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Today, one in four people experience depression at least once in their lives. And no wonder: in the modern world, people face a huge number of stressful situations every day. Any of them could be the last straw.

Chronic fatigue, inattention, memory impairment, a sense of hopelessness, derealization , low self-esteem … If this is all about you, it is possible that you need urgent treatment!

The New Year holidays are the best time to slow down a little, understand yourself and learn how to be happy. Shall we start?

What is depression?

First of all, depression is a disease, not a weakness of character, as many believe. In confirmation – a small list of people who survived this painful condition: Abraham Lincoln, Winston Churchill, Eleanor Roosevelt, Sigmund Freud, Joan Rowling, Charles Dickens, Mark Twain.

Unfortunately, most people are ashamed of depression and self-flagellate instead of taking treatment. But acknowledging a problem is the first step towards solving it.

Depression is not just melancholy or sadness. Emptiness, fatigue, tension, absent-mindedness, loss of meaning in life, a sense of hopelessness, lack of connection with reality, low self-esteem are far from all symptoms of depression. After all, it affects thoughts, feelings, behavior, and even the body.

Perhaps the most frustrating thing is that depression physically affects our brain. The hippocampus shrinks significantly, causing problems with memory and concentration. But there is good news: this process is reversible.

How does depression occur? Psychotherapist Richard O’Connor writes:

“Depression is the result of the impact of current stress on a vulnerable person. Stress is enough for a person to cross the invisible line and fall into a vicious circle of repressed thoughts, self-destructive behavior, guilt and shame, neurochemical changes. These elements both evoke and reinforce each other.”

Traps of thinking

“My friends, relatives and colleagues do not really know me, they do not even suspect how insignificant I am. I’m absolutely incapable of anything.” Depressed people often engage in this kind of internal monologue. The first step on the path to healing is to learn to notice such thoughts and perceive them as something alien, which has nothing to do with your personality.

Here are some typical thinking mistakes of a depressed person:
Expecting the worst. In this way, depressed people try to protect themselves from disappointment. Some of them have experienced betrayal or aggression from those they trusted. Frustrated expectations can also relate to other events, such as failure to succeed.

Self-flagellation. The thoughts “I can’t”, “I don’t have a chance”, “I’m not capable of anything”, “I’m disgusting”, “I’m trapped” constantly appear in a person suffering from depression.

Fatalism. A depressed person usually believes that some external forces influence him. He believes that he cannot really change his life and decide something in his destiny.

Selective attention. A person pays attention only to what can confirm his expectations. So he tries to avoid stress and feel safe. But such behavior leaves no chance to see the love and respect of others, the beauty of the world, and so on.

Depressive logic (excessive responsibility, catastrophization , overgeneralization, self-obsession and other destructive thought habits).

How to change your mindset

Negative thoughts are just a bad habit. Fortunately, you can get rid of it: regular mindfulness meditation will help reprogram the brain and remove obsessive anxiety. Start with the following simple exercise.

Find a quiet place where you will not be disturbed for at least half an hour. Turn off all phones, TV, music. Sit comfortably. Place your feet under your knees, but without stretching. Sit up straight with your back straight. The weight of the head is directed down to the spinal column.

Close your eyes. Breathe calmly, slowly and deeply. You can focus on a word or phrase by linking the pronunciation to the rhythm of breathing – “inhale … exhale”, or something else according to your mood. Imagine that distracting thoughts and sensations are bubbles on the surface of a still pond. They rise and burst, the circles diverge and disappear. The water surface is calm again. Don’t rate anything. Do not worry if you are doing the exercise correctly.

Remember that intrusive thoughts and feelings are normal noise generated by the brain; it is used to working this way under stress.

To drive away intrusive thoughts, you can imagine putting them in a box or writing them down – see later. Or tell yourself, “No thanks.” Don’t get angry if you get distracted, just focus on your breathing again.

Sources of pride and self-respect

Reconsider your view of achievements, praise yourself more often and be proud of your successes, even if they seem insignificant to you. Finding a few minutes to read a book with a naughty child is already a major achievement, not only because it is difficult to find time, but also because it has benefited the child.

Whether you love your job or not, it’s important to remember that it brings a lot of pride. You get up and get to the office on time, stay there for the rest of the day, sometimes doing difficult or unpleasant things. It can also be a source of self-respect!

Recall right now for what recent achievements you are worthy of praise. Maybe you fed a stray kitten, supported a friend in a difficult situation, or just did your morning exercises?

Depression Behavior

Depressed people are often procrastinators . By postponing important things for later, they protect their own unstable self-esteem. If something doesn’t work out, then you can always find an excuse: “Now if I had more time!”

In this case, you need to gradually accustom yourself to action. Get rid of perfectionism and in no case expect the perfect result, but just take on real goals. First, you will experience relief when you complete a task that you have long been afraid to start. And secondly, work often helps to distract from problems. But even here it is impossible to go too far.

Sometimes the opposite habit develops: the desire to work until you drop. A depressed person does not know how to prioritize and mindlessly moves forward. The fear of stopping and being alone with emptiness makes you work without respite.

Those who are prone to workaholism need to learn how to relax. You can find a hobby and improve in it (then there will be no feeling of guilt for inactivity). Better to get used to enjoying doing nothing. Walking, meditating, playing with animals, or listening to music are great ways to pass the time.

Attention to your body

Depressed people do not care about their health. They seem to say in plain text: “We don’t deserve better.” These people may neglect physical activity, medical help (or turn to charlatans), develop poor eating habits, and abuse alcohol and drugs.

Such a careless attitude towards oneself and attempts to harm the body are considered skills of depression. This is another way to avoid meeting the real world.

Patients with depression need to learn to listen to their body and take care of it. Everything is important here: proper nutrition, timely rest, and exercise. The latter is especially useful.

Several studies in older age groups have shown that brisk exercise three times a week is as effective as medication in the short term, and that participants who continue the exercise program are significantly more likely to avoid future episodes of depression.

brain training

Really severe depression causes serious changes in the brain. This leads to the fact that we lose the ability to experience pleasure from something good: we are let down by degraded receptors for joy hormones. But don’t worry. Scientists have found out that the brain can be trained. We ourselves are able to influence it.
You can get rid of “depression skills” by improving your lifestyle. The facts confirm that by changing habits, we erase old neural connections in the brain and replace them with others.

In this article, you will learn how to make friends with the hormones of happiness and become an optimist.

The UK National Institutes of Health recommends mindful meditation as a cure for depression.

Mothers who suffer from postpartum depression react differently to the crying of their babies than mothers without depression. Such conclusions were made by researchers at the University of Oregon based on fMRI (functional magnetic resonance imaging) data of the brain.

It turned out that in response to the crying of their child, in depressed women, changes in the brain are less pronounced than in those who do not have depressed mood. Such conclusions were made on the basis of fMRI , which shows changes in the blood flow of the corresponding parts of the brain and visualizes these data on the monitor screen.

Study Characteristics

Brain responses to the crying of their babies have been studied in mothers with and without clinical depression. For all women, these were the first children under the age of 18 months inclusive.

Initially, the initial state of the brain was recorded on the fMRI machine, and then they were allowed to listen to the crying of their child.

The responses of mothers with depression were not negative, as expected, but rather more muted. On fMRI , in response to the crying of babies, there were reactions in the limbic system of both hemispheres. Mainly in the striatum, thalamus and midbrain. These are deep subcortical structures responsible for emotions.

In the non-depressed mothers, these subcortical structures were much more activated than in the depressed group. Pronounced differences were observed in the striatum, in particular, in the caudate and nucleus accumbens, and in the medial thalamus.

Areas of the brain closely associated with motivation and positive reinforcement were activated.

Mothers without depression reacted positively to their children’s crying. They showed a desire to approach their children and they realized it when possible.

And in moms with depression, brain activation was often not enough to produce similar responses.

In women with severe depression, fMRI also showed decreased activity in the prefrontal region of the brain, especially in the anterior cingulate gyrus. These are areas of the brain associated with the evaluation of information, planning and regulating the response to incoming emotional signals.

conclusions

Depression can have a long-term impact on mother and child and their relationship. Attention is drawn to the impossibility of a mother in a depressed state to correctly and optimally respond to the reactions of her child.

This requires coordination of the activity of the cortical and subcortical systems of the brain, which suffers from depressive states in the mother. And, it is possible that it leads to not quite correct formation of response emotional reactions in the child.

Such a mechanism can be considered as one of the risk factors for the development of attention deficit hyperactivity disorder, minimal brain dysfunction in such a child.

The results obtained should be applied in the development of new treatments for depression in mothers. The researchers plan to continue studying these women and their children. Now they will cover the period from the intrauterine period to the first year of motherhood. The goal is to get a complete picture of how the brain works and the relationship between mother and child is formed during this critical period in the development of children.

Commentary by Professor Gimranov

It can be seen that the problem of depression affects not only the patients themselves, but also their children. It is clear that the same wrong reactions of the brain occur when communicating with relatives and friends. Constant use of antidepressants often exacerbates the problem.

Our experience shows that it is promising to activate the brain using transcranial magnetic stimulation. As can be seen from this work, such stimulation of subcortical structures is physiological, natural, and non-invasive. Unfortunately, politicians and various leaders also suffer from depression. And the consequences of the wrong reactions of their brain can be felt by the whole country, and sometimes the world.

Dementia ( dementia – insane), a pathological process in the brain that occurs as a result of damage to neurons. The reasons for this phenomenon are different: vascular, metabolic, organic. Pathology is characterized by a deterioration in cognitive, cognitive functions: speech, thinking, memory, intelligence, understanding of new information, changes in character.

After the diagnosis is established, the patient needs help from both relatives and friends, and from doctors.

In the world there are more than 40 million people suffering from this disease. By 2050, this figure will exceed 100 million. The pessimistic forecast is associated with the general aging of the population. And a greater prevalence of risk factors for dementia.

Causes and provoking factors

Typically, senile dementia ( senilis – senile) in everyday life is called senile insanity. However, in addition to age-related degradation, dementia can be the result of other diseases:

1. atherosclerosis of cerebral vessels;
2. AIDS;
3. infectious and toxic encephalitis;
4. damage to internal organs (kidneys, liver);
5. intoxication with alcohol, drugs, poisons.

MRI data published in April 2013 in The Journal of Alzheimer’s Disease ” indicate that the development of dementia is influenced not only by high risk factors for stroke – hypertension, diabetes, but also by the presence of plaques and other focal changes in the brain. Often, various manifestations of depression and changes in character and behavior can be early precursors of this disease.

It should be borne in mind that a person not only loses previously acquired skills and knowledge. The ability to learn and acquire new skills is significantly worsened or even lost.

In the earliest stages of the onset of the disease, only an experienced neurologist can make a diagnosis.

Principles of diagnosis and treatment

It is important to notice signs of trouble in time. Then doctors have more time and resources for the timely diagnosis of cognitive disorders. More likely to find the cause, stop the progression of the disease.

Having established the cause of dementia, it is necessary to draw up courses of complex pathogenetic and etiotropic therapy. Without this, it is impossible to achieve positive results. It is important to correct blood pressure, blood sugar, cholesterol, vitamins, testosterone and estrogens, etc.

We must not forget about regular physical and intellectual activity. We observe the diet (vitamins B, E, antioxidants) and rest (good sleep, walks).

Alcohol and smoking should be completely excluded.

Training of cognitive functions of the brain is achieved by playing chess, solving crosswords and puzzles. Actual reading books, communicating with other people, memorizing poetry, foreign words.

It is important to start active prevention and treatment at the initial stages of the onset of the disease. It is at this stage that one can count on good clinical results and slow down the further development of the disease.

Comments by Professor R.F. Gimranov .

The problem of dementia affects not only the patients themselves, but also their families.

Strange and inadequate actions, at the initial stages of the disease, are considered by relatives as manifestations of character, whims. But they should not be ignored. For example, mild depression may be an early symptom of personality degradation.

Timely diagnosis of the problem, and then proper treatment and prevention, can radically change the situation. And most importantly – to slow down the further development of the pathological process. For many years, the Clinic of Rehabilitation Neurology has been successfully performing brain stimulation in combination with standard therapy in such patients.

Depression is a common problem in 21st century society that we encounter frequently in our clinic. And it’s not easy to deal with it. Therefore, the doctors of the clinic of restorative neurology understand that depression is better to prevent. To do this, you need to work on your own psychology and lifestyle. Because the phrase “a healthy mind in a healthy body” is directly related to the prevention of depression.

Psychological moments

1. The main cause of depression is constant frequent stress. Learn to avoid them, quickly get out of conflict situations. The implementation of this paragraph depends only on ourselves.
2. If there is a global goal in life, then it is better to break the process of moving towards it into more short stages. You need to focus as often as possible on solving current tasks that are easy to complete at a particular point in time.
3. In a difficult situation, do not forget that there are people whose situation is much worse than yours. Compare yourself with these people and see how everything in your life is more favorable than theirs.
4. It is necessary to treat your own psychological potential sparingly. Live in those rhythms that are comfortable and cozy for you. You should not waste your energy in vain, it is also pointless to “compete” with someone in success.
5. Let go of deceptive values in life. Realize that they bring much more suffering than positive emotions. Try not to be consumerist.
6. Knowing your worth, do not seek to enter into quarrels with people who do not deserve it.
7. Focus on the little joys that life brings. Learn to enjoy even the smallest positive.

Lifestyle advice

1. It is necessary to strengthen your own willpower by all available means. As an option – morning exercises, which must be performed every day. Running and swimming are sports that have a beneficial effect on the emotional background. The body welcomes any sport.
2. Yoga classes help to stabilize the psycho-emotional background.
3. Try to drink alcohol as little as possible. If you smoke, then take the trouble to quit this habit.
4. Wear only clothes and shoes that are comfortable for you.
5. Optimize the mode of your day, especially labor. There must be periodic five-minute breaks in work.
6. Try to get at least 8 hours of sleep at night. At the same time, you should be comfortable in bed.
7. Optimize your diet. Be sure to include fresh fruits, vegetables, vitamin complexes in it daily.

Brain damage at the perinatal stage, as a rule, manifests itself in three variants of clinical symptoms. They depend on the localization and scale of the focus:

1. Gross movement disorders, against which an intellectual deficit may also occur. A typical example of such a lesion is cerebral palsy, cerebral palsy.
2. Conditions when the intellect suffers to a greater extent, and movement disorders are less pronounced. Considered moderate or moderate.
3. Relatively mild lesions of the central nervous system, with a smoothed, not obvious picture of motor and intellectual anomalies. But with signs of psychological disorders.

Simply put, MDM refers to any brain pathology, which is the basis for the formation of mental pathology or movement disorders. With varying severity: from behavioral disorders to cerebral palsy.

Here it is appropriate to recall the staging of the maturation and development of intellectual abilities in children under 7 years of age. It was proposed by Piaget ( Piaget , 1994, 1997 ), highlighting 4 periods. And in each of them, children with brain dysfunctions have their own deviations.

Common manifestations by sub -periods

The first 1.5 years of life is the sensorimotor phase. If a child has suffered perinatal hypoxia of the brain, then his coordination of movements is disturbed, motor activity is weakened or increased.

The second phase is from a year to the complete formation of speech skills. During this period, children with MDM begin to lag behind their peers in speech.

The first words often appear on time (about a year), then stagnation sets in, development stops. The period of “muteness” is characterized by the fact that children understand the appeal to them with gestures and give feedback. They just keep silent.

From 2.5 to 4-6 years old, the child learns the world already without the need for tactile information, due to not only tactile information. The so-called preoperative intelligence is involved in this. In a child with brain dysfunction, it is disturbed: video motor coordination is lame, coordination between the assimilation of visual and auditory information is disordered.

There are varying degrees of problems with the pronunciation of sounds, speech therapists interpret this as dyslalia.

The phase of specific operations (from 6-7 years of age onwards), when experience and accumulated knowledge are synthesized with genetic abilities, is accompanied by learning problems in children with MMD.

There are also behavioral deviations, difficulties with social communication in the team.

The problem of diagnosis and therapy of minimal brain dysfunctions remains debatable. Next, we will take a closer look at what is outlined in the previous part of the article.

Etiology and pathogenesis of minimal brain dysfunctions

Neuropathologists perceive MMD as pathological manifestations of brain damage in the early period. And which are manifested in violation of maturation, disharmonious development of higher nervous activity.

As a result of such disorders, we are faced with the immaturity of the functional resources of the brain. Those that provide higher nervous functions: speech development, the ability to memorize, perceive and analyze information from the outside.

The level of intellectual development in children with MMD is within the normal range. Difficulties arise in the processes of learning, learning, and social adaptation.

Brain damage is usually focal in nature. Depending on the localization of the site, there are violations of one or another nervous function. One child will find it difficult to write ( dysgraphia ), another will find it difficult to work with numbers ( dyscalculia ). Also, ADHD – Attention Deficit Hyperactivity Disorder, should be considered as a variant of the manifestation of MMD.

General symptoms

In addition to disorders in the work of higher nervous functions, children with CNS lesions show other symptoms:

• fast fatigue from intellectual activity;
• difficulty concentrating;
• difficulties with mastering new school topics;
• poor adaptation to conditions requiring autonomic regulation – heat, stuffiness, bright light and loud noise;
• tendency to motion sickness, “seasickness”;
• headaches since childhood.

Temperament also affects manifestations. For example, at the end of the day in the kindergarten group, choleric people become overexcited, and phlegmatic people become inhibited.

A study of the anamnesis of problem children shows that many of them demonstrate the phenomena of hyperexcitability . Such a syndrome in most occurs from the first months after birth. Delayed onset, from the age of 6-8 months, occurs in about 20% of children with MMD.

Infant age

Even with the observance of the requirements of caring for the child, providing him with proper nutrition and regimen, he is restless. Shouts for no apparent reason, haphazardly moves arms and legs.

Vegetative reactions are likely: sweating, redness of the skin and its marbling, increased heart rate and respiration.

Attacks of screaming are accompanied by muscle reactions: increased tone, trembling of the chin and twitching of the limbs. There is such a movement when the child opens his arms, as if for a hug – a spontaneous Moro reflex.

Sleep suffers. The child does not fall asleep for a long time, wakes up at night for no reason, gets up early. In a dream shudders, groans.

Digestion is disturbed, children do not take the breast well, they are restless during sucking. They gasp for air and often burp. Due to dysregulation of the muscles of the stomach, food from it does not pass into the intestines, the child vomits.

Again, autonomic dysregulation of the gastrointestinal tract causes an increase and decrease in intestinal motility. Hence – frequent and loose stools, followed by constipation.

early childhood period

From one to three years, children with CNS damage have:

• strong excitability of the nervous system;
• restless behavior, spontaneous movements;
• sleep problems;
• disorders of appetite and digestion;
• poor dynamics of weight gain;
• subtle lag in the development of psychoverbal function, motor skills.

Deficiency and lag in psychomotor maturation (in comparison with peers) is well visualized by 2-3 years. At this age, the diagnosis of minimal brain dysfunctions is most often made for the first time.

If you pay attention to the child, then from the first years you can notice motor disinhibition – hyperkinetic phenomena. Children are clumsy, they have problems with fine motor skills of hands, precise finger movements.

Hence the difficulties with self-care skills: fastening buttons, tying shoelaces

Therefore, they hardly master the skills of self-service, for a long time they cannot learn how to fasten buttons, lace up their shoes.

The desire of parents to educate the child early, with MMD, overloads his brain. Instead of growing intellect, children become stubborn, naughty. Possible neuroses, tics. The opposite result is not excluded: a slowdown in psychoverbal development.

By the age of 3 years, the following come to the fore:

• motor awkwardness;
• high fatigue, asthenia ;
• difficulty concentrating;
• hyperactivity;
• tendency to impulsiveness;
• stubbornness and negativity.

Urinary incontinence (enuresis) and fecal incontinence ( encopresis ) are often superimposed on such phenomena.

A jump, an increase in the manifestations of MMD, as a rule, coincides with changes in the external environment. At 3 years old – kindergarten, at 6-7 – school.

This phenomenon is explained by the weak resources of the damaged brain for adaptation. Since during these periods the child experiences a sharp jump in physical and mental stress.

School age

The greatest difficulties for children with MMD at school are associated with maladjustment in the team and behavioral disorders.

Psychological difficulties in such cases entail psychosomatic disorders, the debut of VVD.

Preschool children with MMD are hyperexcitable and clumsy. At the same time, they are scattered, distracted, restless and quickly get tired. Motor activity can both increase, and vice versa – slow down.

Behavioral and social deviations are noticeable: infantilism, impulsiveness

Schoolchildren experience problems with learning, assimilation of new things. Behavioral disorders are aggravated: psycho-emotional instability, low self-esteem, insecurity. And at the same time – hot temper, cockiness, aggressiveness. Social phobias and opposition are being laid.

With the entry into adolescence, behavioral deviations against the background of MMD become aggravated. Children behave more aggressively, the corners are sharpened in relationships at school and at home, in the family. Academic performance suffers, the risk of early initiation to alcohol, psychoactive substances is high.

Such a danger requires directing the efforts of doctors, parents and teachers to identify and eliminate the manifestations of MMD.

Critical periods

That is, it is noticeable that the jump in the symptoms of MMD falls on certain periods of psychoverbal development. The first one falls on 1-2 years, at which time the cortical zones responsible for speech skills are actively developing.

The second period is 3 years. At this age, children accumulate vocabulary, develop the skills of forming phrases, improve attention and memory. With MMD, in this phase, a lag in speech and articulation becomes noticeable.

The third critical period is considered to be 6-7 years. The child begins to master writing and reading, which increases the requirements for the functional abilities of the brain.

Noticeable, the symptoms of brain dysfunctions become at the elementary school level.

A complex of behavioral disorders is characteristic:

1. high excitability;
2. restlessness;
3. dispersion;
4. disinhibition of drives;
5. there is no self-control, a sense of guilt is not developed;
6. there is no age-appropriate criticality.

The behavior of such children is disinhibited: they are not assiduous, they jump up from their seats. they don’t walk, but run, distract themselves and interfere with their neighbors in the desk. They grab onto several things at once, they rarely finish what they started.

Promises are made and immediately broken (forgotten). They show inadequate playfulness, negligence, carelessness. Intellectual activity is weakened. The instinct of self-preservation is reduced – they often fall, get injured and bruised.

At first glance, children with MMD show a choleric temperament. However, the essence of their inconsistency and behavior lies in the weakness of the functional regulation of the brain.

The lack of self-control and criticality arises due to the underdevelopment of the frontal cortex. Since these areas are responsible for control, moral and volitional properties of the individual.

Psychophysiological features of children with MMD

A child with minimal MD does not have typical, specific symptoms. The appearance of “small neurological signs” in early childhood, which are combined with emotional and volitional deviations, may suggest a problem. Because of what there is a lack of intellectual abilities.

Intelligent Features

For children with non-severe forms of MD, mental retardation is quite typical. But if mental retardation is accompanied by irreversible intellectual impairment, from with MMD, the lag is due to behavior, then it is reversible.

In preschoolers, mental retardation is manifested by a violation of three functions:

• perception of new information;
• ability to concentrate;
• memory deviations.

Disturbances in spatial representations are considered typical manifestations of mental retardation in children. The child is poorly oriented in his own body, his fine motor skills are weakened. The function of attention suffers: it becomes fragmented, its volume is limited.

Many children with mental retardation have a peculiarity of memory: involuntary memorization is better in terms of productivity than attempts to learn any material.

emotional sphere

Children are characterized by labile, unstable emotions. It is difficult for them to adapt to the team in the group, in the classroom. Mood swings are combined with asthenia, fatigue. There are such children who have emotional deviations combined with a lack of cognitive activity.

Communication with such children is difficult. For an ordinary person, their peer, a child with behaves unpredictably. Acts thoughtlessly, impulsively. Children around them may be aggressive. Parents often mention when talking that their children have no friends.

Signs of MMD

Anomalies are noted in various areas of higher nervous activity. This is confirmed by the ambiguity of the results of psychological testing of children with MMD. In different subtests , different results are noted: increased, decreased, or even in some places – normal.

Anomalies of perception:

• unable to perceive and distinguish the sizes of objects;
• get confused between the parties (left-right);
• do not distinguish between top and bottom;
• find it difficult to navigate in space;
• get confused in time;
• sometimes there are violations of reading, writing (for example, the inscription of letters and words in a mirror image).

Neurological disorders, if any, are mild. Reflexes are slightly asymmetric, hearing is weak, visual acuity is reduced, coordination is slightly disordered, etc.

How many signs one patient will have depends on the extent of brain damage. Gross anomalies are rare.

Speech

There are various forms of aphasia. Speech development slows down. Due to impaired auditory perception, slight pronunciation disorders may occur.

Motor skills

Motor activity, if impaired, may have a different character. Tremors, muscle rigidity, uncontrolled sweeping movements, tics. Naturally, fine motor skills and coordination suffer.

Learnability

As mentioned above, there may be problems with counting, writing, spelling rules. With motor disorders – difficulty with tracing the contour. It is difficult to get organized, to complete the work that has been started.

Thinking

Abstract thinking suffers the most. There are also difficulties with the synthesis of concepts. Weak arbitrary memory makes it difficult to form conclusions and conclusions. A floating type of thinking is characteristic.

Constitution of the psyche

There is neurotic behavior:

• nail biting;
• biting a pen, pencil;
• children suck their fingers;
• unconsciously nodding;
• eat food out of the usual order (start with dessert);
• get tired easily;
• nocturnal enuresis is typical;
• hygiene skills are formed and fixed with great difficulty.

Emotions and will

Uncontrolled impulsivity, irritability and irritability. The ability to self-control and criticism is reduced.

Dream

Disorders of circadian rhythms (drowsiness in the morning, activity in the evening). They experience less need to sleep than their peers. They sleep restlessly, toss and turn. Sleep is either superficial or extremely deep.

Sociability

The ability to contact with peers is weak, obsessive affection is possible. In games, they are impulsive, losing – annoyed. They prefer a narrow circle of 1-2 children. Reach out to those who are younger than them.

Somatic maturation

Physical parameters, as a rule, also with deviations. Although sometimes in somatic development they are ahead of their peers.

social behavior

The level of intelligence allows a higher level of social behavior of the child than that which is realized. Authorities are not recognized. The behavior may not be appropriate for the current situation.

Personality character

Trusting, tend to imitate elders and peers. Periodic irritability and aggression change to attention to those who are nearby, and vice versa. Changes in the environment are difficult to accept, they strive to maintain the familiar environment in everything. They love boasting, self-esteem, as a rule, is underestimated.

Concentration of attention

Typical distraction. The concentration of attention is weakened. Viscosity of speech, inertia of motility are characteristic.

Frequency of symptoms

It is rare for a child to have less than one of the above symptoms. Next, let’s see how often certain symptoms of MMD occur.

Attention disorders

The most common symptom, 90-95%. The consequences of MMD do not allow children to concentrate and for a long time to delay concentration on the subject of activity. Weak ability to ignore external stimuli that are easily distracted.

Hyperactivity

It is also a frequent occurrence, found in 75-85% of children. Talkativeness is one of the most common manifestations. At the same time, up to 20% of children with MDM have signs of hypoactivity .

Complex of neurological phenomena

75-80% have 5-6 mild neurological abnormalities:

1. difficulty making complex movements;
2. tics of mimic muscles;
3. trembling of the muscles of the chest and back;
4. restless fingers;
5. hyperkinesis;
6. deviations from tendon reflexes, problems with coordination.

Emotional lability

It occurs in 70-75%. Children of any age group with MMD are prone to neurosis, anxiety, and tearfulness. The mood is constantly changing. Failures are perceived with great feelings, resulting in either irritability or phobia.

For the first time, it was only in 1937 that the child’s behavior could be associated with changes in his brain. This idea was expressed by the American neurologist Samuel Orton ( Samuel Orton ), dealing with the problem of children’s learning. The term “minimal brain dysfunction, MMD” or “mild MD” itself appeared in 1955.

The findings were confirmed by Strauss , Werner in 1947 and Strauss , Lethinen in 1955. These doctors were engaged in observing the maturation of behavioral responses in children with a normal birth history and prematurity. Doctors have established that there is a direct relationship between the characteristics of the development of the child’s psyche and damage to his brain.

What is Minimal Brain Dysfunction

Synonyms: hyperkinetic chronic brain syndrome, minimal brain damage, mild infantile encephalopathy, mild brain dysfunction.

Research on this topic was carried out by both domestic and foreign neurologists. Statistics say that from 5 to 20% of preschool children and schoolchildren have one or another version of MMD.

The pathology is widespread. Doctors refer it to encephalopathies of the perinatal period. This term summarizes all the problems and lesions of the brain that occur during the perinatal period.

According to clinical criteria, the perinatal period is further divided into three sub -periods :

1. Prenatal or antenatal – calculated from the 7th month of gestation until the onset of labor;
2. Intrapartum or intranatal – begins with the onset of contractions and ends with the baby leaving the birth canal or from the incision during caesarean section.
3. Early neonatal is the first 7 days of an independent life of a child, when his body is forced to adapt to a changed environment.

MMD is characterized by delayed maturation of brain structures. Regulatory functions of the nervous system are also violated. This is reflected in the emotional sphere of the child, the ability to adapt, vegetative regulation, behavior.

In other words, the term MMD combines non-gross deviations in behavior and cognition, while maintaining intelligence at an acceptable level.

Such anomalies are the result of mild insufficiency of the functionality of the brain. And they arise, as a rule, as a result of one or another of his lesions.

Causes of brain dysfunctions

The main mechanism that affects the nervous tissue of the fetus, the newborn is hypoxia, oxygen deficiency.

The danger of brain hypoxia increases in late pregnancy and in the phase of childbirth. This is confirmed by data obtained from the results of EEG, computed tomography .

According to the criterion of cause and development, lesions of the nervous system in the perinatal period are divided into three types:

1. Hypoxic- ischemic. Occur due to oxygen starvation of the fetus with a deficiency of O ₂ or chronic metabolic disorders in the prenatal period ( feto -placental insufficiency). There is a danger of intranatal hypoxia, asphyxia, when the umbilical cord is infringed during childbirth or the vessels of the fetal neck are clamped.

1. Traumatic, usually caused by physical impact on the head.
2. Mixed, hypoxic -traumatic – when a combination of both of the above effects is noted.

It is noticed that in children with prematurity, subcortical structures suffer from hypoxia. Who is born at term, more at risk of damage to the cortex. Due to the anomalies that have arisen, minimal brain dysfunction (MMD) occurs. In childhood, they are regarded as encephalopathy. Manifestations in adults are explained by the weakness of the nervous system.

Below we will dwell in more detail on the factors that can cause CNS damage in the fetus and newborn.

Which period of pregnancy is more dangerous?

As you know, during the first 12 weeks, the laying, the formation of the foundation for the body of the future person takes place. Including – brain sprouts are formed. And the protection of the fetus, the placental barrier, matures by the end of the first trimester.

Therefore, in the first weeks of gestation, infections are dangerous:

1. toxoplasmosis;
2. chlamydia;
3. listerellosis ;
4. syphilis;
5. serum hepatitis;
6. cytomegalovirus infection, etc.

Pathogens from the mother’s body freely reach the fetus and disrupt the primary growth processes. The emerging brain structures are no exception.

At the stage of laying, infections lead to generalized lesions of the fetus. Due to the high sensitivity to damage, the correct formation of the nervous system is disrupted.

From the 13th week, when the placental barrier begins to work, the influence of adverse effects does not lead to gross defects. However, the risk of intrauterine malnutrition, premature birth and the birth of a child that is not yet ripe for this remains.

Factors that have a negative impact on the development and maturation of the nervous system are known. They can affect both at the time of conception (if the reproductive organs of the parents are affected), and subsequently.

Typical: ionizing radiation, alcohol, acute and chronic poisoning.

Risk factors for MMD during gestation

We list the main reasons due to which nervous tissue suffers in the perinatal period:

1. chronic and acute diseases suffered by a pregnant woman;
2. pathologically occurring pregnancy – severe toxicosis, eclampsia, the threat of interruption;
3. any sources of chronic intoxication in the body of the expectant mother;
4. unbalanced diet, inadequate diet during pregnancy;

1. the early age of the expectant mother, her immaturity;
2. hereditary pathology, metabolic disorders (diabetes mellitus, etc.);
3. negative impact of the environment;
4. environmental situation at the location of the pregnant woman – toxic damage, poisoning, the effect of ionizing radiation, certain drugs, etc .;
5. abnormal course of labor – weakness of labor activity, or vice versa – rapid labor, delivery of obstetrics (forceps);
6. prematurity and immaturity of the baby;
7. genetic anomalies ( Down’s b- n ).

miscarriage is more important . When, due to the health problems of the mother, the baby is born prematurely, immature and premature, with low body weight.

Such a child, as a rule, is not yet ready for overload during childbirth, which is why it is injured in the birth canal. Also, immature children have a higher risk of adaptation failure in the postpartum period.

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Statistics show that brain tissue anomalies that cause MMD are most often provoked by the use of alcohol by parents on the eve of conception. Or when a pregnant mother “uses”. Ethanol is a killer for immature fetal neurons, disrupts the laying and maturation of the brain.

No less harmful are strong stimulants – coffee, energy drinks. They constrict blood vessels, including the umbilical cord. Those can cause acute or chronic fetal hypoxia.

Risk factors for MMD during labor

At this stage, the born baby is at risk of being exposed to hypoxia or infection. Typical causes for brain dysfunctions in childbirth:

1. a long pause between the discharge of water and contractions;
2. insufficiency of contractions, weakness, which forces the use of stimulation of uterine contractions;
3. small opening of the pharynx of the cervix;
4. rapid childbirth;
5. the need to use obstetrics – turning the fetus, forceps;
6. entanglement with the umbilical cord, clamping of its vessels;
7. emergency caesarean section with general anesthesia;
8. excessive size and body weight of the fetus.

Children at risk for brain damage include those who are preterm and who are abnormally overweight (too large or too small).

As a rule, damaging factors during childbirth rarely directly affect the structures of the central nervous system. But the consequences of such exposure indirectly disrupt the biological and physiological maturation of the infant’s brain.

Risk factors for MMD in the early postnatal period

Immediately after birth, to get brain damage, the child risks for the following reasons:

1. neuronifections ;
2. trauma;
3. intoxication.

Combining or separately, genetic anomalies with organic lesions of the nervous tissue become the basis for the characteristics of the character and behavior of children described below.

Schizotypal disorder until the nineties of the last century was known as “sluggish schizophrenia” or “slow-flowing” (“pre-schizophrenia”, “mild schizophrenia”, “pseudoneurotic schizophrenia”). It is a relatively benign, slowly progressive endogenous process that occurs in one third of all schizophrenic patients . In the current ICD-10 classification of mental disorders, schizotypal disorder is an independent diagnosis, isolated from schizophrenia. It includes a group of functional mental disorders that occupy an intermediate position between schizophrenia and personality pathology.         

In the current ICD-10 classification of mental disorders, schizotypal disorder is an independent diagnosis, isolated from schizophrenia.   

The group of schizotypal disorder includes persons with impaired interpersonal functions, cognition, emotions and behavioral control who show a genetic predisposition to schizophrenia, the so-called “hidden carriers of the disease.” The latter are members of the family of patients with schizophrenia, are distinguished by chronic features of thinking and communication, and low social activity.      

The first signs of schizotypal disorder appear in childhood or adolescence. The provocation that triggers the disease can be psychological stress. Schizotypal disorder is characterized by a gradual, usually imperceptible onset, the absence of pronounced exacerbations and outlined remissions, and has a chronic continuous character.  

With the course of the disease, there is a gradual decrease in working capacity associated with a drop in intellectual activity and initiative, impoverishment of emotions and contacts, and deepening of social self-isolation. At the same time, about 30% of patients with schizotypal disorder continue to work, choose easier, home-based types of work activities that are more acceptable to them; some of the sick become dependents, invalids.      

The main symptoms of schizotypal personality disorder

The clinical signs of schizotypal disorder are varied, but some of them are fundamental for diagnosis:  

strange beliefs, speech;

strange or magical thinking;

unusual sensations and bodily illusions; 

Suspicious or paranoid thoughts (thoughts of stalking) 

inappropriate emotions or lack of emotional response (narrowed affect);

strange, eccentric, or specific behavior or appearance;

lack of close friends or confidants, except for relatives of the first degree of kinship;

excessive social anxiety that does not diminish after dating and is usually associated with paranoid fears.   

These signs can be grouped into three groups: 

• cognitive-perceptual deficits: strange beliefs, perceptual impairment, paranoia, or suspicion
• interpersonal deficits: lack of close friends, social anxiety, paranoia, or suspicion
• disorganization: fuzzy speech or thinking, dull affect, strange behavior

Additional signs

Along with the main signs of schizotypal disorder listed above , other symptoms in both men and women are present in the clinical picture , which are usually found in neurotic diseases, mood, behavior or personality disorders.   

Neurotic manifestations. The most common disorders in schizotypal disorder include anxiety-phobic – fears, panic attacks, obsessive-compulsive symptoms; heightened self-observation, heightened reflection, somatoform phenomena, asthenia. There are frequent cases of painful concern about their somatic or mental health (hypochondria) or “mysterious” symptoms and diseases, unconfirmed by specialists.     

Eating disorders. Eating disorders are quite common – in the form of anorexia or bulimia.   

Mood disorders (affective disorders). Comorbid mood disorders are the rule rather than the exception – long-term mild depression or unreasonable mood swings (euphoria), long-term or short, but without psychotic symptoms.   

Conduct disorders. Aggressive, antisocial behavior, ridiculous actions, impulse disorders in the form of vagrancy, sexual perversion, alcohol abuse, psychoactive substances can be observed .  

Some of the described disorders become permanent or “axial”, others can replace each other or join the existing ones, becoming additional, aggravating the patient’s condition.  

In Depending on the predominance of certain symptoms distinguish several basic options for schizotypal personality disorder:  

• pseudoneurotic schizophrenia (outward resemblance to neurosis) 
• pseudopsychopathic schizophrenia (outwardly similar to psychopathy) 
• poor in symptoms of schizophrenia (characterized by increasing asthenia and a decline in working capacity) 
• schizotypal personality disorder
• latent schizophrenia

Differences between schizotypal disorder and schizophrenia in psychiatry 

The diagnosis “schizotypal disorder” excludes gross psychotic disorders characteristic of schizophrenia, among them: delusional, hallucinatory, movement disorders (catatonia), confusion.

In addition, schizotypal disorder never has such severe outcomes as schizophrenia, such as apathic-abulian dementia. 

In addition, schizotypal disorder never has such severe outcomes as schizophrenia, such as apathic-abulian dementia. 

Causes of schizotypal disorder

Genetic reasons. The external clinical similarity of schizotypal disorder with other mental illnesses may be due to hereditary factors. Scientists have found a number of common genetic abnormalities with schizophrenia, bipolar disorder, and personality disorders (psychopathies). For example, the genetic contribution explains the exceptionally high level of characteristic features of patients: strange appearance and behavior, alienation, and lack of close friends. The genetic commonality of schizotypal disorder and schizophrenia also determines some cognitive abnormalities that relate to attention and memory.         

Environmental factors. The causes of schizotypal disorder are associated not only with heredity, but also with factors unfavorable for the development of the fetus, psychological trauma in early childhood, and chronic stress. In particular, maternal influenza during the sixth month of pregnancy was associated with a higher level of schizotypal symptoms in the adult male population. Serious risk factors for the development of schizotypal disorder in adolescence can be malnutrition of a pregnant mother and child under three years of age, a history of child abuse, emotional abuse (including bullying and post-traumatic disorder), neglect, neglect, especially if the genetic background is appropriate.                 

The combination of various adverse effects leads to disturbances in the neurochemical balance in the brain, hormonal and immune abnormalities that determine the clinical picture and accompany schizotypal personality disorder.    

Diagnosis of schizotypal disorder

The variety and multicomponent symptoms in men and women with schizotypal disorder in psychiatry creates difficulties in diagnosis. Outwardly, patients may exhibit anxiety or “neurotic conflicts” that are defined or aggravated by “hidden” magical ideas, strange beliefs, or overvalued ideas. Therefore, schizotypal patients are initially often diagnosed with attention deficit disorder, social anxiety disorder, autism, dysthymia, neuroses, bipolar disorder, depression, and psychopathy.   

Only a psychiatrist can make a diagnosis of schizotypal disorder and give a prognosis after appropriate clinical studies of the patient, obtaining objective information about his behavior and manifestations of the disease from close relatives.  

Only a psychiatrist can establish a diagnosis of schizotypal disorder after appropriate clinical studies of the patient, obtaining objective information about his behavior and manifestations of the disease from close relatives.  

Additional methods – pathopsychological, neurophysiological examinations, blood tests to identify markers of activity and severity of a mental disorder (for example, Neurotest) – will help to improve the quality and reliability of diagnostics .    

Thanks to the pathopsychological examination (carried out by a psychologist), the peculiarities of cognitive processes, the emotional-volitional sphere, and personal characteristics, which form the psychological portrait of the patient, along with pathological features caused by schizotypal disorder, are revealed. Neurophysiological examination gives an idea of ​​the degree of damage or distortion of cognitive functions, the degree of reserve and compensatory capabilities of the brain.      

The neurotest includes several indicators reflecting the state of the immune system involved in the formation of schizotypal disorder and other disorders of the schizophrenic spectrum. Certain combinations of deviations in the indicators indicate a specific variant of the disease, suggest its prognosis, the severity, severity of the condition and the effectiveness of the therapy.      

Treatment for schizotypal disorder

Treatment for schizotypal disorder should begin as early as possible and be comprehensive. Timely diagnosis and adequately selected therapy not only reduce painful symptoms, but also reduce the risks of complications in the form of disability, social isolation, loneliness, the transition of a slow-paced painful process to more severe forms of schizophrenia, addictions, and suicidal tendencies.       

Complex therapy is an effective combination of psychotropic drugs and psychotherapeutic techniques. Remember! Only a trained psychiatrist knows how schizotypal disorder is treated.    

Drug therapy. Used drugs of various pharmacological groups – neuroleptics, antidepressants, normotimics, tranquilizers. Specific schemes are selected individually, taking into account the clinical picture, the duration of the disease, the state of somatic health. Treatment is long-term: after the relief of actual symptoms, supportive therapy is carried out.   

Psychotherapy. In order to obtain a positive and stable result, the patient’s supervision by a psychotherapist is mandatory. In contrast to schizophrenia, schizotypal disorder when allowed to use virtually all types of known psychotherapeutic methods. In the sessions with a psychotherapist produced the necessary skills of coping with symptoms, maintain social ties, the formation of plants on the activation of volitional and motivational impulses, correction of pathological personality characteristics. Psychotherapeutic sessions have an important psychoprophylactic value, helping to increase the patient’s stress resistance and prevent auto-aggressive behavior.          

In contrast to schizophrenia, schizotypal disorder under treatment involves the use of almost all known psychotherapeutic methods.  

The primary prevention of schizotypal disorder in children is early environmental enrichment. This includes exercise, cognitive stimulation, and improved nutrition between the ages of three and five, which improves brain function and reduces the likelihood of developing illness in adolescence.        

In this article, I have attempted to answer the questions that clients with newly diagnosed bipolar disorder ask me . I will try to answer in a simple and understandable way, based on scientific facts and information that I received during my practical work with BAR.            

According to what the symptoms are diagnosed with “bipolar disorder”? How does the disease manifest itself? 

Bipolar disorder is characterized by severe mood swings. The mood for several months, weeks, or (less often) for several hours “goes to extremes” – it becomes too cheerful and too bad.     

The mood for several months, weeks, or (less often) for several hours “goes to extremes” – it becomes too cheerful and too bad.     

Mania or hypomania is an elevated mood and intense physical and mental activity. Mental activity becomes heterogeneous – attention catches every detail, but it is difficult to concentrate it on one thing for a long time . Thoughts are constantly “jumping”, one idea is quickly replaced by another. All emotions intensify: joy – to euphoria, irritation and resentment – to aggression, suspicion – to paranoia. Physical activity also increases: I almost do not want to sleep (three hours of sleep seems to be enough), sexual desire increases. Behavior becomes impulsive, reckless, sometimes even adventurous and eccentric. A person can become obsessed with some idea. In an episode of mania, delusions and hallucinations may appear .                 

Hypomania is liked by everyone who has experienced it at least once. In hypomania, in contrast to mania, delusions or hallucinations occur less often, criticality remains, aggression is lower. Nevertheless , hypomania is not a normal state for the psyche, the brain works in an enhanced mode. On the acceleration of mental processes are redundant resources, and when they end, comes complete exhaustion. With hypomania, the psyche runs a sprint, as it were. Imagine if all your life you will only run – the body will quickly become depleted and worn out. So it is with the psyche. Hypomania can turn into more unpleasant states – mania or depression.                    

On the acceleration of mental processes are redundant resources, and when they end, comes complete exhaustion. With hypomania, the psyche runs a sprint, as it were.   

Another sign of bipolar disorder is not just a bad mood, but depression, from mild short- term to severe long-term. The opposite is true here. Activity falls: when you need to do something, there is neither strength nor desire. Mental activity is even more difficult: in addition to the lack of desire and strength, it is difficult to concentrate attention, remember, analyze, make a decision. The experience of emotions is dulled, with the exception of aggravated resentment, feelings of guilt, hopelessness, confusion, anxiety or indifference. Appetite changes, insomnia or excessive sleepiness appears. Even if you are a very cheerful person, with severe depression, suicidal thoughts appear. With severe depression, delusional ideas and hallucinations may occur.         

These phases can replace each other, they can manifest themselves simultaneously. For a long time, only one pole can appear – then even doctors, instead of a correct diagnosis of “bipolar disorder”, may first put “depression”. The intervals between episodes (intermissions) are different for everyone – it can be a month, a year, three years, five years.   

In a healthy person, changes in the activity of mental processes are not so contrasting, more amenable to regulation. They do not lead to a deterioration in daily functioning – a person can successfully cope with the professional, academic responsibilities assigned to him, establish and maintain relationships with others.          

In what causes bipolar mental disorder? 

By Unfortunately, science does not could answer why there is a bar. It is only known that many factors interacting with each other are involved in this .    

Now the onset and development of the disease is considered through the biopsychosocial model (BPSM). According to this model, the development of the disease is influenced by three factors – biological, psychological and social.    

The biological factor includes genetics, physiological and biochemical characteristics of the organism.   

The psychological factors in the development of bipolar disorder include the number and intensity of stressful experiences, coping strategies, character traits, emotional sphere, and thinking.   

Social factors – cultural and political environment, economic situation, microsocial environment (family, friends, professional environment, acquaintances). 

The emergence and development of bipolar disorder is not due to one of these factors, but is a consequence of their interaction.     

By Unfortunately, science does not could answer why there is a bar. It is only known that many factors interacting with each other are involved in this .    

Questions like “Why me?”, “What causes BAR?”, Which cannot be answered, are called ruminations. Thought chains that arise when thinking about such questions do not lead to an answer, but lead to a decrease in mood, an increase in anxiety and a feeling of hopelessness. Psychotherapeutic techniques and communication with loved ones will help to switch or abstract from such thoughts .         

How is bipolar personality disorder treated? Am I going to be in a mental hospital?  

The need for hospitalization may not arise if you approach treatment responsibly . If treatment is neglected, episodes of mania and severe depression are more likely to lead to hospitalization. However, hospitalization does not put an end to a person’s life, but helps to get out of an episode of depression or mania and return to normal life.             

As mentioned earlier, there are three factors that influence the course of bipolar disorder – biological, psychological, and social. To minimize the impact of bipolar disorder on your life as much as possible , you need to take control of all three factors. In this case, you do not have to go to the hospital and outpatient treatment will be enough.        

The biological factor will be taken over by drugs and a healthy lifestyle. Your psychiatrist will prescribe the medication you need. The drugs should be taken regularly, you should not pause without consulting your doctor. If you experience any side effects, talk with your doctor and decide together – should there be patient, change the dosage or switch to another medication.          

A healthy lifestyle helps to maintain the normal state of all body systems , including the nervous system. Taking medications will not give a good effect if drugs or alcohol are acting on the brain in parallel . To maintain the nervous system, and therefore all mental activity, will help you in good condition: stable good sleep (at least seven hours), absence of bad habits (alcohol, drugs, smoking), regular physical activity, good rest, adherence to the daily routine, correct nutrition.       

The drugs should be taken regularly, you should not pause without consulting your doctor. If you experience any side effects, talk with your doctor and decide together – should there be patient, change the dosage or switch to another medication.        

The psychological factor will help regulate and take control of psychotherapy. The recommended psychotherapy for bipolar disorder is cognitive behavioral therapy (CBT). Psychotherapy will not cure the disease, but will allow you to develop skills in problem solving, effective communication, coping strategies. New skills or habits will help you cope with stress and anxiety and resolve intrapersonal conflicts. After completing psychotherapy, you will be able to independently apply these skills in life. Depressive episodes will be easier to experience, and their consequences will cease to be so severe. Psychotherapy promotes the development and harmonization of the personality, which prevents the emergence of some stressful situations (conflicts, destructive relationships).           

The social factor in the development of bipolar disorder is relationships with loved ones, work or study, social activity. The support of relatives and friends has a positive effect on the psychological state, helps to cope with episodes more easily. Stable work is also important, not only as ensuring economic stability, but also in order to observe the daily routine, expand the circle of friends, and feel their own importance and need. Spending time with friends and comrades has a positive effect, brings positive emotions, distracts from sad thoughts in a depressive episode.           

I would like to summarize the above about the treatment of bipolar disorder:  

Bipolar Affective Disorder (BAD) Treatment Cheat Sheet 

Control of biological factors:

1. Observe a psychiatrist (at least once every three to four months);   
2. Take medications prescribed by a psychiatrist;
3. Lead a healthy lifestyle;
4. Set the daily routine.

Controlling psychological factors:

1. Accept yourself with bipolar mental disorder; 
2. Take a course of psychotherapy;
3. Apply independently acquired skills to prevent and resolve stressful situations; 
4. If possible, minimize the number of stressful situations. 

Control of social factors:

1. Help and support of family members; 
2. Stable and feasible work; 
3. Communication, pastime with friends and acquaintances;  
4. Social activity, expanding the circle of acquaintances.

In this memo is clearly visible that you yourself can do a lot to improve their condition. Almost everything depends on you.   

Remember, when protective factors outweigh risk factors , this is a good tool to reduce the frequency and intensity of episodes.  

Is it possible to completely remove the symptoms, be cured? 

Bipolar personality disorder is a chronic disorder. You cannot be cured forever, but you can minimize the symptoms , sometimes even completely remove them . With the combination of pharmacotherapy, psychotherapy and prevention methods, the manifestations of the disease can be minimized. If there are more protective factors than risk factors, then the symptoms of bipolar disorder will not affect your life or will go away altogether.       

Is it possible to remove a bad mood (depression) and leave only good mood (hypomania)?  

No, unfortunately, you cannot remove depression and leave only hypomania.  

How will bipolar disorder affect my life? 

If a patient with bipolar disorder takes pharmacotherapy and adheres to the rules for preventing episodes, the number and intensity of episodes is minimized, and symptoms are completely absent in intermissions. Under these conditions, bipolar disorder does not significantly affect life.        

Bipolar disorder, like any chronic disease, makes changes in the regimen: systematic visits to the doctor, medication, preventive measures.  

If bipolar disorder is left untreated, episodes can significantly impact work and personal life.   

BAD, like any chronic disease, makes changes in the regime: systematic visits to the doctor, taking medications, preventive measures.  

During the hypomanic and manic phases, mental and physical activity increases, but becomes impulsive and chaotic. The work will be easy, but it will not bring results . You will be able to deal with many things at the same time, but no one is not to be brought to an end. In relation to close people, hostility and aggression arise , which gives rise to conflicts. Without malicious intent, you can offend loved ones and not even notice it, quickly switching to something else. A manic episode can be accompanied by delusions and hallucinations, therefore, the likelihood of hospitalization increases.                   

In a depressive episode, there is neither the desire nor the strength to do anything, so work and study will be difficult. Severe depression forces them to take an academic leave from studies, leave from work. In relation to close people, indifference, resentment and isolation appear .         

In addition to what has already been said, such a “swing” tire not only you, but also the people around you. For the employer, this is an unstable worker who cannot be relied upon . For loved ones (especially if they do not know about the diagnosis of bipolar disorder) , unpredictability of mood causes emotional stress, this leads to misunderstandings and conflicts.          

Can you have children while taking pharmacotherapy? 

There are no contraindications for men. Women should discuss pregnancy with their healthcare provider beforehand . During pregnancy, the doctor may change the combination of drugs and their dosage.    

Will children inherit bipolar disorder? 

According to the Center for Clinical Interventions, children of patients with bipolar disorder have an 8% risk of inheriting the disease. According to Bebbington (2004), the probability of inherited bipolar disorder is 5-15%. At the same time, the likelihood that relatives of bipolar patients will develop unipolar depression is twice as likely (that is, ordinary depression without the second pole – without mania / hypomania).         

This does not in any way mean that you do not need to have children. This is a reason to take care of the biological, psychological and social components of their development. Do not forget that the probability of staying healthy in children of patients with bipolar disorder is 65-75%.            

How to explain to loved ones what is happening?

A negative attitude towards mental disorders still persists in society , so it is difficult for a person with a psychiatric diagnosis to tell even close people about it. However, the support of family and friends plays a very important role in psychological well-being and gives strength to cope with stressful situations.        

Talking about the features and symptoms of bipolar disorder, you can always use the description of its symptoms given at the beginning of this article.    

Why is it important to inform loved ones about your condition: 

1. Family and friends will be able to spot dangerous behavioral changes that precede episodes and advise you to go to an unscheduled doctor’s appointment. The doctor will have the opportunity to correct pharmacotherapy in time, which will shorten the duration and intensity of the episode.       
2. Relatives will not take the behavior during the episode personally and it will be easier to tolerate irascibility, resentment, aggression. The amount of conflict and additional stress for you will be reduced . If you tell people about meaningful diagnosis, it will help make communicating with them more environmentally friendly, positive, less traumatic.         

If you do not want to explain your condition in detail, at least do not isolate yourself from loved ones. Avoid creating new stress for yourself in the form of conflict and breaking up with family and friends. You can simply reduce the amount of communication. Spending less or less time with loved ones during an episode does not necessarily raise suspicion. We all have periods of high utilization and employment. And only you can decide whether to tell someone about your diagnosis or not.                    

And only you can decide whether to tell someone about your diagnosis or not.   

Support can be found in psychotherapy and bipolar disorder support groups . These are special groups with certain rules in which you can meet people with the same diagnosis, discuss issues of concern to you about bipolar disorder, gain understanding and support.           

Where to go for advice and help?  

There are different options for receiving psychiatric and psychotherapeutic help. 

State psychiatric hospitals and neuropsychiatric dispensaries at the place of residence.   

Private clinics licensed to provide medical care. The authenticity of the license can and should always be checked on the website of the licensing authority. Do not forget to verify the authenticity of the education specialists you contact.      

No option can 100% guarantee the best mental health care. If you have any doubts or discomfort, you can always change your doctor, listen to several opinions and try different treatment options. A good specialist will always be able to tell you about the diagnosis and the course of treatment, back up his words with data from modern research. The choice is yours.       

Oncophobia or carcinophobia is the fear of cancer , including cancer. Most often it occurs in people predisposed to increased anxiety and suspiciousness after a collision with oncology in another person.       

A predisposition may arise in a child whom anxious parents constantly take to doctors. He learns to be attentive to his health and grows into an anxious adult.      

If a family member, close friend, or coworker dies of cancer, an obsessive fear of cancer can develop .   

Often a person has a pain, and he strengthens his suspicions. He loses weight, begins to look bad, his appetite disappears. For most, these are signs of cancer. A person goes to oncologists, oncologists find nothing and refer to a psychotherapist, because it is most likely depression , which manifests itself in the same symptoms – weight loss, lack of appetite, weakness, lethargy and even pain.              

If a family member, close friend, or coworker dies of cancer, an obsessive fear of cancer can develop. 

A mild degree of oncophobia can go away on its own. The man went to the examination, made sure that he had nothing, and calmed down. Fear can appear from time to time when cancer is mentioned in conversations, when someone from the environment is found to have cancer. Then it passes.       

If emotions prevail, and fear is very strong, one might say pathological, you will not be able to cope on your own . A person does not believe in rational arguments, criticism of his condition disappears . Doubts arise – they suddenly missed it, made a mistake, the doctor was caught unqualified. Obsessive thoughts interfere with work and communication, sleep is disturbed. In this state, you need to go to a psychotherapist.        

The fear of oncology can be the only thought of a person

If nothing is done about oncophobia, fear can seize all spheres of a person’s life, take away all the time and energy.   

Someone devotes their lives to looking for cancer, to double-check the opinions of doctors, to go for second and third opinions.  

She had a fear that it was oncology. In that moment, she closed her eyes and with since they did not open.      

Someone has been diligently engaged in prevention all their lives, this is called “health hypochondria.” A person begins to lead an impeccably healthy lifestyle, quits smoking, drinking, trying more and more new recipes for “cleansing the body” from the Internet.  

Someone has suspected for years that he may have an oncological disease, and refuses to go to doctors, fearing that the diagnosis will be confirmed. Against the background of experiences, a depressive state may develop.    

In my patient it was recently. Three years ago, she had a uterine bleeding, in which she is not addressed to the doctor. This condition has passed, everything was normal, but in it there was a fear that this is oncology. In that moment, she closed her eyes and with since they did not open. Says: “When I open my eyes, I have a burning sensation in my eyes, I feel bad, they are watering.” If you give a psychological explanation for this, she is so afraid of oncology that she does not want to “see” this problem.                 

Treatment of oncophobia – psychotherapy. Medicines at the request of the patient  

To cope with oncophobia, you need a psychotherapist. An expert who is well versed and in pharmacotherapy (medication therapy), and in psychology.     

At first the doctor will suggest psychotherapy: cognitive-behavioral, therapeutic hypnosis, gestalt therapy, rational therapy. Any kind of psychotherapy will give results if it is comfortable for the patient.  

They usually start with rational psychotherapy – to explain to a person what is happening to him, together to weigh the arguments for and against.     

The less anxiety, the less thoughts about oncology. 

When it is impossible to cope with conversations alone, the anxiety is too strong, the doctor suggests pharmacotherapy.

If you engage in psychotherapy and follow the recommendations of your doctor, the result, of course , will be. It must be remembered that psychotherapy is not only the work of a doctor, it is not just to come and sit and listen. The patient must study, do the assignments given by the psychotherapist. Then everything will work out.      

Independent work with anxiety is imperative. 

Defeating oncophobia in sessions with a psychotherapist is not enough. Professional support is the first step in learning how to deal with anxiety on your own.     

You can relax – do auto-training, go to yoga, learn breathing exercises, take a course of biofeedback therapy (biofeedback therapy ).   

You can be distracted and relieved of anxiety through exercise, fitness, and jogging.   

It is important to go to bed on time, not to overwork, to meet with friends, to communicate, not to withdraw into yourself, if something bothers you, to talk about it.     

You need to stop surfing the Internet and look for symptoms in yourself. This is a very important point, because many diagnose themselves over the Internet – very scary diagnoses. If something bothers you, it is better to go to the doctor.     

The less anxiety, the less thoughts about oncology. 

Neurasthenia is a borderline neurotic disorder caused by overwork or chronic stress. Neurasthenia is much more common than one might think – and not in the weak and melancholic, but in the most active and committed young men and women.            

The disease of hyperresponsible people and perfectionists 

The average age of a neurotic patient is from twenty-five to fifty years. As a rule, this is a resident of a big city who works hard, leads an active social life and, as they say, always succeeds in everything. When psychologists say “burnout,” psychiatrists often refer to neurasthenia.   

Typical personality traits that become favorable factors for the development of the disease: asthenic type (“nervous weakness”, exhaustion), increased anxiety, suspiciousness and perfectionism. Such people are very responsible, they are very worried about their obligations, they try to do everything at the highest possible level. They are never late, they are very worried if they cannot keep their promise.       

When psychologists say “burnout,” psychiatrists often refer to neurasthenia.

It also happens in another way: difficult life circumstances fall on a person – a serious illness of a relative, alcoholism or betrayal of a partner, household and financial difficulties. In a word, an unfavorable environment, overexertion and pressure, which lead to constant stress and frequent overwork.       

Types of neurasthenia

According to the international classification of diseases, revision 10 (ICD-10), the types of neurasthenia are represented by two types.  

The first type is increased fatigue after mental work. The person complains that they are less successful at work or in everyday activities due to distracting associations, memories, problems with attention. Mental exhaustion is more pronounced.     

The second type is general weakness after minor physical exertion (not going to the gym, but something ordinary) with a feeling of pain in the muscles. Also, the person says that he cannot relax.        

In other classifications, there is hypersthenic and hyposthenic neurasthenia – these are rather phases (stages) of the disorder, which will be discussed later.    

Symptoms and signs of neurasthenia: from irritability to deep fatigue   

A person can suspect neurasthenia on the following grounds:  

• became more irritable;
• gets very tired in the evening; 
• reacts sharply to insignificant stimuli (“everything pisses me off”); 
• began to swear with colleagues and loved ones more often , “snap back”;  
• has always been calm, and now he loses his composure, raises his voice or cries for no serious reason. 

The disease develops in three phases. Signs of neurasthenia at different stages are slightly different.  

1 The first (hypersthenic) phase is expressed in increased excitability, irritability and sleep disturbance. A person is “on edge” all the time , a sharp sound or sudden bright light causes pain in him. Disturbed by dizziness, headache, throws in a fever or chills, excitement is accompanied by attacks of palpitations.       

2 The second (hyposthenic) phase is an increase in weakness. The nervous system is depleted, a person has to strain in order to maintain a habitual way of life. It becomes difficult to get out of bed in the morning and do housework: “I can’t bring myself to do it,” “I don’t have the strength to leave the house,” the ability to “think quickly” is lost.        

3 Phase of exhaustion – symptoms of neurasthenia are complemented by a deep feeling of weakness. There is tearfulness, conflict, general lethargy. I don’t want anything, nothing motivates. The disease has completely taken over a person’s life.    

Neurasthenia and depression 

If neurasthenia is not treated for a long time , it leads to changes in the body: the resource is depleted, immunity decreases. There is a decrease in the production of neurotransmitters in the brain (serotonin, dopamine), which can lead to an even more serious pathology – depression.      

In psychiatry, there is a term “disorder of adaptive reactions.” So they say when, for example, depression develops as a reaction to prolonged neurasthenia.   

In pure depression there are some differences: 

• mood noticeably worse for more than two weeks;
• there are long-term sleep and appetite disturbances ; 
• worried about pain not associated with a disease of internal organs (pain in the abdomen, in the pelvic region);    
• mood and well-being fluctuates during the day (worse in the morning).  

Treatment of neurasthenia

In each case, the treatment of neurasthenia should begin with the elimination of the traumatic situation and the activity that is overwhelming. If you cannot get away from stress (go to another department, change jobs, part with your partner), then you need to learn how to cope with it through meditation, auto-training or psychotherapy.          

I always recommend that patients start by resting, rethinking their lifestyle and maintaining a healthy regimen, but, unfortunately, it is not always possible to solve the problem without therapy . If the symptoms do not go away within a month after the start of the recovery regimen, you need to make an appointment with a psychiatrist.        

If the symptoms do not go away within a month after the start of the recovery regimen, you need to make an appointment with a doctor. A psychiatrist or a psychotherapist (not a psychologist) will tell you how to treat neurasthenia .    

The diagnosis is made on the basis of complaints and the patient’s story about the disease. Additional methods are prescribed to rule out other diseases. For the treatment of neurasthenia, a psychiatrist prescribes modern antidepressants – SSRIs (selective serotonin reuptake inhibitors) or similar drugs.    

In addition to meditations, which help a person restore the balance of the body’s work, I also recommend sessions of restorative hypnosis to patients. Hypnotic techniques are highly effective treatments for neurasthenia.   

The prognosis for neurasthenia is good – it can be cured of it.  

Once again, I emphasize that depression can be hidden behind the symptoms of neurasthenia. Although we and describe their differences higher urge: Do not put yourself diagnoses themselves. It also happens that even psychiatrists put neurasthenia where a more serious condition is observed. To such patients come to me. They assume they have chronic fatigue syndrome, the diagnosis is “neurasthenia”, and I see a classic case of recurrent depression. If a patient is depressed, he definitely needs the help of a doctor.