How it manifests itself
Manifestations are divided into several groups. Hallucinations are the perception of something that is not there: most often a person hears voices commenting on his actions or talking to each other. Delusions are persistent false beliefs that cannot be convinced: persecution, surveillance, poisoning, a special mission. Disorganization is manifested by incoherent speech, inconsistent actions, and strange behavior. The general lifestyle often changes: a person stops sleeping, gives up work, moves away from loved ones, and stops taking care of himself.
- Auditory hallucinations, less often visual
- Delusions of persecution, poisoning, grandeur
- Incoherent or fragmented speech
- Strange, incomprehensible behavior to others
- Intense fear and wariness
- Insomnia and refusal to eat
- Lack of understanding that he is sick
Reasons
Psychosis should never be automatically considered a manifestation of schizophrenia: there are many more causes, and some of them require urgent somatic treatment. It occurs with bipolar disorder and severe depression, with the use of psychostimulants and synthetic drugs, with alcohol withdrawal, with infections with high fever, tumors and brain injuries, epilepsy, and severe metabolic disorders. In the elderly, delirium due to infection, dehydration or medications, and dementia are common causes. Therefore, examination is mandatory.
- Schizophrenia and schizoaffective disorder
- Bipolar disorder and severe depression
- Use of drugs and psychostimulants
- Alcohol withdrawal
- Infections, fever, dehydration
- Brain tumors and injuries
- Side effects of drugs
- Postpartum psychosis
Early signs that loved ones notice
Before full-blown psychosis, there often passes a period when the person still maintains contact with reality, but noticeably changes. He becomes withdrawn, suspicious, neglects his studies or work, begins to become interested in unusual topics, sleep is disturbed, and emotionality decreases. Relatives usually explain this by character, fatigue or adolescence. Seeing a doctor during this period improves the prognosis, so persistent changes in behavior over several weeks are a sufficient reason for consultation.
- Increasing isolation and suspicion
- Decline in academic performance or performance
- Sleep disturbance, nocturnal activity
- Strange sayings and ideas
- Decreased emotional reactions
- Neglect of hygiene
- Beginning of substance use
What to do for loved ones
The main task is safety and a speedy meeting with a doctor. It is useless to argue with nonsense and prove its falsity: it increases mistrust. It is better to speak calmly, in short phrases, do not raise your voice, do not get close, remove dangerous objects, and do not leave the person alone. You can say that you see how hard and scary it is for him, and that the doctor will help him cope with this. In case of threats, aggression or refusal to eat or drink, you need to call an ambulance by calling 103 and wait for specialists.
- Ensure safety, remove dangerous objects
- Speak calmly, do not argue with nonsense
- Don't judge or ridicule
- Don't leave someone alone
- Reduce noise and the number of people around
- Call 103 in case of threat to life or aggression
- Tell your doctor about medications, alcohol, and substances
Examination and treatment
A psychiatrist assesses the condition and at the same time excludes physical causes: he prescribes blood tests, tests for psychoactive substances, and, if necessary, a CT or MRI of the brain and an EEG. The basis of treatment is antipsychotic drugs, which are selected by the doctor; If the condition is serious or life-threatening, hospitalization is required. After the acute episode has stopped, maintenance therapy is important: unauthorized withdrawal of medications is the most common reason for the return of psychosis. Family psychoeducation, psychotherapy and a gradual return to study or work are of great importance.
- Psychiatric examination and risk assessment
- Blood tests, substance tests
- CT or MRI of the brain according to indications
- Antipsychotic drugs as prescribed by a doctor
- Hospitalization in severe condition
- Maintenance therapy and regular visits
- Psychosocial rehabilitation and work with families
- Complete abstinence from alcohol and drugs