Postoperative psychosis in the elderly: treatment, causes

Living after psychosis

Hello, please help. How to force yourself to live. ? I recently suffered a lot of stress, after which I developed psychosis (obsessive thoughts, fear of everything and everyone), which did not stop coming to my head for 2 years.. now it’s better. then remission.. maybe the treatment is doing its thing. .. But there are no such emotions, sensations as there were before.. an almost emotionless creature.. It’s very difficult for me. I didn’t know what was happening to me.. I had social phobia for psychosis.. and every year it got worse and worse (this was after work, which I was very afraid to go to - psychosis occurred). I believe in God, I pray, I confess.. but I don’t understand why a person can endure such a terrible, serious illness or trials.. I can’t fully come to terms with the fact that I am a mentally ill person.. in my family and in my mother’s and on my father’s side there were schizophrenics (close relatives). Like every girl, I dream of getting married and having children, but I understand that it’s better not to think about it, because this disease can be passed on to children (and this is unbearably difficult), and I think that if psychosis develops again, the young man will not be able to stand it. and I don’t know.. or whether I can still endure this moral and physical torment. Support the site:

Irina, age: 24/01/21/2014

You are not a mentally ill person. Besides, you are not alone. You have someone to live for. Help your young man. Let him help you. Ask him to protect you from this. I'm sure he will be flattered and hug you. And believe me, such sincere hugs may well be at least temporary protection from this feeling. Try to do a lot of good for him and other loved ones for free. Improve yourself. Perhaps you should change your job to a place with some kinder team. Maybe find some kind of hobby. And of course, develop your relationships. Tell your boyfriend how much you love him. Happiness and kindness. As they say, your life is at its most beautiful time.

Anastasia, age: 31 / 01/21/2014

Hello! I would really like to call you by name and wish you health. My name is Svetlana, and I will speak based on my experience. My mother is sick with schizophrenia, the heyday of her illness began during my eleventh birthday, throughout the acute phase and beyond I was with her. Now I am no longer 11 years old, I am married and have four children. If we proceed from the materialistic concept of illness of the Soviet period, then it comes down to the postulates that were in your post. It seems to me that you are very brave, this demonstrates your trust in us, visitors to this site. Karl Jaspers defines illness as “a borderline state that sobers up, awakens from spiritual sleep, reveals the true essence of a person”

Svetlana123, age: 37 / 01/21/2014

Whether children will get sick or not depends on the will of God. And healthy people give birth to sick children, and sick people give birth to healthy ones. If God wants, the child will be healthy.

Sonya, age: 33 / 01/21/2014

Dear Irusya. The fact that you believe in God, pray and confess is simply wonderful! Keep praying, everything will be fine. God will not leave you! If you are tormented by thoughts of suicide, you can read this prayer: https://duhovnik.com/node/64 Maybe you just need to convince yourself that all people are our brothers and sisters, we have no strangers. There is no need to be afraid of anyone. Try to communicate with people, do not isolate yourself. Fighting pride and trying to do everything in good faith can also help you get rid of social anxiety. Go to an Orthodox church, confess, take communion and everything will be fine!

Victoria, age: 19 / 01/23/2014

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snarkov May 22, 2012

Hello, I'm 26 years old, working, single. by nature he is an impressionable, emotional person, takes everything to heart, well-read... before the hospital he lived a full life, sports, communication. 9 months ago I was admitted to the hospital with manic syndrome, not forcibly, friends brought me, symptoms - I slept little, a lot of ideas related to professional activities (to the doctor they seemed crazy, they still seem real to me))), reassessment of my capabilities, increased strength. , talked a lot, tried to convey his ideas to close friends. I felt renewed, I told the doctors that my thinking had changed and that I myself had changed, saying that I was now capable of anything. the acute condition was stopped with trunks, then they prescribed Invega. I took it for a month and quit, my condition was very bad, I didn’t take Sedalite either, that is, I didn’t actually treat the manic state, I spent a month in the hospital, I was discharged, after discharge my mood changed very much, I don’t feel like living in the morning; it’s easier in the evening; I didn’t communicate with anyone. I tried hard to recover after the hospital - sports, I went to the sea several times. And only in the last couple of months I began to feel more or less stable, I communicate, I work a little, my interest in my former hobbies returned, but not completely. A couple of times after the hospital there was mild hypomania for a couple of days, which was controlled..

Today I am worried about the following - I objectively cannot feel the same as before going to the hospital, first of all I am worried about some kind of reduced emotionality, at times strong apathy, it is difficult to concentrate, I do not assimilate and analyze information as quickly as before, less interest in friends , sports, I can’t normally get involved in work... and some strange perception of the world around me, for example, you come to those places where your heart always sank before and you experience NOTHING, as if everything is unfamiliar, there is always some kind of disconnection from reality . The doctor says that this condition is recovery from psychosis. I’m constantly driven and thinking about it, it’s very hard to worry about it. What does this state mean - recovery from psychosis, or the beginning of some more serious illness, for example a simple form of schizophrenia or schizotypal disorder. BAR.

Deltel Jun 22, 2012

From your story, I understand that you have already been taken off the anti-inflammatory drug (Invengu). The fact that doctors say that your condition “is a recovery from psychosis” is complete nonsense. I’ll tell you the following, you simply need an antipsychotic drug now and it will make it “easier to recover.” You are just going through psychosis right now.

Recommendations . Risperidone according to the regimen: days 1-4 1 mg at night, days 4-8 2 mg at night, days 8-10 2 mg at night. Then it will be seen whether to increase the dosage or not. If significant relief occurs at any given dose, then you can stop and not increase the dose further. If your doctors do not agree with me, then try to buy the drug yourself and try to drink it. It won't be worse for sure.

neuroleptic.ru

Electroconvulsive therapy

The basis is the induction of convulsive seizures due to the action of electric current, affecting the subcortical structures of the brain and the metabolism of the nervous system.

The success of therapy largely depends on the time at which treatment measures begin: the earlier treatment begins, the higher the likelihood of curing a mental disorder and preventing negative consequences for the individual.

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Briefly, three weeks ago I took my daughter with acute psychosis to a psychiatric clinic. In general, there are a lot of such stories on this forum, so I won’t describe mine for now. I read on the forum that the diagnosis is important for my daughter’s future life and it would be desirable for it to be milder. In a week, the doctor will close the sick leave, which is needed at the place of work. In this regard, the question is: will the diagnosis be indicated on the sick leave certificate? Or will the local psychiatrist make the diagnosis?

Thanks in advance for your answer.

PS. A little later I will try to formulate and ask a question about medical leave, because... I have already had a negative experience.

It is important that the diagnosis is established correctly and the treatment is selected correctly. This is for later life. And for a sick leave, it is desirable that the diagnosis be “softer”.

The diagnosis is no longer very important. It can be said to be one thing - a mental illness. Most likely they won’t write it on the sick leave, but they will put a stamp from the mental hospital - everything is clear on it. The diagnosis will be more specific, naturally, the psychiatrist in the hospital will make it, write it down in the medical history (secret for you), and the local psychiatrist will strictly adhere to this diagnosis, because For them, the hospital is a “more senior” authority; there, as it were, collegiality is considered. Most likely they won’t tell you the diagnosis, but in prescriptions for medications they can, and for free ones they should, write it in the form F. which can then be deciphered using the reference book. In case of psychosis, an antipsychotic will always be prescribed to suppress it. They treat direct relatives as if they were people with a genetic deformity who gave birth to genetically defective children, which in fact is not true. (Don’t be offended by my words - I myself am the father of a sick son). Quote:

Ask right away, about academic leave or what? What was the negative experience?

Thank you very much for your answers. Sola05 , thanks for the clarification. This is exactly what I meant. Dr.Admin , my wife immediately said something similar. Problems with the endocrine system, thyroid gland, etc. cross , how can I be offended by the words of a person who is trying to help. I can’t say that the doctor treats the spit like “genetic freaks,” but rather like unreasonable children, and, as the wife says, “looks mysteriously.” A typical answer is: “why do you need this” or takes the conversation aside, etc.

Question about medical leave. The daughter was allowed on medical leave for 7 days after two weeks in the clinic. I forgot to write, they gave me 5 mg of triftazine and 12.5 mg (quarter) of azaleptin at home before bedtime, there were no correctors. As a result, I brought her to the clinic a day early, and she was again placed in the violent ward. Learned a lot about her friends. After communicating with them, a healthy person will be blown away, what can we say about a sick person. Now the question is, what to do on your next medical leave? I plan to limit my daughter's communication with her friends, including on the phone. What does this mean? a nervous breakdown?

Now psychiatrists have come up with these releases from the hospital for a while in order to check how the patient can exist at home, how inhibited he is and accustomed to taking a neuroleptic (NL). Some people immediately stop taking it (they imitate taking it in front of their relatives and then spit it out) and become violent again. For some, the relatives themselves are dull and mistake youthful energy for illness and needlessly push their children back into the madhouse; the views of children and parents often diverge. Some have friends who are drug addicts, alcoholics, etc., who immediately begin to push all sorts of rubbish, leading to a mental breakdown. There may be other options. What you have is unclear, because you didn’t tell anything about the illness or the reason for the negativity towards your daughter’s friends. It is hardly reasonable to limit communication without reason; communication is the best way to overcome mental illness.

The option of psychiatrists treating the parents of patients as underdeveloped children also occurs.

The cause of the disease, by the way, may just be hidden in the endocrine system, and in the thyroid gland, and elsewhere, but psychiatrists will not identify this cause, your daughter will forever remain sick with this thyroid gland, etc. plus inhibited from taking NL. IMHO, they give her enough for the first time, but if they give her such old NL without proofreaders, she won’t stand it for long.

psychoreanimatology.org

Age-related changes in the human body

With age, various changes occur in the human body, functionality decreases, the heart wears out, and the performance of most organs and systems deteriorates.

There are signs of aging that become noticeable first: the appearance of wrinkles, deterioration of skin color, deterioration of physical capabilities.

The aging mechanism is quite complex and individual in each individual case, so the aging process progresses differently in each person.

Surgery under general anesthesia

The following changes occur in the human body with age:

the sensitivity of nerve cells decreases;
blood supply deteriorates, which leads to cell aging and decreased performance of the central nervous system;
heart function worsens;
the blood becomes thicker;
atherosclerotic plaques appear on the vessels;
the functioning of the respiratory organs decreases: dystrophic changes occur in the lungs, their vital capacity decreases;
Most older people have reduced hemoglobin levels in the blood;
In men, prostate hypertrophy develops in old age, which leads to deterioration of kidney function.

Deterioration in the functioning of the body increases the risk of complications after anesthesia in older people: anesthesia drugs act more slowly on the patient, and recovery from anesthesia is longer and more difficult. However, this is not a contraindication to surgery in old age.

How should older people prepare for anesthesia?

Physical and mental health becomes more susceptible to various irritants with age.

To assess the effect of anesthesia on the body and the development of possible consequences, doctors conduct a comprehensive examination.

Diagnostic measures consist of:

taking a laboratory test of blood and urine - the level of red blood cells and hemoglobin is checked; if their numbers are low, it may be necessary to prescribe drugs rich in iron or a blood transfusion; the ESR content is assessed; A general urine test allows you to assess the performance of the kidneys;
ECG - study of heart rhythm, in case of violations of which general anesthesia can be replaced with local anesthesia;
Ultrasound of the abdominal cavity - is carried out to assess the internal organs, their size, the presence of pathological processes;
blood for sugar - almost half of the elderly population suffers from diabetes, which reduces the functions of the circulatory system; when glucose deviates from normal values, regeneration processes are reduced, which delays the healing of postoperative wounds;
blood for clotting;
blood test for biochemistry;
blood type and Rh factor;
RW, HIV, hepatitis C and B;
Fluorography.

The doctor carefully studies the patient's medical history, in particular information about allergic reactions to medications.

Types of anesthesia

To minimize the risks of recovery from anesthesia after surgery for an elderly person, it is important to choose the safest method of anesthesia.

There are a large number of types of anesthesia, the most commonly used are local, general, combined and combined.

Local anesthesia is much safer in older people

When combined, they combine the use of different methods of one type of anesthesia, such as inhalation and non-inhalation, and others. The combined type is the combined use of general and local anesthesia.

For older people, for minor surgical interventions, local anesthesia or neuroleptanalgesia (intravenous anesthesia, during which the patient is conscious, but there is no sensation) is used.

Local

Local anesthesia is a reduction or complete elimination of pain in a specific area of the skin.

Superficial – an anesthetic is applied to the operated area of the mucous membrane or skin.
Infiltration - the patient is given an injection to block nerve conduction.
Conductive - an anesthetic is injected into the paraneural space and blocks the transmission of nerve impulses along a large nerve trunk.
Spinal - the medicine is administered through a lumbar puncture into the cerebrospinal fluid.
Epidural (peridural) - an anesthetic is injected through a catheter into the epidural space of the spine.

“My life changed when I was admitted to a psychiatric hospital.”

Today everyone struggles with stress. But sometimes completely healthy people have breakdowns that only a specialist can cope with. But in the mass consciousness, a psychiatric hospital, psychosis, and simply a visit to a psychiatrist seem to be something wrong and shameful. An anonymous author talks about his experiences with mental illness.

I sat in the living room with my stunned parents, social worker and nurse. I just found out that I have a mental disorder.

Just a week ago I was at a professional training. But I had to go home because I was overcome with anxiety and became increasingly depressed. For several days I wandered aimlessly around my parents' house.

Like most people, I tried to get rid of sad thoughts as quickly as possible. But this time I couldn't do anything about this terrible depression. I couldn't concentrate even on primitive television series. I listened to the songs and didn't understand what they were about. I thought I was going crazy. I was watching TV, but I saw something of myself: God, the devil, my boss and colleagues. Such hallucinations are one of the signs of psychosis, which develops as a result of deep depression. It was as if I had fallen out of reality.

The diagnosis of psychosis changed my life. I used to think that “mentally ill person” was the same as “psychopath.” I was sure that all mentally ill people are aggressive and antisocial. But I learned from my own experience that mental disorder is a perception of reality that is different from the perception of others, which is often accompanied by hallucinations.

When they told me that I had psychosis, I thought that I was now a danger to society, and I became even more scared. “I may have already done something terrible, but I don’t remember it,” I thought then.

One of my neighbors believed that he was the devil, and another said that he would save the world from evil

I spent ten days in a mental hospital. All the patients and nurses were the heroes of a fantastic story that arose in my sick brain. The nurses seemed to me like messengers of evil forces, and my stay in the hospital was a punishment for my sins. One of my neighbors believed that he was the devil, and another said that he would save the world from evil.

A few days later, they found therapy for me, and I was able to return to reality. I started listening to doctors and reading articles about psychosis. I learned that many patients, like me, believe that mental illness is accompanied by psychopathic manifestations. Journalists and writers use the words “mentally ill” and “psychopath” thoughtlessly. And people who are far from medicine perceive them as synonyms.” For example, maniacs like Freddy Krueger are called mentally ill.

After the psychiatric hospital, my life changed. I went back to work. I am one of the lucky few who love my job. But my life today is completely different from my old life. People who have experienced deep depression often lose faith in themselves and in a happy future. In my hallucinations, I kept seeing a prison with monster nurses. And it seemed to me that it would be like this forever.

Mentally ill people are not dangerous, and the tolerant attitude of others contributes to rapid recovery

After treatment, I was surprised to discover that everything I saw was not really happening. It was as if my brain was mocking me. I was the hero of a thriller and lived episode after episode. Thankfully this terrible movie is over. I left the hospital and began to lead a happy life, which just recently seemed unattainable. After my illness, I began to appreciate my life and the opportunities it gives me.

I'm lucky. I have not had a relapse of the disease since 2014. But for many people they happen regularly. And the misuse and perception of medical terms in society makes these people feel ashamed of their illness. Due to the feeling of guilt that the patient experiences, treatment becomes more complicated and delayed.

I appeal to people to understand and remember that “mentally ill” does not mean “psychopathic, violent, cruel and dangerous.” Mental disorder is an internal state when a person perceives reality in a distorted form. I urge the media, public figures and simply caring people to tell us that mentally ill people are not dangerous, and the tolerant attitude of others contributes to a quick recovery.

Source: The Guardian

Autism: how a child's diagnosis changes a mother's life

April is declared Autism Awareness Month by the UN. We spoke to three parents whose children live with autism spectrum disorder (ASD). What problems did they face, what help did they need, and how did their children help them?

Male and female sexuality: what are the real differences

Today, sexuality has become a source of stress for many, precisely because it has ceased to belong exclusively to the intimate sphere. Common truths, old misconceptions and new standards are so mixed up in our minds that we often find ourselves at a loss. Let's try to clarify.

www.psychologies.ru

Causes

Scientists are currently continuing to study the reasons why psychosis develops. Today we know about the influence of predisposing factors on this, which are:

Mental. The presence of acute or chronic mental disorders, the development of degenerative processes in the brain, etc.
Genetic. In the process of examining twins, it was determined that genes are important, but not predetermining.
Biological. We are talking about malformations and infection of the fetus during pregnancy; also important factors are birth injuries, previous diseases, dysfunction of the endocrine system, neurological disorders, etc.
Psychosocial. Such factors are psychological trauma, constant high stress, regular conflicts, poor relationships with loved ones and others. Intoxication with alcohol and psychotropic substances can also affect the tendency to psychosis.

However, in the development of psychosis, the decisive factor is not one factor, but a number of the reasons listed above.