Drug therapy is an integral part in the treatment of psychosis. To relieve attacks, neuroleptics are most often used, and in some cases, antidepressants or mood stabilizers. In addition to medication methods, psychotherapy and social rehabilitation methods are used in the treatment of psychosis. Psychosis cannot be cured on its own, and it is not recommended to practice treatment at home. With such treatment, even with outpatient observation by a psychiatrist, there is a high probability of inappropriate behavior that is dangerous both for the patient himself and for others. In a hospital setting, the patient’s condition is constantly monitored, which helps reduce the danger to a minimum. For a person with psychosis, inpatient treatment is recommended, the duration of which will be at least three weeks.
After psychosis. Recovery. Reflection
Post to the League of Psychotherapy
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I remembered one story that happened in the hospital where I was a resident when I was studying to become a clinical psychologist. I had years of training behind me at the German Institute of Psychodrama - this is a type of psychotherapy, and in the hospital there were psychodrama groups under the guidance of a very experienced psychiatrist G.O., who loved this method very much.
It is clear that he was delighted with the new addition, gladly took me on as an assistant psychotherapist, and we met with patients twice a week. One group was from the Ministry of Defense, veterans with post-traumatic stress syndrome, and the other was patients from the psychiatric department through the Ministry of Health. I would like to tell you about one such activity in the hospital.
A 20-year-old guy entered the department, quiet, calm, the fourth child in the family. The mother had a second pregnancy, a firstborn, and then triplets. And it so happened that she emotionally accepted two children from these triplets (a boy and a girl), and poured out all her irritation, anger, and fatigue on the third child. He was a whipping boy all his life.
He was considered limitedly fit for military service and was not drafted. He didn’t know who to study next, and he ended up in the hospital because one day he stopped going to work, lay down with his face to the wall and stopped talking. They persuaded him to go to hospital, to change the environment, talk with doctors, and so that he could show “more activity,” the doctor prescribed him psychodrama.
Group classes go as follows: first, twenty participants in a circle talk about who came to class in what mood, then the presenters offer a warm-up exercise, then ask who wants to role-play their own situation.
If there are several people interested at once, chairs are placed in the center of the circle, and behind whose chair there will be more people supporting the situation for acting out - that’s where the energy of the group is, then the leaders will act out.
They will ask questions, invite people from the group to play the roles of actors, change the person who has applied for the game in roles with these actors - in general, work through the situation. If the role is too difficult for patients, the assisting therapist takes on it.
Then everyone sits in a circle, people tell from their roles how it was experienced, and the lesson ends with sharing - everyone tells a situation from their past that echoes the situation that was played out.
When the guy said that he wanted to play, the hosts were delighted - he was finally coming out of his apathy and showing activity. The group supported us and began to build a stage.
“This is McDonald's,” said the patient. – I need a table, chairs and people who sit at the tables. We eat.
G.O. asked him to choose from a group of those who would portray visitors and designate the tables and chairs of the cafe using the furniture available in the hall.
“I’m sitting here,” the patient explained, “the girl is sitting here and looking like this, he’s here, he’s here.”
“Yes,” the presenter helped distribute the roles. -And what happens in this scene?
“Laser rays of evil come out of the eyes of these people and enter my eyes,” answered the quiet man. “This is an evil that burns right through, but in my head their glances cross and burn out my brain.” And it turns black.
This is called a “psychotic perception”, a completely delusional and unrealistic figurative perception, and at the same time aggressive, because something is being destroyed. G.O. by my facial expressions he realized that I understood everything and gave a sign that I should not interfere.
We couldn’t build the scene “three random people in a cafe are killing me with their eyes” on a group of 20 patients - violence is prohibited. We couldn’t swap his roles with the performers of the “visitors” and ask how you feel in the role of the one who kills.
(We had no idea that he had such a psychotic nightmare blazing in his head. He was lying face to the wall in the department, apathetically quiet, it was his attending physician who came up with the idea to make it look like a psychodrama).
“Thank you, great start,” said G.O. - Let’s let the people go, we caught your idea, now we’ll put three chairs in their place, let the visitors indicate things
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The patients returned to their seats, and the guy remained sitting at the table, closing his eyes. It was clear that he was deeply agitated inside.
– Did you close your eyes so that the laser beams don’t harm you? - suggested G.O., trying to comprehend his experiences.
“Yes,” answered the patient.
(But he’s on antidepressants, not neuroleptics,” a thought flashed through my head. The benefit of the class is that the other side of the clinical picture has been revealed, and they will change his treatment after this class. Although the doctor, of course, could have been more conscientious conduct an interview with the patient, frankly speaking).
– What would you like to do with laser beams? – asked G.O. in hopes of somehow transforming the scene.
“This girl from the cafe, she’s actually my mother,” the guy said in a changed voice. And the other two are like my father and my brother. They all hate me and want me gone.
(what a beautiful psychodynamic hypothesis for the crystallization of a delusional plot about withering glances, G.O. will later say)
- Yes, they hate me. I see their rays, they are here now,” he began to wave his hands.
It was clear to half the group that he was hallucinating—these were patients who knew firsthand about hallucinations.
“Go to the post, ask the doctors for help,” G.O. sent me. for the orderlies. I left.
When we returned, the quiet guy was breaking down chairs with physical strength that no one could have expected from him, and G.O. stood between him and a group of patients.
The moral of this story is clear: when the group leader follows safety precautions, everyone stays alive
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Source: https://pikabu.ru/story/posle_psikhoza_vosstanovlenie_refleksiya_6034987
Recovery from psychosis
Drug therapy is an integral part in the treatment of psychosis. To relieve attacks, neuroleptics are most often used, and in some cases, antidepressants or mood stabilizers.
In addition to medication methods, psychotherapy and social rehabilitation methods are used in the treatment of psychosis. Psychosis cannot be cured on its own, and it is not recommended to practice treatment at home.
With such treatment, even with outpatient observation by a psychiatrist, there is a high probability of inappropriate behavior that is dangerous both for the patient himself and for others.
In a hospital setting, the patient’s condition is constantly monitored, which helps reduce the danger to a minimum. For a person with psychosis, inpatient treatment is recommended, the duration of which will be at least three weeks.
What is necessary for quality recovery after psychosis?
In addition to early diagnosis, it is necessary to pay attention to the treatment process itself and involve the patient in it. Often the patient does not admit that he is sick and refuses to contact a specialist, which negatively affects the probable prognosis of the disease.
Therapeutic interaction, alliance, so-called compliance is what allows the patient to be included in the treatment process as much as possible. Thanks to the creation of such interaction, the effectiveness of treatment is significantly increased. Compliance is sometimes incredibly difficult to achieve.
The reason for this is the patient’s denial of the disease as such, or the patient’s false confidence in the futility of medical care, the stigmatization of mental illness and the belief in the futility of treatment. Also among the reasons that complicate compliance is fear of psychiatrists and mental health institutions.
While in psychosis, a person may lose some of their social connections and skills. To restore them, social rehabilitation is used in individual and group forms.
Group work
Group work is effective with patients who do not admit that they have a disease. In this form of work, they see people who have similar symptoms, and this allows them to see their own deviations.
For example, a patient may appreciate that the delusions of other patients are not true. In group work, the feedback he receives from other patients is important, as well as the opportunity to respond to their statements and behavior.
This is a very important part of the patient's resocialization.
Psychoeducation
There is also another area that promotes recovery from psychosis: psychoeducation. This is informing the patient and his family about what is happening, what are the first aid methods for the onset of an acute psychotic state, how to correctly recognize symptoms and prevent their increase in time.
Assistive psychotherapy
Assistive psychotherapy is aimed at learning to control one’s mental state. The acquired knowledge reduces the likelihood of relapse and helps build self-confidence in the patient and his relatives.
Social communication trainings
For successful adaptation, the use of social communication training is effective. During the classes, patients learn to correctly perceive the verbal and nonverbal reactions of other people, develop their own communication skills and problem-solving behavior skills.
Metacognitive trainings
The Mental Health Clinic also uses the metacognitive training method in the treatment of psychosis. This method allows patients to identify disturbances in their own thinking, as well as restore cognitive abilities affected by the disease. Thanks to metacognitive training, the patient learns to control thinking and subsequently successfully adapt to society.
To work with the restoration of everyday and simple work skills, the use of labor rehabilitation is practiced. As part of rehabilitation, patients first perform simple work in the clinic for a short period of time, and then the complexity and time of work increases.
Treatment and recovery after psychosis at the Mental Health Clinic
The treatment of psychosis at the Mental Health clinic is carried out not only by psychiatrists, but also by psychotherapists, psychologists, and social educators. This allows you to restore a person’s condition in the shortest possible time.
In our clinic, when treating psychosis, we use an integrated approach, which consists of a combination of medicinal and non-medicinal methods.
In addition to the above, we also use the latest, safe methods of instrumental therapy: biofeedback (BF), transcranial magnetic stimulation (TMS), light therapy.
Biofeedback
Biofeedback allows the patient to observe the strength of his own reaction to various stimuli and, with the help of special exercises, develop new, more effective response skills.
Light therapy
It has a beneficial effect on the body's circadian rhythms (sleeping and waking patterns), which helps restore the body of a person who has experienced a psychotic episode.
Transcranial magnetic stimulation
Allows you to track the state in which the motor zone of the cerebral cortex is located. Also, TMS, due to a magnetic pulse, has a depressing or stimulating effect on the cortex, depending on the state in which the patient is, providing a therapeutic effect.
This combination of various methods of influencing the disease significantly reduces treatment time and leads to effective results. In our practice, we use only proven, reliable, well-tested methods of diagnosis and therapy. Additionally, I would like to note that the provision of timely assistance is the key to a successful prognosis in the treatment of psychosis.
Still have questions? We know how to help you! Call us
Source: https://psyclinic-center.ru/articles/vosstanovlenie-posle-psihoza
Alcohol depression
Alcoholic depression is not identified as a separate disease. Its duration can range from several days to several weeks or even more. A person’s mood ranges from deep repentance to blaming others for their bad attitude towards him. The patient feels unwanted, lonely, abandoned, becomes tearful and touchy. He feels sad, everything around him irritates him, and he may experience anxiety attacks. The emotional background is painted in dark colors. This condition is very dangerous; a person begins to have thoughts of suicide, which he harbors and ultimately tries to bring into reality.
Frequently asked questions about psychosis | clinical
There is currently a strong interest in the topic of psychosis (schizphoria, etc.) in society. The very concept of psychosis is perceived in different ways: from curiosity to fear. The phenomenon of psychosis is incorrectly and erroneously often used in philistine psychology.
All sorts of prejudices and myths, on the one hand, see psychosis where there is none, and on the other hand, they prevent people from noticing and recognizing changes in time, both in themselves and in their loved ones. There is a denial of the problem out of fear of being branded a “crazy person.” Whereas timely seeking help from a specialist can help prevent the development of a serious disorder.
The lack of adequate information gives rise to distrust in doctors, the emergence of a large amount of unfounded information both in the media and on the Internet, which undermines not only trust in the medical service, but also makes life difficult for those who suffer from this kind of disorder. People can become victims of healers and fortune tellers who speculate on this complex phenomenon.
We have selected the most frequently asked questions, the answers to which must be given not only to the patients themselves and their relatives, but also to simply people who want to understand this phenomenon.
1.What is psychosis? Psychoses are manifestations of mental disorders, often chronic, which manifest themselves as disturbances in 4 main areas: perception, thinking, emotions and will, behavior and interaction with the outside world.
In the realm of perception, we are talking about hallucinations, that is, actually and plausibly seeing, hearing or feeling something that does not actually exist. A thinking disorder manifests itself as delusion, that is, false, irrational judgments that are subjective in nature.
Emotional disturbances can range from excessive activity, agitation with aggression and irritability to complete lack of will and isolation. Also in behavior, a person ceases to take into account social roles and the context of situations, to understand others; one may notice a stereotypical repetition of movements or performance of rituals.
In psychiatry there is the concept of negative and positive symptoms. Positive symptoms are those mental phenomena that were not previously present in the psyche, but have appeared (delusions, hallucinations, aggression).
Negative symptoms are those mental qualities that have begun to be lost and erased (unemotionality, memory loss, loss of social contacts). All these phenomena lead to a loss of connection with the outside world and interfere with the correct interpretation of reality, which explains one of the main signs of psychosis - a lack of criticality.
2.Can neurosis turn into psychosis? Psychosis is a disorder that is characterized by gross violations of the emotional-volitional sphere, changes in thinking and is accompanied by a violation of criticality towards one’s condition with a violation of the ability to distinguish internal experiences from external sources.
With neurosis, emotional or physical manifestations of internal conflict come to the fore without disrupting thinking and being overly critical of one’s condition. Biological causes predominate in the occurrence of psychoses, while intrapersonal conflicts play a leading role in the occurrence of neuroses.
The mechanisms underlying neurosis and psychosis are so different from each other that one does not transform into the other.
3.
Can psychosis be cured? There are acute (transient) psychoses, which can more often be caused by acute stressful situations (life-threatening situations, loss of a loved one), intoxication (alcohol, popularly “delirium tremens”), infection (with meningitis), severe physical illness (with a heart attack). myocardium), with timely and correct drug treatment, their complete cure is possible without maintaining residual signs. In cases of chronic psychosis (example: schizophrenia, bipolar affective disorder), the course can be long. As with any chronic disease, there are periods of complete health, doctors call them remissions, and periods of exacerbation of the disorder. The prognosis largely depends on the correct treatment started in a timely manner.
4.What causes psychosis? Currently, medicine has adopted a multifactorial model, which shows that the development of the disease is influenced by a combination of several causes.
The predominant reasons are still biological: changes in metabolism in the brain, namely the substance dopamine, which serves impulses, emotions, feelings of pleasure and motor activity, affects the severity of symptoms and their nature.
In addition, psychosocial reasons can be identified: conflicts, mental trauma, tension, disharmonious relationships in the family, which will affect the course of the disease and the recovery process.
5. Is it possible to get psychosis if a relative suffered from it? There is a pattern that says that the closer the degree of relationship, the higher the risk of getting sick. However, it is worth remembering that predisposition is inherited. For the development of the disease itself, a combination of many factors is necessary.
Currently, there are no reliable formulas by which this probability could be determined. The heredity factor plays the same role as in cancer, diabetes and arterial hypertension.
It is known that if both parents suffered from the disease, then the risk is 50%, if only one of them, then the risk is estimated at 25%
6. Can psychosis be cured without medication? Unfortunately no. Since biological causes are dominant in the occurrence of psychoses, a special group of drugs is used to treat psychoses - antipsychotic drugs, another name for neuroleptics.
Their effectiveness has now been proven and they are widely used in practice. Drug therapy is currently the most reliable and effective way to cope with acute symptoms and prevent their return.
It is important that drug therapy is combined with individual and/or family psychotherapy, which will help the sufferer and his loved ones develop a real understanding of the disorder, teach them to cope with it, and take measures to prevent it.
The social rehabilitation program will help you return to normal daily activities by restoring and improving social skills (communication with others, daily routine activities, rational behavior).
7. Are people in psychosis dangerous to others? In the acute stage of psychosis, when the understanding of reality is greatly impaired, i.e. it is misperceived (hallucinations), interpreted (delusions), and it is also impossible for a person to control his impulses, he can be dangerous to himself and others.
However, the likelihood of an attack is quite low, because... The main experience of such patients is horror and anxiety, while rage and anger are secondary. It is very important then to behave correctly.
Do not argue or convince a person that what is happening is wrong, do not find out the details of his experiences, and hide dangerous objects. You need to listen to him carefully and try to calm him down, ensure a calm environment, shouting or arguing is not allowed, stress in such a situation should be minimized.
Try, but only if the person is calm, to persuade him to see a doctor. In other situations, you can seek emergency help.
8. Are people with psychosis able to work? A mental disorder is just like any physical illness, just like any physical illness, it can impose its limitations.
People who experience psychosis exhibit disturbances of impulse to act and will, which should not be considered signs of human or moral weakness. The “pull yourself together” approach is similar to treating deafness through “willpower”.
People suffering from psychosis may experience certain difficulties and, as a result, restrictions in performing work activities. Sometimes this requires the creation of certain conditions on the part of the employer (reducing the load, working hours, intensity, complexity of the work performed). At the same time, work is very important for such people, because...
contributes to the preservation and restoration of thought processes, motivations and activity. However, in some cases, the disorder does not affect activity in any way, as evidenced by the examples of many talented scientists, writers and artists.
9. How dangerous are antipsychotic drugs? All antipsychotic drugs have a certain range of side effects. It is important to carefully select the type of drug and dose, taking into account the symptoms of the disease, age, and state of physical health.
Currently, there are antipsychotics, when taken, the development of unpleasant side effects is minimized. There are also injectable forms of the drug, which can be taken 1-2 times a month.
Trust in the doctor, agreement and discussion with him of the manifestations of the disease and side effects, setting realistic goals for treatment and adherence to the chosen treatment tactics are also of great importance.
10.Can people with psychosis start a family and have children? As with any disorder, this is not an obstacle. However, the partner must have complete, comprehensive and adequate information about the disease, its course and manifestations.
It is also worth discussing in advance with doctors - geneticists, gynecologists, psychiatrists - all possible risks for future children and the process of the course and management of pregnancy.
Therefore, it is necessary to approach this issue with greater prudence and become familiar with pregnancy planning methods.
11.Are people with psychosis able to make important decisions on their own? Yes, if the disease is in remission and there are no gross disturbances in the area of thinking.
The overwhelming majority of people suffering from psychosis during health are indistinguishable from people without a mental disorder. It is worth remembering that basically there is no total defeat of the personality, but only some of its aspects and functions suffer.
Therefore, with timely treatment and adequate treatment in combination with rehabilitation methods, it is possible to relieve acute symptoms and return a person to a full life.
With timely, proper treatment and organization of life with psychosis, incl. with schizophrenia, you can live a full life: study, work, have a family and children, favorite activities and friends.
Source: https://mokc.by/content/naibolee-chasto-zadavaemye-voprosy-o-psihozah
Acute psychosis
A person in a state of acute psychosis loses touch with reality. Various reasons contribute to this - diseases of the nervous system, schizophrenia, bipolar disorder, age-related changes, infections, alcohol or drug abuse, severe stress. But acute psychosis manifests itself very clearly in all cases.
Acute psychosis - what is it?
Psychosis itself is a condition characterized by a severe disturbance of mental activity, as a result of which the patient begins to perceive the world distortedly, through the prism of his own pathological ideas about what is happening.
Attacks of the disorder can be:
- one-time (such that it happened for the first time and has not yet been repeated);
- recurring (such that they arise again with a certain periodicity);
- continuous (such that they appear constantly).
Sometimes the symptoms subside. But as soon as they arise again, this is acute psychosis. This is the name given to the active phase of the disorder, when the signs of pathology are most clearly visible, and the person poses the maximum danger to himself and others.
Acute psychosis: symptoms
Treatment always begins with an assessment of the patient's general condition. Signs that concern him must be taken into account, including:
- Hallucinations. When a person sees, hears, feels something that is not really there, this is not normal. In acute psychosis, auditory hallucinations most often occur - so-called “voices”, giving hints or advice, threatening, convincing. In some cases, they lead to the patient causing harm to others.
- Depersonalization. A person loses touch with his body and his own personality. He perceives himself as someone else and cannot fully control his thought process.
- Derealization. The patient sees the world in the form of changing pictures - like in a movie. The subjective perception of time is distorted: for the patient it either compresses or slows down. A familiar environment suddenly seems unfamiliar. Episodes of déjà vu are common.
- Rave. Patients actively produce delusional ideas that cannot be attributed to rich imagination. It seems to a person that aliens are watching him, that the secret services are pursuing him, or that his neighbors want to kill him. Sometimes delusions of grandeur develop when the patient imagines himself to be a descendant of kings, the heir of ancient civilizations, the keeper of sacred secrets. There may be experiences that someone is reading thoughts or instilling them from the outside. Characteristic attacks of hypochondria.
- Unhealthy emotional reactions. The patient is either in a state of severe depression, or goes into manic “mode” and suddenly becomes active, cheerful, and active. And just as quickly and unexpectedly it returns to loss of strength and apathy.
- Movement disorders. Periods of stupor, when a person sits motionless in one position, are replaced by intervals of motor activity. Moreover, there is no objective reason for switching from one state to another.
Signs are not related to character traits. They indicate illness, and not just harmfulness and bad character. In this condition, a person needs immediate medical attention.
Acute psychosis: symptoms that portend an exacerbation
An attack of acute psychosis is usually heralded by certain signs. They are often overlooked because they may not be too obvious. Observed:
- increased anxiety, restlessness, unreasonable fears;
- sensitivity to stimuli, especially sound and light;
- general agitation;
- loss of interest in the world, lack of desire to do anything;
- mood swings;
- memory losses;
- sleep problems;
- difficulties in performing habitual mental work;
- increased or decreased appetite;
- distrust of others, desire to isolate from the world;
- commitment to ideas (belief in magic, religiosity, desire to donate things from home to shelters, etc.)
Sometimes, even before an attack of acute psychosis, a person demonstrates delusional ideas. But at this stage they are controllable: the patient may suffer from the belief that his neighbors are aliens, but for now he is able to control himself.
Alcohol delirium
This condition ranks first among all other forms of psychosis. It is also commonly called “delirium tremens”. Develops against the background of withdrawal syndrome, with a sharp forced cessation of alcohol consumption. The onset of delirium is characterized by sleep disturbance. Next, insomnia develops, which is gradually joined by visual and auditory hallucinations, as well as loss of orientation in space. In this case, it is visual hallucinations that predominate. These visions are characterized by a certain multiplicity of images. During delirium tremens, the alcoholic's mood changes very sharply and varies from panic states and deep apathy to complete despair and aggression.
One of the symptoms of the genesis of delirium is a yellow tint of the eyeball
The genesis of delirium will necessarily be accompanied by such physiological symptoms as:
- chills;
- tremor of hands and feet;
- pale skin;
- increased sweating;
- change in the color of the eyeballs (they acquire a yellow tint);
- dehydration.
