Psychosis: causes, symptoms, classification and treatment of pathology
Psychosis is a mental illness in which a person is unable to adequately perceive the surrounding world and react appropriately to it .Psychoses are quite diverse in their manifestations, and very serious diseases can also accompany from the category of "psychiatry" - for example, schizophrenia, "white fever", senile dementia, but can manifest itself as an independent disease.Contents: What is psychosis? Causes of psychosis development. Symptoms of psychosis.
. What is psychosis?
. In simple terms, with psychosis in a sick person, reality is so distorted in the mind of a person that the "picture" before his eyesHas nothing to do with the reality of .An objective patient can not be because of fear for one's own life, presence of voices in the head or visions - these internal prisms and change the behavior of a person, his reaction becomes unpredictable and inadequate.For example, with psychosis, a person can suddenly laugh or, conversely, begin to sob "in the voice."
Psychosis is not a wrong way of thinking, it's a disease.Do not argue with the patient and even more so to condemn him, to argue with him - psychosis is exactly the same disease as diabetes, and in fact to diabetics in our society the ratio is quite adequate.By the way , psychoses do not belong to irreversible processes!Most often after a certain period of the disease( it can take place and very hard), the patient is in remission, and the psyche is completely restored.
Interesting! There are cases when the disease under consideration has never occurred more in life, although psychoses are inherent in a cyclic character, when after a long period of recovery hallucinations or delusions suddenly appear.Usually, such a development of the disease takes place if the prescriber's appointments are not fulfilled.
Note: if a person does not follow the recommendations and prescriptions of a doctor, then psychosis can be transformed into a chronic form of the current, and in this case, mental health will be lost forever, without the chances of recovery.
In general, psychosis is a fairly common problem, according to statistics, 15% of patients in psychiatric clinics are just patients with psychoses. By the way, most often the disease is developing in women - for example, manic-depressive psychosis is 4 times more often diagnosed in female patients.In addition, psychoses worsen during the menopause, immediately after birth or during menstruation, and this allows us to conclude that mental illness is somehow associated with hormonal "leaps" in the body.
Reasons for the development of psychosis
Various factors and causes can lead to the considered disease, and sometimes doctors simply can not understand why a person has such pathological changes in mental health.And nevertheless, the doctors systematized and identified several factors that can lead to psychosis:
- Heredity.There is a group of genes that are necessarily passed from parents to children - genes that control the sensitivity of the brain to external influences and / or signaling substances.
If both parents have a history of psychosis, then with a probability of 50%, it is possible to predict the birth of a child, in the future of which the development of the psychosis is possible.By the way, if parents do not suffer from psychosis, then this problem may manifest in their children because of the sudden manifestation of "defective" genes inherited from other generations.
Note: if a person has a weighed heredity, then the psychosis in him can develop against a background of even a small injury or some kind of illness.In this case, psychosis will develop already in early childhood, to flow quickly and in very severe form.Brain Injury.
- Brain Injury.The following can lead to psychoses:
- head trauma received by a child during childbirth;
- bruises and concussions of the brain;
- craniocerebral trauma of the open and closed type.
This disorder of the mind can occur in a few hours or even a few days after getting injured.Physicians clearly distinguish regularity - the heavier the trauma, the harder the psychosis proceeds.
For the disease under consideration, the cause of which is trauma of the brain, is characterized by a cyclic character - periods of pronounced manifestations of psychosis are replaced by periods of remission.This wavy course of the disease is associated with the tides and outflows of the cerebrospinal fluid, that is, with the increase and stabilization of intracranial pressure.
- Intoxication of the brain.Such poisoning can be triggered by a variety of substances - alcohol, drugs and medicines.
- Diseases of the nervous system.These include multiple sclerosis, stroke, Parkinson's disease, epilepsy and Alzheimer's disease.These diseases provoke the death of cells in the cerebral cortex, which ends with swelling of surrounding tissues and the violation of the functions of certain affected areas of the brain.
- Tumors of the brain.
- Infectious diseases.It means flu, Lyme disease, mumps, malaria, leprosy.With the development of such diseases in the human body, living microorganisms, however, like the dead, release toxins that can poison nerve cells, which leads to their death.
- Diseases, accompanied by severe pain and panic.These include bronchial asthma, colitis, myocardial infarction.Pain is always stress, and attacks of suffocation can completely drive anyone crazy!Such violations lead to a malfunction of the nervous system.
- Hormonal disorders.They can be caused by childbirth or abortion, problems in the functioning of the thyroid gland, dysfunction of the ovaries or adrenal glands.
Psychiatrists are confident that the disease in question never appears "one day," for example, after a nervous shock.Simply every stressful situation "undermines" the brain, each time a person's reaction to an event becomes brighter and more emotional, and so will continue until psychosis develops.
Symptoms of psychosis
Manifestations of psychosis are very diverse, but it is advisable to know the main symptoms of this disease in order to be able to provide medical care at an early stage of the pathology in question. For example, others may notice that a person reacts too emotionally to an event, refuses food, makes strange statements, or vice versa - does not take an interest in the world around him, shows indifference to everything.
The main manifestations of psychosis include:
They can be sound, visual, tactile, olfactory and tasteful. Most often, psychosis is manifested by voice hallucinations - a person seems to hear voices that can not only be in the head, but also go from the body or come from outside .The voices are so real that the patient takes them seriously and does not doubt their authenticity.These voices can swear, blame the patient for something, threaten and order.Just the last option is the most dangerous - patients in almost 100% of cases follow orders of these votes, and what they will order is unknown to anyone.
Guess that a person has hallucinations can be on the following grounds:
- in the middle of the phrase, he suddenly suddenly falls silent;
- person is not able to focus on the conversation with the other person, as something carefully looks at;
- for no apparent reason there is laughter or, conversely, mood depression;
- the patient conducts the conversation "with himself", but it looks like replicas-answers to someone's said phrases;
- person suddenly freezes and listens to something.
Affective disorders( mood disorders)
They can be depressive and manic. The manifestations of depressive disorders will be as follows:
- the patient remains in one position for a long time, he has no desire to move;
- a person wakes up early - at 3-4 in the morning, his sleep is broken;
- the patient is in a pessimistic mood, that is, expresses dissatisfaction with everything possible;
- a person constantly takes food, or completely refuses it.
But the manic disorders look completely different:
- the patient is excessively emotional, becomes extremely active, moves a lot, but more often it is aimless;
- person is constantly in an optimistic mood and does not see any problems;
- patient is verbose, communicates with others, reacts too emotionally to everything that is happening around;
- people build unrealistic plans, his need for sleep decreases - he sleeps a little, but always feels himself and looks cheerful and rested;
- the patient can abuse alcohol and lead a promiscuous sex life.
Delusions of the
Delirium is a thinking disorder that manifests itself in the form of an idea that does not correspond to reality.Brad has also a distinctive feature - others can not convince the patient, even if they give quite reasoned and logical reasons.Delusions of the patient with psychosis expresses very emotionally, and he is firmly convinced of his own rightness. The distinguishing features of delirium include:
- heightened emotionality;
- delirium sharply differs from reality;
- always mentions his own self in the central place;
- the behavior of the patient completely submits to the delusional idea( for example, he can refuse food, being sure that he is being poisoned);
- shows protective actions of an unreasonable nature.
During periods of exacerbation of the psychosis, the patient may have movement disorders:
- Stupor / retardation - a person freezes in one pose, for a long time( for days and even weeks) remains motionless.
- Motor stimulation - all movements become too fast and impetuous, but often - aimless, the facial expression of the patient will be excessively emotional.
Note: personality features always manifest themselves in the symptoms of psychosis.Both doctors and relatives of the patient have long noted that the propensities, interests and fears inherent in a healthy person are amplified during illness and in some cases become the goal of its existence.
Classification of psychoses
Most often, manic and depressive psychoses are diagnosed when suddenly externally absolutely healthy people show signs of depression or significant arousal. Similar types of psychosis are called monopolar, that is, deviations occur in one of these parties.In some cases, the disorder is bipolar in nature and in this case doctors diagnose a "manic-depressive psychosis".
This is a serious mental disorder characterized by heightened mood, accelerated thinking and speech, and the motor activity of .Such periods of excitement can last from 3 months to one and a half years.
A person has an excellent mood and an optimism for no apparent reason.Moreover, the positive attitude is maintained even with the existing difficulties and problems - the patient is glad to meet new people, actively communicating with others, is ready to help everyone, is full of ideas and appreciates his own possibilities.
In some cases, an attack of excellent mood is replaced by an angry mania - the actions of others around the patient cause irritation, the person constantly finds an excuse for a fight / fight, he may have an attack of rage.
Accelerated speech and thinking
With manic psychosis, all mental processes in the human body occur at an accelerated pace, which leads to uncontrolled excitation in different parts of the brain. The patient's speech becomes loud / expressive / fast, he is able to quickly get involved in the work, he has an active manifestation of his creative abilities.
Did you know that Kafka, Dali, Bulgakov and other authors wrote their best works at the time of aggravation of manic psychosis?Some psychiatrists are generally confident that the state of the brain in manic psychosis is more productive.
The problem is that a man with a manic psychosis rarely brings the case to the end, it's hard for him to concentrate on one task and the surrounding people notice his absent-mindedness or forgetfulness.
Manic psychosis makes you take impulsive decisions - for example, a patient can quit in order to start traveling.
Increased motor activity
The attack of this mental disorder is accompanied by the discovery of the reserves of the patient's body - he is constantly in motion, absolutely does not feel fatigue, eats very much, but does not get fat, as his caloric activity burns all the calories arrived in the body.
This is a brain disease, but the external side of the disease is precisely the manifestations typical of depressive psychosis.The considered state also has three characteristic features.
Pathologically low mood
Thoughts of the patient are concentrated only around themselves, their shortcomings and mistakes. Such constant thoughts lead to the conclusion that in the past, a person was all bad, the present is also not at all iridescent, and it is not worth thinking about the future - this condition is very dangerous, because it leads to suicide.
In a patient with depressive psychosis, the intellect is fully preserved, so he can carefully hide his state from others. This leads to the fact that it is impossible to prevent a suicide attempt at home, therefore people with depression, who focus on self-destruction and their own low value, are placed in hospital departments of medical institutions for treatment.
A person in this state is constantly experiencing wanton anguish, which oppresses and presses.It is interesting that in such a state the patient can accurately indicate the place of pain localization.The patient always looks sad and sullen, avoids communication with people, tries to retire, reacts slowly to treatment, and answers questions positively, in monosyllabic and monotonous voice.
Depressive psychosis is characterized by a refusal of food - the patient quickly loses weight .Therefore, when a person in this state begins to eat regularly and gain weight, it is believed that the process of his recovery is in progress.
The patient's movements are inhibited, slow.He is constantly experiencing a breakdown, and any physical activity provokes only a deterioration in the state.
If the mental disorder in question is severe, the patient may fall into a stupor - for a long time sitting in one position, does not move and looks at one point.
This is a fairly rare occurrence of a mental illness, the signs of which appear at 4-6 weeks after the birth of .The difference between postpartum psychosis and depression is that in this case hallucinations, delusions and a desire to harm yourself or a child will be characteristic.
The first signs of postpartum psychosis to are:
- sharp mood swings;
- is a strong concern;
- unreasonable fears.
As the problem develops, women may experience delusions and hallucinations.For example, a woman can claim that her baby was born dead or crippled, or a young mother stops going on walks because of the development of paranoia.
Note: on statistics 5% of women with postpartum psychosis commit suicide, and in 4% - kill their own child.Therefore, others should carefully monitor the behavior of the mother, in time to pay attention to the signs of the considered mental abnormality and seek qualified medical help.
It is also called psychogenic shock, which means the development of a mental disorder after a trauma of a psychological nature. This type of disease under consideration has distinctive features:
- Reactive psychosis begins after a severe emotional shock.
- This type of mental disorder is a reversible process.The longer the time passes after a psychological trauma, the less intense the symptoms appear.Approximately one year later, human health is restored.
- All manifestations and experiences in reactive psychosis have a direct relationship with the nature of the psychological trauma, they are quite understandable to others.
The treatment of reactive psychosis rarely requires the use of specific drugs, but the help of a therapist is an important part of recovery.But it is advisable to resort to such specialists only after the acute phase of the disorder has passed, and the patient is able to adequately perceive the arguments of specialists.
Treatment of psychosis
Treatment of the disease should begin as early as possible. As a rule, in this case the treatment will be in the form of consultations, but there are certain criteria that are the reason for the hospitalization of the patient:
- a person with psychosis poses a danger to themselves and others;
- the patient is helpless and unable to independently provide his own vital needs;
- is a risk that human health will be harmed.
Recommendations of specialists:
- Psychosis should be perceived as an ordinary disease - there is nothing shameful about it.Many psychiatrists and psychologists compare the disease in question with bronchial asthma - both pathologies need treatment, they equally need the appointment of specific medications and can be cured.
- Treatment of psychosis should start from the moment of its first manifestations.In this case, the duration of treatment will be a maximum of 2 months, but in advanced cases it may take a year for complete recovery.It is worth knowing that prolonged psychosis without treatment leads to irreversible consequences.
- For recovery, it will be necessary to take medications prescribed by the doctor.Please note, the psychiatrist makes such appointments on an individual basis, therefore, it is strictly forbidden to change the dosage or duration of medication independently.
In addition, it is worthwhile to ensure that during the treatment of the patient led a healthy lifestyle - exercise, nutrition, communication with loved ones, holidays are able to restore mental health, to return the patient in life.
Please note: is strictly prohibited during the treatment of psychosis to consume alcoholic beverages.First, the drugs used in the therapy are incompatible with alcohol-containing beverages, and secondly, alcohol can only exacerbate gloomy thoughts, make them deeper.
First aid for psychosis
The health of people with this diagnosis is largely dependent on the actions of the surrounding people( we are talking about loved ones). The basic rules for communicating with a sick person should be remembered:
- If a person is clearly traced signs of manic excitement, then do not argue with him or object to him.This can provoke an attack of rage or anger, aggression.It is advisable at times of manic activity to observe calmness, self-confidence and goodwill towards the patient.It is necessary to isolate him from others, to try to talk with him and during the conversation to reassure him.
- 80% of suicides are committed by people in a state of depressive psychosis.You need to be extremely attentive to the patient during this period - you should not leave him alone, especially in the morning hours.Suicide is preceded by a sharp transition from depression to a light, peaceful mood - the patient begins to tidy up all his affairs, makes a will.Such a sharp change should alert others, it may be necessary to turn to specialists.Another point - you need to hide from the patient all the items that can be used for suicide - household chemicals, weapons, any sharp objects, weapons.
- If it was noticed that the patient had hallucinations, then you need to calmly take his hands and ask about what happened.If the patient answers that he saw or heard something unusual, then ask him how he relates to what he / she saw / heard.In no case can you ridicule him, argue with him about hallucinations and say that you can not hear voices.
Note : do not ask for help from psychics or healers.Psychoses are complex mental disorders, for which it is important to determine the cause of the onset and only then to treat.The later the treatment for qualified medical care is made, the more difficult it will be to recover.
The most difficult step for relatives of a patient with psychosis is to call for emergency psychiatric care, which will result in the placement of a person in a specialized psychiatric clinic.But it is necessary to do this if the patient constantly speaks about suicide, or can harm others.
The most important stage in the treatment of psychoses is psychotherapy.T Such psychological help includes:
- Group therapy - helps the patient feel like a member of society, gives hope and faith in healing.
- Psychoeducation is the education of a patient and members of his family, which helps both the patient and his surrounding close people to perceive psychosis as an ordinary disease.
- Dependence therapy - applies only if the psychosis has developed against the background of alcohol or drug use.
- Behavioral( cognitive) therapy - the doctor teaches the patient to be critical of their own judgments, tells how to quickly find a solution to the problem.It is behavioral therapy that is considered one of the best methods of treatment of depressive psychosis.
- Family therapy - special classes that are conducted by a psychiatrist for family members of a patient with psychosis.
Note: psychoses are never treated with hypnosis.This method can lead to irreversible pathological processes in the psyche of the patient.
Drugs for the treatment of psychosis
There is no single prescribing regimen for the treatment of the disease in question.But you need to know that taking medication is a prerequisite for recovery.
Typically, doctors during the treatment of psychosis use the following medications:
- Solian, Zeldox, Fluanxol - antipsychotics;
- Actinerval, Contemnol - mood stabilizers;
- Zopiclone, Oxazepam - benzodiazepines;
- Cyclodol - holinoblokator;
- Sertraline, Paroxetine - antidepressants.
Only the physician can select an effective medication, prescribe the dose and the duration of the course of the ma.Self-adjustment of these appointments is strictly prohibited!
Prevention of recurrence of psychosis
Unfortunately, 80% of patients with psychosis suffer a relapse of the disease.But there are some measures that can prevent the re-emergence of the disease in question. To prevent the recurrence of psychosis include the following recommendations:
- Continuous use of medications prescribed by a doctor.This is the main point of prevention of recurrences of psychoses, without which the patient's condition will only worsen.After the first case of the disease in question, it will be necessary to take medicines for 12 months.
- Regular individual or group sessions of psychotherapy.This not only helps the patient to get out of the illness, restore his mental state, but also catch the approaching signs of a relapse of psychosis - this will be done by the specialist directly in the class.
- Do not overwork and drink a lot of coffee.And so that there is no fatigue, it is necessary to make a daily routine, to accustom yourself to get up and go to bed at the same time, to make an "action plan" for each day.
Psychosis is a disease that can be treated.Do not be afraid or ashamed of your condition, because only the timely application for qualified medical care will be a guarantee of recovery.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category