Symptom psyche disease. Types of psychological disorders and their signs

Our psyche is pretty thin and complex system. Experts classify it as a form of active mapping by a man of objective reality, which arises in the interaction of an individual with an external world and regulates its behavior and activities. Quite often doctors have to deal with pathological deviations from the normal state they call impairment of psyche. There are many mental disorders, but some of them are more common. Let's talk that it represents a violation of the psyche of a person slightly in more detail, discuss the symptoms, treatment, types and causes of such health problems.

Causes of psyche violations

Disorders of the psyche can be explained by the most different factors, which in general can be divided into exogenous and endogenous. The first is the factors of external influence, for example, the reception of hazardous poisoning substances, viral ailments and traumatic lesions. And the internal causes are represented by chromosomal mutations, hereditary and genital illness, as well as mental disorders.

The stability of the individual to the impairment of the psyche is determined by both specific physical characteristics, and the general development of the psyche. After all, different subjects react differently to spiritual flour and various kinds of problems.

Typical reasons causing psyche disorders include neurosis, neurasthenia, depressive states, aggressive impact of chemical or toxic elements, as well as traumatic lesions of the head and hereditary factor.

Violation of the psyche - symptoms

There are a number of different symptoms that may be observed in mental disorders. They are most often manifested by psychological discomfort and violations of activities in various fields. In patients with such problems, various symptoms of physical and emotional nature, congressive and perceptual violations may also occur. For example, a person can feel unhappy or ultra-fast irrelevant seriousness of the events that occurred, it can also have failed to build logical relationships.

Classical manifestations of mental disorders consider excessive fatigue, fast and unexpected change of sentiment, not enough adequate response to events, spatial-temporal disorientation. Also, experts face a violation of perception in their patients, they may have an adequate attitude to their own state, there are abnormal reactions (or lack of adequate reactions), fright, confusion of consciousness (sometimes hallucinations). A rather frequent symptom of mental disorders becomes anxiety, problems with sleep, falling asleep with a wake.

Sometimes issues in mental health are accompanied by the emergence of obsessive ideas, persecution and different phobias. Such violations often lead to the development of depressive states that can be interrupted by frantic emotional splashes, as directed to perform some incredible plans.

Many mental violations are accompanied by self-consciousness disorders, which make themselves known to be confused, depostection and derealization. People with such problems often weakens the memory (and sometimes no absent), paramnezia and violation of the thought process is observed.

A frequent satellite of mental disorders is considered nonsense, which can be both primary and sensual, and affective.

Sometimes mental disorders manifest themselves with food intake - overeating, which can cause obesity, or, on the contrary, refusal to food. It is often observed alcohol abuse. Many patients with such issues suffer from violation of sexual functions. They also often look neakkurat and even refuse hygienic procedures.

Types of psyche violations

There are quite a few classifications of psyche disorders. We will consider only one of them. It includes states provoked by different organic brain diseases - injury, strokes and systemic diseases.

Also, the doctors separately consider persistent or drugs.

In addition, the disorders of psychological development can be distinguished (debut in early childhood) and violations of activity, concentrations of attention and hyperkinetic disorders (are usually recorded in children or adolescents).

Violation of the psyche - treatment

Therapy of problems of this kind is carried out under the supervision of the psychotherapist and other narrow specialists, while the doctor takes into account not only the diagnosis, but also the condition of the patient, and other presentation of violations of health.

So quite often, experts use sedatives that have a pronounced soothing effect. Tranquilizers can also be used, they effectively reduce anxiety and remove emotional tensions. More such means lower musculature tone and have a soft impact effect. The most common tranquilizers are chlordiazepoxide, and.

Also mental disorders are treated with neuroleptics. These drugs are considered to be the most sought after such diseases, they are not bad reduced the excitement of the psyche, reduce psychomotor activity, reduce aggressiveness and suppress emotional tensions. Popular products of this group are prepasy, pimozide, as well as Flupenixol.

Antidepressants are used to treat patients with complete depression of thoughts and feelings, with the strongest decline in mood. Such drugs are able to increase the pain threshold, raise the mood, relieve apathy and lethargy, they are not bad normalize sleep and appetite, and also increase the activity of the psyche. Qualified psychotherapists are often used as pyriticol antidepressants and.

Even the treatment of psyche violations can be carried out with the help of normatimics, which are designed to regulate inadequate manifestations of emotions, and have anticonvulsant efficiency. Such medicines are often used in bipolar affective disorder. These include, etc.

Made by safe drugs for the treatment of mental disorders are nootropics, which have a positive effect on congenitive processes, increase memory and increase the stability of the nervous system to the effects of various stresses. Preparations of choice usually become aminal.

In addition, patients with mental violations are corrective psychotherapy. They will benefit hypnotewers, suggestion, sometimes NLP methods. Mastering the methodology of autogenic workout plays an important role, and without supporting Rodney.

Violation of the psyche - national treatment

Specialists of traditional medicine argue that some of the medicines based on herbs and subwoofers may well contribute to the elimination of psyche violations. But they can only be used after agreeing with the doctor.

So medicine of traditional medicine can be an excellent alternative to some sedative medicines. For example, to eliminate the nervous excitement, irritability and insomnia, the characteristics are advised to mix three parts of the crushed Valerian root, the same number of peppermint leaves and four parts of the clover. A table spoon of such raw material makes a glass of only pile water. Insist the medicine for twenty minutes, after strain, and peel vegetable raw materials. Take a ready-made candy on half a glass twice a day and immediately before bedtime.

Also, with irritability of the nervous system, insomnia and nervous excitement, you can mix two parts of valerian roots with three parts of daisy flowers and three parts of cumin seeds. Brew and take such a means by the same scheme as in the previous recipe.

You can cope with insomnia using a simple hinter infusion. A pair of tablespoons of crushed cones of this plant pour half alert cool, pre-boiled water. Insist for five to seven hours, after strain and drink across the tablepooner three times a day.

Anotherly excellent soothing means is a soul man. A pair of tablespoons of such a weed make boiling water half minutes. Insist for half an hour, after expanding and take half a glass of a glass three times a day directly before the meal. Such a medicine perfectly eliminates problems with sleep.

Some folk medicine funds can be used to treat depressive states. So a good effect gives a taking medication based on the root of chicory. Twenty grams of such chopped raw materials brew glass boiling water. Weganize the remedy on the fire of minimal power for ten minutes, after the strain. Take a ready-made decoction on a tablespoon five or six times a day.

If depression is accompanied by the strongest decline, prepare rosemary-based medicine. Twenty grams of crushed leaves of such a plant makewill with one glass of boiling water and tapping on the fire of minimal power for fifteen-twenty minutes. The finished medicine will cool down after strain. Use it to half the teaspoon for half an hour before the meal.

A wonderful effect of depression gives both infusion based on an ordinary dispatch. A couple of tablespoons of such a weed make boiling water half minutes. Insist for half an hour, after express. Take through the day in small portions.

Psyche disorders are quite serious states that require close attention and adequate correction under the supervision of specialists. The feasibility of the use of folk remedies should also be discussed with the attending physician.

"The crazy lives for a high fence, and idiots walk along the crowds street"
"Unweight", directed by Francis Weber

We live in times when hysterics and protracted Steel for many ordinary phenomenon. Each of us is familiar to the condition when close people behave inadequately or they themselves suffer from insomnia, overnight overnight in the head one and the same obsessive thought. But this is the signs of the presphomic state: anxiety, insomnia, unwillingness to live, hysterics, attack on others, the attempt of suicide and sharp change changes. In order to identify deviations in the psyche, it is necessary to observe a person in a hospital for 30 days, and in some cases, to make a diagnosis of schizophrenia, a patient survey is required for 6 months.

Mental illness - This is not only schizophrenia, they also include neurosis, psychosis, mania, panic attacks, paranoia, dementia and bipolar disorder. In turn, each mental deflection is divided into several more species. It is considered if there are situations that in humans cause sharp stress reactions: hysterics, crying, attack, nervous trembling and other aggressive actions aimed at others or on themselves, are episodic and pass after some time, they do not interfere with living and are not deviation from the norm.

However, it often happens that after examining the doctor no mental disorders in the patient Does not reveal, and after some time it makes a rigid planned murder or harm to health itself or others. This is an explicit deviation in psyche and not to become a victim of such a patient, it is very important to have some ideas about how signs of mental abnormalities are manifested and how to behave when communicating or even accommodation together with them.

Nowadays, many people are forced to live together or by neighborhood With alcoholics, drug addicts, neurasthenics and elderly parents, sick dementia. If you delve into the subtleties of their daily life can easily come to the conclusion that absolutely mentally healthy people are simply not, but there are only unfinished.

Permanent scandals, accusations, threats, handscript, reluctance to live and even attempts by suicide are the first signs that the psyche of participants in such conflicts are not in order. If such human behaviors are repeated from time to times and begin to influence the personal life of other people, they are talking about mental illness and requires a survey from a specialist.

Deviations B. psyche First of all, it is manifested in the fact that the person changes the perception of the world and the attitude towards the people around him changes. Unlike healthy, people who have deviations in the psyche seek to satisfy only their physical and physiological needs, they do not care how their inadequate behavior will affect the health and mood of others. They are cunning and attentive, selfish and hypocritical, emotional and dodes.

It is very difficult to understand when close You person exhibits excessive anger, aggression and unreasonable accusations of your address. Few capable of keeping calm and take the inadequate behavior of a loved one associated with impaired psyche. In most cases, people think that a person mocks him, and try to apply "educational measures" in the form of morals, requirements and evidence of innocence.

With time mental diseases Progress and can combine crazy, hallucinatory and emotional disorders. The manifestations of visual, auditory and delusional hallucinations are manifested in the following:
"A person talks to himself, laughs without a visible cause.
- It can not focus on the topic of conversation, always has a concerned and alarmed appearance.
- hears foreign voices and sees someone that you can not perceive.
- Refers hostile to family members, especially those who serve it. In later stages of the development of the mental illness, the patient becomes aggressive, attacks others, deliberately breaks the dishes, furniture and other items.
- tells the stories of implausible or dubious content about themselves and loved ones.
- fears for his life, refuses to eat, blaming loved ones in an attempt to poison it.
- writes statements to the police and letters to various organizations with complaints about relatives, neighbors and just acquaintances.
- hides money and things, quickly forgets where they put them and accuses others in the steal.
- It does not wash for a long time and does not shave, in behavior and appearance there is inaccurability and uncleanness.

Knowing common signs Mental abnormalities It is very important to understand that the mental illness brings suffering, above all, the patient himself, and only then his close and society. Therefore, it is completely wrong to prove the patient that he behaves immorally, blaming or reproach him that he does not love you and worsens your life. Of course, a mentally sick person is a trouble in the family. However, it should be treated as a sick person, and respond to their inadequate behavior with understanding.

It is impossible argue With the sick, trying to prove to him that his accusations are wrong. Listen carefully, calm and offer help. Do not try to clarify the details of his delusional accusations and statements, do not ask him questions that can aggravate having disorders in the psyche. Any mental illness requires attention from loved ones and treating specialists. It should not cause complaints and accusations of selfishness towards a sick person.

Alas, from the development of mental abnormalities Nobody is insured. This is especially true of those who have a hereditary predisposition to the disease or caring for the elderly parents, sick dementia. Show an example of a good attitude towards them to your children so that they do not repeat the mistakes of their parents.

The weak floor is more prone to a gland associated with the psyche. Emotional involvement in social life and natural sensitivity increase the risk of developing diseases. They need to be diagnosed in time to start proper treatment and return life into the usual direction.

Mental diseases in different age periods of women

For each age period (girl, girl, woman), a group of the most likely mental illness is determined. At these critical stages of development, situations occur most often to develop development.

Girls are less susceptible to mental illness, as opposed to boys, however, they are not insured against school phobias, attention deficit. They have increased the risk of the emergence of anxiety disorders and disorders associated with learningability.

Young girls in 2% of cases may be victims of premenstrual dysphoria after the first case of bleeding in the menstrual period. After puberty, the girls are 2 times more exposed to the development of depression than the young men.

Women who are in a group of patients with mental disorders, do not pass drug treatment when planning. By this they provoke the emergence of relapses. After giving birth, the likelihood of signs of depression, which, however, can escape without medication treatment.

A small percentage of women still develop psychotic disorders, the treatment of which is complicated by a limited amount of allowed drugs. For each individual situation, the degree of benefit and risk from medication treatment during breastfeeding is determined.

Women from 35 to 45 years in the risk area of \u200b\u200bdisturbing disorders, they are subject to changes in mood, and are not insured against the appearance of schizophrenia. Reducing the sexual function can happen due to antidepressants.

Menopause changes the usual course of life of a woman, her social role and relationship with loved ones. From care of their children, they switch to the presence of their parents. This period is associated with depressive moods and disorders, but officially the connection of the phenomena has not been proven.

In the elderly, women are susceptible to the appearance of dementia and complications of somatic pathologies mental disorders. This is due to the duration of their lives, the risk of developing dementia (acquired dementia) is growing proportion to the number of years lived. Older women who take a lot and suffering from somatic diseases, more than the rest are inclined to obey.

Those who for 60 should pay attention to the symptoms of paraffrenation (severe shape of delusional syndrome), they are in the zone of the greatest risk. Emotional involvement in the life of surrounding and loved ones in the midwives, when many are completing their life path, can cause mental disorders.

The division of the existence of a woman for periods allows doctors from the variety of diseases with similar symptoms to allocate the only correct one.

Signs of mental disorders in girls

In childhood, the development of the nervous system occurs continuously, but unevenly. However, the peak of mental development is 70% for this period, the personality of the future adult is formed. It is important in time to diagnose the symptoms of certain diseases from a specialist.
Signs:

• Reduced appetite. It occurs with sudden changes in the power mode and when coercive meals.
• Increased activity. Differs with sudden forms of motor arousal (bouncing, monotonous run, croutons)
• Hostility. It is expressed in the child's confidence in a negative setting towards it surrounding and loved ones, not confirmed by facts. It seems such a child that everyone is laughing at him and despise him. On the other hand, he himself will show unfavorable hatred and aggression, or even fear towards his relatives. It becomes rude in everyday communication with relatives.
• Painful perception of physical disadvantage (dysmortophobia). The child chooses a slight or apparent flaw in appearance and trying to disguise him with all their might, even turning to adults asking for a plastic surgery.
• Game activity. It comes down to monotonous and primitive manipulation of objects not intended for the game (cups, shoes, bottles), the nature of such a game does not change over time.
• Painful looping on health. Excessive attention to its physical condition, complaints of fictional.
• Repeating word movements. They are involuntary or intrusive, for example, the desire to touch the subject, roll up, tang.
• Violation of mood. The state of longing and meaninglessness of what is happening does not leave the child. It becomes fuse and irritable, the mood does not improve for a long time.

• Nervous state. The change of hyperactivity on lethargy and passivity and back. Bright light and loud and unexpected sounds are heavily tolerated. The child can not long strain his attention because of what it suffers from studying. It can be visited in the form of animals, frighteningly looking people or to hear the voices.
• Disorders in the form of repeated spasms or cramps. The child can freeze for a few seconds, while palene or rolling his eyes. The attack can manifest in shuddering shoulders, hands, less often like squats. Systematic walking and talking in a dream at the same time.
• Disorders in everyday behavior. The excitability is associated with aggression expressed in the tendency to violence, conflicts and rudeness. Unstable attention against the absence of discipline and motor dismissal.
• A pronounced desire to harm and subsequent receipt from this pleasure. The desire for hedonism, an increased suggestibility, a tendency to leaving the house. Negative thinking together with vitality and omble against the background of a general tendency to cruelty.
• Painful-abnormal habit. Blooming nails, pulling hair from the hair of the skin and at the same time a decrease in psychological stress.
• Obsessive fears. Day forms are accompanied by redness of the face, increased sweating and heartbeat. At night, they are shouting and crying from frightening dreams and motor anxiety, in such a situation the child may not recognize loved ones and dismissed from someone.
• Violation of reading skills, letters and accounts. In the first case, children with difficulty correlate the appearance of the letter with sound or hardly recognize images of vowels or consonants. When withdrawing (letter disorder), it is hard for them to write what they are pronounced out loud.

These signs are not always a direct consequence of the development of the mental illness, but require qualified diagnosis.

Symptoms of diseases characteristic of adolescent period

For teenage girls, nervous anorexia and bulimia, premenstrual dysphoria and depressive states are characteristic.

To anorexia, respected on the nervous soil, belong:

• Denial of an existing problem
• Painful-obsessive feeling of excess weight when he is visible
• Eating standing or small pieces
• Violated mode
• Fear to score overweight
• Depressed mood
• Angleness and unreasonable syradiability
• Passionate cooking, cooking for family meals without personal participation in the meal
• Avoiding common food meals, minimal communication with loved ones, long staying in the bathroom or sports outside the house.

Anorexia causes physical disorders. Due to weight reduction, problems with the menstrual cycle begins, arrhythmia appears, constant weakness and pain in the muscles. The attitude towards itself depends on the volume of the dropped weight to the dialed. The man of a patient with nervous anorexia is inclined to be believed to estimate its condition until the point of no return.

Signs of nervous bulimia:

• The amount of food consumed at a time exceeds the norm for a person a certain set. Slices of food are not chewed, but quickly swallow.
• After a meal, a person deliberately tries to cause vomiting to clean the stomach.
• In behavior, the mood differences are dominated, closeness and impairment.
• A person feels his helplessness and loneliness.
• Overall disabilities and lack of energy, frequent diseases, upset digestion.
• The destroyed dental enamel is the consequence of frequent vomiting, which contains gastric juice.
• Increased salivation glands on cheeks.
• Decitment of the problem.

Signs of premenstrual dysphoria:

• The disease is typical for girls forming premenstrual syndrome. He, in turn, is expressed in depression, gloomy mood, unpleasant physical sensations and uncomfortable psychological state, plasticity, violation of the usual mode of sleep and meals.
• The dysphoria occurs 5 days before the start of menstruation, and on the first day ends. The girl during this period is completely defocused, nothing can focus on, she overcomes fatigue. The diagnosis is put if the symptoms are bright - expressed and interfere with a woman.

Most of the diseases of adolescents are developing on the basis of nervous disorders and features of puberty.

Postpartum disorders of psyche

In the field of medicine, there are 3 negative psychological states of the feminine:

• Neurotic. There is an aggravation of the problems with the psyche, which were still at the end of the child. This ailment is accompanied by an oppressed state, nervous exhaustion.
• Traumatic neurosis. It appears after long and difficult gods, subsequent pregnancies are accompanied by fear and anxiety.
• Melancholy with brought ideas. A woman feels a feeling of guilt, may not recognize close and see hallucinations. This disease is a prerequisite for the development of a manic depressive psychosis.

Mental disorder can manifest itself in the form:

• Invalued state and plasticity.
• Unreasonable anxiety, a feeling of concern.
• Irritability and excessive activity.
• Distribution of others and feeling.

• Species of speech and lowered or elevated appetite.
• Outlusion in communication or desire to burn out from all.
• Confusion in consciousness and lack of concentration.
• Inadequate self-esteem.
• Thoughts about suicide or murder.

In the first week or a month later, these symptoms will be felt in the event of the development of postpartum psychosis. Its duration is equal to four months on average.

The middle-aged period. Mental agens developing on the background of the onset of menopause

During the period of menopause, the reverse development of the hormonal glands of sexual secretion occurs, this symptom is most pronounced in women from 45 to 50 years. Turns the cell renewal. As a result, those diseases and disorders begin to manifest themselves, which were missing completely or hidden.

Mental diseases characteristic of the period of menopause are developing or 2-3 months before the final completion of the cycle of menstruation or even after 5 years. These reactions are temporary, most often this:

• Mood swings
• Concern about the future
• Increased sensitivity

Women at this age are prone to self-criticism and dissatisfaction with themselves, which entails the development of depressive sentiment and hypochondriad experiences.

With physical discomfort during a climax associated with blood ties or fainting, hysterics appear. Serious disorders against the background of menopause develop only in women who originally had such problems

Psyche disorders in women in the senile and prediction period

Involutionary paranoid. This psychosis appearing during the involution is accompanied by delusional thoughts in combination with the unreasonable memories of traumatic situations from the past.

Involutionary melancholy is characteristic of women since 50 years. The main prerequisite for the appearance of this disease is the depression anxious and delusional. Typically, the involutionary paranoid appears after changing the lifeguard or stressful situation.

Dementia of late age. The disease is an acquired dementary, which over time is enhanced. Based on clinical manifestations, allocate:

• Total dementia. In this embodiment, perception is reduced, the level of thinking, the ability to creativity and solve problems. There is an erase of the facets of the person. A person is not able to critically evaluate himself.
• Lacooner dementia. Memory disabilities occurs when the level of cognitive functions is preserved. The patient can critically evaluate itself, the personality is basically unchanged. This disease is manifested in syphilis of the brain.
• These diseases are an alarming sign. Mortality of patients with dementia after a stroke is several times higher than those who escaped this fate and did not become weak.

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Treatment of psyche disorders to share for medication and complex psychotherapy. In the food disorders characteristic of young girls, the combination of these methods of treatment will be effective. However, even if most of the symptoms coincides with the disorders described, before carrying out any type of treatment, it is necessary to consult with a psychotherapist or psychiatrist.

This chapter presents a review of mental violations that are often found in women, including their epidemiology, diagnosis and therapeutic approach (Table 28-1). Mental disorders are very often found. The monthly morbidity among adult Americans exceeds 15%. The morbidity over the course of life is 32%. Most often, women meet a large depression, seasonal affective disorders, manic-depressive psychosis, disorders of food behavior, panic disorders, phobias, generalized alarming states, somatized mental disorders, pain, border and hysterical disorders and suicidal attempts.

In addition, women are much more likely there are alarming and depressive disorders, they are more resistant to medication therapy. However, most studies and clinical trials are carried out on men, and then extrapolate results on women, despite the differences in metabolism, sensitivity to drugs, side effects. Such generalizations lead to the fact that 75% of psychotropic drugs are prescribed to women, and they are more often observed serious side effects.

All doctors should know the symptoms of mental disorders, first aid for them and accessible methods of preserving mental health. Unfortunately, many cases of mental diseases remain undiagnosed and unclean or not sufficiently treated. Only a small part of them comes to a psychiatrist. Most patients are observed in other specialists, thus, with primary handling, only 50% of mental disorders are recognized. Most patients make somatic complaints and do not focus on psycho-emotional symptoms, which again reduces the diagnosis of this pathology by incompatient. In particular, affective disorders are very often found in patients with chronic diseases. The occurrence of mental illness in patients with general practitioners is two times higher than in the population, and even higher in serious patients of hospitalized patients and often resort to medical care. Neurological disorders, such as stroke, Parkinson's disease and Meniere syndrome are associated with mental.

Untreated large depression may worsen the forecast of somatic diseases and increase the amount of medical care. Depression can enhance and increase the number of somatic complaints, reduce the threshold of pain, increase the functional incapacity. The study of patients often enjoyed medical care has revealed depression in 50% of them. Only those who during the year of observation have decreased the severity of the symptoms of depression, an improvement in functional activity was observed. Symptoms of depression (reduced mood, hopelessness, lack of satisfaction from life, fatigue, violation of the concentration of attention and memory) violate the motivation of medical treatment. Timely diagnosis and treatment of depression in chronic patients helps to improve the forecast and increase the effectiveness of therapy.

The socio-economic price of mental diseases is very high. About 60% of suicidal cases are caused only by affective disorders, and 95% are combined with the diagnostic criteria for mental illness. The costs associated with treatment, mortality and disability due to clinically diagnosed depression, for the year in the United States are estimated by more than 43 billion dollars. Since more than half of people with affective disorders either remain without treatment, or inadequate treatment, this figure is much lower than the total value in which the depression costs society. Mortality and disability in this population that does not receive sufficient treatment, most of which are women, especially depressing, because from 70 to 90% of patients with depression respond to antidepressants' therapy.
Table 28-1.
Major mental disorders in women

1. Violations of food behavior

Nervous anorexia

Nervous Bulimia

Attacks of gluttony
2. Affective disorders

Big depression

Depressive Mood Adaptation Violation

Postpartum affective disorder

Seasonal affective disorder

Affective insanity

Distimia
3. Alcohol abuse and alcohol addiction

4. Sexy disorders

Violations of libido

Violations of sexual excitement

Organic disorders

Pain sexy disorders:

Vaginism

DISSAREUTION
5. Alarm disorders

Specific phobias

Social phobia

Agoraphobia

Panic disorders

Generalized alarming disorders

Obsessive state syndrome

Post Stramatic Stress
6. Somatoform disorders and false disorders

False disorders:

Simulation

Somatoform disorders:

Somatization

Conversion

Hypochondria

Somatoformous pain
7. Schizophrenic disorders

Schizophrenia

Paraffrenation
8. Delirium
Mental diseases during the life of a woman

During the life of a woman there are specific periods, during which it has increased the risk of mental diseases. Although the main mental disorders are mood and disturbing disorders - may occur at any age, various provoking conditions are more common in specific age periods. During these critical periods, the clinician must include special issues to identify mental disorders, collecting history and examining the mental status of the patient.

Girls have increased risk of school phobias, disturbing disorders, hyperactivity syndrome with a deficit of attention and learning disorders. Adolescents have increased the risk of violations of food behavior. During Menarche, 2% of girls develop premenstrual dysphoria. After Pubertata, the risk of depression increases sharply, and in women twice the men in the men of the same age. In childhood, on the contrary, girls have the frequency of mental illness less or the same as the boys of their age.

Women are subject to mental disorders during and after pregnancy. Women with mental disorders in history often, when planning pregnancy, refuse drug support, which increases the risk of recurrence. After the generations of most women, mood changes occur. Most has a short period of depression "Baby Blues", not requiring treatment. Others develop heavier, violating disability, the symptoms of depression in the postpartum period, a small number of women develop psychotic disorders. The relative risk of receiving drugs during pregnancy and breastfeeding makes it difficult to choose treatment, in each case the relationship of the benefit and risk of therapy depends on the severity of symptoms.

The middle-aged period is associated with the continuation of the high risk of anxiety disorders and disorders, as well as other mental disorders, such as schizophrenia. Women can break the sexual function, and if they take antidepressants about affective or alarming disorders, they increase the risk of developing side effects, including a decrease in sexual function. Although there are no clear evidence that menopause is associated with an increased risk of depression, most women have serious changes in life during this period, especially in the family. In most women, their active role in relation to children is replaced by the role of nurses with elderly parents. Care for older parents is almost always carried out by women. Monitoring the mental status of this group of women is necessary to identify possible violations of the quality of life.

As women agrees, women increase the risk of developing dementia and psychiatric complications of somatic pathologies, such as stroke. Since women's life expectancy is greater than in men, and the risk of developing dementia is growing with age, the majority of women develop dementia. In the elderly women with multiple somatic diseases and a large number of medications taken, the risk of delirium is high. In women, the risk of developing paraffrenion is a psychotic disorder, usually coming after 60 years. Due to the long life expectancy and great involvement in interpersonal relationship, women are more often experiencing the loss of loved ones, which also increases the risk of mental diseases.
Survey of psychiatric patient

Psychiatry is engaged in the study of affective, cognitive and behavioral disorders arising from the preservation of consciousness. Psychiatric diagnosis and treatment selection are followed by the same logic of the collection of history, surveys, differential diagnosis and therapy planning, as in other clinical industries. Psychiatric diagnosis must be responsible for four requests:

1) mental illness (that the patient has)

2) temperament disorders (which is a patient with itself)

3) violation of behavior (that the patient does)

4) disorders arising in certain life circumstances (with which the patient faces in life)
Mental illness

Examples of mental diseases are schizophrenia and large depression. They look like other nosological forms - have a discrete beginning, the course, clinical symptoms that can be clearly defined as existing or absent, each individual patient. Like other nosologies, they are the result of genetic or neurogenic violations of the body, in this case - the brain. Under explicit abnormal symptoms - auditory hallucinations, mania, severe obsessive states - the diagnosis of mental disorder is easy. In other cases, distinguish pathological symptoms, such as a reduced mood with a large depression, from a normal feeling of sadness or disappointment caused by life circumstances may be difficult. It is necessary to focus on identifying known stereotypes of symptoms characteristic of mental illness, and at the same time remember the diseases most common in women.
Disorders of temperament

Understanding the patient's personality features increases the effectiveness of treatment. Personal features, such as perfectionism, indecision, impulsivity, one way or another, is quantitatively pronounced in people, as well as physiological - growth and weight. In contrast to mental disorders, they do not have clear characteristics - "symptoms", opposed "normal" values, and individual differences are normal in the population. Psychopathology or functional violations of the individual arise when the features acquire the nature of extremes. When the temperament leads to a violation of professional or interpersonal functioning, this is sufficient for its qualifications as a possible personality disorder; In this case, medical care and cooperation with a psychiatrist are needed.
Violations of behavior

Behavior disorders have a property of self. They are characterized by targeted, insurmountable forms of behavior, subordinate to themselves all other activities of the patient. Examples of such disorders can serve food disorders and abuse. The first treaties of treatment are the switching of the activities and attention of the patient, the termination of the problem behavior and the neutralization of provoking factors. The provoking factors may be associated mental disorders, such as depression or alarming disorders, illogical thoughts (anorectician opinion, that "if I eat more than 800 calories a day, I will become thick"). Group therapy may be effective in the treatment of behavior disorders. The final phase of treatment is the prevention of relapses, since recurrence is a normal form of the flow of behavioral disorders.
The history of the patient's life

Stressors, life circumstances, social circumstances are factors that can modulate the severity of the disease, personality features and behavior. Various life periods, including pubertat, pregnancy and menopause, may be associated with an increased risk of developing certain diseases. Social conditions and variability of sexual roles can help explain the increased frequency of specific symptom complex in women. For example, focusing the attention of mass media on an ideal figure in Western society is a provoking factor in the development of women's violations of food behavior. Such conflicting the women's roles in modern Western society, as a "loyal wife", "Madly loving mother" and "Successful Business Woman" add stress. The goal of collecting anamnesis of life is the more accurate selection of internal-oriented psychotherapy methods, finding the "meaning of life." The treatment process is facilitated when the patient comes to understand himself, a clear separation of its past and recognizing the priority of real for the sake of the future.

Thus, the formulation of a psychiatric case should include answers to four questions:

1. Does the patient have a disease with a clear time of the beginning, defined etiology and response to pharmacotherapy.

2. What features of the patient's personality affect its interaction with the environment and how.

3. Does the patient have targeted behavioral disorders

4. What events in the life of a woman contributed to the formation of her personality, and what conclusions she removed from them.
Eating disorders

Of all mental disorders, almost exclusively in women are found only disorders of food behavior: anorexia and bulimia. For 10 women suffering from them, there are only one man. The incidence and frequency of occurrence of these disorders increases. Young white women and girls from the middle and highest classes of Western society have the highest risk of developing anorexia or bulimia - 4%. However, the occurrence of these disorders in other age, racial and socio-economic groups is also growing.

As in cases with abuses, food disorders are formulated as violations of behavior caused by a violation of the regulation of hunger, saturation and learning. Violations of behavior associated with nervous anorexia are to limit food, cleansing manipulations (vomiting, abuse of laxative and diuretics), exhausting physical exertion, stimulators abuse. These behavioral reactions are intrusive, supported by the psychological attitude relative to food and weight. These thoughts and behavior dominate in all aspects of a woman's life, violating physical, psychological and social functions. Just as for abuses, treatment can be effective only if the patient is desired to change the situation.

According to the diagnostic and statistical manual on mental disorders (DSM-IV), the nervous anorexia includes three criteria: voluntary starvation with refusal to maintain weight more than 85% of the required; Psychological installation with obesity fear and discontent with its own weight and body forms; Endocrine disorders leading to amenorrhea.

The nerve bulimia is characterized by the same fear of obesity and discontent with his own body, as well as nervous anorexia, accompanied by increments of gluttony, and then compensatory behavior aimed at maintaining low body weight. In DSM-IV, anorexia and bulimia differ primarily on the sign of insufficient body weight and amenorrhea, and not on behavior, with the help of which the weight is controlled. Compensatory behavior includes periodic hunger strikes, exhausting physical exertion, reception of laxatives and diuretics, stimulants and vomiting provoking.

The attacks of gluttony differ from the nervous bulimia absence of compensatory behavior aimed at maintaining body weight, as a result, such patients develop obesity. In some patients, there is a change in the change of one disorder of food behavior to others; Most often, the change goes towards the restrictive type of nervous anorexia (when the behavior is dominated by the restriction of food and excess physical exertion) towards nervous bulimia. There are no uniform causes of eating disorders, they are considered as multifactor. Known risk factors can be divided into genetic, social predisposition and temperature features.

Studies have shown a higher concortancy of single-time twins compared to multi-alopecia. One family study revealed a tenfold risk of anorexia from relatives on the female line. On the contrary, for Bulimia, neither family nor twin studies revealed hereditary predisposition.

Features of temperament and personality contributing to the development of disorders of food behavior include introversion, perfectionism and self-criticism. In patients with anorexia, restricting food, but not engaged in cleansing procedures, anxiety is most likely dominated, which keeps them from life-threatening behavior; In suffering bulimia, such personal features are expressed as impulsivity, the search for novelty. In women with attacks of gluttony and subsequent cleansing procedures, other types of impulsive behavior can have, such as abuses, sexual audit, kleptomania, and autocheted.

Social conditions contributing to the development of edible disorders are related to the idealization of a slim androging figure with a lack of body weight in modern Western society. Most young women adhere to a restrictive diet - behavior that increases the risk of food disorders. Women compare their appearance with each other, as well as with the generally accepted ideal of beauty and strive to look at it. This pressure is especially expressed in adolescents and young women, since endocrine changes in Pubertate increase the content of adolescents in the body of a woman by 50%, and the psyche of adolescents at the same time overcomes such problems as the formation of a person, separation from parents and puberty. The incidence of nutritional behavior in young women over the past few decades has increased in parallel with strengthening the attention of the mass media as a symbol of the success of a woman.

Other risk factors for the development of violations of edible behavior are family conflict, loss of a significant person, such as a parent, physical illness, sexual conflict and injury. Triggers may also be marriage and pregnancy. Some professions require keeping harmony - ballerin and models.

It is important to distinguish primary risk factors that launch the pathological process from those that support already existing behavior disorder. Eating disorders periodically cease to depend on the etiological factor running them. Supporting factors include the development of pathological food habits and arbitrary starvation. Patients with anorexia begin to maintain a diet. They are often inspired by their initial weight loss, receiving compliments of their appearance and self-discipline. Over time, the thoughts and behavior associated with nutrition becomes dominant and subjective goal, the only removal of anxiety. Patients resort more and more intensively immersed in these thoughts and manner of behavior to maintain their mood, as alcoholics increase the dose of alcohol to remove stress and translate other ways to discharge alcohol.

Diagnosis of food disorders is often underestimated. Patients hide symptoms associated with a sense of shame, internal conflict, fear of condemnation. Physiological signs of edible behavior disorders can be seen when inspection. In addition to the reduced body weight, fasting can lead to bradycardia, hypotension, chronic constipation, slow down gastric emptying, osteoporosis, disorders of the menstrual cycle. Cleaning procedures lead to violations of the electrolyte balance, dental problems, hypertrophy of the near-dry salivary glands and dyspeptic disorders. Hyponatremia can lead to the development of a heart attack. With such complaints, the clinician must hold a standard survey, which includes the clarification of the minimum and maximum weight of the patient during the adulthood, brief history of food habits, such as calorie counting and grams of fat in the diet. Further survey can identify the presence of increments of gluttony, the frequency of residence in compensatory weight recovery measures. It is also necessary to find out if the patient, her friends and family members believe that it suffers from the disorder of food behavior, and whether it bothers it.

In patients with anorexia, resorting to cleansing procedures, high risk of severe complications. Anorexia has the highest mortality rate among all mental illness - more than 20% of anorecticists die after 33 years. Death usually comes due to the physiological complications of starvation or due to suicide. With nervous bulimia, death is often a consequence of arrhythmia caused by hypokalemia, or suicide.

Psychological signs of edible behavior disorders are regarded as secondary to the main mental diagnosis or coming. The symptoms of depression and obsessive neurosis may be associated with starvation: reduced mood, constant thoughts on food, decrease in attention concentration, ritual behavior, decrease in libido, social isolation. With nervous bulimia, the feeling of shame and the desire to hide the attacks of gluttony and cleansing procedures leads to an increase in social isolation, self-critical thoughts and demoralization.

Most patients with nutritional disorders have increased risk and other mental violations, most often there are large depression, anxiety disorders, abuse, personality disorders. Related large depression or distortium was observed in 50-75% of patients with anorexia and 24-88% of patients with Bulimia. The obsessive neuroses in the course of life met in 26% of anorecticors.

For patients with violations of food behavior, social isolation, difficulties of communication, problems in intimate life and professional activity are characteristic.

The treatment of eating disorders occurs in several stages, begins with an assessment of the severity of pathology, identifying concomitant mental diagnoses and establishing motivation for change. Consultation of a nutritionist and psychotherapist, specializing in the treatment of patients with eating disorders. It is necessary to understand that, first of all, it is necessary to stop pathological behavior, and only after it is taken under control, it will be possible to prescribe treatment aimed at internal processes. Parallel can be carried out with the primacy of abstinence in the treatment of abuses when therapy, carried out simultaneously with the continuing intake of alcohol, does not bring results.

Treatment from a general psychiatrist is less desirable from the point of view of maintaining treatment motivation, more efficient treatment in special stationary agencies such as sanatoriums - the mortality rate in patients of such institutions are lower. Group therapy and hard monitoring of food and the use of the restroom, carried out by the medical staff of these institutions, minimizes the probability of breakdown.

In patients with disorders of food behavior, several classes of psychopharmacological agents are used. Double-blind placebo-controlled studies have proven the effectiveness of a wide range of antidepressants in reducing the frequency of accurates of gluttony and subsequent cleansing procedures with nervous bulimia. Imipramine, desipramine, trazodone and fluoofsetine reduce the frequency of such attacks, regardless of the presence or absence of a concomitant depression. When using fluoofsetine, a more efficient dose is greater than is commonly used in the treatment of depression - 60 mg. Monoaminoxidase inhibitors (MAO) and buproprion are relatively contraindicated, since when using inhibitors of MAO, dietary constraints must be observed, and on the background of buproprion, the risk of developing a heart attack increases during bulimia. In general, the treatment of bulimia should include an attempt to use tricyclic antidepressants or selective inhibitors of serotonin inverse seizure (SIRES) together with psychotherapy.

With a nervous anorexia, no drug tool aimed at improving body weight has not proved its effectiveness in controlled studies. Except for the cases of having a severe depression or obvious signs of neurosis of obsessive states, most clinicians recommend to control the mental status of patients during remission than to prescribe drugs while the weight has not yet gained. Most of the symptoms of depression, ritual behavior, obsessions pass when the weight approaches normal. When a decision on the appointment of antidepressants is made, low doses of SSRS are the safest choice, given the high potential risk of cardiac arrhythmias and hypotension against the background of receiving tricyclic antidepressants, as well as the overall risk of developing side effects of drugs in people with insufficient body weight. A recent double-blind placebo-controlled study of the effectiveness of fluoofsetine with nervous anorexia showed that this drug can be useful to prevent weight loss after reaching its norm.

Research on the study of levels of neurotransmitters and neuropeptides in patients and recovered patients with disorders of food behavior was carried out slightly, but their results show the dysfunction of serotonin, noradreen and opiate SNS systems. Studies of food behavior on animal models give the same results.

The effectiveness of serotonergic and non-porterergic antidepressants at Bulimia also confirms the physiology of this disorder.

These studies in people are contradictory, and it remains unclear whether violations of neurotransmitter levels are connected in patients with food behavior disorders with this state, whether they appear in response to starvation and attacks of increments and purification or precede mental violation and are the features of the personality of susceptible to this Patient disorder.

Studies of the treatment of nervous anorexia show that among hospitalized patients, after 4 years of control observation, 44% have a good result with an imposition of normal body weight and menstrual cycle; In 28% the result was temporary, 24% did not have 4% died. Adverse prognostic factors are an embodiment of anorexia with attacks of gluttony and purification, low minimum weight and inefficiency of therapy in the past. More than 40% of the anorecticists develop a bulimic type of behavior over time.

Long-term forecast for Bulimia is unknown. Episodic recurrences are most likely. A decrease in the severity of boulim symptoms is observed in 70% of patients with a short period of observation after treatment with drugs in combination with psychotherapy. As with anorexia, the severity of symptoms at Bulimia affects the forecast. Among patients with severe bulimia, 33% in three years there was no result.

Violations of food behavior are a comprehensive mental disorder, which most often occurring in women. The frequency of occurrence of them in Western society is growing, they are combined with high soreness. The use of psychotherapeutic, training and pharmacological techniques in treatment makes it possible to improve the forecast. Although at the first stage may not need specific assistance, the ineffectiveness of treatment requires early appeal to the psychiatrist. Further research is needed to clarify the reasons for predominance among women's patients, to evaluate real risk factors and to develop effective treatment.
Affective disorders

Affective disorders are mental illness, the main symptom of which are changes in mood. Everyone in life occur changes in mood, but their extreme expressions are affective disorders - there are few. Depression and mania are two main disorders observed in affective disorders. These diseases include large depression, manic-depressive psychosis, Distimia, violation of adaptation with depressive mood. Features of hormonal status can serve as the risk factors for the development of affective disorders during the life of a woman, exacerbations are associated with menstruation and pregnancy.
Depression

Depression is one of the most common mental disorders, which is more common in women. Most studies assesses the frequency of occurrence of depression in women are twice as high as men. This pattern can be partially explained by the fact that women are better remembered with them in the past the attacks of depression. The diagnosis of this state is complicated by a wide spectrum of symptoms and the absence of specific features or laboratory tests.

Diagnosis is quite difficult to distinguish between short-term periods of sad mood associated with life circumstances, and depression as a mental disorder. The key to the differential diagnosis is the recognition of typical symptoms and monitoring their speakers. A person without mental abnormalities usually do not have any disturbances of self-esteem, suicidal thoughts, feelings of hopelessness, neareegetative symptoms, such as sleep disorders, appetite, lack of vital energy for weeks and months.

The diagnosis of large depression is based on the collection of history and the examination of the mental status. The main symptoms include low mood and an adonia - the loss of desire and the ability to enjoy the usual life manifestations. In addition to depression and angedonia, lasting for at least two weeks, the episodes of large depression are characterized by the presence of at least four of the following neareegetative symptoms: a significant loss or weight gain, insomnia or increased drowsiness, psychomotor inhibition or revival, fatigue and loss of forces, reduced concentration ability attention and decision making. In addition, many people suffer from high self-criticism with feelings of hopelessness, excessive guilt, suicidal thoughts, feeling like burden for their loved ones and friends.

The duration of symptoms of more than two weeks helps to distinguish the episode of a large depression from a short-term adaptation violation with reduced mood. Violation of adaptation is a reactive depression at which depressive symptoms are a reaction to a clear stress factor, limited in quantities and can be minimal therapy. This does not mean that the episode of a large depression cannot be provoked by a stress event or cannot succumb to treatment. From violation of adaptation, the episode of a large depression is characterized by the severity and the duration of symptoms.

In some groups, in particular, the elderly often does not notice the classic symptoms of depression, such as a decrease in mood, which leads to underestimation of the depression frequency in such groups. There is also information that in some ethnic groups, depression is more expressed by somatic signs than classical symptoms. Elderly women have complaints about the feeling of social closerness and a set of characteristic somatic complaints need to be taken seriously, as they may require drug antidepressive care. Although some laboratory tests were proposed for diagnostics, such as dexamethasone sample, they are not specific. The diagnosis of large depression remains clinical and is raised after a thorough study of the history and assessment of mental status.

As a child, the metabolism of depression in boys and girls is the same. Differences become noticeable in Pubertat. Angola and Worthman consider the reason for these differences in hormonal and conclude that hormonal changes may be a trigger mechanism for a depressive episode. Starting with Menarche, women increase the risk of developing premenstrual dysphoria. This mood violation is characterized by symptoms of large depression, including the anxiety and mood lability, advancing the last week of the menstrual cycle and terminated in the first days of the folliculin phase. Although premenstrual emotional lability occurs in 20-30% of women, its heavy forms are quite less common - in 3-5% of the female population. A recent multicenter randomized placebo-controlled study of the use of sertraline in a dose of 5-150 mg has demonstrated a significant improvement in the symptoms against the background of treatment. 62% of women in the main group and 34% in the Placebo group responded to treatment. Fluoksetin at a dose of 20-60 mg per day also reduces the severity of premenstrual disorders by more than 50% of women - according to a multicenter placebo-controlled study. In women with a large depression, as well as with manic-depressive psychosis, mental disorders are exacerbated in the premenstrual period - it is unclear whether it is an exacerbation of one state or the imposition of two (basic mental disorder and preposition).

Pregnant women have a whole spectrum of affective symptoms as during pregnancy and after childbirth. The frequency of occurrence of a large depression (about 10%) is the same as that of non-remote women. In addition, pregnant women can have less severe symptoms of depression, mania, psychosis periods with hallucinations. The use of medicines during pregnancy is used both during the exacerbation of the mental state and for the prevention of relapses. Interruption of medication reception during pregnancy in women with previously important mental disorders leads to a sharp increase in the risk of exacerbations. To make a decision on drug treatment, it is necessary to compare the risk of potential damage to the fetal drugs with both the fetus and the mother recurrence.

In a recent review, AltShuler et al, existing therapeutic recommendations for the treatment of various mental disorders during pregnancy. In general, if possible, it is necessary to avoid receiving medicines during the first trimester due to the risk of teratogenic effect. However, with the pronounced severity of symptoms, treatment with antidepressants or mood stabilizers may be necessary. Initial studies of the use of fluoxetin have shown that SSRS is relatively safe, but there is still no reliable data on the intrauterine influence of these new drugs. The use of tricyclic antidepressants does not lead to high risk of congenital anomalies. Electrosusproy therapy is another relatively safe method for treating severe depression during pregnancy. Reception of lithium preparations in the first trimester increases the risk of congenital pathologies of the cardiovascular system. The reception of antiepileptic preparations and benzodiazepines is also associated with an increase in the risk of congenital anomalies and it should be avoided. In each case, it is necessary to evaluate all the testimony and risks individually, depending on the severity of symptoms. To compare the risk of untreated mental illness and the risk of pharmacological complications for mother and the fetus, a psychiatrist is needed.

Many women have disorders of mood after childbirth. The severity of symptoms varies from "Baby Blues" to severe large depression or psychotic episodes. Most women have these mood changes in the first six months after childbirth, at the end of this period all signs of the dysphoria disappear independently. However, some women have depressive symptoms reserved for many months and years. In a study, which included 119 women after the first births, half of women who received drug treatment after childbirth occurred during the next three years. The early definition of symptoms and adequate treatment is necessary both for the mother and for the child, since depression can affect the ability of the mother to adequately care for the child. However, treatment with antidepressants of nursing mothers requires caution and comparative risk assessment.

Changes in mood during menopause have been known for a long time. Recent studies, however, did not confirm the presence of a clear connection between menopause and affective violations. The review dedicated to this problem, Schmidt and Rubinow found a very minor number of published research results that approve the availability of this relationship.

Changes in moods associated with hormonal changes in menopause can be held when taking UGT. In most women, the UGT is the first stage of treatment in front of psychotherapy and antidepressants. If the symptoms are severe, the initial treatment with antidepressants is shown.

Due to the long life expectancy of women compared to men, most women are experiencing their spouses, which is a stress factor in older age. At this age, monitoring is needed to identify the symptoms of severe depression. Collecting anamnesis and the study of mental status in older women should include screening of somatic symptoms and identifying the sensation of unnecessaries, their own burdens for loved ones, because for depression, the elderly is uncharacterically reduced mood as a primary complaint. The treatment of depression in the elderly is often complicated by low tolerance for antidepressants, so they must be prescribed in a minimum dose, which then can be gradually increased. SSIRS is undesirable at this age due to their anticholinergic side effects - sedation and orthostasis. When taking a patient of several drugs, medicinal monitoring is needed due to mutual influence on metabolism.

There is no single cause of depression. The main demographic risk factor is belonging to the female floor. An analysis of population data shows that the risk of developing a large depression is raised in divorced, single and lost work. The role of psychological reasons is actively studied, but so far the consensus is not achieved in this matter. Family studies have demonstrated an increased frequency of occurrence of affective disorders from the nearest relatives of the proband. Twin research also support the idea of \u200b\u200bgenetic predisposition in some patients. Especially strong, hereditary predisposition plays a role in the genesis of maniacal depressive psychosis and a large depression. The likely reason is the violation of the functioning of serotonergic and noradreengic systems.

An ordinary therapeutic approach to treatment is a combination of pharmacological agents - antidepressants - and psychotherapy. The emergence of a new generation of antidepressants with a minimum number of side effects increased therapeutic capabilities for patients with depression. 4 main types of antidepressants are used: tricyclic antidepressants, SIRES, MAO inhibitors and others - see Table. 28-2.

The key principle of using antidepressants is the adequate time of their reception - at least 6-8 weeks for each drug in the therapeutic dose. Unfortunately, many patients stop taking antidepressants to develop the effect, since they do not see improvements in the first week. When taking tricyclic antidepressants, medicinal monitoring can help confirm the achievement of a sufficient therapeutic level in the blood. For SSIOS, this method is less useful, their therapeutic level varies greatly. If the patient did not accept the full course of the antidepressant and configures to test the symptoms of a large depression, it is necessary to start a new course of treatment with another class.

In all patients receiving antidepressant treatment, it is necessary to monitor the development of symptoms of mania. Although this is a fairly rare complication of antidepressant admission, it still happens, especially in the presence of manic-depressive psychosis in a family or personal anamnesis. Symptoms of Mania include a reduction in the need for a dream, a feeling of increased energy, an assets. Before the assignment of therapy in patients, it is necessary to carefully assemble anamnesis in order to identify symptoms of mania or hypomania, and if they are presented or with family history of manic-depressive psychosis, a psychiatrist consultation will help choose the treatment with mood stabilizers - lithium drugs, valproic acid, possibly in combination with antidepressants.
Seasonal affective violations

In some people, the course of depression is seasonal, exacerbating in winter. The severity of clinical symptoms varies widely. With moderate severity of symptoms, it is sufficiently irradiated with a full-respected wasteless light (daylight lamps - 10 thousand suite) for 15-30 minutes every morning during the winter months. If the symptoms fit in the criteria of a large depression, to light therapy you need to add antidepressants treatment.
Bipolar disorders (manic-depressive psychosis)

The main difference of this disease from a large depression is the presence of both episodes of depression and mania. The criteria for depressive episodes are the same as a big depression. Episodes of Mania are characterized by attacks of a raised, irritable or aggressive mood, which are at least a week. These mood changes are accompanied by the following symptoms: increased self-esteem, reduced need in a dream, loud and fast speech, jumping thoughts, assessment, outbreaks of ideas. Such an increase in vital energy is usually accompanied by excessive behavior aimed at obtaining pleasure: a waste of large sums, drug addiction, audiscation and hypersexuality, risky business projects.

There are several types of manic-depressive disorder: the first type is a classic form, 2 type includes a change of depression episodes and hypologia. Episodes of hypologia proceed more mildly than classical mania, with the same symptoms, but not violating the patient's social life. Other forms of bipolar disorders include a quick mood change and mixed states when the patient simultaneously present signs and mania and depression.

The first line preparations for the treatment of all forms of bipolar disorders are mood stabilizers, such as lithium and hip preparations. The initial dose of lithium - 300 mg once or twice a day, is then refined to maintain a blood level of 0.8-1.0 MEKV / L for bipolar disorder of the first type. The level of bloodflows in the blood, effective for the treatment of these diseases, is not exactly established, it is possible to navigate the level recommended in the treatment of epilepsy: 50-150 μg / ml. In some patients, a combination of mood stabilizers with antidepressants for the treatment of depression symptoms is necessary. To control the symptoms of acute mania, a combination of mood stabilizers with low doses of neuroleptics is used.
Distimia

Distimia is a chronic depressive state, which is rated for at least two years, with symptoms less pronounced than with a large depression. The severity and number of symptoms are insufficient to achieve the criteria of a large depression, but they violate social functioning. Usually symptoms include disorders of appetite, reducing energy, disruption of the concentration of attention, sleep disorders, sense of hopelessness. Studies conducted in different countries affirm the high prevalence of Distimia in women. Although reports on the therapy of this disorder is a bit, there is evidence that SSRS, such as fluoxetine and sertraline, can be used. In some patients, on the background of Distimia, episodes of large depression may arise.
Coexisting affective and neurological disorders

There are many certificates of associations between neurological disorders and affective disorders, more often with depression than with bipolar. The episodes of great depression are often found at the Hantington Horreton, Parkinson and Alzheimer diseases. In 40% of patients with Parkinsonism, there are episodes of depression - half of the half - a large depression, half of the Distimia. In the study, which included 221 patients with multiple sclerosis, a 35% was diagnosed with large depression. Some studies demonstrate the relationship between a stroke in the field of the left frontal share and a large depression. In patients with AIDS, both depression and mania are developing.

Neurological patients with signs that satisfy the criteria for affective disorders should be prescribed drugs, since drug treatment of mental violations improves the forecast of the main neurological diagnosis. If the clinical picture does not satisfy the criteria for affective disorders, enough psychotherapy is enough to help the patient cope with difficulties. The combination of several diseases increases the number of prescribed drugs and sensitivity to them, and consequently the risk of delirium. In patients receiving a large amount of drugs, antidepressants must begin in a low dose and increase it gradually, monitoring possible symptoms of delirium.
Alcohol abuse

Alcohol is the most frequent substance that is abused in the United States, 6% of the adult female population has serious alcohol problems. Although the degree of alcohol abuse in women is lower than in men, alcohol addiction and alcohol caused by the incidence and mortality is significantly higher in women. Studies of alcoholism are focused on a male population, the eligibility of extrapolation of their data on a female population is doubtful. For diagnostics typically use questionnaires that reveal problems with law and employment - much less often found in women. Women are more likely to drink alone and less often fall into the attacks of rage in a state of intoxication. One of the main risk factors for the development of alcoholism in a woman is a partner of a patient with alcoholism, inclining it to drinking consumerism and not giving to seek help. In women, signs of alcoholism are manifested expressive than in men, but doctors are determined by women less often. All this makes it possible to consider the official frequency of occurrence of alcoholism in women understated.

Complications associated with alcoholism (liver dystrophy, cirrhosis, hypertension, gastrointestinal bleeding, anemia and digestive disorders), women develop faster and at lower doses of alcohol reception than in men, because women are lower than in men, levels Gastric alcohol-dehydrogenase. Alcohol dependence, as well as from other substances - opiates, cocaine - women develops in a smaller reception time than in men.

There is evidence that the incidence of alcoholism and associated medical problems increases in women born after 1950. During the phases of the menstrual cycle of changes in the metabolism of alcohol in the body, it is not observed, but the irregularity of the menstrual cycle and infertility occur more often in the drinkers. During pregnancy, such a complication as an alcohol fetal syndrome. The rate of development of the cirrhosis increases sharply after menopause, in addition, alcoholism increases the risk of alcoholism in older women.

In women suffering from alcoholism, increased the risk of accompanying psychiatric diagnoses, especially narcotic dependencies, mood disorders, nervous bulimia, anxiety and psychosexual disorders. Depression is found in 19% of women alcohols and in 7% of women who do not abuse alcohol. Although alcohol brings temporary relaxation, it exacerbates the course of mental disorders in susceptible people. To achieve remission, several weeks of abstinence are required. Women with a family history of alcoholism on the father's line, anxious disorder and premenstrual syndrome are more drinking in the second phase of the cycle, perhaps in an attempt to reduce the symptoms of anxiety and depression. Women's alcohols are highly risk of suicidal attempts.

Women are usually looking for salvation from alcoholism by the neighbral paths, referring to psychoanalysts or general practitioners with complaints about family problems, physical or emotional complaints. They rarely apply to the centers for the treatment of alcoholism. Alcoholic patients need a special approach due to their frequent inadequacy and a reduced sense of shame.

Although the direct question of such patients on the number of accepted alcohol is practically impossible, the screening of alcohol abuse should not be limited to indirect signs, such as anemia, increasing the level of hepatic enzymes and triglycerides. The question "whether you ever have problems with alcohol" and the Cage questionnaire (Table 28-3) provides a quick screening with a sensitivity of more than 80% at more than two positive responses. Support, explanation and discussion with a doctor, psychologist and members of anonymous alcoholics societies helps the patient to adhere to treatment. In the period of the abstinence, it is possible to appoint diazepam in the starting dose of 10-20 mg with a gradual increase of 5 mg every 3 days. The control visits should be at least twice a week, they are estimated by the severity of signs of abstineent syndrome (sweating, tachycardia, hypertension, tremor) and the dose of the drug is corrected.

Although the abuse of alcohol in women is less common than in men, its harm for women, taking into account the associated morbidity and mortality, is significantly higher. New research is needed to clarify the pathophysiology and psychopathology of the sex features of the disease.
Table 28-3.
Cage Questionnaire

1. Have you ever experienced that you need to drink less?

2. Did it happen that people bother you with their criticism to admit alcohol?

3. Did you ever feel guilty of taking alcohol?

4. It happened that alcohol was the only means that helps in the morning to become bodic (reveal the eyes)
Sexual disorders

Sexual dysfunctions have three consecutive stages: disorders of desire, excitation and orgasm. In DSM-IV, pain sexual disorders are considered as the fourth category of sexual dysfunction. Desire disorders are further divided into reduced sexual desire and perversions. Pain sex disorders include vaginism and dispensing. Clinically women often have a combination of several sexual dysfunctions.

The role of sex hormones and disorders of the menstrual cycle in the regulation of sexual desire remains unexplained. Most researchers suggest that endogenous oscillations of estrogen and progesterone do not have a significant impact on sexual desire in women of reproductive age. However, there are clear data on the decline in desire in women with surgical menopause, which can be restored by the introduction of estradiol or testosterone. Studies of the interconnection of excitation and orgasm with cyclic vibrations of hormones do not give unambiguous conclusions. A clear correlation is seen between the plasma level of oxytocin and the psycho-physiological value of the orgasm.

Women in postmenopausus increases the number of sexual problems: a decrease in vaginal lubrication, atrophic vaginitis, a decrease in blood supply, which are effectively solved using estrogen replacement therapy. Adding testosterone helps to increase sexual desire, although there are no clear data on the supporting effect of androgens on the influx of blood.

Psychological factors, communication problems play a much more important role in the development of sexual disorders in women than organic dysfunction.

Special attention deserves the influence of medicines taken by psychiatric patients, on all phases of the sexual function. Antidepressants and antipsychotic drugs are two main class of drugs associated with similar side effects. Anorgazmia is observed when using the sizes. Despite the clinical reports on the effectiveness of adding cyprogeptadine or the interruption of the maintenance of the main drug on the weekend, a more acceptable output is still a change in the class of antidepressant to another, with a smaller severity of side effects in this area, most often on buproprion and nefazodon. In addition to the side effects of psychopharmacological agents, the chronic mental disorder in itself can lead to a decrease in sexual interest, as well as physical diseases, accompanied by chronic pain, reduced self-esteem, changes in appearance, fatigue. The presence of depression in history may be the cause of reduced sexual desire. In such cases, sexual dysfunction occurs during the manifesting of affective disorder, but does not pass after the end of its episode.
Alarm disorders

Anxiety is a normal adaptive emotion, developing in response to a threat. It works as a signal to activate behavior and minimize physical and psychological vanity. Reducing anxiety is achieved either overcoming or avoiding provoking situation. Pathological alarming states differ from normal anxiety degree of severity and chronizing disorders provoking incentives or adaptive behavioral response.

Anxiety disorders are widespread, the occurrence among women per month is 10%. The average age of the development of anxiety disorders is a teenage period and youth. Many patients never seek help on this occasion or turn to unexigrators with complaints about somatic symptoms associated with anxiety. Excessive reception of drugs or their abolition, the use of caffeine, addresses for weight loss, pseudoephedrine can exacerbate alarming disorder. Medical examination should include careful collection of anamnesis, routine laboratory tests, ECG, toxicological analysis of urine. Some types of neurological pathology are accompanied by alarming disorders: motor disorders, brain tumors, brain blood supply disorders, migraine, epilepsy. Somatic diseases accompanied by disturbing disorders: cardiovascular, thyrotoxicosis, systemic red lupus.

The alarming disorders are divided into 5 main groups: phobias, panic disorders, generalized anxiety disorder, obsessive state syndrome, post-traumatic stress syndrome. With the exception of obsessive state syndrome, which meets the same often in men and women, disturbing disorders are more common in women. In women, there are three times more often specific phobias and agoraphobia, 1.5 times more often - panic with agoraphobia, 2 times more often - generalized anxiety disorder and 2 times more often - post-traumatic stress syndrome. The reasons for the predominance of disturbing violations in the women's population are unknown, hormonal and sociological theory are proposed.

Sociological theory focuses on traditional polyassal stereotypes that prescribe a woman helplessness, addiction, avoiding active behavior. Young mothers are often worried if they will be able to secure their children, reluctance of pregnancy, infertility - all these states can exacerbate disturbing disorders. A large number of expectations and conflicts of the roles of Mother's Women, Wife, Housewives and Successful female workers also increase the frequency of disturbing disorders in women.

Hormonal oscillations exacerbate the alarming states in the premenstrual period during pregnancy and after delivery. Progesterone metabolites function as partial agonists of GABA and possible modulators of the serotonergic system. The binding of alpha-2 receptors also changes through the menstrual cycle.

For disturbing disorders, a combination with other psychiatric diagnoses is most often affective disorders, drug addiction, other disturbing disorders and identity disorders. With panic disorders, for example, a combination of depression occurs more often than 50%, and with alcohol dependence - at 20-40%. Social phobia is combined with panic disorder by more than 50%.

The general principle of treatment of anxiety disorders is the combination of pharmacotherapy with psychotherapy - the effectiveness of this combination is higher than the use of these methods is isolated from each other. Drug treatment affects three main neurotransmitter systems: noradreengic, serotonergic and gamke-eergic. The following classes of drugs are effective: antidepressants, benzodiazepines, beta-blockers.

All drugs must begin at low doses, and then gradually increase them twice every 2-3 days or less often to minimize side effects. Patients with alarming disorders are very sensitive to side effects, so the gradual increase in the dose increases the compliance of therapy. Patients need to be explained that the action of most antidepressants is developing in 8-12 weeks, to tell about the main side effects, help continue the drug the required amount of time and explain that some of the side effects pass over time. The choice of antidepressant depends on the patient's complaints and from its side effects. For example, patients with insomnia are better to start with more sedative antidepressants, such as imipramine. In case of effectiveness, treatment must be continued within 6 months.

At the beginning of treatment, before the development of the effect of antidepressants, it is useful to add benzodiazepines, allowing you to sharply weaken the symptoms. Long-term intake of benzodiazepines should be avoided due to the risk of developing dependence, tolerance and cancellation syndrome. When prescribing benzodiazepines, it is necessary to prevent the patient about their side effects, the risk associated with their long-term use and the need to consider them only as a temporary measure. The reception of the clonazepam in a dose of 0.5 mg twice a day or a lorazepam in a dose of 0.5 mg four times a day for a limited period of 4-6 weeks can improve the initial compliance with antidepressants treatment. When taking benzodiazepines, longer than 6 weeks stops must occur gradually to reduce the anxiety associated with the abnormal abolition syndrome.

In pregnant women with caution, anxiolytics should be used, the safest drugs in this case are tricyclic antidepressants. Benzodiazepines can lead to the development of hypotension, respiratory distress syndrome and low assessment on the apgar's scale in newborns. The minimum potential teratogenic effect is marked with clonazepama, this drug can be used in pregnant women with severe disturbing disorders. The first step should be an attempt to neurmacological treatment - cognitive (training) and psychotherapy.
Phobic disorders

There are three types of phobic disorders: specific phobias, social phobia and agoraphobia. In all cases, an alarm occurs in the provoking situation and the development of panic attack is possible.

Specific phobias are irrational fears of specific situations or objects forcing them to avoid. Examples can serve as fear of height, fear of flights, fear of spiders. They usually arise at the age of younger than 25 years, women earlier develop fear of animals. Such women are rarely treated for treatment, since many phobias do not interfere with normal life, and their incentives (for example, snakes) avoid fairly easy. However, in some cases, for example, with flight fees, phobias can interfere with the career, in this case the treatment is shown. With simple phobias, it is fairly easy to cope with psychotherapeutic techniques and system desensitization. Additionally, a single dose of 0.5 or 1 mg of Lorazepam in front of the flight helps to reduce this specific fear.

Social phobia (fear of society) is the fear of a situation in which a person is available to the close attention of other people. Avoiding provoking situations with this phobia dramatically limits the working conditions and social function. Although social phobiasis is more common in women, it is easier for them to avoid provoking the situation and do homework, so men with a social phobia are more common in the clinical practice of psychiatrists and psychotherapists. With social phobias can be combined with violations of motor activity and epilepsy. In the study of patients with Parkinson's disease, the presence of social phobias revealed 17%. Pharmacological treatment of social phobia is based on the use of beta blockers: propranolol in a dose of 20-40 mg per hour to anxious presentation or atenolol at a dose of 50-100 mg per day. These drugs block the activation of the autonomic nervous system due to anxiety. Antidepressants, including tricyclic, SSRS, MAO blockers, can also be used - in the same doses as in the treatment of depression. Preferably a combination of pharmacotherapy with psychotherapy: short-term use of benzodiazepines or low doses of clonazepam or a lorazepam in combination with cognitive therapy and systematic desensitization.

Agorafobia - fear and avoiding places of large cluster of the people. Frequently combined with panic attacks. Avoid in this case provoking situations is very difficult. As in the case of a social phobia, agoraphobia is more common in women, but men appeal for help more often, since its symptoms prevent their personal and social life. The treatment of agoraphobia is a systemic desessitization and cognitive psychotherapy. Due to the high combination with panic disorders and a large depression, antidepressants are also effective.
Panic disorders

Panic attack is a sudden attack of strong fear and discomfort, which lasts a few minutes, passing gradually and includes a minimum of 4 symptoms: discomfort in the chest, sweating, trembling, tide of the heat, intercepting breathing, paresthesia, weakness, dizziness, heartbeat, nausea, disorder Chair, fear of death, loss of control over yourself. Panic attacks can occur with any alarming disorder. They are unexpected and accompanied by a constant fear of waiting for new attacks, which changes behavior, directs it to minimize the risk of new attacks. Panic attacks are also with many states of intoxication and certain diseases such as emphysema. In the absence of therapy, the number of panic disorders acquires chronic character, but the treatment is effective, and a combination of pharmacotherapy with cognitive-behavioral psychotherapy causes a sharp improvement in most patients. Antidepressants, especially tricyclic, SIRES and Mao inhibitors, in doses are comparable to those that are used in the treatment of depression are a means of choice (Table 28-2). Imipramine or northriptyline starts in a low dose of 10-25 mg per day and increase by 25 mg every three days to minimize the severity of side effects and enhancing compliance. The level of northriptyline in the blood should be maintained between 50 and 150 ng / ml. Fluoksetin, fluouxamine, tralylsipromine or phenylsine can also be used.
Generalized anxiety disorder

DSM-IV determines the generalized alarmed disorder as a constant, severe, poorly controlled concern associated with daily activity, such as work, study, which prevents living and is not limited to the symptoms of other alarming disorders. There are at least three of the following symptoms: fatigue, poor concentration of attention, irritability, sleep disorders, anxiety, muscle tension.

Treatment includes medicines and psychotherapy. The preparation of the first line in the treatment of generalized anxiety disorder is Buchariron. The initial dose is 5 mg twice a day, gradually increase it in a few weeks to 10-15 mg twice a day. Alternative is imipramine or SSRS (sertraline) (see Table 28-2). The short-term appointment of benzodiazepines for continuous action, such as clonazepam, can help cope with the symptoms in the first 4-8 weeks, before the onset of the main treatment.

Psychotherapeutic techniques used in the treatment of generalized anxiety disorder include cognitive behavioral therapy supporting therapy and an internal-oriented approach, which is aimed at improving the patient's tolerance to alarm.
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The disease is manifested in a sharp change in the patient's behavior, the loss of an adequate attitude towards life and others, in the absence of the desire to perceive the existing reality. At the same time, mental disorders prevent awareness of the presence of these very problems, a person cannot eliminate them independently.

Due to the emotional component, hormonal explosions and stress exposure, women psychosis and other mental disorders are two times more often than in men (7 against 3%, respectively).

What are the reasons and who risks most of all?

The main reasons for the development of psychosis in female people are as follows:

• pregnancy and childbirth;
• climax;
• diseases of different organs and systems;
• infectious diseases;
• alcohol poisoning or drug abuse;
• prolonged chronic stress;
• mental diseases of different types;
• depressive states.

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

Who is in the risk group

The root cause of the appearance of psychosis often becomes the abuse of alcohol and subsequent intoxication of the body. In most cases, alcoholism is most exposed to men, so the female sex suffers from alcohol psychosis much less and transferred faster and easier.

But there is also a reason that is characterized only for women, which increases the risk of the disease. This pregnancy and the birth of a child. Physical factors for the appearance of psychosis in this case include toxicosis, avitaminosis, a decrease in the tone of all organism systems, various diseases or complications due to complex toaling and childbirth.

Psychological belongs - fear, experiences, increasing emotional sensitivity, unpreparedness to become a mother. At the same time, the postpartum mental violation occurs more often than during pregnancy.

Features of behavior

For a woman with mental disorders are characterized by such changes in behavior and livelihoods (what the symptoms are noticeable only from the side, the most sick and the uncommon, that it is ill):

• lack of stress resistance, which often leads to hysterics or scandals;
• the desire to burn out from communicating with colleagues, friends and even close;
• there is a thrust for something unrealistic, supernatural, interest in magical practices, shamanism, religion and similar directions;
• the emergence of various fears, phobias;
• reduced concentration, inhibited mental activity;
• decay of forces, apathy, unwillingness to show any activity;
• sharp mood change without visible reasons;
• violations of sleep mode, can manifest itself both in excessive drowsiness and in insomnia;
• lower or complete lack of desire to eat food.

Variations in mental state

Psychosites can be divided into two large groups:

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

Separately, postpartum psychosis can be distinguished, it appears in 1 - 3% of women in the first months after the birth of a child, unlike a more common postpartum depression, the psychotic deviation does not pass itself and requires treatment under qualified observation of specialists.

• decline in appetite and fast weight loss;
• constant anxiety, sharp mood swings;
• the desire for isolation, refusal to communicate;
• violation of self-esteem;
• thoughts about the commitment of suicide.

Symptoms are manifested individually, some may have during the day after delivery, others in one month.

A collection of psyche can accompany various states that provoke violations in the work of the entire body of a woman.

Violation of the power, activity and recreation, emotional tensions, adoption of medicines. These factors "beat" on the nervous, cardiovascular, respiratory, digestive and endocrine systems. The manifestation of concomitant diseases is individually.

Who to ask for help?

Self-medication in this case is contraindicated. Do not also address familiar doctors of various specialties, psychologists, folk healers. Treatment should only conduct a state or private doctor - psychotherapist having high qualifications!

A specialist will conduct a survey of the patient, will send for additional analyzes and according to their results, treatment and necessary drugs will prescribe.

Treatment can be held in a hospital with the participation of medical staff, or at home. In the treatment at home, a mandatory security measure will be a concern for the baby with the smallest intervention of the mother (in the case of the postpartum fault of the psyche). Nanny or relatives should take these care for themselves before the disappearance of all the symptoms of the disease in the patient.

Treatment usually consists of a complex, which includes:

• medicines, usually neuroleptics, antidepressants, mood stabilizers;
• psychotherapy - Regular sessions with a psychotherapist and a family psychologist;
• social adaptation.

The patient does not immediately realize immediately, take its condition to the end. Relatives and friends must be patient to help a woman return to a normal lifestyle.

The effects of the absence of therapy are extremely unfavorable. The patient loses its relationship with reality, its behavior becomes inadequate and dangerous not only for his own life and health, but also for others.

The person is inclined to suicide, it can become a victim or cause of violence.

How to prevent mental failure?

Preventive measures include:

• regular monitoring of his health;
• treatment of diseases that may cause violations of mental functions;
• strengthening immunity;
• physical activity;
• active social life;
• refusal of smoking, alcohol, narcotic substances;
• reducing stress and fatigue in everyday life;
• thorough, diverse preparation for pregnancy and childbirth;
• preparation for menopacteric changes in the body.

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

This section is created to take care of those who need a qualified specialist without disturbing the usual rhythm of their own life.

Symptoms of mental disorders

The article presents an overview of the symptoms and syndromes of mental disorders, including the features of their manifestations in children, adolescents, the elderly, men and women. Mentioned by some methods and means used in traditional and alternative medicine for the treatment of such diseases.

Causes of emotional diseases

Pathological changes in the psyche can lead:

• infectious diseases affecting the brain directly or as a result of secondary infection;
• the impact of chemicals - drugs, food components, alcohol, drugs, industrial poisons;
• lesions of the endocrine system;
• heart and brain injuries, oncology, structure anomalies and other brain pathology;
• humidated heredity, etc.

Syndromes and signs

Asthenic syndrome

The painful state, called as asthenia, neuropsychic weakness or chronic fatigue syndrome, is manifested by increased fatigue and extractability. Patients have a weakening or complete loss of ability to any long-term physical and mental tension.

The development of asthenic syndrome can lead:

• long-term physical, emotional or intellectual overvoltage;
• some diseases of the internal organs;
• intoxication;
• infections;
• nervous and mental illness;
• wrong organization of labor, recreation and nutrition.

Asthenic syndrome can be observed both at the initial stage of the development of the disease of the internal organs, and occur after the acute disease suffered.

Asthenium often accompanies a chronic disease, being one of its manifestations.

Chronic fatigue syndrome is more often manifested in people with an unbalanced or weak type of higher nervous activity.

The presence of asthenia is indicated by the following signs:

• irritable weakness;
• the predominance of reduced mood;
• sleep disorders;
• intolerance of bright light, noise and sharp odors;
• headaches;
• weather dependence.

Manifestations of neuropsychic weakness are determined by the main disease. For example, atherosclerosis, pronounced memory disorders are observed, with hypertension - painful sensations in the field of heart and headaches.

Oscape

The term "obsession" (obsessive state, obsession) is used to designate the set of symptoms associated with periodically emerging obsessive unwanted thoughts, ideas, ideas.

An individual, which is fixed on such thoughts, as a rule, causing negative emotions or stressful state, is difficult to get rid of them. This syndrome can manifest itself in the form of obsessive fears, thoughts and images, the desire to get rid of which often leads to the fulfillment of special "rituals" - copulsions.

Psychiatre highlighted several distinguishing features of obsessive states:

1. The obsessive thoughts are reproduced by consciousness arbitrarily (against the will of a person), while consciousness remains clear. The patient is trying to fight obsession.
2. The obsessions are alien thinking, the visible relationship of obsessive thoughts and the content of thinking is absent.
3. Outlusion is closely related to emotions, more often than a depressive nature, anxiety.
4. At the intellectual abilities of the obsession are not reflected.
5. The patient aware of the unnaturalness of obsessive thoughts, retains a critical attitude towards them.

Affective syndrome

Symotic syndromes call symptoms of mental disorders, closely related to mood disorders.

Two groups of affective syndromes are distinguished:

1. With the predominance of a manic (elevated) mood
2. With the predominance of depressive (reduced) mood.

In the clinical picture of affective syndromes, a leading role belongs to violations of the emotional sphere - from small mood oscillations to sufficiently pronounced disorders (affects).

In character, all affects are divided into the lunatic, which proceed with the predominance of excitation (delight, joy), and asthenic, flowing with the predominance of braking (longing, fear, sadness, despair).

Affective syndromes are observed in many diseases: with circular psychosis and schizophrenia, they are the only manifestations of the disease, with progressive paralysis, syphilis, brain tumors, vascular psychosis - its initial manifestations.

Affective syndromes are such disorders like depression, dysphoria, euphoria, mania.

Depression is quite common mental disorders that require special attention, because 50% of persons who perform suicidal attempts are there are signs of this mental disorder.

Characteristic features of depression:

• reduced mood;
• pessimistic attitude to reality, negative judgments;
• motor and volitional inhibition;
• depression of instinctive activities (loss of appetite or, on the contrary, a tendency to overeating, reducing sexual attraction);
• concentration of attention on painful experiences and difficulties in its concentration;
• reduced self-esteem.

Dysphoria, or mood disorders, which are characterized by angrily-dust, stress affect with irritability, reaching outbreaks of anger and aggressiveness, are characteristic of psychopaths of excitable type and alcoholics.

Dysphoria is often found in epilepsy and organic CNS diseases.

Euphoria, or a raised mood with a shade of carelessness, content, not accompanied by accelerating associative processes, is found in the atherosclerosis clinic, progressive paralysis, brain injury.

Mania

Psychopathological syndrome, which is characterized by triad symptoms:

• unmotivated high mood,
• acceleration of thinking and speech,
• motor excitation.

There are signs that are not manifested in all cases of manic syndrome:

• strengthening instinctive activities (increase in appetite, sexual attraction, self-defense trends),
• the instability of attention and reassessment of themselves as a person who sometimes achieves the delusional ideas of greatness.

Such a condition may occur during schizophrenia, intoxication, infections, injuries, brain lesions and other diseases.

Senentopathy

The term "senthenetopathy" is determined by a suddenly appearing painful, extremely unpleasant bodily sensation.

This deprived objectiveness occurs in localization site, although there is no objective pathological process in it.

Sentenestopathy are frequent symptoms of mental disorders, as well as structural components of depressive syndrome, hypochondriac, mental automatism syndrome.

Hypochondriac syndrome

Heproyondria (hypochondriatic disorder) is a condition characterized by constant concern due to the possibility of getting sick, complaints, concern for their self-meaning, the perception of ordinary sensations as abnormal, assumptions about the presence, except for the main disease, any additional.

Most often concerns arise about the heart, gastrointestinal tract, genital organs and brain. Pathological reversal of attention can lead to one or another failures in the work of the body.

Some features of the hypochondria are inherent in the development of hypochondria: imperidity, anxiety, depressiveness.

Illusion

Illusions - distorted perceptions in which a real object or phenomenon is not recognized, and another image is perceived instead.

The following varieties of illusions distinguish:

1. Physical, incl. Optical, acoustic
2. Physiological;
3. Affective;
4. Verbal and others.

Metamorphycia (organic), physical and physiological illusions can occur in people whose mental health is no doubt. The patient with optical illusions can perceive the raincoat hanging on the hanger as the killer, stains on the bed underwear to him, the belt on the back of the chair - snake.

In the acoustic illusions, the patient in an overheardous conversation distinguishes the threats to its address, the replicas of passers-by perceives as the accusations and insults addressed to it.

Most often illusions are observed in infectious and intoxication diseases, but may occur with other painful states.

The emergence of illusions predispose fear, fatigue, anxiety, exhaustion, as well as distortion of perception due to poor lighting, noise, reduction of hearing and visual acuity.

Hallucination

The image, without an irritant arising in consciousness, is called hallucination. In other words, this is a mistake, the error of the perception of the senses, when a person sees, hears, feels what does not really exist.

The conditions under which hallucinations arise:

• strong fatigue
• consumption of some psychotropic substances,
• the presence of mental (schizophrenia) and neurological diseases.

The true, functional and other varieties of hallucinations are distinguished. True hallucinations are customary to classify by analyzers: visual, acoustic, tactile, taste, olfactory, somatic, motor, vestibular, complex.

Dead disorders

A nonsense disorder is called a condition for which the presence of nonsense - thinking disorder, accompanied by the emergence of distances from the reality of reasoning, ideas and conclusions.

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There are three groups of delusional states combined by a common content:

1. Brad prosecution. This group includes beliefs that the patient is pursued, want to poison (nonsense of poisoning), his property spoils and plunder (nonsense damage), the sexual partner changes (Brad of Jealousy), everything around is adjusted, experiment (nonsense broke) is held.
2. Brad greatness in all varieties (Brad of wealth, invention, reformity, origin, love). Sometimes a patient with a mental disorder in the form of religious nonsense can call himself a prophet.
3. Depressive nonsense. The main content of delusional states is self-evidence, self-evidence and sinfulness. This group includes hypochondriac and nihilistic nonsense, coat syndrome.

Catatonic syndromes

Catomiconic syndrome refers to the group of psychopathological syndromes, the main clinical manifestation of which motor disorders are.

The structure of this syndrome is:

1. Cattonic excitation (pathetic, impulsive, silent).
2. Catomonic stupor (cataleptic, negativistic, stupor with a stupor).

Depending on the form of excitation, a moderate or pronounced motor and speech activity may be observed in a patient.

The extreme degree of excitement is chaotic, senseless actions of an aggressive nature, making themselves and surrounding heavy damage.

For the state of the catatonic stupor, the motor inhibition, silence. The patient can be in a casual state for a long time - up to several months.

Diseases in which manifestations of catatonic syndromes are possible: schizophrenia, infectious, organic and other psychosis.

Measurement of consciousness

Twilight disorder (permanent) of consciousness is one of the types of violations of consciousness, which arises suddenly and manifests itself the inability of the patient to navigate in the surrounding world.

It remains unchanged ability to fulfill the usual action, there are speech and motor arousal, affects of fear, malice and longing.

There may be acute nonsense prosecution and predominantly visual hallucinations of a frightening nature. The delusional ideas of persecution and greatness become defining factors for the behavior of a patient who can make devastating, aggressive actions.

For the twilight permanent of consciousness, amnesia is characterized - the complete forgetting the breakdown period. The specified state is observed in epilepsy and organic lesions of the brain hemispheres. Less often occurs during crank-brain injuries and hysteria.

Dementia

The term "dementia" is used to indicate an irreversible discrepancy of mental activities with loss or decreased by the emergence of this state of knowledge, skills and inability to acquire new ones. Demissions arises as a result of transferred diseases.

According to the degree of severity distinguish:

1. Complete (total), resulting in progressive paralysis, peak disease.
2. Partial dementia (with vascular diseases of the central nervous disease, consequences of cranial injury, chronic alcoholism).

With full dementia, there are deep disorders of criticism, memory, judgments, unproductiveness of thinking, the disappearance of the individual character traits previously inherent in the patient, as well as a careless mood.

With partial dementia, a moderate decrease in criticism, memory, judgments is noted. Reduced mood with irritability, tearful, fatigue.

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Symptoms of mental disorder

Among women. Increased risk of mental disorders in the premenstrual period, during and after pregnancy, during the middle-aged and aging. Disorders of food behavior, affective disorders, including postpartum, depressed.

In men. Mental disorders arise more often than women. Traumatic and alcoholic psychosis.

In children. One of the most common disorders - attention deficit syndrome. Symptoms - problems with a long-term concentration of attention, hyperactivity, weakened control over impulses.

In adolescents. Often there are disorders of food behavior. School phobias, hyperactivity syndrome, alarming disorders are observed.

In the elderly. Mental diseases are detected more often than young people and middle-aged people. Symptoms of dementia, depression, psycho-neurotic disorders.

Video: Panic Attacks

Treatment and prevention

In the treatment of asthenic syndrome, the main efforts to eliminate the cause of the disease. A concrete therapy is carried out, including the reception of vitamins and glucose, the correct organization of work and recreation, sleep restoration, full nutrition, dosage physical exertion, prescribed medicines: nootropics, antidepressants, sedatives, anabolic steroids.

The treatment of obsessive states is carried out by eliminating the causes of traumatic patient, as well as using the impact on the pathophysiological links in the brain.

Therapy of affective states begins with the establishment of the supervision and direction of the patient to the specialist. Depressive patients capable of committing a suicidal attempt are subject to hospitalization.

When prescribing medication therapy, the characteristics of the patient's condition are taken into account. For example, when depressed, which is the phase of circular psychosis, psychotropic drugs are used, and in the presence of anxiety, combined antidepressants and neuroleptic treatment are prescribed.

Acute mental disorder in the form of a manic state is an indication for hospitalization necessary to protect others from inadequate actions of a sick person. Neuroleptics are used to treat such patients.

Since nonsense is a symptom of brain damage, pharmacotherapy and biological methods of influence are used for its treatment.

For the treatment of hypochondria, it is recommended to use psychotherapeutic techniques. In cases where psychotherapy turns out to be unsolved, activities are held to reduce the importance of hypochondriacal concerns. For most cases, hypocritical therapy is excluded.

Folk remedies

The list of funds used by folk healers for the treatment of depression includes:

• flower pollen,
• bananas
• carrot,
• the tincture of ginseng roots and Aralia Manychu
• infusions of Dyagil and a bird's mountaineer,
• brigade of pepper mint sheet,
• baths with infusion of poplar leaves.

The arsenal of the funds of traditional medicine has many advice and recipes that help get rid of sleep disturbances and a number of other symptoms of mental disorders.

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How to determine the signs of mental disorder in time?

The weak floor is more prone to a gland associated with the psyche. Emotional involvement in social life and natural sensitivity increase the risk of developing diseases. They need to be diagnosed in time to start proper treatment and return life into the usual direction.

Mental diseases in different age periods of women

For each age period (girl, girl, woman), a group of the most likely mental illness is determined. At these critical development stages, situations occur, which most often provoke the development of disorder.

Girls are less susceptible to mental illness, as opposed to boys, however, they are not insured against school phobias, attention deficit. They have increased the risk of the emergence of anxiety disorders and disorders associated with learningability.

Young girls in 2% of cases may be victims of premenstrual dysphoria after the first case of bleeding in the menstrual period. After puberty, the girls are 2 times more exposed to the development of depression than the young men.

Women who fall into a group of patients with mental disorders, during pregnancy planning do not pass by drug treatment. By this they provoke the emergence of relapses. After giving birth, the likelihood of signs of depression, which, however, can escape without medication treatment.

A small percentage of women still develop psychotic disorders, the treatment of which is complicated by a limited amount of allowed drugs. For each individual situation, the degree of benefit and risk from medication treatment during breastfeeding is determined.

Women from 35 to 45 years in the risk area of \u200b\u200bdisturbing disorders, they are subject to changes in mood, and are not insured against the appearance of schizophrenia. Reducing the sexual function can happen due to antidepressants.

Menopause changes the usual course of life of a woman, her social role and relationship with loved ones. From care of their children, they switch to the presence of their parents. This period is associated with depressive moods and disorders, but officially the connection of the phenomena has not been proven.

In the elderly, women are susceptible to the appearance of dementia and complications of somatic pathologies mental disorders. This is due to the duration of their lives, the risk of developing dementia (acquired dementia) is growing proportion to the number of years lived. Older women who take many medicines and suffering from somatic diseases, more than others are inclined to obey.

Those who for 60 should pay attention to the symptoms of paraffrenation (severe shape of delusional syndrome), they are in the zone of the greatest risk. Emotional involvement in the life of surrounding and loved ones in the midwives, when many are completing their life path, can cause mental disorders.

The division of the existence of a woman for periods allows doctors from the variety of diseases with similar symptoms to allocate the only correct one.

Signs of mental disorders in girls

In childhood, the development of the nervous system occurs continuously, but unevenly. However, the peak of mental development is 70% for this period, the personality of the future adult is formed. It is important in time to diagnose the symptoms of certain diseases from a specialist.

• Reduced appetite. It occurs with sudden changes in the power mode and when coercive meals.
• Increased activity. Differs with sudden forms of motor arousal (bouncing, monotonous run, croutons)
• Hostility. It is expressed in the child's confidence in a negative setting towards it surrounding and loved ones, not confirmed by facts. It seems such a child that everyone is laughing at him and despise him. On the other hand, he himself will show unfavorable hatred and aggression, or even fear towards his relatives. It becomes rude in everyday communication with relatives.
• Painful perception of physical disadvantage (dysmortophobia). The child chooses a slight or apparent flaw in appearance and trying to disguise him with all their might, even turning to adults asking for a plastic surgery.
• Game activity. It comes down to monotonous and primitive manipulation of objects not intended for the game (cups, shoes, bottles), the nature of such a game does not change over time.
• Painful looping on health. Excessive attention to its physical condition, complaints of fictional diseases.
• Repeating word movements. They are involuntary or intrusive, for example, the desire to touch the subject, roll up, tang.
• Violation of mood. The state of longing and meaninglessness of what is happening does not leave the child. It becomes fuse and irritable, the mood does not improve for a long time.

• Nervous state. The change of hyperactivity on lethargy and passivity and back. Bright light and loud and unexpected sounds are heavily tolerated. The child can not long strain his attention because of what it suffers from studying. It can be visited in the form of animals, frighteningly looking people or to hear the voices.
• Disorders in the form of repeated spasms or cramps. The child can freeze for a few seconds, while palene or rolling his eyes. The attack can manifest itself in shuddering shoulders, hands, less frequent legs, similar to squats. Systematic walking and talking in a dream at the same time.
• Disorders in everyday behavior. The excitability is associated with aggression expressed in the tendency to violence, conflicts and rudeness. Unstable attention against the absence of discipline and motor dismissal.
• A pronounced desire to harm and subsequent receipt from this pleasure. The desire for hedonism, an increased suggestibility, a tendency to leaving the house. Negative thinking together with vitality and omble against the background of a general tendency to cruelty.
• Painful-abnormal habit. Blooming nails, pulling hair from the hair of the skin and at the same time a decrease in psychological stress.
• Obsessive fears. Day forms are accompanied by redness of the face, increased sweating and heartbeat. At night, they are shouting and crying from frightening dreams and motor anxiety, in such a situation the child may not recognize loved ones and dismissed from someone.
• Violation of reading skills, letters and accounts. In the first case, children with difficulty correlate the appearance of the letter with sound or hardly recognize images of vowels or consonants. When withdrawing (letter disorder), it is hard for them to write what they are pronounced out loud.

These signs are not always a direct consequence of the development of the mental illness, but require qualified diagnosis.

Symptoms of diseases characteristic of adolescent period

For teenage girls, nervous anorexia and bulimia, premenstrual dysphoria and depressive states are characteristic.

To anorexia, respected on the nervous soil, belong:

• Denial of an existing problem
• Painful-obsessive feeling of excess weight when he is visible
• Eating standing or small pieces
• Vassed sleep mode
• Fear to score overweight
• Depressed mood
• Angleness and unreasonable syradiability
• Passionate cooking, cooking for family meals without personal participation in the meal
• Avoiding common food meals, minimal communication with loved ones, long staying in the bathroom or sports outside the house.

Anorexia causes physical disorders. Due to weight reduction, problems with the menstrual cycle begins, arrhythmia appears, constant weakness and pain in the muscles. The attitude towards itself depends on the volume of the dropped weight to the dialed. The man of a patient with nervous anorexia is inclined to be believed to estimate its condition until the point of no return.

Signs of nervous bulimia:

• The amount of food consumed at a time exceeds the norm for a person a certain set. Slices of food are not chewed, but quickly swallow.
• After a meal, a person deliberately tries to cause vomiting to clean the stomach.
• In behavior, the mood differences are dominated, closeness and impairment.
• A person feels his helplessness and loneliness.
• Common malaise and lack of energy, frequent throat diseases, upset digestion.
• The destroyed dental enamel is the consequence of frequent vomiting, which contains gastric juice.
• Increased salivation glands on cheeks.
• Decitment of the problem.

Signs of premenstrual dysphoria:

• The disease is typical for girls forming premenstrual syndrome. He, in turn, is expressed in depression, gloomy mood, unpleasant physical sensations and uncomfortable psychological state, plasticity, violation of the usual mode of sleep and meals.
• The dysphoria occurs 5 days before the start of menstruation, and on the first day ends. The girl during this period is completely defocused, nothing can focus on, she overcomes fatigue. The diagnosis is put if the symptoms are bright - expressed and interfere with a woman.

Most of the diseases of adolescents are developing on the basis of nervous disorders and features of puberty.

Postpartum disorders of psyche

In the field of medicine, there are 3 negative psychological states of the feminine:

• Neurotic depression. There is an aggravation of the problems with the psyche, which were still at the end of the child. This ailment is accompanied by an oppressed state, nervous exhaustion.
• Traumatic neurosis. It appears after long and difficult gods, subsequent pregnancies are accompanied by fear and anxiety.
• Melancholy with brought ideas. A woman feels a feeling of guilt, may not recognize close and see hallucinations. This disease is a prerequisite for the development of a manic depressive psychosis.

Mental disorder can manifest itself in the form:

• Invalued state and plasticity.
• Unreasonable anxiety, a feeling of concern.
• Irritability and excessive activity.
• Distribution of the surrounding and feeling of fear.

• Species of speech and lowered or elevated appetite.
• Outlusion in communication or desire to burn out from all.
• Confusion in consciousness and lack of concentration.
• Inadequate self-esteem.
• Thoughts about suicide or murder.

In the first week or a month later, these symptoms will be felt in the event of the development of postpartum psychosis. Its duration is equal to four months on average.

The middle-aged period. Mental agens developing on the background of the onset of menopause

During the period of menopause, the reverse development of the hormonal glands of sexual secretion occurs, this symptom is most pronounced in women from 45 to 50 years. Climax will slow down the cell renewal. As a result, those diseases and disorders begin to manifest themselves, which were missing completely or hidden.

Mental diseases characteristic of the period of menopause are developing or 2-3 months before the final completion of the cycle of menstruation or even after 5 years. These reactions are temporary, most often this:

• Mood swings
• Concern about the future
• Increased sensitivity

Women at this age are prone to self-criticism and dissatisfaction with themselves, which entails the development of depressive sentiment and hypochondriad experiences.

With physical discomfort during a climax associated with blood ties or fainting, hysterics appear. Serious disorders against the background of menopause develop only in women who originally had such problems

Psyche disorders in women in the senile and prediction period

Involutionary paranoid. This psychosis appearing during the involution is accompanied by delusional thoughts in combination with the unreasonable memories of traumatic situations from the past.

Involutionary melancholy is characteristic of women since 50 years. The main prerequisite for the appearance of this disease is the depression anxious and delusional. Typically, the involutionary paranoid appears after changing the lifeguard or stressful situation.

Dementia of late age. The disease is an acquired dementary, which over time is enhanced. Based on clinical manifestations, allocate:

• Total dementia. In this embodiment, perception is reduced, the level of thinking, the ability to creativity and solve problems. There is an erase of the facets of the person. A person is not able to critically evaluate himself.
• Lacooner dementia. Memory disabilities occurs when the level of cognitive functions is preserved. The patient can critically evaluate itself, the personality is basically unchanged. This disease is manifested in syphilis of the brain.
• These diseases are an alarming sign. Mortality of patients with dementia after a stroke is several times higher than those who escaped this fate and did not become weak.

While watching the video, you will learn about the aneurysm of the brain.

Treatment of psyche disorders to share for medication and complex psychotherapy. In the food disorders characteristic of young girls, the combination of these methods of treatment will be effective. However, even if most of the symptoms coincides with the disorders described, before carrying out any type of treatment, it is necessary to consult with a psychotherapist or psychiatrist.