Today, the basic principles of providing psychiatric care in Russia are maximum humanity and voluntariness. However, often a person suffering from a mental disorder is not ready to admit that he needs the help of a doctor. In this case, any citizen has the right to contact a neuropsychiatric dispensary to indicate an existing problem.

All algorithms and principles of actions of psychiatrists described in this article are regulated by the Law of the Russian Federation of 07/02/1992 N 3185-1 (as amended on 07/03/2016) "On psychiatric care and guarantees of the rights of citizens in its provision" (as amended and supplemented entered into force on 01.01.2017)

By law, a psychiatric examination of a person may be carried out without his consent or without the consent of his legal representative in one of the following cases:

a) a citizen poses an immediate danger to himself or others;

b) he is not able to satisfy his basic vital needs on his own;

c) there is a danger that if a citizen is left without psychiatric help, his mental state will worsen.

In what situation can it be assumed that a mentally ill person is next to you?

The most common marker of mental illness is inappropriate behavior, namely:

Inability to take care of yourself, keep yourself and your home in order;

· Aggressive behavior, loss of self-control, sudden outbursts of rage, creating a threat to others;

Autoaggression, systematic self-infliction of pain, suicide attempts;

Habits and lifestyle that create discomfort for others (unsanitary conditions, unpleasant odors from the apartment);

Hallucinations, loss of orientation in time and space, etc.

If a person whose behavior causes concern to friends, acquaintances, colleagues, neighbors does not agree to turn to a psychiatrist himself, any citizen has the right to contact a neuropsychiatric dispensary at the place of registration of the suspected patient and report his suspicions.

How do you state that you suspect another person has a mental disorder?

To report to a medical organization about a possible mental disorder of your friend, relative or neighbor, you need to go to a neuropsychiatric dispensary (PND) and submit an application using a certain form.

You can submit an application to the PND of Moscow, which includes the address of the place of residence of the alleged patient.

Contact the PND registry and they will give you a sample application.

Information that must be included in the application:

· Your surname, name, passport data;

Your contacts (phone number, address);

· Who are you related to the suspected patient;

· The essence of the appeal. List the disorders for which you believe the person has a mental illness, describe in detail the nature of the disturbing behavior - best in your own words, but as detailed as possible. Try to avoid near-medical terms and general phrases (such as "delusions, hallucinations"). Best of all, describe what you saw, observed.

Upon acceptance of the application, the PND staff will check your passport and register your appeal in the log of incoming correspondence. You will receive a copy of the application, on which the incoming number will be affixed. From that moment on, the application is considered accepted.

What happens after you submit an application?

Consideration of the application.

Option 1. A psychiatrist reviews the application and decides on the immediate taking of medical measures without a court examination.

When is a court examination not required?

The main question is whether a citizen is dangerous for himself and others at the moment? If dangerous, then the statement of any citizen is the basis for an immediate medical examination without the consent of the patient.

An alleged patient can be recognized as dangerous to himself and others if he is noticed:

Attempts of suicide and autoaggression;

Aggressive behavior towards others.

In this case, the psychiatric emergency team will be sent to the address of the alleged patient immediately.

Option 2. In all other cases A psychiatrist will review your request within one to two days of submission. After that, you as an applicant will be invited to the MHP for an interview with a psychiatrist.

Applicant's interview with a psychiatrist. At a personal meeting in the PND, the doctor will clarify all the necessary information with you, as well as explain to you the rules and principles of involuntary psychiatric examination.

In particular, the psychiatrist is obliged to warn the applicant that if a lawsuit for involuntary examination is filed, the court has the right to invite the applicant to testify.

Collection of objective information about the alleged patient. If there is a statement about the alleged patient, the PND employee has the right to apply to various social structures to collect additional information and clarify all the facts about a potential patient.

Attention! Regardless of the situation described in the application, no active action will be taken by MHP officers until a decision is made to conduct an involuntary psychiatric examination of the person.

Based on the results of all the measures taken, the doctor decides whether there is reason to assume that the alleged patient has a severe mental disorder.

If there is no reason, the doctor refuses a psychiatric examination of a citizen and gives a reasoned written refusal to the applicant (within a week) .

If there is a basis the doctor decides on an involuntary examination. The case is registered, then the conclusion of the psychiatrist is transferred to the judicial authorities at the place of registration of the citizen.

Basic principles of psychiatric examination

1. The psychiatrist is independent and independent in making decisions. Neither the applicant nor the MHP leadership has the right to influence his decision.

2. MHP staff rely on the integrity of the applicant therefore, each application is subject to consideration and further clarification of the circumstances. However, neither statement is taken for granted.

3. The presence of a mental illness in the applicant is not grounds for rejecting the application. If the applicant has previously consulted a psychiatrist himself or is under the supervision of the MHP, his application will still be considered.

Attention! The algorithm of actions described above is adequate if the alleged patient is not under dispensary observation in a neuropsychiatric dispensary. If the alleged patient is already under the supervision of psychiatrists, newly received applications are taken into account, and if the patient's condition worsens, appropriate medical response measures are taken (including visiting the patient at home).

According to official statistics, 40% of Russians are prone to mental disorders, which without professional help can develop into a serious illness. And only 30% of potential patients visited a doctor. Many of those at risk are under 20 years of age.

According to the World Health Organization, by 2020 mental disorders will become one of the main causes of disability, overtaking even cardiovascular diseases.

What to do if one of the family members starts behaving strangely? How to deal with a mentally ill person? Where to go and how to continue to live if someone close to you gets sick? Answers to all these questions can be found, for example, on stands in the Psychoneurological Dispensary. But few people will visit this institution just to study the posters on the walls. The editors visited the PND and collected all the necessary information and expert advice.

First episode of illness- the most important stage of its development, during this period, irreversible disorders without treatment are formed that impede the social functioning of the patient. Therefore, it is necessary to detect and treat diseases as early as possible.

Early combined drug (including atypical antipsychotics of the new generation) and psychosocial treatment will make it possible to stop the disease in its infancy, radically change its course and outcomes for the better, alleviate emotional distress, social losses of patients and their loved ones, and improve their quality of life.

It is impossible to trust the treatment process only to medicine and a doctor (like education - at school) - this is a painstaking joint work. Modern therapeutic measures certainly include the active participation of the patient and his family in the process of recovery.

The disease, like everything, passes. And a new day comes. Be healthy, and, therefore, happy - you will succeed.

Could you please explain if there is any mechanism in the system of psychiatric care for providing it, in the event that help is needed, but he refuses it?

Yes, in accordance with the law Russian Federation"On psychiatric care and guarantees of the rights of citizens in its provision" such a mechanism is provided. A patient may be placed in a psychiatric institution and held there on an involuntary basis if the psychiatrist believes that the person is suffering from a mental illness and, left untreated, may cause serious physical harm to himself or others.

To persuade the patient to voluntary treatment, the following can be advised:

Choose the right moment to start a conversation with your client and try to be honest with him about your concerns.

Let him know that, above all, you are concerned about him and his well-being.

Consult with other people about how you should do better: relatives, your doctor.

If all else fails, seek advice from your primary care physician and, if necessary, contact emergency psychiatric help.

An important point that stabilizes the condition of a sick person is the preservation of the usual, simple life routine in the house, for example, a stable time to get up in the morning, sleep time, and meal hours. It is necessary to create a calm, consistent, predictable life as much as possible.

This will enable the sick person to cope with anxiety, confusion, to understand what and at what time you expect from him and what to expect from you in turn.

Try to make the life of a sick person as ordered as possible, this will protect you from chaos.

What should I do when my sick son says he doesn't need my help? He even gets angry with me, sometimes shouts rudely. And I'm worried, what if this is not so, and he needs my help? And how do I know if I'm annoying?

Psychiatrists and psychologists face similar situations quite often. Mental illness can drive a wedge between the sick person, their relatives and friends. A sick person can lead an isolated or nocturnal lifestyle, lock himself in his room, get carried away watching television too much. At the same time, he may experience deep depression, have suicidal thoughts. He may also harm himself or use drugs. However, even if your loved one really needs your help, his illness may make him say that he does not need help. It is understandable that this behavior causes you great concern.

In this case, you can talk to other family members or friends. If they are not emotionally involved in your problems and are an independent third party, they can fairly objectively tell you whether you are pushy or your help is really needed.

What can I and other family members do to help my sick child?

This is a very important question. We have no doubt that it concerns many families and friends of the mentally ill. Of course, each situation requires an individual approach. But we can give general recommendations, which, we are sure, are suitable for every family. Remember that not only the success of the treatment, but also the possibility of his return to normal life will largely depend on your attitude, on your desire to help a loved one. Therefore, let's focus on the 10 most common, but very important tips that you can try to follow.

1. Love your sick relative, respect in him the human personality, its dignity and value.

2. Accept the patient as he is at the moment, and not as he was before illness or will be after recovery.

3. Control the intake of maintenance doses of psychotropic drugs, do not allow unauthorized termination of maintenance treatment. It is important not to miss the possible unwanted side effect when prescribing high doses of psychotropic drugs.

4. Constantly monitor the patient's condition to notice the onset of an exacerbation of the disease. It is important to remember that changes in behavior, judgments, statements, sleep disturbances are often not a reaction to the environment, but signs of deterioration.

5. Guide a sick person through life, gently and unobtrusively helping him make the right decisions. Remember that the patient really needs confirmation from those close to him of his significance, their respect for his own decisions and desires.

6. Try to make the patient's life more orderly, devoid of sudden changes.

7. Try to keep the patient in active life. If the patient is working, help him keep his job. It is important that he does not lose his usual social circle, and, if possible, make new friends.

8. Awaken the patient to activity, encourage his activity.

9. It is important to establish a good relationship with your doctor. In no case do not frighten the patient with treatment in a psychiatric hospital or a psychiatrist. Try to maintain a trusting relationship with the doctor in the patient.

10. Do not forget about your own state of mind, health, try not to deprive yourself of the joys of life. Remember that you will help your loved one much better if you are healthy yourself. In addition, we would like to advise you the following. Think over and try to understand what you can change in your life and in the life of the patient, and what you cannot change. Talking to professionals, other parents, and patients themselves will help you understand what is realistic and what is not. Try to involve your loved one as much as possible in making decisions about what might be beneficial for them. Sometimes relatives fall into a trap, trying to do as much as possible for the patient of one thing, even if this “something” does not work, does not help. Instead, you need to experiment, look for something new. Rule number one for you should be the following - evaluate what does not work; try to find other ways to solve the problem. If you find that it really helps, you should go down this path and solve the problem as consistently as possible.

How can loved ones cope with the everyday problems that arise when living together with a mentally ill person?

Try to speak as simply and clearly as possible. If you yourself are unsettled, indignant, tired, upset about something, if you cannot pull yourself together and calmly continue the conversation, it is better to postpone this conversation for a while. Having calmed down, you will assess the situation more objectively and, probably, it will be easier to achieve the desired result.

Calmness and restraint are important principles of communication in the family.

What are the general rules for dealing with an excited patient?

Excited behavior is one of the most frightening behaviors of people with mental illness. Patients in a state of excitement move a lot, gesticulate intensely, almost always scream, demand something, save themselves from something. Doctors call this condition psychomotor agitation.

Almost any excited patient is dangerous both for himself and for others. Excitation indicates an exacerbation of psychological illness, even if the patient does not commit any destructive actions. For these two reasons, any excitement requires urgent medical measures.

Therefore, if your relative has a state of psychomotor agitation, then, as a rule, it is necessary to urgently call a doctor to resolve the issue of hospitalization.

The difficulty in caring for a patient with psychomotor agitation is largely due to the fact that this condition usually begins unexpectedly, often at night, and often reaches its highest development in a few hours. Relatives of the patient, neighbors or other people around do not always correctly assess the possible consequences: they underestimate the danger if the excited patient is familiar to them, or, on the contrary, overestimate the danger, since the acutely ill person causes unjustified fear and panic among others.

It is necessary to keep in mind a few general rules for dealing with excited patients.

1. Calm conversation can often reduce arousal levels right away.

2. Under no circumstances should you enter into an argument, object, or try to dissuade a relative of the incorrectness of his beliefs.

3. Before the doctor arrives, it is advisable to cope with confusion and panic, create conditions for providing assistance, try to isolate the sick relative in a separate room. It is necessary to remove all strangers from the room where the patient is located, leaving only those who can be useful, and it is also necessary to remove all piercing, cutting objects and other things that can be used as weapons of attack or self-harm.

4. Under all circumstances, your own safety must be ensured. Feeling that you are in danger and that the patient is unable to control himself, stop contact with him or call the police in order to protect yourself and your relative before the doctor arrives.

5. Learn to recognize the first signs of a relative losing control of himself, for example, threatening gestures, rapid breathing. The probability of occurrence of agitated behavior allows you to assess the history of the disease of a relative. If he has never had such a state before, then most likely he will not have it in the future.

How to help a loved one suffering from a neurotic disorder?

Here are some tips.

First of all, it is important to be attentive to a loved one.

In no case be limited to such advice - "it's time to pull yourself together."

You can not blame such a patient for weakness. A neurotic disorder is not a weakness, but a painful condition.

Try to save your loved ones from grief or the action of other psycho-traumatic factors.

It is very important to set up a loved one for treatment, to convince them to see a doctor.

How loved ones cope with everyday problems that arise when living together with a mentally ill person

Avoiding the situation of communication with the mentally ill could be the best solution, if not for the circumstances that may make this communication forced. It is impossible to stop communicating with a relative or loved one if such a misfortune befalls them. A situation may arise when for some time you have to contact with strangers with mental disabilities.

How can you protect yourself in this communication from negative emotional consequences?

Define clearly your strengths and resources, evaluate whether they are enough for you to communicate in this situation.

Mental illness manifests itself differently in different people. There are patients with whom only a qualified specialist can communicate. You can not live and interact with those who are able to bring a real threat to human life. Such patients are placed in special conditions and contact with them is possible only for a limited time and with certain protective measures.

In all other cases, communication with mental patients does not pose a threat to life, but is also stressful and energy-consuming.

Determine clearly how much time you can communicate with the patient without serious losses for your mental health, to what extent you are able to direct his behavior. Depending on this, attract outside help or look for other ways to solve everyday situations.

Consult a qualified professional about a person's mental illness.

All mental illnesses have their own specifics, which it is important for you to know about. You will receive additional information and extra ways to control the situation if the specialist talks about the prognosis of the disease, its course and other features. You will also be warned about the unexpected, which you need to be prepared for and about your behavioral strategies that will help relieve many tense moments. Sometimes these strategies may seem strange to us from an ordinary point of view, but they can be the most effective in dealing with people with mental disabilities.

It is important to change your attitude towards a mentally ill person.

A completely natural reaction that appears in most people at the beginning of contact with mental patients is shock and stress. Strong irritation can accompany such communication for quite a long time. It is important to give yourself time to get over this stress. Do not refuse help for yourself, which can be provided by a qualified specialist in this difficult time. For you, this period may be more difficult than for a mentally ill relative with whom you have to maintain a relationship.

The right attitude towards the patient is very important. The very fact that he behaves this way or does not understand something causes great irritation. Although this may be the result of a disease, and not the evil will of a person. It is very difficult to accept this fact, because out of habit we demand normal and correct behavior from a mentally ill person. Our irritation, although quite justified, takes a lot of energy and makes the situation much more difficult than it really is.

Find a way to fully accept it as a given, without judgment. At the same time, you may well not like it, but you cannot treat a mentally ill person as a healthy person who behaves incorrectly.

If you can achieve this attitude, the situation becomes much easier.

The explanations of a specialist about a mental illness and rethinking one's attitude towards the patient can help in this.

Communication with a person with a mental disorder can be a serious test. If it is not possible to avoid such communication, then it is quite possible to make it, if not pleasant, then at least less stressful and emotionally costly.

Sometimes it seems that a loved one has gone crazy.

Or starts to go. How to determine that "the roof has gone" and it didn't seem to you?

In this article, you will learn about the 10 main symptoms of mental disorders.

There is a joke among the people: "There are no mentally healthy people, there are underexamined." This means that individual signs of mental disorders can be found in the behavior of any person, and the main thing is not to fall into a manic search for the corresponding symptoms in others.

And it's not even that a person can become a danger to society or himself. Some mental disorders occur as a result of organic damage to the brain, which requires immediate treatment. Delay can cost a person not only mental health, but also life.

Some symptoms, on the contrary, are sometimes regarded by others as manifestations of bad character, promiscuity or laziness, while in fact they are manifestations of the disease.

In particular, depression is not considered by many to be a disease requiring serious treatment. "Pull yourself together! Stop whining! You're weak, you should be ashamed! Stop delving into yourself and everything will pass!” - this is how relatives and friends exhort the patient. And he needs the help of a specialist and long-term treatment, otherwise he will not get out.

The onset of senile dementia or early symptoms of Alzheimer's disease can also be mistaken for age-related decline in intelligence or a bad temper, but in fact it's time to start looking for a nurse to look after the sick.

How to determine whether it is worth worrying about a relative, colleague, friend?

Signs of a mental disorder

This condition can accompany any mental disorder and many of the somatic diseases. Asthenia is expressed in weakness, low efficiency, mood swings, hypersensitivity. A person easily begins to cry, instantly irritated and loses self-control. Often, asthenia is accompanied by sleep disturbances.

obsessive states

A wide range of obsessions includes many manifestations: from constant doubts, fears that a person is not able to cope with, to an irresistible desire for cleanliness or certain actions.

Under the power of an obsessive state, a person can return home several times to check whether he turned off the iron, gas, water, whether he closed the door with a key. An obsessive fear of an accident may force the patient to perform some rituals that, according to the sufferer, can avert trouble. If you notice that your friend or relative washes his hands for hours, has become overly squeamish and is always afraid of getting infected with something - this is also an obsession. The desire not to step on cracks in the pavement, tile joints, avoidance of certain types of transport or people in clothes of a certain color or type is also an obsessive state.

Mood changes

Longing, depression, the desire for self-accusation, talk about one's own worthlessness or sinfulness, about death can also be symptoms of the disease. Pay attention to other manifestations of inadequacy:

• Unnatural frivolity, carelessness.
• Folly, not characteristic of age and character.
• Euphoric state, optimism, which has no basis.
• Fussiness, talkativeness, inability to concentrate, confused thinking.
• Heightened self-esteem.
• Projection.
• Strengthening of sexuality, extinction of natural modesty, inability to restrain sexual desires.

You have cause for concern if your loved one begins to complain about the appearance of unusual sensations in the body. They can be extremely unpleasant or just annoying. These are sensations of squeezing, burning, stirring “something inside”, “rustling in the head”. Sometimes such sensations can be the result of very real somatic diseases, but often senestopathies indicate the presence of a hypochondriacal syndrome.

Hypochondria

It is expressed in a manic concern about the state of one's own health. Examinations and test results may indicate the absence of diseases, but the patient does not believe and requires more and more examinations and serious treatment. A person speaks almost exclusively about his well-being, does not get out of clinics and demands to be treated like a patient. Hypochondria often goes hand in hand with depression.

Illusions

Do not confuse illusions and hallucinations. Illusions make a person perceive real objects and phenomena in a distorted form, while with hallucinations a person feels something that does not really exist.

Examples of illusions:

• the pattern on the wallpaper seems to be a plexus of snakes or worms;
• the dimensions of objects are perceived in a distorted form;
• the sound of raindrops on the windowsill seems to be the cautious steps of someone terrible;
• the shadows of the trees turn into terrible creatures crawling up with frightening intentions, etc.

If outsiders may not be aware of the presence of illusions, then the susceptibility to hallucinations may manifest itself more noticeably.

Hallucinations can affect all the senses, that is, be visual and auditory, tactile and gustatory, olfactory and general, and also be combined in any combination. To the patient, everything he sees, hears and feels seems completely real. He may not believe that others do not feel, hear, or see all this. He can perceive their bewilderment as a conspiracy, deceit, mockery, and get annoyed at the fact that they do not understand him.

With auditory hallucinations, a person hears all sorts of noise, snippets of words, or coherent phrases. "Voices" can give commands or comment on every action of the patient, laugh at him or discuss his thoughts.

Taste and olfactory hallucinations often cause a sensation of an unpleasant quality: a disgusting taste or smell.

With tactile hallucinations, it seems to the patient that someone is biting, touching, strangling him, that insects are crawling over him, that certain creatures are being introduced into his body and moving there or eating the body from the inside.

Outwardly, susceptibility to hallucinations is expressed in conversations with an invisible interlocutor, sudden laughter or constant intense listening to something. The patient may shake something off himself all the time, scream, examine himself with a preoccupied look, or ask others if they see something on his body or in the surrounding space.

Rave

Delusional states often accompany psychoses. Delusions are based on erroneous judgments, and the patient stubbornly maintains his false conviction, even if there are obvious contradictions with reality. Crazy ideas acquire supervalue, significance that determines all behavior.

Delusional disorders can be expressed in an erotic form, or in a belief in one's great mission, in descent from a noble family or aliens. It may seem to the patient that someone is trying to kill or poison him, rob him or kidnap him. Sometimes the development of a delusional state is preceded by a feeling of unreality of the surrounding world or one's own personality.

Gathering or excessive generosity

Yes, any collector can be suspect. Especially in those cases when collecting becomes an obsession, subjugates the whole life of a person. This may be expressed in the desire to drag things found in garbage dumps into the house, accumulate food without paying attention to expiration dates, or pick up stray animals in quantities that exceed the ability to provide them with normal care and proper maintenance.

The desire to give away all your property, immoderate squandering can also be regarded as a suspicious symptom. Especially in the case when a person was not previously distinguished by generosity or altruism.

There are people who are unsociable and unsociable due to their nature. This is normal and should not raise suspicions of schizophrenia and other mental disorders. But if a born merry fellow, the soul of the company, a family man and a good friend suddenly begins to destroy social ties, becomes unsociable, shows coldness towards those who were dear to him until recently, this is a reason to worry about his mental health.

A person becomes sloppy, ceases to take care of himself, in society he can begin to behave shockingly - to commit acts that are considered indecent and unacceptable.

What to do?

It is very difficult to make the right decision in the case when there are suspicions of a mental disorder in someone close. Perhaps a person is just having a difficult period in his life, and his behavior has changed for this reason. Things will get better - and everything will return to normal.

But it may turn out that the symptoms you noticed are a manifestation of a serious disease that needs to be treated. In particular, oncological diseases of the brain in most cases lead to one or another mental disorder. Delay in starting treatment can be fatal in this case.

Other diseases need to be treated in time, but the patient himself may not notice the changes taking place with him, and only relatives will be able to influence the state of affairs.

However, there is another option: the tendency to see in everyone around you potential patients of a psychiatric clinic can also turn out to be a mental disorder. Before calling psychiatric emergency for a neighbor or relative, try to analyze your own condition. Suddenly you have to start with yourself? Remember the joke about the under-examined?

"In every joke there is a share of a joke" ©

The advice that will be given may be useful to anyone who has experienced schizophrenia or other serious mental illness in their family.

When communicating with mentally ill people, it is very important to remember that many of them are characterized by rather low self-esteem, self-doubt, which, of course, is facilitated by the attitude of society, wary and generally intolerant, as well as the understanding that the disease has changed a lot in life. their lives.

Due to the morbid state, the inner world of patients with a mental disorder is often disorganized, so they are not always able to cope with cases, situations, problems that are quite common for other people.

It is very important for loved ones who understand this to learn how to behave respectfully towards a person suffering from a mental disorder. Your relationship will noticeably improve if, while communicating with him, you show him by your behavior that you love him, respect him, appreciate him as a person, that his mental disorder has not changed your good feelings for him.

This will give the patient confidence, help himself to accept the fact of the presence of a mental illness.

Even if you remind the patient several times in the morning that you need to brush your teeth, sweep the room, change clothes, clean up the dishes, even if for a reason, a dismissive and condescending tone is unacceptable. He will not help you achieve what you want, but you will lose the trust and disposition of a loved one.

You must keep in mind that a person suffering from a mental illness may experience strong feelings, his thoughts may be confused, flow too slowly, or, on the contrary, quickly, and his feelings can be very strong and contradictory.

Communicating with a sick person, especially during periods of deterioration in his condition, it is important to learn to behave calmly and with restraint.

Such behavior contributes to the stabilization of the mental state, and in some cases even helps the patient to calm down and cope with anxiety.

It is equally important to understand that verbose emotional phrases can confuse a person who is already overwhelmed by his own experiences and emotions. He may simply not understand what the matter is, not remember everything that you want from him, and the phenomenon that is undesirable for you will repeat again.

Therefore, try to speak as simply and clearly as possible. If you yourself are unsettled, indignant, tired, upset about something, if you cannot pull yourself together and calmly continue the conversation, it is better to postpone this conversation for a while.

Patients with mental disorders tolerate some distance from loved ones more easily than situations of quarrels, conflicts, showdowns in raised voices, many of them need to maintain some distance and strive for this themselves.

Mental illnesses differ from somatic illnesses in that they do not always require spending as much time as possible with a sick relative. Scientists have proved the fact that patients who are in contact with their close relatives for more than 35 hours a week have an increased risk of relapse of the disease (although this is typical for families where relatives show "strongly expressed emotions").

At the same time, a sick person can very hard experience his misbehavior in relation to loved ones, incontinence, rude conversation, even if this was associated with an exacerbation of his mental state. It is important for relatives to know that it is necessary to take active actions, take urgent measures only in the event of a threatening situation for the patient himself or for those around him.

Calm, even and even somewhat detached behavior is quite important both from the point of view of maintaining the stability of the condition of a sick person, and in terms of a long-term perspective - to maintain a good relationship with a sick relative and your own peace of mind.

You and I know that mental illness affects both how a person thinks and how he behaves, what he is able to do.

In some cases, this will help you not to be offended by any statements or actions of a sick person, not to take the manifestation of painful symptoms on yourself.

Many of the relatives probably have a sad experience and know that people living with a sick person can become the object of painful experiences, actions, manifestations of feelings.

You need to learn to differentiate these phenomena and remember that these are nothing more than symptoms of the disease. In another situation, for example, in a hospital, the manifestations of the disease may be directed not against relatives, but against medical workers who during this period directly communicate with a sick person.

Communication with a person suffering from a mental disorder.

It is very important and at the same time very difficult not to lose hope for recovery. Often a chronically ill person has a hard time, a painful condition can last for months and years, taking away hope for recovery, or at least for a significant relief of the condition. Friends, peers have gone far ahead in life, got a profession, have their own families. It may so happen that it will never be available to a sick person.

You need to learn to find certain positive signs, and sometimes just words of support and approval in difficult, crisis periods of the disease. And if a sick person himself paid attention to the approaching symptoms of an exacerbation of the condition and decided to go to the hospital, it would be very useful to support him, express approval and say that the ability to independently recognize the approaching exacerbation of the condition is the key to successful prevention of attacks of the disease in the future.

An important point that stabilizes the condition of a sick person is the preservation of the usual, simple life routine in the house, for example, a stable time to get up in the morning, sleep time, and meal hours. It is necessary to create a calm, consistent, predictable life as much as possible. This will enable the sick person to cope with anxiety, confusion, to understand what and at what time you expect from him and what to expect from you in turn.

For many patients with severe, chronic disorders, it is useful to create a daily routine, for example, such as the example given, which includes, along with the performance of certain duties, periods of rest.

Approximate daily routine of a sick person who is constantly at home.

8.15 Take a shower, clean up.

9.00 Prepare and eat breakfast, drink medicine.

9.30 Wash the dishes, make the bed.

10.00 Walk during which you can send

letter, buy newspapers, groceries.

11.30 Reading, journaling, rest.

13.00 Warm up lunch, have lunch, wash dishes.

14.00 Listen to music.

15.00 Wash, iron, put in order

clothes, clean the apartment.

18.00 Preparing for dinner, cook some

dish, set the table.

19.00 Dinner with the whole family.

20.00 Together with relatives, clean the dishes.

20.30 Communication with family, calls to friends.

23.00 Getting ready for bed, taking medication.

At the same time, it is important to encourage the activity of a sick person, his independence, desire for activity, build relationships in such a way that he does not take a passive role in life, declaring himself disabled and refusing to perform his duties. It is very important that a person suffering from a mental disorder strive for the most independent life. Try to encourage activity, independence of a sick person!

To end the conversation about the peculiarities of communication in a family, one of whose members is ill with a mental disorder, we would like not so much with a recommendation as with a wish and parting word to remember the need to obtain the basics of psychiatric knowledge.

After all, having an idea of ​​\u200b\u200bwhat is happening with your loved one, you can understand what the change in his condition is connected with, figure out what to do in this or that case, and avoid many mistakes.

And having learned about the effect of psychotropic drugs, what are the principles of their administration, how to minimize their side effects. You will take a very big step in preventing exacerbations of the condition of your loved one.

E.G. Rytik, E.S. Akimkin

How do loved ones cope with everyday

problems arising from joint

living with a mentally ill person.

How to deal with a mentally ill person?

If an ordinary mentally healthy person can rejoice at a discount on milk or meat in a supermarket, then it is useless for a sick person to talk about his joy - he will not understand and appreciate it, because at the moment (while he is sick) he is more often worried about completely different problems.

Therefore, when communicating, you should not expect that in this way you can cheer up a sick person.

You will have to reduce your emotions, as sometimes they can unnecessarily irritate a sick person.

It is better to behave calmly, neutrally. You can’t be zealous and say that a person needs fresh air and needs to immediately go for a walk. Do not hesitate - if a person were healthy, he would go for a walk without any advice. Do not want - this is not the word that reflects the true state of affairs. There are no emotions, which means there is no motivation, motivation, mood, etc.

It cannot be given in words. You can meet misunderstanding and irritation.

No need to "pull" a person away from the computer, talking about the dangers of radiation. It is sometimes easier for a sick person to write than to build his thoughts with the help of words. Many mentally ill people find it much easier to communicate virtually.

You can’t say insulting words to the patient, namely, “I’ll call you a psycho-carriage now,” “it’s time for you to go to the hospital,” or something like that. The reaction may be unpredictable. Again, due to the fact that the state of the brain (reactions occurring in it) does not always allow you to answer with dignity, and it is logical to build a defense against such an attack, and even rudeness, if you like.

With mentally ill people it is better, in general, to talk less on such topics that will unnecessarily strain their brain.

You can discuss any domestic problems, but do not make long-term plans for life, etc.

You should not complain about the fact that the whole life will now go awry, that the wife / husband will leave, etc.

Therefore, an important principle is peace and goodwill. Less excessive activity, less notations and moralizing.

It is important to believe that this disease is curable. It is important to instill this faith in a sick person. Let, not with words, but with deeds, deeds, emotions.

These people differ from healthy people only in reduced emotions. And there are a lot of cases when they were cured by helping themselves on their own - fortitude, knowledge, desire to be healthy.

In these cases (for the benefit of the sick person) you should immediately resort to the help of psychiatrists. By any means, a person should be hospitalized so that nothing terrible happens.

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Mentally ill - how to live loved ones?

According to official statistics, 40% of Russians are prone to mental disorders, which without professional help can develop into a serious illness. And only 30% of potential patients visited a doctor. Many of those at risk are under 20 years of age.

According to the World Health Organization, by 2020 mental disorders will become one of the main causes of disability, overtaking even cardiovascular diseases.

What to do if one of the family members starts behaving strangely? How to deal with a mentally ill person? Where to go and how to continue to live if someone close to you gets sick? Answers to all these questions can be found, for example, on stands in the Psychoneurological Dispensary. But few people will visit this institution just to study the posters on the walls. The Bati editors visited the PND and collected all the necessary information and expert advice.

photosight.ru Photo: Miren Marks

The first episode of the disease is the most important stage of its development; during this period, disorders that are irreversible without treatment are formed that impede the social functioning of the patient. Therefore, it is necessary to detect and treat diseases as early as possible.

Early combined drug (including atypical antipsychotics of the new generation) and psychosocial treatment will make it possible to stop the disease in its infancy, radically change its course and outcomes for the better, alleviate emotional distress, social losses of patients and their loved ones, and improve their quality of life.

It is impossible to trust the treatment process only to medicine and a doctor (like education - at school) - this is a painstaking joint work. Modern therapeutic measures certainly include the active participation of the patient and his family in the process of recovery.

The disease, like everything, passes. And a new day comes. Be healthy, and, therefore, happy - you will succeed.

Could you please explain if there is any mechanism in the system of psychiatric care for providing it, in the event that help is needed, but he refuses it?

Yes, in accordance with the Law of the Russian Federation "On psychiatric care and guarantees of the rights of citizens in its provision", such a mechanism is provided. A patient may be placed in a psychiatric institution and held there on an involuntary basis if the psychiatrist believes that the person is suffering from a mental illness and, left untreated, may cause serious physical harm to himself or others.

To persuade the patient to voluntary treatment, the following can be advised:

Choose the right moment to start a conversation with your client and try to be honest with him about your concerns.

Let him know that, above all, you are concerned about him and his well-being.

Consult with other people about how you should do better: relatives, your doctor.

If all else fails, seek advice from your primary care physician and, if necessary, contact emergency psychiatric help.

An important point that stabilizes the condition of a sick person is the preservation of the usual, simple life routine in the house, for example, a stable time to get up in the morning, sleep time, and meal hours. It is necessary to create a calm, consistent, predictable life as much as possible.

This will enable the sick person to cope with anxiety, confusion, to understand what and at what time you expect from him and what to expect from you in turn.

Try to make the life of a sick person as ordered as possible, this will protect you from chaos.

What should I do when my sick son says he doesn't need my help? He even gets angry with me, sometimes shouts rudely. And I'm worried, what if this is not so, and he needs my help? And how do I know if I'm annoying?

Psychiatrists and psychologists face similar situations quite often. Mental illness can drive a wedge between the sick person, their relatives and friends. A sick person can lead an isolated or nocturnal lifestyle, lock himself in his room, get carried away watching television too much. At the same time, he may experience deep depression, have suicidal thoughts. He may also harm himself or use drugs. However, even if your loved one really needs your help, his illness may make him say that he does not need help. It is understandable that this behavior causes you great concern.

In this case, you can talk to other family members or friends. If they are not emotionally involved in your problems and are an independent third party, they can fairly objectively tell you whether you are pushy or your help is really needed.

What can I and other family members do to help my sick child?

This is a very important question. We have no doubt that it concerns many families and friends of the mentally ill. Of course, each situation requires an individual approach. But we can give general recommendations, which, we are sure, are suitable for every family. Remember that not only the success of the treatment, but also the possibility of his return to normal life will largely depend on your attitude, on your desire to help a loved one. Therefore, let's focus on the 10 most common, but very important tips that you can try to follow.

1. Love your sick relative, respect in him the human personality, its dignity and value.

2. Accept the patient as he is at the moment, and not as he was before illness or will be after recovery.

3. Control the intake of maintenance doses of psychotropic drugs, do not allow unauthorized termination of maintenance treatment. It is important not to miss the possible unwanted side effect when prescribing high doses of psychotropic drugs.

4. Constantly monitor the patient's condition to notice the onset of an exacerbation of the disease. It is important to remember that changes in behavior, judgments, statements, sleep disturbances are often not a reaction to the environment, but signs of deterioration.

5. Guide a sick person through life, gently and unobtrusively helping him make the right decisions. Remember that the patient really needs confirmation from those close to him of his significance, their respect for his own decisions and desires.

6. Try to make the patient's life more orderly, devoid of sudden changes.

7. Try to keep the patient in active life. If the patient is working, help him keep his job. It is important that he does not lose his usual social circle, and, if possible, make new friends.

8. Awaken the patient to activity, encourage his activity.

9. It is important to establish a good relationship with your doctor. In no case do not frighten the patient with treatment in a psychiatric hospital or a psychiatrist. Try to maintain a trusting relationship with the doctor in the patient.

10. Do not forget about your own state of mind, health, try not to deprive yourself of the joys of life. Remember that you will help your loved one much better if you are healthy yourself. In addition, we would like to advise you the following. Think over and try to understand what you can change in your life and in the life of the patient, and what you cannot change. Talking to professionals, other parents, and patients themselves will help you understand what is realistic and what is not. Try to involve your loved one as much as possible in making decisions about what might be beneficial for them. Sometimes relatives fall into a trap, trying to do as much as possible for the patient of one thing, even if this “something” does not work, does not help. Instead, you need to experiment, look for something new. Rule number one for you should be the following - evaluate what does not work; try to find other ways to solve the problem. If you find that it really helps, you should go down this path and solve the problem as consistently as possible.

photosight.ru Photo: Igor Vyushkin

How can loved ones cope with the everyday problems that arise when living together with a mentally ill person?

Try to speak as simply and clearly as possible. If you yourself are unsettled, indignant, tired, upset about something, if you cannot pull yourself together and calmly continue the conversation, it is better to postpone this conversation for a while. Having calmed down, you will assess the situation more objectively and, probably, it will be easier to achieve the desired result.

Calmness and restraint are important principles of communication in the family.

What are the general rules for dealing with an excited patient?

Excited behavior is one of the most frightening behaviors of people with mental illness. Patients in a state of excitement move a lot, gesticulate intensely, almost always scream, demand something, save themselves from something. Doctors call this condition psychomotor agitation.

Almost any excited patient is dangerous both for himself and for others. Excitation indicates an exacerbation of psychological illness, even if the patient does not commit any destructive actions. For these two reasons, any excitement requires urgent medical measures.

Therefore, if your relative has a state of psychomotor agitation, then, as a rule, it is necessary to urgently call a doctor to resolve the issue of hospitalization.

The difficulty in caring for a patient with psychomotor agitation is largely due to the fact that this condition usually begins unexpectedly, often at night, and often reaches its highest development in a few hours. Relatives of the patient, neighbors or other people around do not always correctly assess the possible consequences: they underestimate the danger if the excited patient is familiar to them, or, on the contrary, overestimate the danger, since the acutely ill person causes unjustified fear and panic among others.

It is necessary to keep in mind a few general rules for dealing with excited patients.

1. Calm conversation can often reduce arousal levels right away.

2. Under no circumstances should you enter into an argument, object, or try to dissuade a relative of the incorrectness of his beliefs.

3. Before the doctor arrives, it is advisable to cope with confusion and panic, create conditions for providing assistance, try to isolate the sick relative in a separate room. It is necessary to remove all strangers from the room where the patient is located, leaving only those who can be useful, and it is also necessary to remove all piercing, cutting objects and other things that can be used as weapons of attack or self-harm.

4. Under all circumstances, your own safety must be ensured. Feeling that you are in danger and that the patient is unable to control himself, stop contact with him or call the police in order to protect yourself and your relative before the doctor arrives.

5. Learn to recognize the first signs of a relative losing control of himself, for example, threatening gestures, rapid breathing. The probability of occurrence of agitated behavior allows you to assess the history of the disease of a relative. If he has never had such a state before, then most likely he will not have it in the future.

How to help a loved one suffering from a neurotic disorder?

Here are some tips.

First of all, it is important to be attentive to a loved one.

In no case be limited to such advice - "it's time to pull yourself together."

You can not blame such a patient for weakness. A neurotic disorder is not a weakness, but a painful condition.

Try to save your loved ones from grief or the action of other psycho-traumatic factors.

It is very important to set up a loved one for treatment, to convince them to see a doctor.

How loved ones cope with everyday problems that arise when living together with a mentally ill person

Difficulty concentrating

Be brief, repeat what has been said

Do not argue, do not aggravate the discussion, limit communication

Inappropriate judgments, statements

Do not count on rational discussion, do not try to convince

Do not argue, do not and do not support delusional statements

Don't take personally what you say or do

Little empathy for others, emotional coldness

Seen as a symptom of mental illness

Start a conversation first, try to engage in communication

Keep calm yourself, try to calm the sick person

Diffidence

Treat with love and understanding

Be respectful, maintain a positive attitude

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Comments:

There is no advice on how to live with a mentally unhealthy person who has long been registered with a psychiatrist, and who always humiliates, insults us, vampirizes. This is our father. It is impossible to live with this, one insult every day. Although we take care of him, he drinks medicines, etc. This is a terrible test. Here it is not written how to live with such a “monster” and our enemy, who, in return for love and care, insults and yells obscenities. Honestly, this is very annoying.

Katya, you are great that despite such behavior of your father, you continue to help him. This is a very difficult test for you. I wish you to endure it, and finally come to a calm, dignified life, which we all deserve. With great sympathy for you. Alexei.

It seems that at first everything is fine, and we talk and eat everything is fine, but in an instant everything changes and such anger, name-calling, shouting, swearing, etc., grows, as you want to live normally, as before. Little children are little troubles, and the children have grown up and the troubles are ALSO. but you don’t feel like it. Some people can’t cope with their problems, there is no work (and there was one in Soviet times, at least a dime a dozen), families break up, they start drinking alcohol and smoking drugs, hence all the troubles. And God forbid to encounter such a mental problem - there is no one to help, everyone has a plank, laws do not allow, etc., etc. ....... Where can I find recovery and help for a poor person?

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We are like Panya and Garanya, - he seems to be joking. But this is not a joke. Now dad is a person without whom Olya is unlikely to cope, and a daughter is the meaning of Alexei's life. A single father from Samara makes his daughter with cerebral palsy happy.

How to survive winter without colds?

Svyatoslav is now 13, he goes to a regular school, goes in for sports, communicates with the guys. Anatoly Gokh from Krasnoyarsk tells how the family achieved such results and how the birth of a child with an autism spectrum disorder changed his life.

On the way home, I thought about how little I understood and accomplished in my life. At forty-seven years old, I'm still trampling on my zero cycle. But he believed - he took the bull by the horns ...

“For many, I am a“ city crazy ”, such a dad with an unexpectedly hatched hypertrophied maternal instinct.”

After 15 years life together his beloved wife, having taken her youngest daughter, left him with two sons. As a veteran of the Chechen war, he did not become depressed and became a real male example for his boys.

Public contract-offer (Robokassa) Mass media registration certificate El No. FSot 04/17/2013, issued by the Federal Service for Supervision of Communications, Information Technology and Mass Communications (Roskomnadzor). Online publication for parents and children. Category 6+

Next to the mentally ill: five rules of behavior

How to live with someone with schizophrenia

Schizophrenia is one of the most famous mental illnesses. Unfortunately, this disease is incurable and any person who encounters it must understand how to behave with the patient. There are only five problems, but each requires special attention. This:

Aggression

Aggressive behavior can be observed in the patient both during the period of exacerbation and during remission. What to do? First of all, never argue. This is inefficient and also unsafe. It is necessary to try to verbally calm the patient, go to another room, give him the opportunity to recover. Be sure to seek help from a doctor, do not postpone hospitalization out of pity.

In what situations can aggressive behavior be observed? For example, if you interfere with the patient doing what he loves. No matter how strange this hobby may seem to you, it can be of great importance to your loved one. And any interference will be regarded as an encroachment on his personal space. You need to learn to control your negative emotions. In response to your dissatisfaction on the part of the patient, an aggressive response may follow.

Refusal to take drugs

In schizophrenia, in addition to thinking and the emotional sphere, the critical attitude of the patient towards himself also suffers. Often patients ask the doctor to reduce the doses of drugs, and often they themselves “quietly” cancel the drugs. They motivate this with the words "I feel better." It is not possible to influence the decision of the patient by persuasion. The result of refusing to take medication is admission to a hospital. After discharge, the scenario is repeated. What can you offer relatives? In modern psychiatry, there are prolong drugs - drugs that are prescribed as injections once or twice a month. In terms of effectiveness, they are not inferior to tablets, but it is more convenient to take.

Energy in a peaceful direction

A patient with a diagnosis of schizophrenia, a young beautiful woman, after discharge, canceled the medication on her own. Within a month, there was a sharp deterioration in his condition: delusions of religious content, aggression towards relatives and, as a result, forced hospitalization. This was repeated until a certain point, until something changed her attitude towards treatment. Perhaps it was the reluctance to be in the hospital again. Maybe it was the endless conversations with the doctor. But the following happened: she began to take drugs regularly and visit the attending physician. The woman directed her indefatigable energy to help homeless people. She picked them up on the street, gave them food and shelter for a while in her house, then accompanied them to a shelter for the needy. She enthusiastically talked about her charitable work. This patient was never admitted to the hospital again.

Suicide

Suicidal behavior is another problem that relatives of patients with a psychiatric diagnosis may face. And the most unpleasant thing about this behavior is the fact that a suicide attempt is difficult to predict. A person can carefully hide his intentions if he has made a final decision. Sometimes the patient manipulates in order to attract attention or obtain some kind of benefit. However, it can be difficult, and sometimes impossible, to distinguish between a demonstrative patient and a patient who has decided to commit suicide. The most dangerous is the so-called extended suicide, when the patient decides to "save the suffering" of other people, such as members of his family. And first he kills his relatives, and then himself.

hallucinations

Hallucinations are the perception of non-existent images. There are several main types of hallucinations: auditory (voices), visual, tactile and gustatory. The patient believes in their reality, it is useless to dissuade him. Hallucinations are a sign of an exacerbation of the disease and require prompt medical attention. There are such types of the course of schizophrenia, when hallucinations take a chronic form and cannot be treated. As a rule, the patient in this case retains a critical attitude towards them, he understands that they are a product of his illness and do not affect his behavior.

Personality change

The two most embarrassing facts about schizophrenia are that the disease is incurable and it irreversibly changes a person's personality. You can experience a variety of feelings about this: fear, resentment, anger, disappointment, but this will not affect the situation in any way. In the emotional sphere of the "mentally ill" there is a kind of bifurcation (splitting). On the one hand, coldness and even cruelty to others, including relatives, on the other hand, vulnerability and hypersensitivity. Psychiatrists on this occasion use the expression "wood and glass." What used to bring pleasure and delight the patient no longer arouses any interest in him.

Gradually, he is more and more immersed in his autistic fantasy world. Personality changes affect appearance: such patients neglect the elementary rules of hygiene. Relatives need a lot of effort to get the patient to wash or brush their teeth. The disease slowly but steadily isolates a person from society.

Legal grounds

Law No. 3185-I. Article 29

A person suffering from a mental disorder may be hospitalized in a psychiatric hospital without his consent or without the consent of his legal representative before the decision of the judge, if his examination or treatment is possible only in hospital conditions, and the mental disorder is severe and causes: a) his immediate danger to himself or others, or b) his helplessness, that is, the inability to satisfy the basic needs of life on his own, or c) significant harm to his health due to a deterioration in his mental state if the person is left without psychiatric care.

How can a family help their sick relative and themselves?

Confidential contact with the doctor

"Insane" patients are very sensitive to the criticism and encouragement of the attending physician. Ask the doctor questions that bother you, because for many, schizophrenia is an obscure condition. However, there is a small "but" here. If the mental state of the patient does not fall under Article 29, then information about his health, even to close relatives, can only be disclosed with his consent.

Hospitalization

If the doctor insists on hospitalization, this means that the mental state of the patient cannot be corrected in the dispensary. What is the advantage of such treatment? Firstly, in a hospital, it is easier and faster to choose an adequate therapy, since the patient is under medical supervision around the clock. Secondly, all medicines that will be prescribed to your relative, he will receive free of charge. And thirdly, in the hospital, the patient is guaranteed to take medication. Many people are frightened by the forced placement of a loved one in a hospital. Relatives feel guilty before the patient. But in fact, involuntary hospitalization is like an operation to open an abscess: an incision is necessary in order for the abscess to heal.

Risks are close

At the end of 2015, at a specialized conference on the dangerous behavior of people with mental illness, disappointing numbers were announced. Now in Russia, patients who are under constant dispensary observation, and coercive measures due to aggressive and unsafe behavior in relation to others, were applied by court order more than to those living in families. It should be noted that we are talking only about people with official diagnoses, meanwhile, some experts believe that at the moment in the country about 40% of people suffer from mental disorders that have not yet transformed into serious illnesses.

How to live nearby?

There is a temptation to completely control your sick relative. However, by hyper-custody you deprive him of the healthy part of his personality (and it certainly exists) of the right to at least some kind of autonomy. It is necessary to learn to separate the person and his disease. When the patient behaves aggressively or inappropriately, understand: now this is not your beloved son, grandson or husband. This is the disease in him. Later, when you “come to your senses,” your loved one will calm down and be able to interact with you in a different way. In our society, the mentally ill are extremely wary. And that is why it is especially important for your relative to feel your support and love, to understand that you accept him as he is. And the last thing: do not try to punish yourself, take responsibility for what happened. You are not to blame for what happened. No matter what, life goes on.

Calling as salvation

John Forbes Nash is an American mathematician and Nobel laureate in economics. The scientist suffered from paranoid schizophrenia. Nash fell ill at age 30. Initially, his wife made attempts to hide the terrible disease from colleagues and friends. But a few months later he had to be forcibly placed in a psychiatric hospital. The scientist's illness progressed. He spoke of himself in the third person, was afraid of something, wrote meaningless letters. Nash's colleagues gave him a job and found a good psychiatrist who prescribed strong drugs. In 1980, the disease, much to the surprise of psychiatrists, began to recede. Perhaps this happened because the scientist again took up his favorite mathematics. In 2015, John Nash received the highest honor in mathematics, the Abel Prize.

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