Both of them are multifunctional hormones, to simplify: serotonin is responsible for the feeling of goodness, security, comfort, harmony with the world and all sorts of things, and dopamine is responsible for the reward and motivation system. When you have depression, everything is gloomy, the meaning of life is lost, apathy, the world seems alien, evil, absurd and you really don’t want to get out into it, “leave the room, make a mistake” - these conditions are mainly associated with disturbances in the metabolism of serotonin and dopamine .
Why does depression occur? Now scientists generally agree that there are several aspects to this. Firstly, there is genetics, which also encodes neurotransmitter metabolism. Cloninger's modern theory of temperaments, for example, connects the classical types familiar to us - choleric, sanguine, and so on - precisely with the exchange of neurotransmitters. Temperament corresponds to how our reward system works, how we react to a possible “carrot”. The gingerbread can be physical, the gingerbread itself, or it can be a bottle of vodka, sex, or a social reward.
People who are more dependent on rewards are more impulsive and more social. They want more attention, are more likely to do impulsive things, and are more likely to abuse substances. This does not mean that a person with such genes is directly doomed to use drugs, but it does mean that the person has some weakness in the neurological system. Those who are less dependent on rewards are usually harder to climb, but are more likely to be nonconformists because they are less likely to “give in” to social approval.
We cannot control our genetics - and this, in fact, is a reason to relax and not be afraid - shit happens, what can we do, and secondly, since the exchange of mediators is neurochemistry, accordingly, neurochemistry can be influenced pharmacologically.
Clinical course of the disease
Dementia is a disease that manifests itself as impairment of cognitive functions (attention, memory, thinking) and personality disorder. Psychiatrists distinguish three stages of the disease:
- The first stage is called early or mild dementia. At this stage of the disease, symptoms are not expressed. Patients may experience decreased concentration, they quickly get tired, and become lethargic. Their memory suffers, their interest in their surroundings decreases. People become emotionally unstable;
- The second stage of the disease is manifested by moderate dementia. Clinical signs of the disease are more pronounced. Patients' memory is severely impaired and their character deteriorates. They lose the ability to navigate in space, become apathetic or aggressive, irritable. Patients cannot perform simple tasks: take care of the house, eat, take care of themselves. At this time, they need the attention and care of loved ones;
- The third stage of the disease is manifested by severe dementia. Patients at this stage are completely dependent on the people around them. They are unable to perform even simple actions without outside help and lose control of urination and bowel movements. Patients often lie in bed and find it difficult to swallow food.
When an elderly relative ceases to be adequate: clinical picture
Many people mistake the disease for ordinary whims, without seeking help from specialists. In most cases, it develops harmlessly. Sometimes you can hear stories about your neighbors or friends that they don’t feed him at home, they try to harm him, and they let dangerous gases into his home. The disease progresses rapidly, gradually the elderly no longer always recognize their relatives, begin to blame them for situations that did not occur (for example, theft, violence), and bring unnecessary garbage from the landfill. Some believe that this is done on purpose, simply to mock their loved ones.
Due to the destructive effect on the brain, the patient does not understand what he is doing. He is not able to fully assimilate and process the information received, and is hypersensitive to any criticism (reacts sharply to all comments). Relatives need to be patient, be attentive, and communicate in calm tones. When a patient feels aggression directed at him, he begins to consider his loved ones as enemies and communicate with them accordingly.
The exact clinical picture depends on the cause that provoked the disease and the location of the affected part. With mild dementia, a person remains critical of his own condition and does not lose the ability to self-care. Over time, the situation worsens, dementia progresses, the clinical picture becomes pronounced, the following are noted:
- Cognitive impairment. Can’t say exactly what day, month or year it is. Episodes of loss in space occur. The patient simply forgets who he is, where he is and where he is going. Speech in any form (oral and written) is perceived with great difficulty. Confusion of thinking occurs - the thread of the conversation is lost, by the end of the sentence the patient does not remember what happened at the beginning;
- Motor disorders. Characterized by a persistent gait and a tendency to fall. Due to disruption of the normal functioning of muscles and ligaments, difficulties with pronunciation may occur;
- Violation of neatness skills. The patient does not care what he looks like, does not wash his clothes, does not take a shower.
How to communicate with a patient
Regardless of the cause of dementia, irreversible changes occur in the cerebral cortex that radically change a person’s life. He loses the ability to remember and understand new information, recognize his children and other loved ones, and think logically. Over time, life skills are impaired, and the sick person cannot be left alone. He loses his personality traits.
Psychologists at the Yusupov Hospital advise people caring for people with dementia to acquire new communication skills:
- Avoid raising your voice;
- Speak slowly, smoothly;
- To make sure that you managed to attract attention to the information, you should look into the patient’s eyes during a conversation and touch him carefully;
- Be the first to take the initiative to talk, since as dementia progresses, it is more difficult for the patient to start a conversation;
- Formulate questions so that the respondent can give an unambiguous answer: I don’t know, no, yes;
- If the patient does not understand what he is being asked about, the thought needs to be formulated differently;
- It should be noted that patients with dementia remember the past better than the future;
- Try to talk more often with the patient about the past, as this calms him down;
- If the patient stops responding to the phrases you say, you do not need to talk about him in his presence in the third person, as this may be perceived as humiliation.
Contact the police - officers must respond
The head of the information and public relations department of the Ministry of Internal Affairs of Russia for the Belgorod region, colonel of the internal service Alexey Goncharuk , said that in such situations, police officers are also guided by the law “On psychiatric care and guarantees of the rights of citizens in its provision.” Based on this document, they determine the indications for the need for medical intervention.
— In cases where a police officer suspects that a person is mentally ill, he can call an ambulance at the place of residence of this person or to the police department, if he is located there. A person’s behavior in such a situation should reflect actions that pose a threat to him or others.
In other cases, information regarding such citizens is sent by law enforcement agencies to the chief physician of the regional clinical psychoneurological hospital.
The police are also obliged to help health workers deliver to specialized medical institutions those people who are summoned there by court decision, but they do not comply with this decision. In case of involuntary hospitalization, the degree of aggressiveness of the patient is taken into account. If he has objects with him that could cause injury, they are confiscated.
The head of the information and public relations department of the Ministry of Internal Affairs of Russia for the Belgorod region recalled that police officers, together with medical workers, must monitor people suffering from mental disorders, alcoholism or drug addiction and posing a danger to others. This is done in order to prevent possible crimes and administrative offenses. If information about a person was provided by medical workers, and he is registered as a preventive at one of the territorial police departments, preventive work is carried out with him: police officers systematically come to his home at least once a quarter to assess his condition.
Alexey Goncharuk explained that when one of the residents in an apartment building litters his apartment and staircase with garbage, has many animals, and does not comply with sanitary and hygienic standards, he is also subject to his own legal norm.
— The owner of a residential premises is obliged to maintain it in proper condition, preventing mismanagement of it, to comply with the rights and legitimate interests of neighbors, the rules for the use of residential premises, as well as the rules for maintaining the common property of the owners of premises in an apartment building. Residents have the right to contact the police regarding such facts to record them and take action in accordance with current legislation.
The police must accept and register a statement or report of an offense, conduct an inspection if necessary, and take measures provided for by the legislation of the Russian Federation. The police must also inform complainants about the progress of such applications and refer them to other organizations if the solution to the problem is within their competence. For example, if sanitary and hygienic standards are not observed, based on the results of the inspection, the police send information to the Sanitary and Epidemiological Supervision authorities and the city department to consider bringing the perpetrators to administrative responsibility.
Living with someone with dementia
People with dementia behave like little children. At the same time, they gradually lose skills without acquiring new ones. Relatives should take this fact for granted and not blame themselves for anything. If you detect the first signs of memory impairment, you should convince your loved one to contact a neurologist. Typically, at the onset of dementia, patients agree to this proposal. Neurologists at the Yusupov Hospital advise people who live next to a person with dementia to adhere to the following rules:
1. Don't be left alone with your problems. Caring for a loved one should not destroy connections with the outside world. You should ask relatives to call and come more often. You need to find people who were in a similar situation and communicate with them; 2. Do not refuse the help of your family and friends. You need to make others feel that their participation is extremely important to you; 3. Do not wait for negative emotions to spill out in the presence of the patient. Take your anger out somewhere else; 4. If you are tired or experiencing emotional exhaustion, contact a psychologist at the Yusupov Hospital. It will help prevent depression; 5. Pay proper attention to yourself, visit beauty salons, dress well.
If a loved one has memory impairment, you should not leave him alone with the problem. By contacting the specialists at the Yusupov Hospital, the patient’s relatives will receive recommendations that will allow them to live more comfortably. Our experts will tell you how to care for it, organize your life, and ensure safety.
Organization of patients' everyday life
If doctors have diagnosed a patient with dementia, his relatives should specially arrange rooms for the patient to live. You need to put locks in them, leave a minimum number of things and furniture, and remove sharp and cutting objects. Most people with dementia exhibit aggression and a tendency to vandalism. They can harm themselves and others. To prevent the patient from throwing away or destroying money and documents, they should be removed from the room and hidden.
A patient suffering from dementia will never be able to appreciate the actions of a caregiver or show gratitude. There is no need to be offended by him about this, just as we are not offended by small children. Dementia does not necessarily progress to the third stage of the disease. In many cases, severe memory impairment can be prevented with adequate therapy.
Some memory disorders are reversible. Sometimes, through the joint efforts of doctors and people caring for a patient, it is possible to partially restore impaired functions and improve the quality of life. Neurologists, psychotherapists and rehabilitation specialists at the Yusupov Hospital together create an individual treatment program for each patient. This guarantees the maximum effect of the therapy. Doctors at the neurology clinic constantly monitor patients and, if indicated, change medications, their doses, and the regimen of use.
To provide your loved one with adequate medical care and professional care if dementia develops, call the contact center at any time of the day, regardless of the day of the week. Our specialists will select a convenient time for consultation with a neurologist who specializes in the diagnosis and treatment of memory disorders.
Words vs pills
The most common pharmacological drugs improve this exchange of neurotransmitters in the brain, especially if we talk about antidepressants, mood stabilizers, “trunks” and the like.
Pills are not needed to replace a personality; after drinking them, you will not become a different person, this is a story about fixing what was broken.
The most advanced antidepressants are called selective serotonin reuptake inhibitors, and sometimes norepinephrine and dopamine. They affect different people a little differently. For example, both I and my co-author Anton have clinical depression, but my depression is more in the direction of apathy, and his depression is more in the direction of anxiety. He is helped by a medicine that affects serotonin more; I was helped by a medicine that also affects dopamine and norepinephrine.
Accordingly, if you go to a specialist, it may take some time to find a personalized cocktail of medications or one medication that is right for you. I changed four patterns until I found mine.
In addition to pills, there is another remedy - psychotherapy. From the point of view of evidence-based medicine, some types of psychotherapy work no worse than antidepressants, primarily cognitive therapy, especially in the case of anxiety disorders.
Here it is worth understanding that this is not a story about someone taking you from point A to point B, but about the fact that you yourself, under the supervision of a specialist, will make your way from point A to point B. And not immediately, but in short periods. then in dashes. So slow. The main thing is to make these progressive movements.
Why cognitive therapy? The well-known psychoanalysis is a wonderful thing, it is very good for introspection. But it’s not very good when you have panic attacks and you need to solve the problem now. The cognitive-behavioral method is about learning to change your behavior in real life.
Nutrition for dementia
Dementia is a pathology that develops against the background of organic brain damage and is manifested by impaired intellectual activity and personality disorder. According to statistics, older people are more susceptible to the disease, although the onset of dementia at an early age cannot be ruled out. The pathology is characterized by progression and a gradual increase in severity; the patient does not immediately lose acquired skills, knowledge and abilities. At the Yusupov Hospital, a personal nutritionist will develop an individual menu according to the recommendations of the attending physician.
Proper and healthy nutrition for dementia
A balanced and nutritious diet plays an important role in the treatment of dementia, since brain cells have an increased metabolism, so even a slight deficiency of any elements can lead to serious consequences. For this reason, it is worth taking foods seriously, as they can not only help improve the condition of patients with dementia, but also help prevent the onset of pathology.
According to statistics, residents of eastern countries, in particular India, rarely suffer from diseases that cause mental impairment, as they attach great importance to the quality of food and its composition. For example, daily use of seasonings contained in oriental dishes (curry, turmeric, cinnamon and others), according to research, can prevent the formation and accumulation of amyloid plaques in the brain, which cause damage to neurons and lead to the formation of Alzheimer's disease, accompanied by dementia. Based on these observations, it is worth concluding that for therapeutic and preventive purposes it is necessary to formulate a diet in such a way as to reduce the degree of manifestations and the likelihood of the formation of diseases leading to dementia.
Vascular dementia often develops against the background of atherosclerosis, which is formed due to elevated cholesterol levels, which leads to the appearance of plaques and blockage of blood vessels. As a result, the brain experiences oxygen starvation, which ends in the destruction of neurons. For this reason, it is worth monitoring your cholesterol levels, in particular, avoiding foods with high cholesterol content and eating those that lead to a decrease in its levels.
Foods that lower cholesterol:
- dry red wine;
- almond;
- beans;
- blueberry;
- avocado;
- vegetable oils;
- barley, etc.
Also, if you have dementia, you need to drink enough water, and your diet should include dishes that improve the functional activity of the brain, which contain:
- fish;
- seafood;
- nuts;
- seeds;
- dairy products;
- dietary meat;
- seasonings (cinnamon, sage, saffron, lemon balm, etc.);
- vegetables;
- sauerkraut;
- fruits
What's harmful about dementia?
In addition to using healthy foods, you should exclude those that worsen the patient’s general condition, enhance the process of neuronal destruction, and negatively affect hormonal and metabolic processes and cerebral blood supply. In case of dementia, it is necessary to completely eliminate foods that increase cholesterol levels: egg yolks, animal fats, offal, sour cream, cheese, mayonnaise.
Excessive consumption of confectionery products is also harmful for dementia, so it is worth limiting or completely eliminating the use of white bread and sugar, pastries, chocolate, cakes, and ice cream. It is also worth reducing the amount of salt in food, eating less fried and fatty foods. It is especially important to give up alcohol, as it only enhances the processes of destruction in the brain.
Any “other citizen” can apply
Legal director Alexandra Bereslavtseva believes that in such situations it is necessary to be careful.
— Before talking about hospitalization, it is necessary to establish whether there are grounds to resort to such extreme measures as forced restriction of a person’s freedom. If you don’t like that your neighbor or acquaintance is acting “strange,” this does not mean that he has mental problems. And even if there is, this does not mean that he can be forcibly hospitalized, otherwise such measures can be used for non-medical purposes and harm the health, dignity and rights of citizens.
In accordance with article four of the law “On psychiatric care and guarantees of the rights of citizens during its provision,” psychiatric care is provided upon voluntary application and with consent to medical intervention, except for cases expressly provided for by law.
Moreover, forced hospitalization or other restriction of the rights of persons suffering from mental disorders solely on the basis of a psychiatric diagnosis in accordance with the law is unacceptable.
Alexandra Bereslavtseva explained in what situations compulsory psychiatric care can be provided.
— If a person poses an immediate danger to himself or others, cannot independently satisfy the basic needs of life, his health deteriorates without the provision of psychiatric care, then, on the basis of Article 23 of the above-mentioned law, a psychiatric examination of this person can be carried out without his consent or without consent his legal representative.
Life expectancy with dementia
It is impossible to give an accurate forecast of how long a person with dementia will live. Dementia comes in different types and can be slow and gradual, or it can progress and be fatal very quickly. Much depends on age, health status, care and adequate therapy.
Life expectancy with vascular dementia
Vascular dementia is a severe form of the disease. Dementia is caused by vascular disease, often develops after an ischemic cerebral infarction or hemorrhagic stroke, with atherosclerosis or hypertension; factors in the development of this form of the disease can be heart defects, high lipid levels and other disorders. Vascular dementia affects men more often.
In dementia accompanied by Parkinson's or Huntington's disease, the prognosis depends on adequate treatment of these diseases. Most often, dementia with such concomitant diseases is not characterized by rapid progression; the life expectancy prognosis is several years, with Huntington's disease - up to 10-15 years. Dementia with Lewy bodies is a rapidly progressive disease with a life expectancy of about 7 years.
Life expectancy for other types of dementia
Dementia can be caused by various diseases. Very often, senile dementia is associated with Alzheimer's disease. In this case, the patient’s age plays an important role: the older the patient, the slower the disease progresses; The younger the patient, the more the disease progresses. The average life expectancy of a patient with Alzheimer's disease is about 6-10 years from the time of diagnosis. Much depends on the age and stage of the disease, the individual characteristics of the body.
Adequate treatment prescribed at an early stage of the disease can significantly prolong life and alleviate the condition. Specialists from the neurology department of the Yusupov Hospital have extensive experience in treating dementia and many other related diseases. Modern diagnostic equipment makes it possible to determine the areas of brain damage and the degree of development of dementia. The use of innovative world-class techniques at the Yusupov Hospital can improve the quality of life for patients with dementia.
Life expectancy in early dementia
Life expectancy at an early stage of the disease largely depends on the age of the patient. The younger the patient, the more complex and faster the disease progresses. In older people, the disease does not develop as quickly. Detected dementia at an early stage allows you to remain in adequate condition for a long time and take care of yourself. Manifestations of dementia at an early stage are:
- forgetfulness,
- slight mood swings,
- slight decrease in intelligence.
Life expectancy of bedridden patients with dementia
Bedridden patients with dementia are most often people who are at an advanced stage of the disease. Bedridden patients with dementia often die from pneumonia and sepsis, concomitant diseases already at a severe stage of dementia. The prognosis for dementia in bedridden patients is unfavorable, the condition is complicated by physical inactivity, impaired mental activity, and circulatory disorders.
Patients in serious condition are completely dependent on outside care; dementia is complicated by other diseases due to the patient’s immobility. At the Yusupov Hospital, relatives of the patient are trained. Caring for bedridden patients is complex and requires patience and knowledge about the characteristics of the disease.
Life expectancy of patients with dementia with optimal treatment
Life expectancy with dementia depends on the adequacy of treatment and care. At the first stage, the doctor prescribes diagnostic tests to differentiate dementia from other diseases. Treatment of senile dementia is based on eliminating the symptoms of the disease and reducing the risk of dementia progression.
Dementia is an incurable disease, the course of which depends on many factors - age, gender, type of dementia, concomitant diseases, adequate treatment and care. A calm environment and lack of stress help reduce the risk of progression of senile dementia.
Doctors recommend a special diet, vitamin therapy, music therapy, aromatherapy, acupuncture and other methods that improve brain activity. The average life expectancy of a young patient with dementia can be about 7 years; older people with dementia live on average from 7 to 15 years.
“Something strange began to happen to my husband...”
Elena (name changed) was a university teacher, students adored her.
Two years ago, she quit her job for no apparent reason, stopped taking care of herself, and lost interest in her son and everyday life. According to the sister who tells this story, she sleeps all day, reads books and smokes a lot, although she has never smoked before. He does not make contact and resolutely refuses offers to go to the doctor or call a doctor at home. When her relative tries to ask for advice from friends or on the Internet, she receives very different answers - from recommendations to “leave the person alone” to suggestions to “artificially create difficulties so that she has a purpose in life” and to put pills in her food.
And Olga (name also changed) noticed about a year ago that something strange was happening to her husband. Wild jealousy appeared, scandals began, checking her phone and social networks.
The husband began to say that he was being followed, on the street, in the subway, in the store... He sees enemies in everyone. On the street he turns off his cell phone, citing the fact that he is being monitored via satellite communication. Of course, he doesn’t want to hear about doctors. “Girl, run, I lived in this hell,” they advise her, but Olga hopes that everything is not so critical.
What's really behind this behavior? Where is the personal crisis, and where is the illness? How to survive the mental illness of a loved one, help him and not harm yourself? Psychiatrist, member of the expert council of the Altsrus Foundation, Viktor Lebedev, explains.
Benefits of treating dementia at the Yusupov Hospital
The Yusupov Hospital has created all the conditions for the treatment of patients suffering from dementia:
- Comfortable rooms equipped with forced-air ventilation and air conditioning;
- Complete high-quality nutrition;
- Competent medical staff;
- Highly qualified doctors;
- Modern equipment from leading global manufacturers;
- Individual approach to choosing a treatment method for each patient.
The neurologists at the clinic have extensive experience in treating patients with various types of dementia. If relatives do not have the opportunity to provide care for the patient at home, comfortable conditions for the patient’s stay have been created in the hospice at the Yusupov Hospital.
To make an appointment with a neurologist, you should call. Contact center specialists will offer a convenient time for consultation with a doctor who specializes in the diagnosis and treatment of memory disorders.
Learn to respect the freedom of others
Priest and psychologist Mikhail Artemenko said that if someone begins to notice unusual behavior of a loved one, he can contact the Family Support Center at the Church of Peter and Fevronia.
— If people believe that their loved one is unwell, his behavior has changed, you need to find out what exactly they don’t like, what they are afraid of. You definitely need to find an opportunity to talk with the person about whom your loved ones are worried. This conversation should be voluntary, it is necessary that the person himself wants to come talk and talk about what is happening to him. “A slave is not a pilgrim” - there is such a phrase. You can’t do anything to a person involuntarily, you can only call on him,” the psychologist explained.
Mikhail Artemenko says that a priest must understand why a person’s habitual way of life can change.
— When changing behavior, it happens that we assume the influence of religious organizations of a totalitarian nature on a person. We need to rule it out or confirm it. If it is confirmed, then there will be two scenarios: if the organization’s activities are prohibited in our country, we must contact law enforcement agencies. If not, again, we can only talk. When there is a suspicion of a possible mental illness, we can give relatives a recommendation to talk to the person about visiting a neurologist or psychiatrist. Then it’s up to the relatives to see how they can persuade and correctly lead their loved one to this. In general, convincing someone to go to a psychiatrist is quite difficult; pride kicks in: “How am I sick?”
If a person exhibits violent behavior, other levers of influence may be used, for example, calling an ambulance. I would also like to add that the behavior of another, which we may not like, is a delicate issue. It’s just that we often want the thoughts and feelings of another to correspond to our ideas about them. And it is important to learn to respect the freedom of others. Maybe someone likes to go out at night and look at the stars for hours, but we don’t understand this. Those same holy fools always had behavior that was incomprehensible and inexplicable to the majority. Well, there’s another good phrase: “Judge not, lest you be judged.”
"Normal" fluctuations
Reckless actions or sudden episodes of insanity are not always symptoms of mental illness.
“We should not forget that any person, even the strongest and most resilient, has moments when he does not understand very well where he is - in the realm of the imaginary, in illusions, in the unreal world - although he is aware that “None of this is reality,” notes Marie-Noëlle Besançon. — Such fluctuations are part of the “normal” functioning of the psyche. True, sometimes they frighten us so much that we try to forget them as quickly as possible.”
Hasn't this ever happened to you - you stop hearing the interlocutor who is boring to you? Silently, unnoticed by others, we leave ourselves every day, leaving our minds for a split second. But we are not sick.
Two types of violations
Psychiatrists do not use the term “madness” in professional conversations. They talk about “illness”, “disorder”, “mental disorders”. Among these, two main categories can be distinguished: psychoses and neuroses. Psychoses include disorders associated with loss of contact with reality: delusions, hallucinations.
The most famous of the psychoses is schizophrenia, but there are others: persecution mania (paranoia), erotomania... “Neuroses are like an excessive exaggeration of ordinary feelings,” defines Marie-Noelle Besançon. “For example, depression is a distorted manifestation of grief, and anxiety disorders are a distorted manifestation of fear.”
And one more important clarification: health does not mean any particularly positive outlook on life. According to Grigory Gorshunin, “a healthy soul is not the content of thoughts, but the way of handling them.” Neurosis is not the presence of bad things, but the power of bad things. These two things are constantly confused and people try to “get rid of the bad.” But we need to get rid of the need for evil power, from the “right to torment and suffer.”
How to preserve your own psyche?
It is very difficult for any person to get used to the fact that his loved one is developing senile dementia. Some people fall into despair: mom or dad has dementia,
what to do, how to help them? After despair comes anger, then powerlessness and apathy. You should not allow problems with your own health to arise against the background of a loved one’s illness. Caregivers often make mistakes in care, performing seemingly natural actions. Psychologists give a number of recommendations on what needs to be done and what points are strictly prohibited:
- Relatives must simply come to terms with the illness of their loved one;
- At the first symptoms of dementia, you should consult a doctor;
- You cannot prescribe treatment yourself;
- You cannot trust the care of minor family members;
- There is no need to forcibly pull the patient out of his imaginary world, you will have to learn to lie for the greater good;
- Do not try to cure a relative using unconventional methods;
- You cannot focus on caring for the sick while ignoring your own needs. If possible, you need to change with someone close to you, give yourself rest and emotional relief;
- It is recommended to use the help of specialists: professional caregivers or volunteers. Anyone who tries to cope with patient care alone very quickly burns out and becomes depressed from a hopeless situation.
The main condition is that you don’t need to expect gratitude from your sick relative. Due to the specifics of the disease, he will not appreciate all the efforts, and even on the contrary, he may accuse his family of inattention, anger and cruelty.
Treat or “Leave Alone”?
— Victor, if a person has changed dramatically, broken with his usual circle of friends, lost his former interests, and become suspicious, are these symptoms of mental illness? Or does he just have a personal crisis, troubles at work, unhappy love?
“Only a doctor can understand this.” Changes in behavior can be caused not only by a mental disorder, but there are signs by which one can suspect it.
For example, a sharp change in social interaction: a person quit his job for no reason, changed his attitude towards relatives, relatives, friends - he began to isolate himself or, on the contrary, became extremely sociable. Perhaps a strange hobby has appeared: he began to read books on a certain topic, talks only about it, and finds it difficult to switch from it. Such a topic could be some kind of conspiracy or some kind of influence, other strange ideas that differ from everyday life and do not coincide with the real picture of the world.
— The first impulse in this case is to convince others, to appeal to logic. It makes sense?
- No, it is impossible to convince a mentally ill person. As a rule, this also turns your loved one against you.
You can answer neutrally: “Yes, yes, okay, that’s probably true. I understood you, I heard you. Let’s talk about did you eat today, how are you, what are you doing?” If it doesn’t switch, then end the conversation. Arguing with a delusional patient is more expensive for yourself, and convincing him is a waste of time. It's no use to him. Why then convince? To feel young? But this is some kind of stupidity.
— What else is worth paying attention to?
- Sleep disorders. Either sleepless nights or inversion: sleeps during the day and does not sleep at night or tries to sleep in fits and starts. Moreover, when you ask him about the reason for changes in sleep patterns, he replies that he is afraid for his life, the lives of loved ones, or throws out meaningful phrases in the spirit of: “Isn’t it clear?”, and goes away from the topic. A fairly typical situation for such cases is the patient reporting that he was “forbidden” to talk about it.
Also, patients often believe that they are being watched, that a conspiracy is being built against them. They try to find the pursuers, look for cameras and listening devices in the apartment, and may even open floors or electrical appliances.
- And if a person stops taking care of himself - he doesn’t wash, doesn’t comb his hair, becomes extremely sloppy, is this a characteristic symptom?
— Yes, this behavior is typical for the deterioration of some mental disorders. This may include schizophrenia, some dementias, or severe depression. Only a psychiatrist can finally figure it out, but the sign itself is alarming.
