Schizophrenia is periodic. How often can there be attacks of schizophrenia? What does a schizophrenic feel after an attack?
Attacks of schizophrenia are a consequence of a functional disorder of the brain. There are several causes and predisposing factors for this disease, such as heredity, emotional shock, brain injury, etc.
Symptoms and frequency of attacks
The first signs of the disease include a sharp change in color preferences and a strange change in behavior.
The development of schizophrenia is signaled by the isolation of a person who tries in every way to protect himself from the outside world. His routine is disrupted, his sleep becomes restless, such a person often suffers from insomnia.
Regular headaches, migraines, sudden changes in mood, behavior patterns - all this is also a possibility. Inappropriate obsessions come to the patient's head, he suffers from hallucinations and delusions. A person becomes suspicious, he considers everything around him suspicious.
The level of sensitivity increases, the patient imagines that someone is following him. An insurmountable fear of death appears. Logical thinking is turned off, and mental abilities are reduced to a minimum.
The patient may begin to speak in a childish voice, lisp, continuously repeat some incomprehensible and unintelligible phrases, elevate himself above those around him, and then completely withdraw from everything that is happening around him.
In some cases, clear consciousness is maintained, but the pathology affects motor reflexes. Patients may experience seizures in schizophrenia, complete stupor, or unusual levels of activity.
Attacks can occur continuously or in periods with long light intervals when the person feels healthy. Such attacks occur once every 2-3 years. Paroxysmal schizophrenia also goes through periods that either change the personality or pass without a trace.
What to do during an attack?
When the patient is in an agitated or aggressive state, it is necessary to try to calm him down and make him harmless to others, and also try to prevent suicide attempts, if any. Only a specialist can help cope with an attack, so the person must be taken to a medical facility where he will receive assistance. You need to behave gently with the patient; he should not feel pressure, as if he was being driven into a trap. Speech should be slow, but not condescending, so that the patient cannot suspect anything
To calm the patient, the clinic uses various antipsychotics, for example: Haloperidol, Triftazin, Truxal, Rispolept. Such drugs have an inhibitory effect on the brain, are suitable for parenteral administration (i.e., bypassing the gastrointestinal tract), they act for 10-12 hours and do not cause an adverse reaction. The dosage of such a drug is determined by the patient's condition.
If the attack does not go away, hypnotics can be added to the antipsychotics. A person who is having an attack of schizophrenia should be kept under the inhibitory influence of medications until he completely calms down.
If the attack manifests itself in the form of a depressive state, then the specialist may prescribe antidepressants, for example, Fluvoxamine, Paroxetine. The dosage depends on the patient’s condition and which symptoms are more severe: anxiety or depression.
How to prevent a second attack?
In order to prevent a recurrent schizophrenic-type attack, you need to seek help from a specialist.
It takes place in several stages. The first phase is taking medications that affect the patient’s brain. Depending on the type of disease and symptoms, the doctor prescribes a medicine according to an individual program.
The next step is to understand the cause of the disease. This may be a manifestation of neurosis, a consequence of a head injury, an emotional shock experienced, the result of alcohol or drug addiction, etc. The doctor will help you understand the sources that influenced the onset of schizophrenia and find out the factors that can provoke a second attack.
There are several recommendations that need to be followed at home. It is necessary to completely eliminate alcohol-containing drinks and narcotic substances from the patient’s life. A person should not feel like an outcast, so he should not be allowed to be isolated from society. The process of socialization will not allow the formation of one’s own reality in the patient’s head. With the support of loved ones, he will not need to create an imaginary world.
Negative experiences should be minimized or completely prevented. It is recommended to throw out all the negativity in the gym or creative expression. Such a hobby will help distract the patient from his fears. A person must be busy with something all the time, then he will not have time to immerse himself in the world of fantasies and hallucinations. Also, the patient will be more tired physically, his sleep will become calmer.
Periodic (recurrent) schizophrenia
The recurrent form of schizophrenia occurs in the form of attacks with a wide variety of durations (from several weeks to several years). The number of attacks in patients during their lives varies - from 1-2 to 10 or more. In some patients, each attack is provoked by an exogenous moment (symptomatic lability). There are three types of attacks characteristic of recurrent schizophrenia. These include oneiric-catatonic, depressive-paranoid and affective attacks. It is not possible to single out one or another variant of recurrent schizophrenia depending on the nature of the attacks due to the fact that most patients experience attacks of different psychopathological structures throughout their lives. The attacks are generally characterized by intense affectivity; one or another type of sensory delirium and catatonic disorders occur quite easily. Remissions are of high quality. The absence of changes in the patient's personality after the first attacks allows us to talk about intermissions. Gradually, after repeated attacks, patients experience personality changes, which are characterized by the following manifestations: asthenic, hypersthenic, with an increase in performance, but with a decrease in creative efficiency and a slight impoverishment of emotional manifestations. Usually these changes are observed after the third or fourth attack. Then the activity of the process decreases: attacks become less and less frequent, personality changes seem to freeze at the same level. One of the important features of patients suffering from recurrent schizophrenia is that they always have a critical attitude towards the psychotic state they have suffered and they clearly distinguish between health and illness.
The performance of such patients usually does not decrease, with the exception of a slight drop in patients with asthenic personality changes. The prognosis for recurrent schizophrenia is quite favorable, but it should be borne in mind that in such patients, against the background of severe depression, suicidal thoughts and attempts are noted. These patients require special monitoring.
Paroxysmal schizophrenia
This form is characterized by recurring attacks against the background of a continuously ongoing process, manifested in productive and increasing negative symptoms.
Attacks in this form of schizophrenia are varied, characterized by extreme polymorphism and unequal duration (from “transient”, lasting minutes, to lasting for many years). However, they are less acute than attacks of recurrent schizophrenia; in their structure, paranoid and hallucinatory manifestations have a greater share. Sometimes productive symptoms in paroxysmal progressive schizophrenia are noted not only during attacks, but also in the inter-attack period; increasing deficit personality changes and residual symptoms of an attack are detected. The structure of attacks in this form of schizophrenia is polymorphic. For example, during a manic attack, the patient often “intersperses” depression in the form of ideas of self-blame, tearfulness, etc. An incomplete critical attitude towards the transferred state is typical, even in cases where the attack was characterized by severe and massive psychotic symptoms, and sometimes it is completely absent .
The age of onset of paroxysmal-progressive schizophrenia also varies. It can begin in childhood, adulthood and late life. Depending on the age period in which the disease begins, age-related features are clearly evident in the clinical picture. For example, the presence of infantilism in a patient allows us to speak with a high degree of confidence about the onset of the disease in childhood. The prognosis for paroxysmal-progressive schizophrenia is varied and depends primarily on the age of onset of the disease, the severity of the process and the degree of personality changes.
In acute attack of schizophrenic psychosis First of all, the first manifestation of psychosis must be correctly assessed. A clinically acute attack can unfold as a second attack or as a subsequent manifestation of psychosis, after the patient has been in a state of complete remission for more or less a long time. Therapeutically, in both cases it is the same problem, although the therapeutic prognosis will not be similar if this applies to the second or third attack of the disease.
Spicy attack most typical for periodic and paroxysmal-progressive types of schizophrenia. The choice of antipsychotic depends on the clinical characteristics of the acute attack.
In cases where the patient is in state of psychomotor agitation, if he is tense, aggressive, hostile, etc., the primary task of the psychiatrist is to quickly calm the patient, make him safe for others as soon as possible, prevent possible suicide attempts, and then include him in the life of the department. For this purpose, neuroleptics with the so-called broad spectrum of action (Bieitband no Arnold or Basis-neuroleptika no Gross and Kaltenback) are most suitable. According to Arnold, an antipsychotic used to relieve agitation must have the following properties:
1) cause a strong inhibitory effect;
2) have a rapid effect no later than 30 minutes after administration of the drug;
3) be suitable for parenteral administration;
4) have a fairly long-lasting effect (10-12 hours);
5) do not cause serious side effects.
Current clinical practice, confirmed by our experience, shows that the most suitable drugs that meet the above requirements are chlorprothixene, chlorpromazine and levomepromazine. The dosage of these drugs is determined by the condition of the patient, who must be under strict supervision. We should not forget that basic neuroleptics, especially at the beginning of their use, cause a strong hypnotic effect, although this is not absolutely necessary, but, of course, does not cause harm. If it is not possible to stop severe agitation, it is recommended to combine drugs.
Gross and Kaltenback believe that the basis neuroleptics should be combined with diazepam (Seduxen) 20-30 mg intramuscularly or intravenously. The same authors, who have extensive experience in treatment with psychotropic drugs, claim that the most pronounced sedative effect is characteristic of the combination of clopentixol (Sordinol) intravenously and diazepam (Seduxen) intramuscularly. We also made sure that the addition of chlordiazepoxide or diazepam to a broad-spectrum antipsychotic significantly enhances its inhibitory effect and thus this antipsychotic more effectively suppresses psychomotor agitation.
In particularly severe cases excitement You can resort to a combination of antipsychotics with an inhibitory effect and hypnotics. Kielholz notes that intravenous administration of 50-200 mg of promazine also produces a rapid sedative effect. According to Arnold, adding 1-2 ampoules of promethazine (Phenergen) to chlorprothixene enhances its effect.
It should be emphasized that as the main antipsychotic Chlorprothixene is more suitable than chlorpromazine, not only because the former acts stronger and lasts longer, but also because it is less toxic, and most importantly, does not cause allergic reactions in operating personnel.
Putting the patient into a long sleep for the purpose of dock excitement, as some psychiatrists once suggested, is not considered the best remedy. The principle of modern treatment of schizophrenia is the rapid introduction of the patient to the life of the department, hospital and the use of other methods, mainly occupational and psychotherapy.
The initial inhibitory therapy should be continued until the patient is completely calm and becomes available for the second phase of antipsychotic treatment, now directed against the core of psychosis. This second phase, which continues until remission occurs, can be called antipsychotic (antischizophrenic). It differs from the third phase - the so-called maintenance therapy, which occupies its special place in the holistic complex of neuroleptic treatment of schizophrenia. We dwelled on this issue in detail in the introduction to psychopharmacology.
medicalplanet.su
Attacks of schizophrenia
A mental disorder is necessarily manifested by external signs. Attacks of schizophrenia can be different in nature and course. They indicate the form and severity of the disease. Having studied their manifestations, the specialist prescribes appropriate treatment.
Mental disorders in people have always caused fear and confusion among healthy people. For a long time, doctors have been trying to figure out where people with strange behavior come from. And only two centuries ago it was possible to describe attacks of schizophrenia, symptoms, and in the 20th century doctors identified the types, forms and stages of the disease, its causes.
Causes of mental disorders
- Dopamine- an excess of this hormone affects the functioning of nerve impulses.
- Speech is impaired, there is delirium, sudden switching to another, strange topic, and tongue-tiedness.
- Complete lack of initiative, lack of will and independent actions.
- Delusions of grandeur, persecution, constant manifestation of one's own exclusivity.
- The sufferer is “attacked” by non-existent voices and communicates with ephemeral personalities and creatures.
- Insomnia occurs, the patient often wakes up and walks from corner to corner.
- The patient becomes distrustful and may stop recognizing a loved one.
- With prolonged consumption of alcohol, brain cells are affected, causing encephalopathy. An alcoholic develops symptoms of schizophrenia: delusions, hallucinations, attacks of aggression, anger, and he becomes uncontrollable. In severe cases, hospitalization in a specific institution is required.
- Heredity- transmission of the disease at the genetic level from parents, grandparents, etc.
- Psychoanalytic. The disease occurs against a background of stress, infectious diseases, injuries, and overexertion.
- Dysontogenetic- the disease is already embedded in a person’s genes, and due to external factors - trauma, stress, infection, etc., it “pops up” to the outside.
- Inappropriate reaction to actions and statements, lack of emotions.
How does the disease manifest itself?
Seizures of schizophrenia have a different character, it all depends on the type and form of the disease. But there are common symptoms that are common to almost all forms of mental illness.
Important: the listed attacks in medicine are called psychosis. They require urgent relief, for which you need to seek help - call a psychiatric team.
Alcohol psychosis
Very often, with prolonged abuse of alcoholic beverages and drug use, psychosis occurs, which is confused with the first attack of schizophrenia (manifestation). The symptoms caused by severe intoxication of the body are indeed similar to mental illness, but there are still distinctive features:
According to the findings of a number of scientists who have been working to identify the causes of the disease for many years, there are a number of factors that provoke mental disorders.
Seizures in mental disorders
- When mental illness worsens, the first thing that occurs is anxiety for no reason.
- There is a loss of appetite or, on the contrary, gluttony. In this state, a schizophrenic can eat a portion many times greater than the daily norm.
- There are outbreaks of aggression, anger, or the sick person hides in a corner, refuses to communicate with loved ones, and completely withdraws into himself.
- There is a desire to run away from home.
How long does a schizophrenia attack last?
It is impossible to determine with accuracy how long a schizophrenic attack lasts. It all depends on the individual’s characteristics, the form of the disease, and aggravating circumstances. According to general data, there are several phases and each of them takes a certain period of time
An attack of schizophrenia: what to do
The main thing is not to bring a person’s condition to acute phases. It is important to pay attention to the first signs of the disease and seek qualified help. If the process is started, you should calm the patient down and at the same time call an ambulance for psychiatric help. It is impossible to cope with mental illness without the intervention of a specialist.
It is necessary to influence the brain cells and the patient’s behavior with antipsychotic and nootropic drugs. The acute phase can pose a risk to the life of both the patient and those around him. Often, during a seizure, people suffering from schizophrenia attacked people, caused injuries, and committed violence. For those who are first faced with a diagnosis of schizophrenia, a video of an attack will tell you in detail what the sick person looks like, what characteristic facial features and behavior are manifested. Thanks to this, you can without a doubt identify the disease and contact the right medical structure.
Treatment of schizophrenia - 10 modern methods, list of medications and drugs
Principles of treatment of schizophrenia
Schizophrenia is a mental disorder (and according to the modern ICD-10 classification, a group of disorders) with a chronic course, provoking the breakdown of emotional reactions and thought processes. It is impossible to cure it completely. However, as a result of long-term therapy, it is possible to restore a person’s social activity and ability to work, prevent psychosis and achieve stable remission.
Treatment of schizophrenia traditionally consists of three stages:
Stopping therapy is therapy aimed at relieving psychosis. The goal of this stage of treatment is to suppress the positive symptoms of schizophrenia - delusions, hebephrenia, catatonia, hallucinations;
Stabilizing therapy is used to maintain the results of relief therapy, its task is to finally remove positive symptoms of all types;
Maintenance therapy is aimed at maintaining a stable state of the patient’s psyche, preventing relapse, and delaying the next psychosis as much as possible.
Stopping therapy should be carried out as early as possible; It is necessary to contact a specialist as soon as the first signs of psychosis appear, since it is much more difficult to stop psychosis that has already developed. In addition, psychosis can cause personality changes that make it impossible for a person to work or perform normal daily activities. To ensure that the changes are less pronounced and the patient remains able to lead a normal lifestyle, it is necessary to stop the attack in a timely manner.
Currently, the following methods of treating schizophrenic conditions have been developed, tested and widely used: psychopharmacology, various types of shock-comatose therapy, high-tech stem cell treatment, traditional psychotherapy, cytokine treatment and detoxification of the body.
Inpatient treatment is necessary immediately at the time of psychosis, and after the attack has stopped, stabilizing and maintenance therapy can be carried out on an outpatient basis. A patient who has completed a course of treatment and has been in remission for a long time still needs to be examined annually and admitted to hospital treatment in order to correct possible pathological changes.
Actually, the time for full treatment of schizophrenia after another psychosis ranges from one year or longer. It takes from 4 to 10 weeks to relieve an attack and suppress productive symptoms, after which, to stabilize the results, six months of intensive inpatient therapy and 5-8 months of outpatient treatment are necessary in order to prevent a relapse, achieve a fairly stable remission and carry out social rehabilitation of the patient.
Treatment methods for schizophrenia
Treatment methods for schizophrenia are divided into two groups - biological methods and psychosocial therapy:
Psychosocial therapy includes cognitive behavioral therapy, psychotherapy, and family therapy. These techniques, although they do not give instant results, can prolong the period of remission, increase the effectiveness of biological methods, and return a person to normal life in society. Psychosocial therapy allows you to reduce the dosage of medications and the length of hospital stay, makes a person able to independently perform daily tasks and control his condition, which reduces the likelihood of relapse;
Biological treatment methods - lateral, insulin comatose, paropolarization, electroconvulsive therapy, detoxification, transcranial micropolarization and magnetic brain stimulation, as well as psychopharmacology and surgical treatment methods;
The use of drugs that affect the brain is one of the most effective biological methods of treating schizophrenia, allowing to remove productive symptoms, prevent the destruction of personality, disorders of thinking, will, memory and emotions.
Modern treatment of schizophrenia during an attack
During psychosis or an attack of schizophrenia, all measures must be taken to stop it as quickly as possible. Atypical antipsychotics are classified as neuroleptics; these are modern drugs that not only remove productive symptoms (auditory or visual hallucinations and delusions), but also reduce possible disturbances in speech, memory, emotions, will and other mental functions, thereby minimizing the risk of destruction of the patient’s personality.
Medicines in this group are prescribed not only to patients at the stage of psychosis, but are also used to prevent relapses. Atypical antipsychotics are effective when the patient is allergic to other antipsychotics.
The effectiveness of relief therapy depends on the following factors:
Duration of the disease - with a duration of up to three years, the patient has a high chance of successful treatment with a long period of remission. Relief therapy eliminates psychosis, and relapse of the disease with properly carried out stabilizing and anti-relapse treatment may not occur until the end of life. If a patient’s schizophrenia lasts from three to ten years or longer, then the effectiveness of therapy decreases;
Age of the patient – schizophrenia at a later age is easier to treat than adolescent schizophrenia;
The onset and course of a psychotic disorder is an acute attack of the disease with a vivid course, which is characterized by strong emotional manifestations, pronounced affects (phobias, manic, depressive, anxiety states) and responds well to treatment;
The patient’s personality type – if before the first psychosis the patient had a harmonious and balanced personality type, the chances of successful treatment are greater than for people with infantilism and underdevelopment of intelligence before the onset of schizophrenia;
The reason for the exacerbation of schizophrenia is if the attack was caused by exogenous factors (stress from the loss of loved ones or overstrain at work, while preparing for an exam or competition), then treatment is quick and effective. If an exacerbation of schizophrenia occurred spontaneously for no apparent reason, then stopping the attack is more difficult;
The nature of the disorder - with pronounced negative symptoms of the disease (impaired thinking, emotional perception, volitional qualities, memory and concentration), treatment takes longer, its effectiveness is reduced.
Treatment of psychotic disorder (delusions, hallucinations, illusions and other productive symptoms)
Psychotic disorders are treated with antipsychotic drugs, which are divided into two groups: conventional antipsychotics and more modern atypical antipsychotics. The choice of drug is made on the basis of the clinical picture; conventional antipsychotics are used if atypical antipsychotics are ineffective.
Olanzapine is a potent antipsychotic that can be prescribed to anyone with schizophrenia during an attack.
The activating antipsychotics Risperidone and Amisulpride are prescribed for psychosis, during which delusions and hallucinations alternate with negative symptoms and depression.
Quetiapine is prescribed if a patient during psychosis experiences increased excitability, interrupted speech, delusions and hallucinations with severe psychomotor agitation.
Conventional or classical antipsychotics are prescribed for complex forms of schizophrenia - catatonic, undifferentiated and hebephrenic. They are used to treat prolonged psychoses if treatment with the above atypical antipsychotics has failed.
For paranoid schizophrenia, Trisedil is prescribed.
For the treatment of catatonic and hebephrenic forms, Mazeptil is used
If these drugs turn out to be ineffective, then the patient is prescribed antipsychotics with a selective effect, one of the first drugs in this group is Haloperidol. It removes the productive symptoms of psychosis - delirium, automaticity of movements, psychomotor agitation, verbal hallucinations. However, its side effects with long-term use include a neurological syndrome, which is manifested by stiffness in the muscles and trembling in the limbs. To prevent these phenomena, doctors prescribe Cyclodol or other corrective drugs.
To treat paranoid schizophrenia, use:
Meterazine – if the attack is accompanied by systematized delirium;
Triftazin – for unsystematized delirium during psychosis;
Moditen - with pronounced negative symptoms with disturbances of speech, mental activity, emotions and will.
Atypical neuroleptics, which combine the properties of atypical and conventional drugs - Piportil and Clozapine.
Treatment with antipsychotics occurs for 4-8 weeks from the onset of the attack, after which the patient is transferred to stabilizing therapy with maintenance doses of the drug, or the drug is changed to another one with a milder effect. Additionally, medications that relieve psychomotor agitation may be prescribed.
Reducing the emotional intensity of experiences associated with delusions and hallucinations
Antipsychotic drugs are given for two to three days after the onset of symptoms, the choice depends on the clinical picture, with the administration of intravenous Diazepam they are combined with:
Quetiapine - prescribed to patients who have pronounced manic agitation;
Klopiksone - prescribed for the treatment of psychomotor agitation, which is accompanied by anger and aggression; can be used to treat alcoholic psychosis, schizophrenia in people in a state of withdrawal after taking alcohol or drugs;
Klopiksone-Acupaz is a long-acting form of the drug, prescribed if the patient is unable to take the medicine regularly.
If the antipsychotics described above are ineffective, the doctor prescribes conventional antipsychotics with a sedative effect. The course of administration is 10-12 days, this duration is necessary to stabilize the patient’s condition after an attack.
Conventional antipsychotics with sedative effects include:
Aminazine - prescribed for aggressive manifestations and anger during an attack;
Tizercin - if the clinical picture is dominated by anxiety, worry and confusion;
Melperon, Propazine, Chlorprothixene - prescribed to patients over 60 years of age or to people with diseases of the cardiovascular system, kidneys and liver.
Neuroleptic drugs are used to treat psychomotor agitation. To reduce the degree of the patient's emotional experiences caused by auditory, verbal or visual hallucinations and delusions, antidepressants and mood stabilizers are additionally prescribed. These drugs should continue to be taken as part of maintenance anti-relapse therapy, since they not only alleviate the patient’s subjective state and correct his mental disorders, but also allow him to quickly integrate into normal life.
Treatment of the depressive component in emotional disorders
The depressive component of a psychotic episode is removed with the help of antidepressants.
Among antidepressants for the treatment of the depressive component of schizophrenia, a group of serotonin reuptake inhibitors is distinguished. The most commonly prescribed drugs are Venlafaxine and Ixel. Venlafaxine relieves anxiety, and Ixel successfully copes with the melancholy component of depression. Cipralex combines both of these actions.
Heterocyclic antidepressants are used as second-line drugs when the effectiveness of the above drugs is low. Their effect is more powerful, but patient tolerance is worse. Amitriptyline relieves anxiety, Melipramine removes the melancholy component, and Clomipramine successfully copes with any manifestations of depression.
Treatment of the manic component in emotional disorders
The manic component helps to remove the combination of neuroleptics with mood stabilizers, both during a psychotic episode and subsequently during anti-relapse therapy. The drugs of choice in this case are mood stabilizers Valprocom and Depakin, which quickly and effectively eliminate manic manifestations. If the manic symptom is mild, Lamotrigine is prescribed - it has minimal side effects and is well tolerated by patients.
Lithium salts are most effective in treating the manic component of emotional disorders, but they should be used with caution, since they interact poorly with classical antipsychotics.
Treatment of drug-resistant psychosis
Pharmaceutical drugs are not always effective in treating attacks of schizophrenia. Then they talk about human resistance to drugs, similar to the resistance to antibiotics developed in bacteria under constant influence.
In this case, it remains to resort to intensive methods of influence:
Electroconvulsive therapy is carried out in a short course, simultaneously with taking antipsychotics. To use electroconvulsions, the patient is given general anesthesia, making the procedure similar in complexity to surgery. Such extreme treatment usually provokes a variety of impairments in cognitive functions: attention, memory, conscious analysis and information processing. These effects are present when using bilateral electroconvulsions, but there is also a unilateral version of the therapy, which is more gentle on the nervous system.
Insulin shock therapy is an intense biological effect exerted on the patient’s body by huge doses of insulin, which causes a hypoglycemic coma. Prescribed in the absence of any results from the use of medications. Intolerance to pharmaceuticals is an absolute indication for the use of this method. The so-called insulin comatose therapy, invented back in 1933, is used to this day to treat schizophrenia in episodic or continuous paranoid form. The unfavorable dynamics of the disease is an additional reason for prescribing insulin shock therapy. When sensory delirium becomes interpretive, and anxiety, mania and absent-mindedness are replaced by suspicion and uncontrollable anger, the doctor is inclined to use this method. The procedure is carried out without interrupting the course of antipsychotic drugs.
There are currently three possible ways to use insulin to treat schizophrenia:
Traditional - subcutaneous administration of the active substance, carried out in a course with regular (most often daily) increasing doses until a coma is provoked. The effectiveness of this approach is the highest;
Forced - insulin is administered through a dropper to achieve the maximum concentration in one daily infusion. This method of inducing a hypoglycemic coma allows the body to endure the procedure with the least harmful consequences;
Potentiated - involves carrying out insulin comatose therapy against the background of lateral physiotherapy, which is carried out by stimulating the skin with electricity in those places where the nerves pass to the cerebral hemispheres. Insulin administration is possible in both the first and second ways. Thanks to physiotherapy, it is possible to shorten the course of treatment and focus the effect of the procedure on the manifestations of hallucinations and delusions.
Craniocerebral hypothermia is a specific method that is used in toxicology and narcology primarily to relieve severe forms of withdrawal symptoms. The procedure involves a gradual decrease in brain temperature to form neuroprotection in nerve cells. There is confirmation of the effectiveness of the method in the treatment of catatonic forms of schizophrenia. It is especially recommended due to the occasional resistance of this type of pathology to medications.
Lateral therapy is a method of rigidly stopping agitations of a psychomotor, hallucinogenic, manic and depressive nature. It consists of conducting electroanalgesia of a specific area of the cerebral cortex. Exposure to electricity “reboots” neurons, similar to how a computer turns on after a power failure. Thus, previously formed pathological connections are broken, due to which the therapeutic effect is achieved.
Detoxification is a fairly rare decision taken to compensate for the side effects of taking heavy drugs such as antipsychotics. Most often used for complications due to taking antipsychotics, allergies to similar medications, resistance or poor sensitivity to drugs. Detoxification consists of a hemosorption procedure.
Sorption is carried out by activated carbon or ion exchange resins that can specifically absorb and neutralize chemical components remaining in the blood after taking heavy medications. Hemosorption is carried out in several stages, due to which sensitivity to drugs prescribed after this procedure increases.
If there is a prolonged course of psychosis or extrapyramidal disorders, such as incoordination and parkinsonism, resulting from long-term courses of taking conventional antipsychotics, plasmapheresis is prescribed (blood sampling followed by removal of its liquid part - plasma containing harmful toxins and metabolites). As during hemosorption, any previously prescribed pharmaceuticals are canceled so that after plasmapheresis a softer course can be started again with a lower dosage or a radical change in the medications used.
Stabilizing treatment for schizophrenia
It is necessary to stabilize the patient’s condition for 3 to 9 months from the moment of complete recovery from attacks of schizophrenia. First of all, during the stabilization of the patient, it is necessary to achieve the cessation of hallucinations, delusions, manic and depressive symptoms. In addition, during the treatment process it is necessary to restore the patient's full functionality, close to his state before the attack.
Stabilizing treatment is completed only when remission is achieved, followed by maintenance therapy against relapses.
The drugs of choice are mainly Amisulpride, Quetiapine and Risperidone. They are used in low dosages for the gentle correction of symptoms of schizophrenia such as apathy, anhedonia, speech disorders, lack of motivation and will.
Other drugs have to be used if a person cannot constantly take antipsychotics on his own, and his family cannot control this. Long-acting medications can be taken once a week, these include Clopixol-Depot, Rispolept-Consta and Fluanxol-Depot.
For neurosis-like symptoms, including phobias and increased anxiety, take Fluanxol-Depot, while for hypersensitivity, irritability and manic symptoms, Clopixol-Depot helps well. Rispolept-Konsta can remove residual hallucinations and delusions.
Conventional antipsychotics are prescribed as a last resort if all of the above drugs do not cope with the task.
In stabilizing treatment the following is used:
Haloperidol is used if the attack is poorly and not completely stopped; the drug removes residual psychotic effects to increase the stability of remission. Haloperidol is prescribed with caution, as it can provoke extrapyramidal disorders and neurological syndrome. Be sure to combine with corrective drugs;
Triftazin – used to treat episodic paranoid schizophrenia;
Moditen-Depot – removes residual hallucinatory symptoms;
Piportil - used to treat paranoid or catatonic schizophrenia.
Maintenance (anti-relapse) treatment of schizophrenia
Maintenance treatment is necessary to prevent relapse of the disease. Under a good combination of various circumstances, thanks to this type of therapy, there is a significant prolongation of remission and partial or even complete restoration of the patient’s social functions. Drugs prescribed during anti-relapse treatment are able to correct disorders of memory, will, too strong emotional sensitivity and thought processes that are caused by a state of psychotic disorder.
The course of treatment is usually two years if the psychotic episode occurs for the first time. After its repetition, anti-relapse therapy should last at least five years. It’s rare, but it gets to the point where psychosis happens a third time. In this case, treatment must be continued until the end of life, otherwise relapse is inevitable.
The list of medications used for maintenance therapy includes the same antipsychotics as for the treatment of seizures, but in a much lower dosage - no more than a third of the amount required for the traditional relief of psychosis.
Non-drug treatment with drugs
Among the most effective drugs for maintenance anti-relapse therapy are Risperidone, Quetiapine, Amisulpride and other atypical antipsychotics. If there is a decrease in individual sensitivity to the active substances, in addition to the above medications, Sertindole may be prescribed.
When even atypical antipsychotics do not bring the desired effect, and it is not possible to stabilize the patient’s condition with prolongation of remission, conventional antipsychotic medications are used: Piportil, Moditen-Depot, Haloperidol, Triftazin.
Long-acting (depot) forms of medications may be prescribed if the patient is unable to take medications regularly and his caregivers cannot control this. Deposition of Fluanxol-Depot, Klopixol-Depot and Rispolept-Consta is carried out by intramuscular or subcutaneous administration once a week.
Another group of pharmaceuticals used in anti-relapse therapy are mood stabilizers, which demonstrate fairly high effectiveness in the treatment of low-grade schizophrenia. For cognitive disorders such as panic attacks and depressive states, Valprok and Depakine are prescribed. Lithium salts and Lamotrigine help relieve passive disorders - anxiety and sad mood, and Carbamazepine is indicated for patients with a tendency to irritable behavior and aggression.
Non-drug methods of anti-relapse therapy
Lateral physiotherapy is used to enhance the effectiveness of drug treatment. The method involves electrical stimulation of areas of the skin controlled by the right or left hemisphere of the brain.
Lateral phototherapy is successfully used to treat a wide variety of phobias, increased or decreased sensitivity, anxiety, paranoia and other symptoms of neurosis. During the phototherapy procedure, the right and left parts of the retina of the eye are alternately exposed to light pulses, the frequency of which determines the stimulating or calming effect.
Intravascular laser irradiation – blood purification using a special laser device. It can increase sensitivity to medications, which reduces their required dosage and minimizes side effects.
Pair polarization therapy is a procedure for correcting disturbances in the emotional sphere by applying electricity to the surface of the cerebral cortex.
Transcranial micropolarization is a method of selectively influencing brain structures through an electric field, which makes it possible to remove hallucinations and residual effects at the stage of remission.
Transcranial magnetic stimulation - this type of impact on brain structures can relieve depression; in this case, the effect on the brain occurs through a constant magnetic field;
Enterosorption. Like intravascular laser irradiation, this type of exposure is aimed at increasing the body’s sensitivity to drugs in order to reduce their dose necessary to achieve a therapeutic effect. It is a course of sorbent drugs taken orally, including activated carbon, Enterosgel, Filtrum, Polyphepan, Smecta. Sorbent substances are used due to their ability to bind various toxins to remove them from the body organically.
Immunomodulators - have a complex effect on the body, allowing not only to improve the effectiveness of the immune system, which helps a person regenerate after damage caused by an attack, but also to increase sensitivity to antipsychotic medications.
In complex therapy, various immunomodulatory agents are used:
Psychosocial therapy
This type of post-remission therapy is carried out after complete relief of the attack and is necessary for the social rehabilitation of a still sick person, restoring his cognitive abilities and teaching him the skills to independently combat the disease.
Important components of psychosocial therapy are not only social, but also labor rehabilitation of the patient. For this purpose, so-called family therapy is used: close relatives or guardians of the patient are taught the rules of careful behavior with the patient. Thanks to this, it is possible to place him at home with free rules of movement and residence. The patient is informed about the importance of regularly taking medications, but an understanding of personal responsibility for their health is formed. In a calm and friendly environment, patients are more quickly rehabilitated after attacks, their mental state is stabilized and the chances of stable remission increase significantly. Interpersonal contacts with friendly people accelerate the restoration of the patient’s social activity.
In addition, a psychotherapist can help a person solve personal problems, cope with neuroses and depressive states, which prevents a new attack.
Another component of psychosocial adaptation is cognitive-behavioral treatment, during which a person restores his mental abilities (memory, thinking, ability to concentrate) to the extent necessary for normal functioning in society.
The results of magnetic resonance imaging after a course of psychosocial therapy prove the effectiveness of this technique for post-remission treatment of schizophrenia.
Traditional drugs for the treatment of schizophrenia
Neuroleptic drugs directly affect the factors that cause the development of schizophrenia, which is why their use is so effective.
At the moment, existing antipsychotics are divided into the following groups:
Atypical neuroleptics – Clozapine, Amisulpride, Risperidone, Quetiapine Olanzapine;
Neuroleptics of the newest generation (atypical) - Aripiprazole, Ipoperidal, Sertindole, Blonanserin, Ziprasidone;
Sedative neuroleptic drugs with a sedative effect: Chlorpromazine, Levomepromazine, Propazine, Truxal, Sultopride;
Incisive neuroleptic drugs that can activate the central nervous system: Hypothiazine, Haloperidol, Klopixol, Prochlorperazine, Tioproperazine, Trifluoperazine, Fluphenazine;
Disruptive neuroleptic drugs that have a disinhibiting effect: Sulpiride, Carbidine.
In addition to antipsychotics, other medications are used in the treatment of schizophrenia for various symptoms:
Antidepressants alleviate the patient's condition with anxiety, anxiety and fear: Amitriptyline, Pierlindol, Moclobemide;
Nootropics that help enhance cognitive functions and restore memory, thinking, attention and concentration: Deanol aceglumate, Pantogam, hopantenic acid;
Tranquilizers are used to relieve anxiety: Phenazepam, Bromazepam, Chlordiazepoxide, Diazepam;
Regulatory drugs help to gain control over emotional manifestations: Carbamazepine.
New drugs for the treatment of schizophrenia
Classical neuroleptics, despite their effectiveness in stopping attacks of schizophrenia and in further stabilizing and maintenance therapy, have a number of disadvantages and side effects. Because of this, their use has to be limited, the minimum dosage required to achieve a therapeutic effect must be observed, and they have to be combined with corrective drugs.
Side effects and disadvantages of conventional antipsychotics:
Extrapyramidal damage – dystonia, akathisia, tardive dyskinesia, neuroleptic syndrome;
Somatic disorders - hormonal imbalance, as a result of which the level of prolactin in the blood increases, which leads to the development of gynecomastia, dysmenorrhea, galactorrhea, and sexual activity disorders;
Allergic reactions of a toxicological nature.
The potency of the new generation of antipsychotic drugs is comparable to the effect of classical antipsychotics, but at the same time they have a much higher rate of onset of effect. And some of the new drugs, for example, Risperidone and Olanzapine, remove delusions and hallucinations even better than the first antipsychotics.
Risperidone is effectively used in the clinical practice of borderline conditions - hypochondriacal disorders, depersonalization, which is often observed in low-grade schizophrenia. Successfully copes with social phobia and agoraphobia, relieves anxiety, which underlies the mechanism of development of obsessions and phobic disorders.
New generation antipsychotic drugs normalize the neurotransmitter balance, thereby providing maximum clinical and pharmacological effect in the treatment of schizophrenia. They selectively act on dopamine, serotonin and other types of receptors in brain structures, which ensures not only the success of treatment, but also its safety for the patient. In addition, new antipsychotics, in particular risperidone, are the drugs of choice for the treatment of schizophrenic attacks in older people, whose risk of complications increases due to extrapyramidal disorders and impaired cognitive function.
The following drugs from the new generation of pharmaceuticals can now be used to treat schizophrenia:
These also include atypical first-generation antipsychotics, such as quetiapine, risperidone and olanzapine.
A tangible advantage of modern antipsychotics is good patient tolerance, minimal side effects, reduced risk of drug-induced depression and cognitive and motor impairment. New antipsychotic drugs not only cope well with delusional disorders and hallucinations, but also remove negative schizophrenic symptoms - memory, speech and thinking disorders.
Characteristics of some alternative treatments for schizophrenia
To treat schizophrenia, specialized clinics use many procedures and therapeutic techniques developed at different times, which, although not included in the general list of international standards, are often quite effective, prolonging remission and improving the patient’s quality of life.
Treatment with cytokines
This is a type of drug treatment for schizophrenia, which does not use substances that affect the central nervous system (like antipsychotics), but drugs that improve the functioning of the immune system and stimulate regeneration processes in the body - cytokines.
Cytokines are used in the form of injections or inhalations, the course of treatment with injections is usually five days, inhalations are done daily for ten days, then every three days for 3 months. Cytokines for intramuscular injections called anti-TNF-alpha and anti-IFN-gamma effectively restore damaged areas of the brain and provide lasting remission.
Stem cell treatment
Schizophrenia can be caused by pathologies or cell death of the hippocampus, so treatment using stem cells gives good results in treating the disease. Stem cells are injected into the hippocampus, where they replace dead structures and stimulate their regeneration. Such treatment is carried out only after the final relief of the attack when the patient’s condition has stabilized and can significantly prolong remission.
Communication therapy
Communication with an experienced specialist can give good results:
Increase the patient’s social adaptation;
To form in him the correct perception of the disease;
Train your skills to control your condition.
This treatment is used during remission in order to prolong it. Therapy gives results only if the personality has not undergone significant changes during the course of the disease, and the patient does not have schizophrenic dementia.
Hypnosis treatment
Hypnosis is a type of communication therapy. During the period of remission, the doctor begins a conversation with the patient when he is in the most suggestible state, or introduces him into this state artificially, after which he gives him instructions, developing the skills necessary for a person to independently control the disease.
Treatment of schizophrenia at home
Hospitalization is necessary for the patient only during a psychotic episode; therapy continues until the condition stabilizes (on average, this takes about 4-8 weeks). When the episode passes, the patient continues treatment as an outpatient, provided that he has relatives or guardians who will monitor compliance with the doctor's instructions.
If the patient refuses to take medications and follow the treatment regimen, becomes irritable and exhibits unusual traits for him, you should take him to see a doctor and change the form of the drug to a long-acting one. In this case, taking the medicine is required only once a week and does not require control from the patient, since it occurs under the supervision of a specialist.
Unusual behavior of the patient may be a sign of impending psychosis; you should immediately consult a doctor.
Rules of conduct with a patient with schizophrenia on the eve of a psychotic attack:
Avoid a commanding and commanding tone, irritation and rudeness when communicating;
Minimize factors that can cause agitation or a strong emotional reaction in the patient;
Avoid threats, blackmail and promises of bad consequences if a person does not listen to you and violates any instructions;
Speech should be even, calm and, if possible, quiet and measured;
It is necessary to avoid criticizing the patient’s behavior and arguing both with him and with other people in his presence;
Position yourself opposite the patient so that your face is at eye level and not higher;
Do not leave a schizophrenic in a closed room; if possible, comply with his requests, if they do not harm him and others.
Treatment prognosis
In 24% of cases, treatment for schizophrenia is successful and the person fully recovers, that is, the rest of his life is in remission and psychosis no longer occurs.
After treatment, 30% of patients feel a significant improvement in their condition, they can take care of themselves, do housework and engage in simple activities without unnecessary mental and emotional stress. Relapse of the disease is possible.
In 20% of cases, after treatment there is no noticeable improvement, the person is not capable of even primitive activities, and needs constant care and supervision from relatives or doctors. The attacks recur periodically and require hospitalization.
In 10-15% of cases, schizophrenia causes a person’s death, since in a state of psychosis, approximately 50% of people attempt to commit suicide.
Favorable treatment of schizophrenia depends on timely consultation with a doctor. Schizophrenia, the manifest form of which occurs at a late age, is best cured. Short-lived, vivid and emotional attacks respond well to drug treatment, with a high probability of long-term remission.
It is worth distinguishing between two concepts - signs and symptoms of the disease, since they will differ in the context of this mental disorder. The signs mean only 4 areas of brain activity that have disturbances. They are also called.
An important distinguishing feature of this type of schizophrenia is the lack of progression. This means that the patient does not degrade after some time, the symptoms of the disease do not intensify, and the personality does not transform. In addition, people with low-grade schizophrenia do not suffer from delusions and hallucinations; they have other neurotic disorders.
Paranoid schizophrenia is a type of schizophrenia characterized by the prevalence of hallucinations and delusions. Other symptoms may also be present, but they are so obvious. Statistics indicate that paranoid schizophrenia is more common than others. The distinctive feature of this one.
Scientists have still not been able to identify the exact causes that contribute to the development of the disease both in childhood and in adulthood. The most probable theories of the origin of childhood schizophrenia are considered to be the hereditary theory and neurotransmitter hypotheses. The theory of inherited transmission of the disease comes down to:
I myself used to suffer from schizophrenia and they helped me. Now I am healthy. I will share my experience.
1. Work through all the conflict situations that you consider the most painful (primarily those after which symptoms of the disease began to appear after some time) as follows. You remember the conflict situation and LIVE in the present time, completely immersing yourself in the event. For example. I'm walking down the street and I see. It is important that the story be in the present tense. You need to immerse yourself in the event, reproducing as much as possible all the sensations, sounds, pictures that you saw then. Remember all the details. Tell the story as many times as you can, so that you can relate to the situation exactly - this is a criterion for effectiveness. When you are living, your task is to release all your emotions about the situation as much as possible - you may want to cry, scream, tear something (prepare that you have something at hand that you don’t mind, for example, magazines, something to tear, if you want to scream, shout at the top of your lungs throat - you can put it in the pillow - your task is to RELEASE emotions). When you feel emptiness, there is no more aggression and negativity, then remember when you are happy. how is it? Live it. Straighten up and remember a situation when you felt good. I love it. What did you see, hear, feel? After serious work, you need 2-3 days to pass; you should not drink alcohol either before or after 2-3 days.
2. Therapy for dissociated states
Voices and visions are just parts of you that you need to find a common language with and make peace with :)
How we do it.
Find these parts. Usually they contradict each other. For example, this happened to me. One part was for spiritual development, vegetarianism, and the second wanted to eat deliciously, enjoy life, etc. It could be your mom's voice in your head that you don't agree with. Whatever. Look for your option. Let's say we found contradictory parts.
Further
Let's sort them. In space we put, for example, a pen where one part will be, and then we put a pen where the second part will be.
Contact. Letting one part express everything it thinks about the other. All. All the negativity, everything you don’t like. Now take the place of the other part and do the same. When you are in the place of a part, speak only from the part. Now think about what good does your part give you? Why do you need it? Do the same with the other part.
Intergration. While in the place of the part, imagine that the other part is connecting to you, make a gesture of connection, for example, hug yourself. Now all your parts have become friends) Feel how comfortable you are with the new new one? How much more complete do you feel?
I don’t know how much these techniques will help you; they helped me. I wish you recovery!
Health
A mental disorder such as schizophrenia has not been fully studied to this day, and therefore is surrounded by rumors and myths, which we will try to debunk in this article.
Myth 1. Schizophrenia is a split personality
For schizophrenia there is a splitting of mental processes. The patient's thoughts, emotions and behavior are illogical: the loss of a loved one can cause him to burst into laughter, while he reacts to a joyful event by crying. Such a person is immersed in his inner world, which is far from modern realities: he is not interested in family, work, or appearance. He can love and hate at the same time, his life is poisoned day after day by obsessive voices that can come from within the patient himself or from outside (from a radio, a non-working telephone, a heating pipe, etc.). At the same time, voices or images put pressure on the patient, ordering him to perform certain actions.
And this is just the surface of the iceberg called schizophrenia. In some cases, the patient feels that the air is thick and opaque, and therefore it is simply impossible to breathe in it. Even one’s own body is perceived as something mutilated, and sometimes hostile: a physically healthy patient with schizophrenia claims that he is missing one or another organ (arm, leg, liver), he is convinced that he is rotting from the inside. Moreover, he can be sure that intelligence agencies or alien beings have implanted a transmitter in his body to control his thoughts and actions. At the same time, neither relatives, nor doctors, nor the results of an x-ray examination can convince him of this. If a patient with schizophrenia refuses treatment, the result is often disastrous: loneliness, loss of family, work and goals in life, lack of livelihood, dementia and complete personality degradation.
With a split personality in one person several “I”s (or “ego states”) coexist, which replace each other. They can have different gender and age, intelligence and moral principles. When ego states change, memory loss is often observed, that is, the patient may not remember what one of his subpersonalities did. Simply put, a person suffering from a split personality lives in parallel realities, communicates with completely different people, and behaves in diametrically opposite ways.
Conclusion: By split personality in schizophrenia we mean the splitting of unified mental processes, while with true split personality independent integrated ego states are formed. At the same time, in schizophrenia, the possibility of developing a split personality cannot be ruled out.
Myth 2. Schizophrenia is a dangerous disease for others
The behavior of patients with schizophrenia may be inappropriate and unpredictable, but they rarely show aggression and violence towards others. Often people with this diagnosis strive for solitude and self-isolation; they are characterized by alienation.
Schizophrenia is more dangerous not for others, but for the people themselves suffering from this disorder. Suicide is one of the most common reasons for the death of patients with schizophrenia at an early age. And the culprit is the loss of work and prospects, fear of the consequences of one’s condition and loneliness. Sometimes it is in suicide that people with schizophrenia see liberation from those voices and images that poison their lives every day.
And yet we should not exclude the fact that with schizophrenia a person can show aggression, especially during periods of prolonged depression and with the abuse of alcohol, drugs and other psychotropic drugs. In general, hostility, anger and aggression are more characteristic of patients with visual and auditory hallucinations, provided that audible voices and visible images threaten, put pressure on the person, order him to commit a crime. To drown out the intrusive voice and get rid of it, people suffering from schizophrenia are even ready to kill. To be fair, we note that the percentage of patients with schizophrenia who are prone to aggression and violence is extremely low.
Myth 3. Schizophrenia develops as a result of poor upbringing
"All problems come from childhood!" - a favorite phrase of psychologists and psychiatrists. Of course, upbringing is the foundation on which the child’s entire future life will be built. And not only his happiness and well-being, but also his mental health depends on what this foundation will be.
But! Poor parenting alone cannot cause a child to develop a disorder such as schizophrenia. This requires more significant factors, among which the main one is considered to be a genetic predisposition to schizophrenia. At the same time, you should not give up on a child whose one of the parents has schizophrenia, because such families often give birth to mentally absolutely healthy children. And remember that in the presence of “bad” heredity, an unfavorable family atmosphere and constant scandals can provoke the early debut of this disorder in a child.
Important! Many believe that a mother or father diagnosed with schizophrenia cannot properly raise their child, instill in him the standards of morality and morality by which any civilized society lives. But this is not true at all! Adequate treatment, care and support from relatives help people with schizophrenia lead a normal life: love, work, have friends, create happy families and raise wonderful children.
Myth 4. Schizophrenia is always inherited
It's no secret that schizophrenia is inherited, but this does not mean that if the mother or father has this diagnosis, then the child has no chance of growing up absolutely mentally healthy.
Psychotherapists say that if one of the parents suffers from schizophrenia, then the risk of developing this disease in the child is about 10–15%, while in children whose mother and father suffer from this mental disorder, this risk increases to 40–50%.
It should be remembered that 1% of patients with schizophrenia did not have relatives with this mental disorder, that is, they did not have “bad” heredity.
Myth 5. Drugs cause schizophrenia
It is not entirely correct or correct to talk about drugs as a cause of the development of schizophrenia. Yes, drugs are evil. Yes, they can cause visual and auditory hallucinations. Yes, they destroy the psyche and cause personality degradation. But! There is no evidence that drugs provoke the development of schizophrenia in a mentally healthy person.
However, we should not forget that if there is a genetic predisposition to schizophrenia, drugs can become one of the triggers for the development of this mental disorder.
Unfortunately, not all patients with schizophrenia manage to muster the will to concentrate on treating their illness. Many people prefer the use of narcotic drugs (marijuana, amphetamines, LSD, spice and other psychotropic stimulants) to competent treatment, which only accelerates the process of personality degradation and aggravates the already vivid symptoms of schizophrenia.
Myth 6: Dementia is the main symptom of schizophrenia
This is not entirely true, especially in cases where schizophrenia is diagnosed in the early stages, and the patient himself adheres to all the instructions of his treating psychiatrist and takes medications.
In general, dementia in schizophrenia has certain characteristics, since the intellect initially practically does not suffer. Even memory is retained for a long time. But! The thinking of a person suffering from schizophrenia is characterized by passivity, abstraction and whimsicality. Apathy and lack of purpose in life leads to the fact that the stock of knowledge and practical skills is not used for its intended purpose, and over time it is completely lost. The patient degrades as a person.
In severe cases of schizophrenia, patients can:
- do not get out of bed for weeks or months (although their motor functions are not impaired),
- refuse to eat on their own (but will eat without objection if they are spoon-fed),
- do not respond to the questions of others (for such a patient an interlocutor means no more than a silent chair or table),
- do not control the acts of urination and defecation, while neurotic disorders may be completely absent.
Myth 7. Many people with schizophrenia are geniuses
Plato also said that genius and madness are sisters. And there is some truth in this, because many great personalities had a history of mental disorders.
For example, Van Gogh He was tormented by visual and auditory hallucinations, provoking aggression and suicidal thoughts in him. In addition, he was prone to bouts of masochism.
Friedrich Nietzsche was simply obsessed with the idea of a superman. He himself suffered from nuclear mosaic schizophrenia with delusions of grandeur. He was treated more than once in psychiatric hospitals, where during periods of enlightenment he continued to write his imperishable philosophical works.
Jean-Jacques Rousseau I saw everything as a conspiracy against myself. Paranoid schizophrenia, aggravated by persecution mania, turned the outstanding philosopher and writer into a lonely wanderer.
Nikolay Gogol suffered from schizophrenia with episodes of psychosis. In addition, he believed that all the organs in his body were in the wrong location.
So what connects genius and schizophrenia? Unusual perception of the world? The ability to create strange associations? Extraordinary thinking? Or maybe a specific gene that links schizophrenia and creativity? There are more questions than answers. But one thing is clear: the world created by geniuses suffering from mental disorders ultimately destroys them.
Myth 8. Schizophrenia can only be treated in psychiatric hospitals
Advances in modern medicine make it possible to treat schizophrenia in most cases without long-term, round-the-clock hospitalization in a psychiatric clinic. The patient can attend a day hospital or be treated at home.
Patients with acute schizophrenia who may cause harm to themselves or others are subject to hospitalization.
After the acute condition is over, patients diagnosed with schizophrenia are discharged home, where they undergo rehabilitation under the supervision of family and friends, social workers, and a supervising psychiatrist.
Myth 9. People with schizophrenia cannot work
With schizophrenia, it is extremely important that a person does not lose social connections. And in this regard, professional activity becomes an excellent help in overcoming self-doubt, isolation and alienation. Work helps not only to adapt to society, but also to assert oneself (even with such a diagnosis, one can achieve a lot in the professional field). But still, there are a number of professions that are not recommended for patients with schizophrenia.
Firstly, this is any night shift work . The fact is that disruption of cyclic biorhythms can lead to a deterioration in the condition of a patient with schizophrenia.
Secondly, this work activity associated with constant psycho-emotional pressure and tension . Conflicts at work can trigger a relapse of the disease. It is also important that the patient does not have disagreements with the team in which he works.
Thirdly, patients with schizophrenia are contraindicated in any work involving danger, i.e. electricity, large machinery, fire, gas .
Fourthly, patients with such a diagnosis contact with weapons is prohibited , let alone own it. Therefore, you can forget about a military career or work in armed security.
Myth 10. Schizophrenia can be cured once and for all
To date, there is no medicine or treatment that can completely cure schizophrenia. But this does not mean that the diagnosis of schizophrenia is a death sentence. If you do not delay the diagnosis and treatment of this chronic disorder, if you strictly follow all the doctor’s instructions, and take medications to relieve the manifestations of schizophrenia, you can achieve a stable, long-term remission.
To achieve stable remission is the main task of the doctor and the patient with such a disorder as schizophrenia. And you can’t do without taking medications, no matter what traditional healers tell you, suggesting that by rubbing and taking herbal decoctions you can get rid of this mental disorder once and for all. Do not waste precious time, seek help from qualified psychiatrists, enlist the support of family and friends, and believe in yourself, only then will you be able to achieve positive results in the treatment of schizophrenia.
Periodic schizophrenia is also called recurrent or recurrent. Its difference from the continuously flowing form is that in this case there are no severe personality changes, therefore periodic schizophrenia is considered a relatively favorable form. Women are more susceptible to this pathology; the disease begins when a person reaches adulthood, usually from twenty-five to thirty-five years. The disease is characterized by defined attacks and high-quality remissions.
The structure of the attack is marked by manic or depressive symptoms, delusional states in acute form, and confusion often occurs, which is sometimes accompanied by catatonic disorders. Basically, an attack begins with a decrease in mood, or, on the contrary, a sharp increase in mood, followed by a feeling of confusion and anxiety. It may seem to the patient that something strange is happening directly around him, and that someone is deliberately pranking him, misleading him, and so on.
Each surrounding phenomenon is given a special meaning, sometimes having a fantastic meaning. Further, a delusional situation can develop depending on the mood of the patient. If he is in a depressed state, then ideas appear in which there is a struggle between good and evil forces, and often the winner is evil. A person is fascinated by such images as “demons”, “evil spirits”. Against this background, suicide attempts cannot be ruled out. If the mood is good, the patient is in the grip of thoughts about his own greatness, he is sure that he occupies a special place in this world, or is destined to fulfill a special mission. Periodic is characterized by attacks that have a different psychopathological structure, as well as remissions expressed in long light periods.
Reasons for periodic
The causes of schizophrenia of any type, including periodic schizophrenia, have not been studied to such an extent as to make an unambiguous statement about the influence of one or another factor. Scientists believe that the leading role in the development of periodic schizophrenia is played by genetic characteristics. The patient's gender and age also matter. Men are most seriously ill; women have milder variants. If schizophrenia began in adolescence, then its course is more malignant than in adult patients. Some experts argue that the origin of the disease lies in childhood, when developmental changes are detected, which represent a special dysontogenesis.
As is known, the schizoid character structure is formed in childhood. And sometimes doctors establish a connection between developmental features and those vague attacks that occur during age-related crises. However, the clinical picture of such attacks is not specific and has a distinct age-related pattern. Usually the patient’s condition is expressed in motor restlessness, fears, obsession, etc. It happens that the patient does not have signs of early periodic schizophrenia, and personality changes are not acute, remaining subtle. Identification of the disease occurs only in a situation when manifest attacks begin to develop.
In most cases, before establishing the cause of periodic schizophrenia, it is first necessary to differentiate it from, among other things, psychopathy and neuroses. This pathology should also not be confused with reactive conditions. If there are signs such as gradually increasing personality changes, or they occur in stages, then the diagnosis of schizophrenia becomes easier. Periodic schizophrenia has a so-called marginal position when other types of this disease are classified. It is adjacent to affective psychoses. The similarity is that a favorable course is observed; in the attacks there are pronounced affective disturbances.
Treatment of periodic schizophrenia
To count on good results, it is necessary to begin treatment for schizophrenia without delaying for a long time. Experts assure that the most effective treatment is provided if it is started no later than two years after the onset of the disease. The initial period is very important, since at this time it is possible to completely stop the destructive processes that occur in the patient’s brain. Sometimes the diagnosis of “recurrent schizophrenia” is made quite late, but in any case, treatment cannot be refused, since the therapy still has a beneficial effect on the patient’s condition.
Treatment of schizophrenia has two directions: psychotherapeutic influence and medicinal influence. If psychotherapeutic treatment is preferable, then in this case the determining positive factor is the patient’s trust in the doctor. Before the psychotherapist begins work, the patient undergoes a thorough examination, which is necessary to identify the state of thinking, assess his memory of information, ability to concentrate, and so on. An individual treatment plan and psychological impact is drawn up taking into account the data obtained.