Psychiatric diseases and their symptoms. What distinguishes illness from short-term stress? How to determine if a mentally ill person is dangerous to others

Ostapyuk L.S.
Pevzner T.S.

Relatives of the mentally ill should know what mental illness how it affects the patient's behavior, how the patient's personality changes under the influence of the disease. Such awareness will create in the family more favorable conditions and a regime that spares the psyche of the patient.

During an exacerbation of mental illness, patients are usually placed in a psychiatric hospital, where they are special treatment. At this time, the tasks are greatly simplified and are determined by the requirements that the hospital doctor imposes on them. But in a state of remission, that is, during a light interval between attacks of the disease, or after a cure, a very great responsibility is placed on the patient's family.

The well-being of the patient, the duration and persistence of the improvement of his condition depend on the extent to which the patients behave correctly. This often depends normal life the whole family, which is inevitably complicated by the exacerbation of the mental disorder of a family member.

It is necessary to strive to create such an environment in the family, at home, when, on the one hand, the patient would be in better conditions, and on the other, it would be possible Cohabitation all family members with him. Wherein " Better conditions“It should not be understood at all that the patient should live in the position of the patient, that he should be served in all respects and be at home in the hospital regime. In some cases this is even undesirable. On the contrary, it is necessary to involve the patient in the life, affairs and cares of the family, it is necessary to promote any manifestation of his useful initiative, activity.

What is mental illness?

This is a disease that changes the patient's personality, changes his behavior, which becomes wrong, contrary to common sense, logic. Exists some signs of mental illness which determine to a large extent the behavior of the patient. This is nonsense, deceptions of perception (hallucinations), melancholy, anxiety.

Rave- most frequent sign many mental illnesses. It occurs in schizophrenia, in the so-called age-related mental illnesses - involutional (presenile) and senile psychoses, in some diseases of the central nervous system, such as traumatic vascular psychoses, as well as with alcoholic lesions of the nervous system. Brad is an erroneous, incorrect judgment.

It is impossible to dissuade the patient, to prove to him that he is mistaken, this is what distinguishes nonsense from error, the patient behaves as if his painful ideas are the only correct and real ones.

Most often, patients feel that they are being persecuted. individuals or organizations, that persecutors unite among themselves, that they are being watched, watched, talked about, hinted at, laughed at, want to arrest, kill, destroy, poison, etc. It seems to them that every step, every their movements immediately become known to their enemies, that all their words, thoughts are recorded by special devices built into the walls of the room, that as soon as they think about something, everything becomes known, and everyone hints at it with gestures, grimaces, words. They feel the impact of currents, rays, special energy that "destroy" their health.

Patients experience fears, under the influence of delusional ideas, they escape from imaginary threats and persecutors, while doing wrong things, from which they themselves suffer and cause trouble to loved ones. Often they are hostile to their relatives, suspecting them of collusion with imaginary persecutors, or regarding them as their own enemies. Patients leave home, family, leave work, quit "for own will", put themselves and their families in difficult conditions, losing their earnings and the right to sick leave.

Sometimes, under the influence of delusional ideas, they consider their situation hopeless and decide to commit suicide or their "enemies". If they are tormented by ideas of poisoning, which neighbors are most often suspected of, patients do not eat at home, do not live at home, start proceedings in courts, various commissions, write complaints, etc. Difficult conditions are created in the family and apartment, complicating life of those around and the patient.

Crazy ideas may relate to the patient's assessment of his health. So, a young woman, a doctor, suddenly decided that she had contracted syphilis even before marriage, she has been sick with it since then, that her health is being destroyed, her brain, bones are being destroyed, internal organs, "everything hurts", that she not only died herself, but killed both her husband and child, whom she also infected with syphilis, that childhood illnesses of a child are also a manifestation of syphilis. She insisted on special surveys, required anti-syphilitic treatment not only for herself, but for her husband and son. Secretly from others, she took the child to venereologists for examination.

Having received the conclusion that she did not have syphilis and her child was healthy, she claimed that they had syphilis in the family, which was not recognizable. She decided that it was better to commit suicide and destroy the child than to slowly die from syphilis. The patient made a serious attempt to commit suicide and then was treated for a long time in psychiatric hospitals.

Sometimes the so-called love delirium develops. The patient believes that someone around her is in love with her, for example, a colleague. Signs of his love are clear only to her. For example, he went up to her table, somehow looked at her in a special way; in a telephone conversation with someone he said that he would be free at 3 o'clock. It was he who thus appointed her a date at the tram stop. The fact that "he" did not come does not dissuade her of anything. This only proves that he was thwarted by their common enemies. The patient behaves in relation to the employee as in love with him and loved by him, which, naturally, puts the unsuspecting person in a false and absurd position.

Another patient decided that one famous musician was her husband. She began to come to his house, telling his wife to get out, that this was her husband and she should stay here. She went backstage after the concert, where the musician performed, told him "you", waited for him to go "home" together. The delirium intensified, and at dawn the patient came to the musician's apartment, demanding to be let in. In the end, the exhausted spouses turned to the police, where they immediately assumed a mental illness, which was confirmed by psychiatrists. The patient had to be hospitalized forcibly, as she considered herself healthy and demanded her "legitimate" place. This whole epic could have been shorter and would have caused less trouble to its participants if the ridiculous behavior of the patient had been correctly regarded by those around him.

The delusion of jealousy is one of the most dangerous for the object of delirium. Evidence of betrayal, infidelity are often ridiculous in nature, but patients consider them justified and are ready to take revenge for the fact that they consider themselves deceived. For example, an old man of 65 years old suddenly remembers that 25 years ago, when he returned home from work, other men's galoshes were standing in the corridor. He clearly imagines how and where they stood, how they looked. Now he "understood" that these were galoshes of his wife's lover, that she then cheated on him. He terrorizes the unfortunate old woman, his wife, who, of course, cannot provide a satisfactory explanation for whose galoshes these were. He demands that she go anywhere, that he no longer wants to have anything to do with her. It is impossible to dissuade him - such is the nature of delirium.

Sometimes, along with delusions, hallucinations are also observed.

hallucinations are delusions of perception caused by a mental disorder. In the absence of a real stimulus of the sense organs, patients hear voices, see images, smell, experience sensations of touch, someone's presence, etc. These perceptual delusions have the properties of real perceptions: voices are clearly heard, vision has all the signs of a really visible one, therefore, patients convinced of their existence. They obey the voices, perceive everything that the voices say as happening in reality. They cannot be dissuaded from this.

Voices discuss the actions of the patient, condemn him, scold him, say insulting things, repeat his thoughts aloud. And sometimes voices order or forbid: "Don't eat!", "Don't wash your face!", "Don't get out of bed!" Or: "Kill yourself!". It happens that patients obey these commanding voices, refuse to eat, do not want to get up in the morning and, most dangerously, make serious attempts to commit suicide.

Important signs of mental illness are having anxiety and sadness, which are found in diseases of depression and presenile psychosis. Anxiety sometimes has specific content. Patients worry about themselves, their future, their health or for the life, fate and well-being of their loved ones. You just need to imagine well that this is not the usual anxiety that all healthy people experience for themselves and their loved ones. This anxiety is painful, never leaving the patient, having no real reason, when it seems to the patient that all his relatives must die, he himself will also die, everything is gone, everyone can become hopelessly ill, not recover, get hit by a car, lose their job, lose their disposition your friends, etc.

There is also anxiety, devoid of such a specific content, when the patient wakes up in the morning and all day and night experiences pointless anxiety, lack of rest, does not find a place for himself, can neither sit nor lie down, nor do anything.

In a state of anguish, everything seems bleak, hopeless, hopeless to patients in a state of anguish, they lose their appetite, sleep, cannot do anything, condemn themselves for this, blame and reproach, and sometimes come to the conclusion that only death will save them from suffering. They often attempt suicide.

Seizures with loss of consciousness are the main manifestation of epilepsy. They also occur in some other diseases, sometimes associated with brain damage by trauma, tumor, infectious diseases central nervous system, for example, with encephalitis, with some poisonings. Seizures often come on suddenly. They find the patient in any position, in any occupation, in any place: there are convulsions, cyanosis, involuntary urination, tongue bite.

The suddenness and rapidity with which the seizure develops pose a threat to the well-being, and sometimes to the life of the patient, especially if the seizure occurs in life-threatening conditions.

In some cases, the process natural aging accompanied mental disorders- develop so-called senile psychoses. By the age of 60-70, and sometimes even earlier, previously healthy people become helpless, fussy. Their behavior is difficult to regulate, because they are not able to understand what they want from them. These people have disturbed sleep, at night they wander around the apartment, eat. Sometimes they have crazy ideas, usually they complain that everything disappears from them, they are robbed by relatives, children, grandchildren, neighbors. They try to tie their things into knots and knots and carry them with them. They do not know the measure in food, they are untidy. In the family, all this creates great difficulties.

It is extremely important that relatives, family members or colleagues, next to whom a sick person works, are able to assume the presence of a mental illness in time and seek help from a doctor.

If this does not happen, if all painful judgments generated by a mental disorder are perceived by others as correct and reasonable, as corresponding to reality, then not quite correct behavior surrounding.

We treated a sick, young woman, an engineer, who had been working in the same institution for 9 years. Her relations with her colleagues at work were normal, she coped with work, everything was fine at home. Then her behavior began to change. She came to work tense, gloomy, gloomy, silently sat at her desk, shifted the same papers, did not talk to anyone. Unexpectedly for everyone, she turned to the head of the institution with a request to dismiss her of her own free will, because everyone changed their attitude towards her and she can no longer tolerate it. They tried to explain to her that nothing had changed and that everyone still treated her well. But she did not agree with this and demanded dismissal.

The employees considered themselves undeservedly offended, they said that her character had deteriorated, that she had become unbearable. In conclusion, the patient's request was granted, she was released from work. She told her relatives that she was being pursued by a "gang of syphilitics", they wanted to kill her. To do this, they conspired with some employees, who are now also pursuing her. The patient was referred to a psychiatrist and admitted to the hospital.

If her colleagues had an idea about mental disorders, they would have treated her more attentively, they would have sent her to a doctor.

In another case, a woman with three children, a housewife, suddenly changed her attitude towards her eldest nineteen-year-old daughter: she became hostile towards her, invited her to dine in the dining room, saying that she would not cook for her and no longer considered her daughter. It turned out that she was convinced of her daughter's connection with her own father. When the daughter, shocked by this accusation, who herself was close to becoming a psychiatric patient, told everything to her father, he did not find anything better than to say: "I do not interfere in these matters, sort it out yourself." But the situation is such that not long before trouble, and the closest person - husband and father - does not understand that such an accusation cannot come from healthy person that it is necessary to consult a doctor and protect the daughter from such difficult experiences that, under the influence of delirium, the mother can become aggressive towards her daughter and towards him.

In this case, the colleague of the girl with whom she shared turned out to be more reasonable than her father and advised her to see a psychiatrist. Thus, a mental illness was established, and the woman was admitted to the hospital, and the daughter of the patient realized that the monstrous accusation from the mother was caused by her illness.

Patient Sh., aged 56, suddenly, without any reason, began to assert that her neighbors hated her, wanted to get rid of her and take over her room. To do this, a neighbor who works at some chemical plant brings home poisons and sprays them in her room, where he enters in her absence. When we asked her how he got into the locked room, she replied that he took a cast of the key, which she once forgot in her coat pocket in the corridor, made himself a key and enters her room when she is not at home.

As soon as she crossed the threshold of her room, she "felt" chemical smells, from which she immediately felt ill, her head hurt, she felt sick, her appetite disappeared. Food, products in the room were also saturated with these poisonous substances; as soon as she was at home or ate there, she became ill.

She began to eat in canteens, avoided being at home, wandered around the city to exhaustion. Then she decided to expose the neighbors, went to sanitary doctors, demanded that the air in her room be taken on various analyzes. She applied to many institutions, demanded investigations. She presented all these accusations to her neighbors without end, they began to be afraid of meeting her, they were very worried, justified themselves, tried to explain that they still treat her well and do not encroach on her room, to which they have no rights. But all this had no effect on the patient. She complained to all her relatives, they scolded the neighbors, but did not understand that she was mentally ill.

If her relatives and neighbors understood that they needed to see a doctor, then this whole protracted story would end much faster.

There are many examples of such an attitude towards patients with mental illness. All of them testify to the lack of awareness of others about the signs of mental illness. Of course, there is no need for non-specialists to read special medical, especially psychiatric literature, but one must be able to draw a reasonable line between mental disorders and ordinary everyday misunderstandings.

In our practice, we often met with rather widespread misconceptions among the relatives of patients regarding the well-being of patients. Almost always, the relatives of discharged patients think that after that it is necessary to send them to a sanatorium, rest home, on a tourist trip, to the south, to the sea, etc. Relatives usually ask the doctor if it is time to start fussing about the appropriate ticket. They are very disappointed if they do not receive such a recommendation.

It should be emphasized that after active treatment in the hospital, no sanatoriums, rest houses, excursions, trips, etc. are undesirable. New impressions, new meetings can worsen the condition of patients, revive fears and delusional experiences, give them fresh food and reinforce their delusional ideas. After all, often painful experiences as a result of treatment do not completely disappear, they lose their sharpness and importance for the patient. In the usual calm home environment, they are more likely to pass than in new conditions, adaptation to which always causes a certain tension, creates a new burden for patients.

Another example. Relatives think that if they marry the sick or marry the sick, then they will recover. This is not true. Whatever mental illness no matter how the patient suffered, to encourage him to marry in order to improve his mental health is a grave mistake, fraught with serious consequences. Even for a neuropsychically healthy person, marriage is always a serious test and a great strain on all neuropsychic forces. The need for mutual adaptation requires great effort, which can cause a deterioration in the patient's condition. It does not follow that survivors of mental illness should not marry and have children. This question is solved jointly with a psychiatrist.

All over the world suffer from one or another mental illness. According to other data, one in five people in the world has a mental or behavioral disorder.

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

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

How to recognize the first signs of the disease

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

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

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

Looking at yourself in the mirror for too long, obsessing over your appearance can also talk about health problems. Not less than serious signal there should be changes in appetite (both an increase and a decrease), sleep patterns, indifference to an interesting pastime. All of these can indicate depression.

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

What causes mental illness

The causes of mental illness are both natural and social factors. However, some illnesses, such as schizophrenia and bipolar disorder, may appear due to a genetic predisposition.

Mental illness occurs twice as often after natural Disasters and disasters. It is also affected by changes in life and physical health person. However, clear reasons for the appearance of disorders on this moment unknown.

How to make a diagnosis

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

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

How to be treated

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

Is a cure possible?

Yes. People can fully recover from acute form disease and learn to overcome chronic conditions. The diagnosis can change, and life can get better. After all the main objective treatment is to enable a person to live the life he wants.

Always taboo, mental illnesses are still quite little known. Result: many suffer from the disease without even knowing it. People affected by mental illness do not have a single profile. Trauma in youth can affect our mental health, but this is not necessary condition: You can grow up in a balanced environment and be more vulnerable while others come out unscathed after the worst of trials. Then what are the reasons? Experts observe 3 factors: biological (genetic or hereditary predispositions), psychological (upbringing, propensity to overcome obstacles) and social (quality of interpersonal relationships and social network). One of these factors can lead to mental illness, but basically it's a mixture of the three.

It is not always easy to distinguish between temporary psychological signs(a decline due to mourning, for example) mental illness (an episode of major depression). It is usually referred to as mental illness, when a person can no longer go about their business normally.

There are 4 main categories of mental illness: mood disorders(depression and bipolar illness); disturbing unrest(generalized anxiety, phobias and obsessive-compulsory anxiety); psychotic disorders(mainly schizophrenia) and personality disorders. The first symptoms usually appear in adolescence or early middle age, but may remain imperceptible for several years.

Depression

What's this?

Much more than a hit of the seasonal blues, depression is a mood disorder that neutralizes a person's ability to function socially and professionally. engulfed constant feeling sadness and despair, this person loses interest in what usually gives him pleasure. It is possible to experience symptoms of depression due to a difficult event (loss of a job, loss of a dear being, etc.). But major depression, characterized by the intensity and duration of the depressive episode, is much more problematic.

Whom does it affect?

You should be concerned if for more than two weeks:

A person experiences a lack of energy, every gesture of everyday life seems to him a huge test;
- he loses interest in such pleasures as cooking, meeting friends, etc.;
- he often cries;
- he suffers from insomnia or always wants to sleep;
- he feels guilty for no reason;
- he experiences problems with concentration, and, consequently, in the performance of professional tasks;
- he looks at most things in a negative way;
- eats less;
- isolates and avoids social contacts;
He has predispositions to thoughts of suicide.

bipolar anxiety

What's this?

Also known as manic-depressive illness, bipolar anxiety is a mood disorder where 2 poles are clearly defined: the depressive and the manic poles. In the depressive phase, the symptoms are entirely similar to those of depression. In the manic phase, the patient's excitation reaches such intensity that he loses confidence in himself: at these moments, his joy and anger unconsciously cross all boundaries. These alternating phases can last from several weeks to several months. To be diagnosed with bipolar anxiety, one must know at least, about an episode of mania.

Who is affected?

1% of the population. It is worth worrying if:

The patient has the same symptoms as depression;
- his energy is excessive when he "recovers";
- he undertakes large objects that are not realistic;
- easy to get angry;
- does not sleep anymore;
- excessive self-respect;
- makes forced purchases and can get into debt;
- speaks quickly and non-stop.

General anxiety

What's this?

Excessive anxiety, perception of what could be. For a diagnosis to be made, this anxiety must prevent us from being functional at least one day out of two for more than 6 months.

Who is affected?

5% of the population (slightly more women). It is worth worrying if:

A person believes that a misfortune has happened to his close relative when he does not receive news from him for a long time;
- Conversations concern, mainly, alarms; he is very excited when people talk to him;
- he has difficulty concentrating and forgets important information;
- he is tense and complains of muscle pain;
- He suffers from insomnia.

Phobias

What's this?

Fear is normal defense mechanism. In people affected by a phobia, this fear is excessive and intense, so great that its manifestations can reach panic attacks. The afflicted person will do everything to outline the situation or goal that provokes his fear, since the mere fact of anticipating this fear can cause him to lose his means.

Who is affected?

7-11% of the population (slightly more than women). Phobias are considered among the most general disorders mental health. You should be concerned if:

A person systematically avoids some situations: flying an airplane, going alone to parties or in public places, visit a friend who has a dog, etc.;
- he comes up with a whole scenario of disasters;
- he is afraid of losing control over himself;
- in some situations he seems irritable, sweats, suffocates;
- suddenly complains of gusts of wind, heat, or chest pains.

Forced obsessive anxiety

What's this?

Anxiety characterized by thoughts or irrational and stubborn fears which are tried to be soothed by coercive rituals. For example, if we are at the mercy of germs, then we wash our hands 2, 5, 10 times a day to calm our anxiety. Since thoughts associated with germs do not disappear, we wash our hands more and more often, thus entering into vicious circle which achieves something that seriously harms our affairs. It is possible to realize that our thoughts are irrational and try to ignore them, but this only serves to increase anxiety. Symptoms usually set in gradually and tend to worsen during periods of stress.

Who is affected?

1-3% of the population, both men and women. It is worth worrying if:

A person is constantly washing or cleaning things;
- has or touches objects in a special order;
- constantly makes lists;
- checks many times whether the door is locked, whether the light is off, whether the burner on the stove is turned off, etc.;
- worries about the safety of others;
- needs to repeat gestures or words, or count systematically.

Schizophrenia

What's this?

In the family of psychotic disorders, schizophrenia is one of the most complex. Perception, thoughts, feelings and worries worsen. However, the affected person sees this as the norm and thinks that something is wrong with the others. He may have bouts of delirium and hallucinations. His attention, memory and ability to discuss information are impaired. Thoughts are disorganized. He loses interest in daily activities, isolates himself, and finds it difficult to take care of himself. Has no more emotions.

Who is affected?

1% of the population. The first symptoms in men appear between 16 and 25 years, in women between 16 and 35 years. Worth worrying about:

Man hears voices;
- visual hallucinations;
- he believes that people will conspire against him;
- he closes in himself and is disinterested in performing daily tasks;
- has difficulty establishing contact with his surroundings;
- he is afraid of falling apart (for example, he refuses to take a bath).

It is very difficult to convince a schizophrenic to consult a doctor. If their behavior is considered to be at risk of becoming dangerous, an urgent psychiatric evaluation should be sought.

Limiter's Anxiety

What's this?

This disorder is characterized by the inability to define one's identity. Affected people maintain tense unstable relationships with others, they show excessiveness in everything, which leads to self-destruction. They have difficulty managing their emotions, changing within the group, and adapting. Some feel misunderstood and harbor a grudge against the judgments of others.

Although the symptoms of this anxiety are similar to those of the manic phase of bipolar anxiety, these two are absolutely various diseases. In bipolar individuals manic phase may last several months, while an anxious person may become aware of daily ups and downs, often depending on what is happening in his environment.

Who is affected?

1-3% of the population, especially women. It is worth worrying if:

The person is afraid of being abandoned;
- has difficulty making friends and maintaining long-term relationships;
- hardly controls his impulses and has dangerous reactions;
- may abuse drugs and alcohol;
- has unrestrained sexual behavior;
- often moves;
- he idealizes, then devalues ​​the same person for several days;
- he is kind and changes his behavior when a third person appears;
- has a predisposition to thoughts of suicide.

Each of us is familiar with the state of anxiety, each of us has experienced difficulties with sleep, each of us has experienced periods of depressed mood. Many are familiar with such phenomena as children's fears, some obsessive melody was "attached" to many, from which it was impossible to get rid of for some time. All of these conditions are found in both normal and pathological conditions. However, normally they appear sporadically, for a short time and, in general, do not interfere with life.

If the state is delayed ( formal criterion is a period of more than 2 weeks), if it began to disrupt performance or simply interferes with a normal life, it is better to consult a doctor so as not to miss the onset of the disease, possibly severe: it does not necessarily begin with gross mental disorders. Most people, for example, think that schizophrenia is necessarily a severe psychosis.

In fact, almost always schizophrenia (even its most severe forms) begins gradually, with subtle changes in mood, character, and interests. So, a lively, sociable and affectionate teenager before becomes closed, alienated and hostile towards relatives. Or a young man, who used to be mainly interested in football, begins to sit for almost days at books, thinking about the essence of the universe. Or the girl begins to be upset about her appearance, to claim that she is too fat or that she has ugly legs. Such disorders can last several months or even several years, and only then a more serious condition develops.

Of course, any of the changes described are not necessarily indicative of schizophrenia or any mental illness at all. character changes in adolescence everyone, and this causes parents well-known difficulties. Almost all teenagers are characterized by grief about their appearance, and very many begin to have "philosophical" questions.

In the vast majority of cases, all these changes have nothing to do with schizophrenia. But it happens that they have. It is helpful to remember that this may be the case. If the phenomena transitional age"are already expressed very strongly, if they create much more difficulties than in other families, it makes sense to consult a psychiatrist. And this is absolutely necessary if the matter is not limited to changes in character, and other, more distinct painful phenomena, such as depression, join them or obsession.

Not all conditions are listed here, in which it would be reasonable to seek help in a timely manner. These are just guidelines that can help you suspect something is wrong and make the right decision.

Is this a disease?

Any disease, whether physical or mental, invades our lives unexpectedly, brings suffering, frustrates plans, disrupts our usual way of life. However, a mental disorder burdens both the patient himself and his relatives. additional problems. If it is customary to share a physical (somatic) illness with friends and relatives and consult on how best to proceed, then in the case of a mental disorder, both the patient and his family members try not to tell anyone anything.

If at physical illness people strive to understand what is happening as quickly as possible and quickly seek help, then when mental disorders occur, the family does not realize for a long time that we are talking about the disease: the most ridiculous, sometimes mystical assumptions are made, and a visit to a specialist is postponed for months or even years.

Mental disorder manifests itself in the fact that perception changes outside world(or perception of oneself in this world), as well as in changing behavior.

Why is this happening?

Symptoms of physical (somatic) diseases are most often very specific (pain, fever, cough, nausea or vomiting, upset stool or urination, etc.) In such a situation, everyone understands that they need to go to the doctor. And the patient may not have the usual complaints of pain, weakness, malaise, there may not be "usual" symptoms like elevated temperature body or lack of appetite. Therefore, the thought of the disease does not immediately come to mind - to the patient himself, and to his relatives.

The symptoms of mental illness, especially at the very beginning, are either rather vague or very incomprehensible. In young people, they often look like difficulties of character ("whims", "whim", age crisis), with depression - like fatigue, laziness, lack of will.

Therefore, for a very long time, people around think that a teenager, for example, is poorly educated or has fallen under a bad influence; that he was overtired or "retrained"; that a person "plays the fool" or mocks relatives, and first of all, the family tries to apply "educational measures" (moralizing, punishment, demands to "pull themselves together").

With a gross violation of the patient's behavior, his relatives have the most incredible assumptions: "jinxed", "zombified", drugged and so on. Often family members guess that it is a mental disorder, but explain it with overwork, a quarrel with a girlfriend, fear, etc. They try in every possible way to delay the time of seeking help, waiting for it to “pass by itself”.

But even when it becomes clear to everyone that the matter is much more serious, when the thought of "damage" or the "evil eye" is already behind us, when there is no longer any doubt that a person has fallen ill, the prejudice still presses that a mental illness is not at all what that disease, such as the heart or stomach. Often this wait lasts from 3 to 5 years. This affects both the course of the disease and the results of treatment - it is known that the sooner treatment is started, the better.

Most people are firmly convinced that body diseases (they are also called somatic diseases, because "soma" in Greek means "body") are an ordinary phenomenon, and mental disorders, diseases of the soul ("psyche" in Greek - soul), - this is something mysterious, mystical and very scary.
Let's repeat that it's just a prejudice and that its causes are complexity and "unusual" psychopathological symptoms. In other respects, mental and somatic diseases are no different from each other.

Signs that suggest mental illness:

• Noticeable personality change.
• Inability to cope with problems and daily activities.
• Weird or grandiose ideas.
• Excessive anxiety.
• Prolonged depression or apathy.
• Noticeable changes in eating and sleeping habits.
• Thoughts and talk of suicide.
• Extreme ups and downs in mood.
• Abuse of alcohol or drugs.
• Excessive anger, hostility, or misbehavior.

Conduct violations- the symptoms of the disease, and the patient is just as little to blame for them, as the flu patient is in the fact that he has a temperature. This is a very difficult problem for relatives to understand and accustom themselves to the fact that the wrong behavior of a sick person is not a manifestation of malice, bad upbringing or character, that these violations cannot be eliminated or normalized (by educational or punitive) measures, that they are eliminated as the condition improves. sick.

For relatives, it may turn out useful information about initial manifestations psychosis or symptoms of an advanced stage of the disease. All the more useful may be recommendations on some rules of behavior and communication with a person who is in sick state. AT real life it is often difficult to immediately understand what is happening with your loved one, especially if he is scared, suspicious, distrustful and does not express any complaints directly. In such cases, only indirect manifestations of mental disorders can be noticed.
Psychosis can have a complex structure and combine hallucinatory, delusional and emotional disorders(mood disorders) in various proportions.

The following symptoms may appear with the disease all without exception, or separately.

Manifestations of auditory and visual hallucinations:

• Conversations with oneself, reminiscent of a conversation or remarks in response to someone's questions (excluding comments aloud like "Where did I put my glasses?").
• Laughter for no apparent reason.
• Sudden silence, as if the person is listening for something.
• An alarmed, preoccupied look; inability to focus on a topic of conversation or a specific task
• The impression that your relative sees or hears something that you cannot perceive.

The appearance of delirium can be recognized by the following signs:

• Changed behavior towards relatives and friends, the appearance of unreasonable hostility or secrecy.
• Direct statements of implausible or dubious content (for example, about persecution, about one's own greatness, about one's inexcusable guilt.)
• Protective actions in the form of curtaining windows, locking doors, obvious manifestations of fear, anxiety, panic.
• A statement without obvious grounds for fear for one's life and well-being, for the life and health of loved ones.
• Separate, incomprehensible to others, meaningful statements that give mystery and special significance to everyday topics.
• Refusal to eat or carefully check the content of the food.
• Active litigious activity(for example, letters to the police, various organizations with complaints about neighbors, colleagues, etc.). How to respond to the behavior of a person suffering from delusions:
• Do not ask questions that clarify the details of delusional statements and statements.
• Do not argue with the patient, do not try to prove to your relative that his beliefs are wrong. This not only does not work, but can also aggravate existing disorders.
• If the patient is relatively calm, tuned in to communication and help, listen carefully to him, calm him down and try to persuade him to see a doctor.

Suicide Prevention

For almost all depressive states there may be thoughts of unwillingness to live. But depressions accompanied by delusions (for example, guilt, impoverishment, incurable depression) are especially dangerous. somatic disease). These patients at the height of the severity of the condition almost always have thoughts of suicide and suicidal readiness.

The following signs warn of the possibility of suicide:

• Statements of the patient about his uselessness, sinfulness, guilt.
• Hopelessness and pessimism about the future, unwillingness to make any plans.
• The presence of voices advising or ordering suicide.
• The patient's belief that he has a fatal, incurable disease.
• Sudden calming of the patient after a long period of melancholy and anxiety. Others may have the false impression that the patient's condition has improved. He puts his affairs in order, for example, writing a will or meeting up with old friends whom he has not seen for a long time.

Preventive action:

• Take any discussion of suicide seriously, even if it seems unlikely to you that the patient might attempt suicide.
• If there is an impression that the patient is already preparing for suicide, without hesitation, immediately seek professional help.
• Hide dangerous items (razors, knives, pills, ropes, weapons), carefully close windows, balcony doors.

If you or someone close to you has one or more of these warning signs, you need to see a psychiatrist urgently.
A psychiatrist is a medical doctor with a degree medical education and completed a specialization course in psychiatry, licensed to practice and constantly improving his professional level.

Questions from relatives about the manifestation of the disease.

I have an adult son - 26 years old. AT recent times something is happening to him. I see him strange behavior: Has stopped going out, is not interested in anything, doesn't even watch his favorite videos, refuses to get up in the morning and hardly cares about personal hygiene. This was not the case with him before. I can't find the reason for the change. Maybe it's a mental illness?

Relatives often ask this question, especially in the most initial stages diseases. Behavior loved one causes anxiety, but it is not possible to pinpoint the exact cause of the change in behavior. In this situation, between you and a person close to you, there may be a significant tension in the relationship.

Watch your loved ones. If the resulting behavioral disturbances are sufficiently persistent and do not disappear with changes in circumstances, it is likely that a mental disorder may be the cause. If you feel any disorder, try to consult a psychiatrist.
Try not to get into conflict with the person you care about. Instead, try to find productive ways to resolve the situation. Sometimes it can be helpful to start by learning as much as possible about mental illness.

How to convince a patient to seek psychiatric help if he says: "I'm fine, I'm not sick"?

Unfortunately, this situation is not rare. We understand that it is extremely painful for relatives to see a family member suffering from an illness, and it is equally difficult to see that he refuses to seek help from a doctor and even from his relatives in order to improve his condition.

Try to express your concern to him - in such a way that it does not look like criticism, accusation or excessive pressure on your part. Sharing your fears and worries with a trusted friend or doctor first will help you talk calmly with the patient.

Ask your loved one if they are concerned about their own condition and try to discuss it with them. possible ways solution of the problem. Your main principle should be to involve the patient as much as possible in the discussion of problems and the adoption of appropriate decisions. If it is not possible to discuss anything with the person you care about, try to find support in resolving difficult situation other family members, friends or doctors.

Sometimes mental condition the patient is rapidly deteriorating. You need to know when mental health services provide treatment contrary to the wishes of the patient (carry out involuntary hospitalization, etc.), and in which they do not.

The main purpose of involuntary (forced) hospitalization is to ensure the safety of both the patient himself, who is in acute condition and the people around him.

Remember that there is no substitute for a trusting relationship with your doctor. With him you can and should talk about the problems that arise before you in the first place. Don't forget that these problems can be no less difficult for the professionals themselves.

Please explain if the system provides psychiatric care any mechanism for its provision in case the patient needs help, but he refuses it?

Yes, in accordance with such a mechanism is provided. A patient may be placed in a psychiatric institution and held there on an involuntary basis if the psychiatrist believes that the person is suffering from a mental illness and, left untreated, may cause serious physical harm to himself or others.

To persuade the patient to voluntary treatment, the following can be advised:

• Choose the right moment to talk to the client and try to be honest with him about your concerns.
• Let him know that you are primarily concerned about him and his well-being.
• Consult with your relatives, the attending physician, what is the best course of action for you.

Psychosis is a serious mental disorder deep violation mental, emotional and affective components is considered quite dangerous for patients.

The disease manifests itself in abrupt change the patient's behavior, the loss of an adequate attitude to life and others, in the absence of a desire to perceive existing reality. At the same time, they interfere with the awareness of the presence of these very problems, a person cannot eliminate them on his own.

Due to the emotional component, hormonal explosions and susceptibility, women and other mental disorders occur twice as often as (7 vs. 3%, respectively).

What are the reasons and who is most at risk?

The main causes of the development of psychosis in females are as follows:

One of the main reasons is increased emotional excitability or the presence similar disease in the family of a woman, a mother, a sister, that is, a genetic component.

Who is at risk

The root cause of the appearance of psychosis is often alcohol abuse and subsequent intoxication of the body. In most cases, men are most susceptible to alcoholism, so the female suffers from much less often and endure it faster and easier.

But there is also a reason that is characteristic only for women, which increases the risk of the disease. This is pregnancy and childbirth. To the physical factors of the appearance of psychosis in this case include toxicosis, vitamin deficiency, a decrease in the tone of all body systems, various diseases or complications due to difficult pregnancy and childbirth.

Psychological ones include fear, worries, increased emotional sensitivity, unwillingness to become a mother. However, postpartum mental disorder occurs more frequently than during pregnancy.

Behavioral Features

For a woman with mental disorders, such changes in behavior and life activity are characteristic (with the symptoms noticeable only from the outside, the sickest and unaware that she is sick):

• lack of resistance to, which often leads to or scandals;
• the desire to isolate oneself from communication with colleagues, friends and even relatives;
• there is a craving for something unreal, supernatural, interest in magical practices, shamanism, religion and similar areas;
• the emergence of various fears, phobias;
• decreased concentration, mental retardation;
• loss of strength, apathy, unwillingness to show any activity;
• sudden mood swings for no apparent reason;
• sleep disturbances, which can manifest itself both in excessive drowsiness and insomnia;
• downgrading either complete absence desire to eat.

If a woman herself was able to detect any signs of psychosis, or if her relatives noticed them, then it is urgent to seek qualified help.

Varieties of deviations in the mental state

Psychosis can be conditionally divided into two large groups:

1. organic. In such cases, it is a consequence physical illness, a secondary disorder after disturbances in the work of the central nervous and cardiovascular systems.
2. Functional. Such disorders are initially due to the psychosocial factor and the presence of a predisposition to their occurrence. These include violations of the process of thinking and perception. Among others, the most common:, schizophrenia,.

Separately, it can be distinguished, it appears in 1 - 3% of women in the first months after the birth of a child, in contrast to the more common postpartum depression, psychotic deviation does not go away on its own and requires treatment under the qualified supervision of specialists.

Symptoms:

• loss of appetite and fast loss weight;
• constant anxiety, sharp drops sentiments;
• desire for isolation, refusal to communicate;
• violation of the level of self-esteem;
• thoughts about committing suicide.

Symptoms appear individually, some may be within a day after giving birth, others a month later.

The causes of this type of psychotic disorder may be different, but they are not fully understood by scientists. It is reliably known that patients who have a genetic predisposition are susceptible to it.

Psychic failure may be associated various states, which provoke disturbances in the work of the whole body of a woman.

Violation of diet, activity and rest, emotional tension, taking medications. These factors "hit" the nervous, cardiovascular, respiratory, digestive and endocrine systems. Manifestation concomitant diseases individually.

Who to turn to for help?

Self-medication in this case is contraindicated. You should also not contact familiar doctors of various specialties, psychologists, traditional healers. Treatment should be carried out only by a public or private doctor - a highly qualified psychotherapist!

Unfortunately, a woman suffering from psychosis cannot seek help herself, because she does not notice the signs of her illness. Therefore, the responsibility lies with the relatives and friends of the mother. Seek help from a doctor as soon as possible.

The specialist will examine the patient, refer to additional tests and according to their results, prescribe treatment and the necessary drugs.

Treatment can take place in a hospital with the participation of medical staff, or at home. When treating at home, a mandatory safety measure will be taking care of the baby with the least intervention of the mother (in case of postpartum mental failure). The nanny or relatives should take care of these concerns until the disappearance of all symptoms of the disease in the patient.

Treatment usually consists of a complex, which includes:

• medicines, usually this,;
• psychotherapy - regular sessions with a psychotherapist and a family psychologist;
• social adaptation.

The patient can not immediately realize, accept her condition to the end. Relatives and friends must be patient to help the woman return to normal life.

The consequences of the lack of therapy are extremely unfavorable. The patient loses touch with reality, her behavior becomes inadequate and dangerous not only for own life and health, but also for others.

A person is suicidal, may become a victim or cause of violence.

How to prevent mental breakdown?

Preventive measures include:

Prevention should be a priority, especially in those women who are prone to emotional disruption or have a hereditary predisposition to psychotic disorders.