I began to sound the alarm, but, as you might guess, the doctors didn't care.

I took it for a year and a half. This led to hormonal disruption and the production of prolactin in huge doses, and now I am being treated.

My current doctor, a very good and competent specialist, canceled the drug and prescribed quentiapine. I felt good, but voices and hallucinations returned, delirium and an unreal craving for self-harm appeared.

She immediately changed it to a zilaxer. Now I take it, in principle, there are no side effects. Psychotic remains so. But I'm used to it, and it is not particularly noticeable. The mood has leveled off, the interphase has come. And delirium and stuff do not interfere with life. Like hallucinations: they are rare and very short. The voices also disappeared, and if there are, they are talking some kind of nonsense that I cannot make out. Anyone "you have to die because you blabblah, no."

Never stop taking any medicine that is prescribed for you unless advised by a qualified healthcare professional who is responsible for your care. Suddenly stopping prescription drugs can cause symptoms to return. It is important to withdraw medications gradually and strictly under the supervision of a doctor.

After an episode of psychosis, most people who recover from their medication need to continue taking them for at least a year. About 50% of people must take long-term medications to prevent recurrence of symptoms.

Antipsychotics certainly affect the patient's personality. A person can become apathetic and lack of initiative. As a rule, the reaction speed and the accuracy of actions are slowed down.

Many describe the experience with antipsychotics as quite negative.

Maria, 30 years old:“Antipsychotics saved my life. This is the guarantor of my peace of mind. As soon as something that seems strange to me in my behavior happens, I increase the dosage and live calmly. Perhaps I was lucky with the treatment regimen.

At one time it seemed to me that they made me dumb, made me ... how to say ... slow, not what I was before. Cheerful and sociable. But over time, I came to the conclusion that no, they did not affect my character in any drastic way. I'm totally for drug treatment, but with a caveat: the scheme must be selected correctly, otherwise it is very painful. "

Unfortunately, it is impossible to cope with psychosis through a healthy lifestyle, climate change, since it is caused by a malfunction of neurotransmitters in the brain - this can only be treated with medication.

For each patient, the end of treatment is determined individually. Someone has psychosis once in a lifetime, someone takes drugs for life. It is worth noting that antipsychotics do not always completely remove the symptoms. Even while taking the medicine, a person may continue to have delusions and hallucinations - but of a lesser intensity.

How to recover from a psychotic episode

Self-help groups

If you have experienced episodes of psychosis, it may be helpful for you to be around other people who have had similar experiences and to participate in psychoeducational activities together. It helps to cope with what happened and to feel that you are not alone. Groups allow people to communicate and support each other during a difficult recovery period.

To recover from a psychotic episode, it is important to know your triggers that can lead to a psychotic breakdown. It can be helpful to keep a diary, noting important events, mood swings, diet, and sleep quality.

It is important to learn to recognize early warning signs of psychosis.

Family and friends can help you determine when you are sick. Pay attention to what your relatives say about your well-being ("you have lost weight ...", "it's time for you to take medications or increase the dosage ...", "please call the doctor ..."). These are signals that you need to seek help from a doctor.

Manage your stress, learn to relax. Try some relaxation techniques. Relaxation can help you take care of your well-being when you feel stressed, anxious, anxious.

Draw, depicting your state on paper, this will help in experiencing emotions.

Monitor your sleep. Get enough sleep. Sleep can give you the energy to deal with difficult feelings and experiences.

Think about nutrition. Eating regularly and maintaining stable blood sugar levels can positively affect your mood and energy levels.

Do your favorite activities and hobbies. They help you feel more meaningful and connected to the world around you.

Exercise and fresh air can be beneficial for mental well-being.

Avoiding drugs and alcohol can prevent psychosis from recurring.

A calm environment coupled with medication can be the key to recovery.

Create an anti-crisis plan in case things go wrong. It should include specific actions. For example, a call to a relative or close friend whom you trust and who is aware of your problem - tell him how you are feeling. The next item can be a call to ambulancetaking antipsychotic drugs. It is important here to build on your past experience and use what has already helped you.

Recommendations for relatives of people with psychosis

Very often, relatives build behavioral tactics that worsen the relationship with a person during the period of illness. Rely on the following guidelines.

Treat a sick relative with care. People tend to feel bad when family and friends are very critical.

Make a crisis management plan. When your loved one is doing well, talk about how you can help when things get worse. This may include helping with hospital visits. Be clear about what you can and cannot do during a crisis.

Offer help. Ask him (her) if he (she) needs any practical help right now.

Get support for yourself. Supporting others can be mentally and physically exhausting. Think about what affects your own well-being. Take time for yourself. Take care of your mental health. Think about what you enjoy doing — painting, exercising, playing an instrument, or going to the movies — it’s good for your well-being to do something that makes you feel good.

Don't blame yourself. Sometimes relatives may feel guilty for not being able to help the sick person recover or for needing time for themselves. It's not your fault: any help you can get is good, and taking care of yourself helps you be more resilient to the stress of dealing with a psychotic person.

Keep in touch with friends and family. Connecting with others can help you cope with adversity, build confidence, and build a network of support.

Take care of your physical health. Eat on time, observe the work and rest regimen, have a good rest, sleep 6-8 hours.

Don't deny your feelings. Just acknowledging your feelings, speaking them out loud, can help.

Focus on “small wins”. Don't chase great achievements. Do the little things and use them as a springboard - something you can be proud of.

Diagnosis and stigma

Experiencing a psychotic episode can be quite traumatic for a person.

Unfortunately, the image of a mentally ill person is stigmatized and often ridiculed by other people, which often leads to self-stigmatization. Self-stigmatization is another risk factor for the development of psychosis: a person becomes isolated, isolated from others, feels loneliness and distrust, it becomes difficult for him to share his experiences with loved ones. But the patient needs support and care.

We must not allow that, behind the diagnosis, we cease to notice the person himself as he is, in all his integrity.

Remain human and responsive to people with mental health problems.

Acute psychosis is a pronounced disorder of mental activity, manifested in an inadequate perception of reality and oneself. With this disease, a person can completely lose control over their own behavior and actions.

In this condition, are often observed. The disease can develop against the background of a somatic illness, psychotrauma, or after severe emotional upheavals.

Psychosis in acute form usually the phenomenon is not a single one, but constantly repeating. Moreover, the likelihood of relapse is high. But unlike the chronic form, acute psychosis is temporary mental disordermay last for days or weeks. The prognosis of therapy is favorable.

People suffering from this disease often withdraw into themselves and do not accept the help and advice of loved ones. Therefore, it is important to diagnose the problem as early as possible so that timely therapy, albeit forced, is prescribed. Indeed, over time, the adequacy of a person becomes lower and lower, against the background of which irreversible for mental state processes.

Causes and forms of acute psychoses

According to statistics, women suffer from acute psychosis more often. This is probably due to hormonal disruptions.

Depending on the cause that provoked the development of the disease, the following types of acute psychosis are distinguished:

According to clinical manifestations, the following types of deviation are observed:

It is often difficult to diagnose the underlying cause of the disease. The impetus can be a combination of several factors.

Alcoholic form

Acute develops in those people who abuse alcohol for several years. And it develops when a person abruptly refuses his bad habit... Alcoholic psychosis manifests itself as follows: there is a sharp change in mood, hallucinations and delirium appear, the patient is dangerous to others.

In this condition, immediate hospitalization and bed rest are required. Usually the patient does not understand what is happening and resists.

In the hospital, he will be constantly monitored, and an appropriate course of therapy will be prescribed.

Mental failure after childbirth

This condition can appear in the first weeks after the birth of the baby. The main cause of mental disorders is illness during the period of bearing a child and painful shock during childbirth. How does it manifest itself? The woman becomes very emotional, whiny, sleep problems appear, no appetite.

Emotional behavior can be different. Some women are indifferent to their baby, while others begin to take care of all the children in the ward. Some young mothers can be in a state of euphoria, while others, on the contrary, become withdrawn and taciturn.

Acute psychosis should not be confused with postpartum depression... In the second case, delusions and hallucinations are absent. Women in labor with such mental disorders should be sent for treatment, otherwise there can be dire consequences, including suicide or the death of the baby.

Psychotic behavior in children can manifest itself in different ways. The most important feature is, that is, the ability to hear and see what is not in reality.

There is also delirium, incomprehensible laughter for no reason and irritation. A child's psychosis can develop against the background of short-term or long-term physical states. This is the use of drugs, fever, hormonal disruptions. It is important to cure the underlying disease, then the mental deviation will also pass.

If psychosis is suspected, the necessary diagnostic tests should be carried out. It is required to visit a neurologist, specialist in developmental diseases, ENT doctor, speech therapist. If the child has experienced severe stress, long-term psychotherapeutic support will be required.

Risk factors

In different life cycles, different types mental disorders. During adolescence, there is a high likelihood of developing.

In old age, when often occur age changes in the vessels and is disturbed, formed.

Manic-depressive type is more likely to affect young, ambitious individuals. During this life period, some kind of global change in fate can negatively affect mental health.

As for the gender factor, statistics say that the disease develops in men and women in the same way. But there are types of diseases that men are more likely to suffer. This, as well as with. And here manic-depressive syndrome is three times more common in women, since hormonal surges often occur in the weaker sex.

If we consider the geographical factor, it is noted that mental ailments are more affecting the inhabitants of large cities. Because in the metropolis there is a high level of stress and a frantic rhythm of life, that's why the psyche suffers.

The social factor manifests itself when a person could not realize himself. For example, a girl did not get married and could not give birth, or a man did not achieve his goals. In such cases, the burden of negativity presses on the personality, but it helps.

Symptoms of the disease

The disease manifests itself from different sides. It all depends on the characteristics of the organism and the causal factor that led to the failure in the psyche.

Alarming symptoms that may indicate possible acute psychosis:

• changeable mood, depression and phobias develop;
• change in character: appears

Modern approach to treatment

Treatment of acute psychosis should be started as early as possible. Only a qualified psychotherapist can identify the provoking cause and prescribe quality therapy. You cannot leave the patient at home on self-medication.

Modern specialists use the following methods of therapy:

A complex of different measures is needed for quality treatment. Such a complex is individual for each person and only a good doctor can pick it up. Timely therapy will help increase the likelihood of a good prognosis.

It should be remembered that psychosis is a treatable disease. The main thing is not to delay therapy. Only self-discipline, regular use of medications, psychotherapy and the help of others will help restore mental health and joy in life.