Treatment of mania and mental disorders in the private psychiatric clinic ROSA

Is persecution mania an independent mental disorder or a symptom of other diseases? Causes, stages and classification of persecutory delusions. What signs may indicate that a person has persecution delusions? What is the danger of a severe form of this disorder, is it possible to get rid of it and how to do it? We decided to discuss this problem in detail with the chief medical doctor, leading psychiatrist, psychiatrist-narcologist and psychotherapist of the clinic, Vladislav Sipovich.

Definition

In psychiatry, mania (manic state) is a mental disorder that is manifested by three signs: elevated mood, accelerated thinking and increased activity.

The people widely understand the word mania as “being overwhelmed by something,” which does not reflect the scientific definition of this term.

Mania is the complete opposite of depression, which is characterized by low mood, slower thinking, and decreased activity.

Mania (or manic state) is a painful condition that requires evaluation by a psychiatrist and treatment. An untreated manic state can reach the level of psychosis and even confusion, which is life-threatening.

How to get rid of persecution mania? Methods of diagnosis and treatment.

When identifying symptoms of persecutory mania, the doctor must first determine the stage and severity of the disorder, as well as identify its connection with other diseases. For this purpose, the following diagnostic methods are used: • CT scan of the brain (BM) and skull makes it possible to identify vascular pathology, tumors, injuries and strokes, which are the root cause of the development of persecutory delusions. • MRI – scanning the brain, skull bones and nearby tissues to identify various pathologies. The safest and most informative method for diagnosing vascular and organic pathologies. • Electroencephalography (EEG) is a safe examination method for assessing the functional state of the brain. It also allows you to identify foci of excitation in epilepsy.

It should be noted that patients often come to the doctor when the disease is already advanced, severe, often with danger for the person himself and others. In this case, urgent hospitalization is required to relieve the most severe symptoms. This primarily concerns insomnia and relieving nervous tension. For this purpose, sedatives, tranquilizers and sleeping pills are prescribed. Subsequent therapy depends on the correct diagnosis, the root cause of persecutory mania, which can be identified by a thorough history taking during a conversation with the patient and his family, as well as the above examination methods.

Persecutory delusions are treated mainly with medication and are often prone to relapsing. Dissuading a person suffering from it is inappropriate, since the dissuading person can be attributed to him in the camp of enemies. Moreover, persecution mania is a mental disorder that cannot be cured by talking and saving conversations. This requires the mandatory assistance of a psychotherapist who knows both medicinal and psychotherapeutic methods of correcting the patient’s condition. The main areas of psychotherapy that are effective in treating delusions are individual cognitive behavioral therapy. Group classes are simply impossible due to total distrust of people - the patient will withdraw into himself even more and will never open up to the group. And the doctor must be as correct and careful as possible, in no way criticizing the content of delirium. He only works through anxiety, irritability, unobtrusively corrects behavior and deals with the patient’s social adaptation. Treatment and its timing are purely individual. Sometimes it can last for years, and sometimes, for example, if the disorder is caused by severe stress, the symptoms subside within a few days.

Drug therapy includes the following drugs: • Neuroleptics. • Antidepressants. • Typical and atypical antipsychotics. • General strengthening drugs. • Vitamins. • Drugs for the correction of metabolic disorders, especially in cases of delirium caused by various intoxications.

Patients usually agree to take medications and even integrate them into the system of their delusions. In particularly severe cases, electroshock therapy may be used, but this is the exception rather than the rule. As with any disease, timely seeking help from specialists at the first signs of persecutory mania is a condition for successful and effective treatment. What do you risk if you just come yourself or bring a loved one for a consultation with a psychotherapist in a private clinic? They won’t register you there, they won’t report you to the relevant authorities, but they will help dispel or confirm suspicions. In addition, the doctor can give recommendations to relatives on how to behave with the patient, and, if necessary, prescribe appropriate treatment.

Causes

Mania is caused by the predominance of overexcitation processes in the brain, which triggers a cascade of complex physiological and chemical reactions in the nervous system, and, as a result, throughout the body.

Doctors identify several groups of causes for the development of mania:

Internal causes (endogenous). These include disorders of protein metabolism in the nervous system, immune disorders in brain tissue, genetic predisposition, hormonal disorders (during the postpartum period, menopause, adolescence).
Consequences of organic damage to the central nervous system due to injuries, poisoning, atrophic processes, neoplasms, impaired blood supply to the brain, etc.
Infections and poisoning.

Treatment of megalomania in medicine

Patients with delusions of grandeur are treated at the clinic anonymously and without registration. Therapy is aimed at identifying the root cause of the disorder and reducing the severity of symptoms.

Depending on the cause that provoked the development of delusions of grandeur, patients may be prescribed antipsychotics, tranquilizers, and sedatives. A psychotherapist and clinical psychologist also work with each patient individually.

If a patient categorically refuses treatment at the clinic, clinic specialists can have a motivational conversation with him. The service of medical intervention is widely in demand in modern society. It allows a person to realize his problem and decide on therapy.

The cost of all services is fixed. Medical care is provided while maintaining patient confidentiality. The clinic is open 24 hours a day. Specialists receive patients at a medical facility and visit patients at home.

You can make an appointment with a doctor, call a doctor at home and get specialist advice by calling the hotline. We are ready to help you even in the most hopeless situation!

Symptoms

Mania is characterized by an elevated mood, with a feeling of euphoria, lightness, “special clarity in the head,” a feeling that “everything is working out easily,” and optimism. Such people speak quickly and a lot, are “easy-going”, and look younger than their age. They easily form ideas of their own greatness, superiority and even power. Often because of this, they give up their usual activities (study, work, projects), leave their families, change their religion and even their appearance (dye their hair, have plastic surgery). Mania is always accompanied by hyperactivity: patients are restless, active, constantly busy with something, and do not feel tired. Sleep is disturbed: it shortens or stops altogether.

During a manic state, patients take out loans, commit irrational actions, make expensive purchases, and enter into marriages that quickly break up.

Clinical picture

Statistically, psychosis is expressed equally often in males and females, as well as in representatives of different cultures and ethnic groups.
However, some researchers (for example, E.V. Kraepelin) claim that the disease is 16% more often detected in females. The phases of mania-depression are noticeable externally - patients' facial reactions, behavior, and emotions change. In the depression phase, a person looks old, gloomy, does not smile, and cries. The mania phase implies a constant state of joy, laughter, and a “running” gaze. In a state of depression, behavior is sluggish, lacking initiative, and difficulties are possible even with everyday chores. In a state of mania, patients often act in extreme ways - they give their property to someone, go on a long dangerous journey, etc.

Speaking about gender differences, it is worth noting that among women the phase of “hidden depression” and severe depressive phase are more common. With latent depression, there are complaints about the physical condition, and mental symptoms fade into the background. Somatic complaints - pain in the chest, abdominal pain, headache, tachycardia, vomiting. Patients experience intestinal upset and dizziness. With a latent form of depression, patients rarely express complaints about mental well-being - but this does not mean that there are no affective disorders. In such patients, with a thorough consultative diagnosis, it turns out that melancholy, lethargy, and absent-mindedness are present.

In manic schizophrenia, mild symptoms of Kandinsky-Clerambault syndrome may develop. Ideation symptoms include the patient’s confidence that his thoughts and emotions are “put” into his head by someone or something from the outside. Sensory symptoms include false sensations in the body in the form of flashes of cold, heat, burning, or penetration of the skin by something from the outside. Motor symptoms include the patient’s belief that something outside is pushing him to perform some action. Pseudohallucinations are also possible - a person is able to “remember” non-existent events from the past.

Due to motor retardation in the depressive phase, patients become very slow, they are able to lie in bed for days. There are difficulties in perceiving and assessing surrounding events. The facial expression is sad. Unlike other types of psychoses on the schizophrenia spectrum, with MDP the patient in the depressive phase is able to answer questions in monosyllabic phrases. He does not show gross negativism or acute thinking disorders.

During the manic phase, the patient’s facial expressions are “lively”, with some theatricality. A “symptom of increased distractibility” is characteristic when any event causes an outbreak of vivid emotional reactions. In the manic phase, patients often begin to talk about erotic topics and become overly sexual. They demonstrate cynicism and often use obscene language.

Psychosis is possible at any age. In children under 10 years of age, diagnosis is difficult. In the depression phase, children become lethargic and demonstrate absent-mindedness and passivity when playing. They are not happy with new toys and pictures. Appearance tired, unhealthy, face haggard. School performance is falling. The manic childhood phase is difficult to recognize. Her symptoms seem to be “superimposed” on the usual picture of the child’s behavior. This is a characteristic activity during the game, laughter and a cheerful mood. During the manic phase, children experience excessive mobility and a sharp increase in the search for new hobbies. Pathological agitation is accompanied by difficult-to-control mobility.

In retirement and old age, patients in the depressive phase are characterized by increased anxiety. Manifestations of hypochondria and excessive fixation on the physical state of one’s body dominate. Delusional hypochondriacal ideas, Cotard's delusions, are formed. During the manic phase, pensioners' productivity and mobility are more blunted than those of young people. Reactions of anger and irritability dominate. The behavior is ridiculous, stupid, inappropriate for age, infantile. The person becomes cynical and sloppy. Distraction of attention leads to forgetfulness.

Conditions similar to mania

Persecution mania is a type of delusion when false conclusions arise that cannot be dissuaded, the content of which is that there is targeted surveillance and pressure.

Megalomania is also a type of delusion (characteristic of mania), which consists in the fact that the sick person considers himself a great specialist, a “perfect person” with outstanding qualities.

Manic-depressive psychosis is a separate disease, which is characterized by alternating periods of depression with stages of elation (manic period).

Mania

Mania (manic syndrome) is characterized by three main symptoms:

euphoria, characterized by an increased background mood, a complacent disposition and manifestations of joy;
excessive speed of processes such as thinking and speech;
increased physical activity.

According to the severity and strength of manifestation, manic syndrome can be characterized by hypomania or a more severe condition - mania.

Hypomania, according to our accepted classification of diseases, is characterized by elevated mood with possible periods of irritability. This mood must be stated as uncharacteristic for a particular individual and be stable for at least four days continuously. A hypomanic state not only affects a person’s mood, but also affects his daily life.

Criteria for hypomanic state:

the person is restless and hyperactive;
excessively talkative;
often distracted and has difficulty concentrating;
has increased libido;
the need for sleep has sharply decreased over time;
signs of reckless behavior have appeared in behavior (carousing, spending money, etc.);
he became increasingly sociable and even familiar in communication.

If a person’s behavior is characterized by three of the listed symptoms, then it makes sense to talk about the development of a hypomanic state. Subjectively, such a phenomenon, like manic syndrome, is not assessed by the patient as something negative or painful, but, unfortunately, it is fraught with dangerous consequences. Thus, an increase in sexual desire can cause infection with unpleasant and, in some cases, incurable diseases, a familiar communication style can cause problems with colleagues or management at work, and increased talkativeness can cause, for example, family discontent.

The picture of manic syndrome is complemented by symptoms such as

suspicion,
even greater acceleration of thoughts with a frequent picture of “jumping ideas”, when a person is not able to think out a specific thought to the end,
self-control may decrease so much that we begin to talk about inappropriate social behavior,
self-esteem increases inappropriately so that the patient is able to experience a state of megalomania,
plans are grandiose, but constantly changing, because a person cannot concentrate on something specific,
behavior that becomes reckless and rash is not subject to internal criticism, and its consequences are not assessed or realized,
increased sexual desire increases to the point of complete sexual promiscuity.

Often manic episodes alternate with depressive periods. Then they talk about bipolar affective disorder (formerly called manic-depressive psychosis).

Treatment of mania, as well as bipolar affective disorders, is the area of professional activity of a psychiatrist. It is very important to start therapy on time in order to avoid worsening the condition in the future.

We conduct a comprehensive diagnosis of this type of disorder, and also provide comprehensive treatment of mania, both on an outpatient basis and in a hospital setting.

Do you need a consultation? Still have questions? Our phone

What to do if mania develops

The first step is to organize an examination of the patient by a psychiatrist. This is often difficult, since in a state of mania, patients feel great and, as a rule, refuse to be examined by a doctor. If you are faced with the fact that your loved one has the symptoms of mania described above, you should contact a psychiatrist yourself, tell him about the patient’s condition and get advice on how to proceed further. Often, in order to provide assistance to such patients, it is necessary to resort to involuntary hospitalization.

How to deal with a person with delusions of grandeur?

This question is often asked by relatives and friends of people with this mental disorder. When communicating with such people, it is important to show your interest in the patient’s stories and in his life. It is necessary to show the patient that he is respected and valued, and at the end of the conversation, be sure to thank him for the interesting conversation and his importance. It is necessary to show the patient that they trust him, this will cause a reverse trusting reaction. A person will be able to be convinced of his significance and exclusivity, will calm down and will be able to avoid nervous excitement from personal experiences.

Symptoms and signs of the disease

In addition to the signs listed above, there are several characteristic symptoms that unite almost all manic states:

Tendency to thoughtlessly waste money.
Tendency to make bad deals and gamble.
Frequent violation of the law.
Tendency to provoke fights and conflicts.
Excessive alcohol consumption or addiction to other bad habits.
Promiscuous sexual behavior.
Pathological sociability - the patient often meets strange, suspicious individuals and spends time in a variety of companies.

If these signs get out of control, qualified medical attention is needed. It is important to understand that such behavior is not promiscuity, but symptoms of a disease that needs to be treated. Appealing to common sense is useless.

In some cases, the patient has a specific mania - for example, a mania of a special purpose. Then the patient is sincerely confident in his special mission and tries to implement it with all his might, despite the skepticism of others.

Diagnosis of persecution mania

Having noticed signs of this disorder in a loved one, you should not even try to convince him: the patient is so convinced of the general hostility towards him that any evidence will be “in the air.” Therefore, you should not waste time on empty shaking of air, but it is better to immediately consult a doctor for psychiatric help. You cannot miss precious days: strengthening delusional ideas in the patient’s mind only aggravates the situation.

Only a psychiatrist can accurately determine persecution mania by conducting psychological and instrumental procedures.

The doctor will carefully examine the patient’s symptoms and medical history and communicate with his relatives. Particular attention is paid to the presence of a genetic predisposition to diseases of the brain and mental health, bad habits. It is important to find out the nature of the delirium and how the patient himself relates to his problem.

Testing is used as additional information to determine the patient’s current state of mind: characteristics of his emotional sphere, memory, mental activity, etc.

Instrumental studies imply:

CT or MRI of the brain (will reveal a tumor or vascular pathology);
electroencephalography - it will allow you to assess the functioning of the brain by the degree of its activity.