Emotionally unstable personality disorder

If a patient is diagnosed with an emotional disorder, it is often accompanied by the development of mental illnesses: neuroses, at various stages of schizophrenia. Since psychiatry, as well as psychologists, study this category of disorders, it is important to consider all possible aspects of the disease.

Emotional and behavioral disorders (psychiatry)

Disorders of emotions and behavior can act as an independent, primary disease, or become a side symptom as a result of neurosis, depression, or severe nervous shock.

Disorders of behavior and emotions in a child

In a child, the disorder manifests itself as the inability to independently plan one’s own time, control emotional manifestations and reactions, and organize behavior in accordance with generally accepted norms.

The main symptoms include the following:

1. Aggressiveness
2. Refusal to obey adults
3. Excessive cruelty
4. Disobedience
5. Pugnacity.

The reasons why a child may develop a behavioral disorder can be divided into several categories:

1. Physiological. Manifests itself in hormonal changes and disturbances in metabolic processes. As a result of the development of cerebral palsy, epilepsy, schizophrenia, as well as increased irritability.
2. Psychological. Occurs as a result of the child's emotional instability. He may develop an unrealistic self-esteem, a depressed emotional background, and constant self-blame may prevail.
3. Family relationships. As a rule, the disorder occurs as a result of constant conflicts between parents. Most often they exhibit immoral behavior, use drugs or alcohol, and often have mental disorders.

Before starting treatment for a pathology, the treating specialist tries to establish the cause of the disorder, as well as organize testing for the child to find out how much it is progressing.

Disturbances in the sphere of emotional reactions

They manifest themselves as disproportionate in intensity or inadequate in quality emotional reactions in response to changes in situations that are essential for patients.

Emotional explosiveness or explosiveness . It manifests itself as an increased readiness for emotional reactions in the form of affects or disorders close to such, in response to various emotiogenic stimuli. From the outside, one may get the impression that violent emotional reactions arise over completely trivial matters (a rude word, an ironic remark, etc.). But these are usually “trifles” that greatly hurt the individual’s wounded pride. Reactions of expressed dissatisfaction, anger with verbal, and often physical aggression predominate. It happens that in such an impulse the victim is seriously injured, sometimes incompatible with life. Sometimes such patients exhibit “free-floating aggressiveness,” so that external aggression can immediately transform into auto-aggression. Such aggressors do not value their own lives or those of others. Most often they are psychopaths. During the reaction, self-control is significantly reduced, patients mostly act impulsively.

Explosiveness is often found in patients with psychopathic-like disorders of various origins (TBI, schizophrenia, etc.). E. Bleuler about and attacks of despair with attempted suicide, as well as “fear or even stuporous states.” Let us remember that we are not talking here about acute reactions to stress or reactions to repeated stress, when the first, as it were, prepared the ground for a reaction to the latter (“mental anaphylaxis”, “mental allergy”). Sometimes hysterical patients can “work themselves up” to the point of passion, especially if they have developed such a defensive reaction somewhere in the zone.

Defensiveness is emotional viscosity. It manifests itself as a persistent fixation of predominantly negative emotional reactions that arose in a situation of frustration. Typical in this case are rancor, vindictiveness, and aggressive fantasies. The patient, for example, talks about a long-standing conflict with his colleague and at the same time plays with his nodules, clenching his fists as if we were talking about a very recent skirmish. He does not forget to add that if he came across this man now, “I would settle accounts with him in full.” Another patient, 15 years later, brutally beat a classmate because he “made fun of me at school in front of everyone.” Such patients overcome mental trauma for a long time and with difficulty, unable to switch to something else. They seem to be invariant and strictly adhere to previous habits and patterns of behavior. Defensiveness can also manifest itself in relation to positive emotions and attachments. Patients say that they are “monogamous” and cannot start a second family if their husband or wife dies, they prefer to live in one place, it is very difficult for them to change their occupation, hobbies, entertainment, they keep old things for a long time, but they cannot get used to new ones. quite difficult, they listen to the same music and watch old films they once loved many times, do not include new people in their circle of friends, etc. Emotional viscosity is characteristic of epileptoid psychopaths, epilepsy, individuals with age-related personality changes, and has been described in parkinsonism and postencephalitic mental disorders.

Emotive lability is a slight, capricious changeability of mood under the influence of the most insignificant reasons, sometimes not noticed by the patient himself, much less by those around him - tachythymia. The wind rose, the sun set, rain splashed, a heel broke, the pen stopped writing, a stain appeared on the blouse - all this can significantly ruin the mood. But it easily rises if pleasant little things happen right away: the seller didn’t shortchange, someone said a compliment, smiled, gave up his seat on the bus - and the mood is good again, life makes you happy again, you like all the people, and rainbow mirages appear ahead again. In some cases, emotional lability reaches the level of emotional hyperesthesia, when the mood becomes dependent on an infinite number of random details of what is happening.

These are mimosa-type people, impressionists who cringe at a random glance, the intonation of a voice, the smell of sweat, the sight of a wilting flower. Such painful fragility makes it difficult to live, maintain smooth relationships with people, think about something serious, and generally creates a feeling of ephemeral, airy existence, in which everything is so conditional and changeable. Emotive lability is a sign of corresponding psychopathy, foreshadowing the possibility of more serious affective pathology.

Emotional incontinence is the inability to control not only your emotions, but also their external manifestations. The disorder was described by E. Bleuler in mental retardation, as well as in mentally ill people. Characterizes a significant decrease in the ability of self-control and dysfunction of higher integrative authorities.

Weakness - compassionate tearfulness, excessive sentimentality, manifested when perceiving or remembering touching events. One of the early signs of cerebral atherosclerosis. Weakness is often associated with traumatic events of the past and in such cases reminds us of the approaching symptom of “living in the past.” Weakness also occurs in states of neuropsychic asthenia, when a rational attitude to what is happening is replaced by a sterile emotional one. Excessive tearfulness often occurs with mild depression and hysteria. Sometimes tears characterize impotent anger, self-pity and resentment towards someone, a state of tenderness, a release of emotional stress, and the ability to share the suffering of someone. There are also tears of joy. The latter things do not relate to weak-willedness itself.

Weakness should not be confused with forced crying, which, like forced laughter, occurs with pseudobulbar disorders. “Hysterics” with sometimes uncontrollable sobs are associated with the fact that patients fall into the corresponding role, needing consolation, but cannot immediately get out of it on their own. Tearfulness in patients with painful insensibility does not relate to weakness: here the tears flow as if on their own, mechanically, not accompanied by the experience of corresponding emotions. There are also “made tears” - someone “forces the patient to cry or he feels that it is not he who is crying, but someone else instead of him.” Tears, like laughter, have many meanings.

Emotional dullness is the underdevelopment or loss of higher feelings while maintaining or even reviving simpler emotions. Patients lack such feelings as compassion, tenderness, a sense of justice, remorse, a sense of beauty, a religious feeling, intellectual feelings, etc. Emotionally stupid individuals are callous, cruel, not prone to repentance, many of them do not even know the feeling of shame. They do not care at all what feelings they form as parents and teachers. Many parents today teach their children to be selfish, to love only themselves, not to stand on ceremony with those who are weaker, to refuse help and to learn to say a firm “no” when asked for something, and if they hit, even when they are down. The leitmotif of such teachings is the conviction that “now you can’t live as a good person and you must win your place in the sun by force.”

Here is an example of the emotional dullness of a school teacher who, due to illness, was transferred to disability. The patient is a teacher-mathematician by profession; she taught physics and mathematics in high school. She said that she had developed a new system for teaching her disciplines and that after six months her class was unrecognizable: the eternal C students began to show miracles in solving problems. That is why - out of envy - she was suspended from lessons. Her method was to create problems of the type that would be interesting to schoolchildren. Over the course of a year, she came up with four hundred such problems and was extremely proud of it. Here are some of them. “A brick is sliding on the roof of a five-story building. The length of the sliding path is 5 m. The height of the house is H, the sliding speed is X. An old man is approaching the house at speed Y. From the place where the brick is supposed to fall, it is located at a distance B. The question is: will the brick fall on the head of this bald old man?” Or: “A climber fell from a cliff 250 m high. The question is: how long will it take him to reach the gorge and at what speed will he crash on its bottom?” The saddest thing about this story about emotional stupidity was that all the children liked the problems, and none of their parents protested.

A somewhat lesser degree of emotional dullness is designated as emotional impoverishment or impoverishment. The attachments, altruistic feelings, and empathy of such patients are significantly weakened, fragile and quickly dry up. Thus, a 30-year-old patient reports that he is still not married and does not intend to get married, that he has never been interested in anyone before, has never been in love and has never liked anyone.

“Love,” he explains, “is animal magnetism, the relationship between a male and a female. Why marry - to mate? And then, even if you get married, you have to adapt to society, and tedious legal procedures will follow.” He doesn’t think about becoming a father at all. “What is this, what is the point of having children, I don’t love them, and caring for them disgusts me.” I got a job several times, even for good pay. After 1–2 months, he quit his job, but did not formalize his dismissal, without notifying him in advance of his intention. Questions about duties, responsibilities, and the fact that he had let someone down were ignored. His motivation to leave work was: “The work is boring, monotonous, I would like bright impressions, but everything gets boring quickly.” He does not visit his parents, does not write letters to them. I had only one friend at school. He is not interested in anything at the moment, does not communicate with anyone, and practically does not leave the house. Lives on the help of his parents. At home he sometimes plays computer games, sometimes watches TV, and occasionally reads anything he can get his hands on.

“Of course, I would have to work, but there is nothing that I would like.”

The degree of emotional impoverishment varies, of course, but usually it concerns higher feelings: affection, love, friendship, gratitude, cordiality, respect, compassion. Even minor emotional changes play, according to E. Bleuler, “an outstanding role” and “especially because in any disorder it is the affective mechanisms that first reveal symptoms.”

Emotional paradox is a disproportion between the intensity of affective reactions and the objective significance of emerging situations and developing circumstances. Thus, a 31-year-old patient, a prosector at a children's hospital, is satisfied with his work, it does not depress him, does not darken his mood. Explains: “At the cellular level, the corpse is not visible.” A good photographer, he especially likes to photograph children. Loves nature, serious music, “pop music disgusts me.” Very vulnerable - “one word is enough to ruin your mood for the whole day.” Not married, never been in a close relationship: “This is pure physiology; love was invented so as not to feel like beasts.”

He tolerates the environment of the psychiatric ward (located in the general ward) calmly, is not burdened by being here, communicates with patients on equal terms, goes with them to lunch and to work. He accepted the offer to undergo treatment without resistance. Informed by the doctor that he is ill, and quite seriously. He listened to this calmly and did not ask why he was sick. He didn’t ask about the threat of this disease or how it would affect his life. I calmly accepted the offer to register for disability. For some reason I remembered that I once spent the night in the morgue for a whole month. “The only bad thing there is that it’s hot.” Another patient reports: “I’m not afraid of fights, men fight bloody, with knives, and I try to separate them. Lately, one has broken up seven fights. “More than anything else, I’m afraid of mysticism and watching thrillers.”

Another patient stoically endures the atmosphere of the department, the noise, quarrels, fights between patients, he is not traumatized by the fact of the disease (he knows what he is sick with), and the not very bright prospects of remaining virtually thrown out of life. And yet one day he suddenly became very indignant, shouted, and was agitated - the reason was that he was moved to another bed in the ward.

Irritability is a tendency to frequent and relatively shallow reactions of dissatisfaction for various, usually minor reasons, which often have no direct relationship to the true causes of the disorder. One of the most common causes of irritability is the egocentrism of patients - many of them are dissatisfied only because “everything is not done as it should be,” that is, “not my way.” An egocentric person gets irritated when people don’t listen to him: how can you not listen to me, others are capable of talking nonsense, but not me. It infuriates him when he is interrupted, although he himself does not allow anyone to open their mouth: “he also interrupts, boorish, it would be better for him to keep quiet, listen to what smart people say.” An egocentric person constantly reproaches someone, lectures, instructs, gives very impartial assessments, he is generally irritated by everything that, in his opinion, is unfair, that is, it hurts his exorbitant pride. They are irritable to the point of scandals and hysterics: they are offended that they are not appreciated, not understood, not thanked at every step, they need their path to be strewn with roses of admiration.

Often, irritability is a way of releasing accumulated resentment on someone. Resentment and tension spill out onto household members, children, animals; goes to objects too. Dishes are shattered, clothes are torn to shreds, pens and pencils are broken. One patient smashed his car with a hammer because it would not start. The transfer of emotions from one object to another is sometimes called the transportation of emotions. Patients, irritated, often want at all costs to maintain the illusion of their control over what is happening by demonstrating aggression, the strength of their ego. Irritability can be a consequence of dissatisfaction with themselves: few are able to understand themselves in order to understand what is wrong with them . The easiest way is to find the culprit in order to distract your attention from yourself with a flash of irritation, as if to crowd out dissatisfaction with yourself, and at the same time restore self-esteem. Sometimes irritation is a mild form of expressing indignation, that is, dissatisfaction with the essence of the matter, which does not affect the dignity of another; such people are often dissatisfied with themselves, or rather, with the fact that they did something wrong, at the wrong time, let someone down, and generally did something unworthy of themselves.

Usually they are immediately ready to apologize and correct the situation as soon as possible. Finally, irritability is a constant companion to asthenia - irritable weakness or “failure of the brakes” - hypersthenia. Such patients are at first indignant, then they think, and then they realize that they “got excited” and were wrong. Emotions are generally difficult to bring under control, but losing control over them is much easier. And when this happens, they always have the first word. If irritability is combined with other manifestations of increased emotional sensitivity, it may be a sign of excessive impressionability in depressed patients. So, irritability can be characteristic of patients with various disorders; we think we have identified some of its main causes.

Emotional coarsening is the loss of subtle, differentiated emotional reactions associated with a mild decrease in intelligence with organic brain damage in persons who are disharmonious in terms of premorbid personality. Due to an overly simplified, incomplete, fragmentary or one-sided understanding of what is happening, patients become quite inadequate: tactless, naked, familiar, boastful or even dishonest, since deception and cunning are in the order of things for them. Their sense of proportion, delicacy, courtesy, tolerance often betrays them; in polite society they resemble a bull in a china shop. They cannot understand that their inappropriate behavior will shock someone, may injure someone with an obscene phrase, offend or cause self-loathing. They also love to joke. But their jokes are vulgar, obscene and often repeated to the accompaniment of their own laughter.

Because of their importunity, they shamelessly barge into someone else’s conversation and try to lead him in their direction, where they wash someone’s bones. They speak loudly, a lot, as if they are trying to shout someone down. Their phraseology is very far from subtlety, the statements of prostitutes, the beginning and end of the latter are rarely on the same line of reasoning. Patients easily cross the boundaries of subordination, interfere with personal relationships with employees, and do not take into account the self-respect and ethical position of the interlocutor. And if the interlocutor is also a subordinate, he finds himself in the position of a “fool” who should not be taken into account at all. Patients are often very cheeky, they can be rude and even mock people who are dependent on them. They are incapable of dialogue: they interrupt the interlocutor, do not allow him to complete his thought, do not try to understand him, impose their opinion, and then draw dubious conclusions from the conversation, relating not so much to the problem being discussed, but to interpersonal relationships.

Subordinates rarely leave the office of such a boss with a light heart, unless they use flattery or something else to appease the “deity.” Such dialogue is somewhat reminiscent of the communication disorder in the form of double dialogue described in families of patients with schizophrenia (J. Batesson, 1956). For example, a son, rejoicing at his mother’s visit, puts his hand on her shoulder. The mother responds with a grimace of disapproval. The patient withdraws his hand, to which the mother reproaches him for not loving her. The patient blushes, but the mother reprimands him, saying that he shouldn’t be so embarrassed. In other circumstances, emotionally hardened patients may behave completely differently: they ingratiate themselves, please, humiliate themselves, agree with everything and eat with the eyes of their boss, trying to speak less so as not to inadvertently anger him. Someone rightly said: silence is a shield for a fool, a fool is smart as long as he remains silent. The essence of the matter does not change from this change of dishes. The coarsening of emotions and feelings occurs quite often and usually comes to the fore, while intellectual decline remains, as it were, in the shadows, and gross violations are often not detected.

Anniversary reactions are the appearance or intensification of feelings of grief on the date of the tragic event. This happens, for example, on Parents' Day, on days of remembrance of victims of war or terrorist attacks, disasters, etc. For example, participants in battles in hot spots get together from time to time to remember their fallen combat friends. Usually reserved in talking about mourning events with outsiders, here they indulge in detailed memories, reviving in their memory the smallest details of what happened. At the same time, it cannot be done without a feast. They drink to remember the dead, to soften the severity of the loss and to suppress the guilt of the survivors. In hindsight, it often seems that the disaster could have been prevented.

Parathymia is an inversion of emotional reactions, the replacement of adequate emotions with the exact opposite. So, a mother congratulates her daughter on her birthday as follows: “Galina! I don't wish you a happy birthday. I don't wish you happiness. I curse you, your mother’s curse is the worst!” The girl was raped in a group; her friends held her legs. In shock, she returned home, did not say anything to her loved ones, went into the bathroom, lay down in the water with her clothes on and burst out laughing. Another patient recalled that at the age of seven she fell into the water, got scared, and began to drown. She was saved by a woman passing by. Instead of the joy of salvation and gratitude to the woman, “I scolded the savior in all sorts of ways, told her that she was a fool and ugly.”

Idiosyncrasy to emotions - intolerance of various emotions: “I perceive my emotions too acutely. And good ones too. After them there is palpitation, discomfort, I feel very bad. I try not to worry or be happy at all.” This symptom seems to be the opposite of painful insensibility. In the latter case, patients suffer from the fact that they have ceased to be aware of their emotions. In the second case, on the contrary, the patient is too acutely aware of her emotions and suffers for this reason.

Emotional ambivalence is the coexistence of polar feelings in relation to the same object or phenomenon: “I seem to have two selves: one loves my mother, the other hates her... I am attached to my husband, I am tender with him and at the same time he infuriates me, I’m ready to kill him”... The patient wants his wife to die, but when he sees her dead in hallucinations, he falls into despair. The disorder indicates a splitting of the ego.

Escalation of affectivity - excessive expressiveness (in gestures, facial expressions, postures, voice intonations) in hysterics as a means of suppressing others, self-affirmation and as a mechanism for discharging excess motivation (teaching a lesson, punishing someone, moderating libido, etc.). Patients start small: they raise their voices, cry, nervously walk around the room. Then, gradually and as if involuntarily, they inflate themselves to such an extent that they can no longer get out of the role on their own unless they are saved by fainting.

Emotional burnout is a symptom complex that includes emotional and (or) physical exhaustion, depersonalization and decreased performance (Pelmann, Hartman, 1982). Emotional exhaustion is experienced as internal emptiness, depletion of affective resources, and emotional overstrain. Interest in work is lost, the patient goes there as if “to hard labor”, without inspiration and enthusiasm, but rather with disgust. Depersonalization is expressed by a feeling of depersonalization of people; they all seem equally unpleasant.

Relations with them become purely formal; employees often cause irritation, hostility, dissatisfaction and indignation. Conflicts with them are quite likely if colleagues do not realize that they are dealing with a person whose mental strength has left them. The decline in performance is associated with such reasons as the emergence of a negative assessment of oneself as a professional, self-doubt, feelings of uselessness, doubts about one’s competence, dissatisfaction with oneself, and decreased motivation to work.

Emotional burnout occurs in individuals who are in intensive and close communication with clients, patients, students, students and colleagues when providing professional assistance. Characteristic of emotional people who do not know how to protect themselves from excessive affective reactions to work situations. The surgeon should not die with every patient, the psychiatrist should not go crazy with the patient, accepting his grief as his own; The teacher should not worry about the failures of his students as if he himself received ones and twos. Work should not exceed the optimal level of tension, otherwise it will lead to fatigue and many mistakes in simple situations. The amount of workload should be rational and in no case go beyond the scope of mental hygiene. Managers do not know anything like this or do not want to know, overloading their subordinates; Usually, unfortunately, they care more about themselves and their prestige in the eyes of their superiors.

The disorder develops at the age of 30–40 years, more often in women with these professions, as well as in scientists and managers. It is sometimes called compassion fatigue. It is necessary to timely identify patients and provide rehabilitation assistance using psychotherapy and psychopharmacotherapy (small doses of antidepressants, nootropics, sleep normalization, physiotherapy, etc.).

Learned helplessness is a condition caused by “being caught in harmful, unpleasant situations” that “can neither be avoided nor prevented” (Seligman). In experiments on animals, the helplessness of the latter becomes such that even the emerging opportunity to get out of the situation is not used. Some authors see in this disorder a factor contributing to the emergence or intensification of depression. V. Frankl observed the complete loss of the ability to resist in the Nazi death camps; For some reason such prisoners were called Muslims, perhaps because they pinned their hopes only on the Almighty.

Dyshomophilia - tension, anxiety during homoerotic fantasies. It is observed in homo-, heterosexuals and even asexual people. It is recommended not to confuse the disorder with “egodystonic homosexuality.”

Emotional paralysis of Beltz (1901), or affective anesthesia. Described as a variant of psychogenic stupor without impairment of consciousness with complete shutdown of emotions without subsequent amnesia. Derealization is also observed, the patient perceives what is happening detachedly, from the outside, as something apparent to him. At the same time, he can move and behave outwardly quite adequately.

The loss of syntony manifests itself in the fact that the patient does not feel the emotional context in someone’s conversation with him, and thus cannot discover the meaning of the speech addressed to him. Thus, the patient perceives the doctor’s usual sympathetic questions about his well-being as an “interrogation” and says that “they are getting into his soul.” When asked to clarify what he means, he states that they are pestering him and showing inappropriate curiosity. He considers the advice to get medical treatment as pressure on him, and is indignant at being “dictated” or “imposed” on him. He is offended by a joke, believing that he is being “mocked”; he regards a friendly attitude towards himself as an attempt to “manipulate” him, etc. It is more often observed in patients with schizophrenia.

Vicarious pleasure is the replacement of one’s own dissatisfaction with joy or pleasure for other people. A father is happy, for example, that his son gets an A in math at school, but no matter how hard he tried, he couldn’t do this at one time. The voyeur gets vicarious pleasure by spying on the intimate relationships of other people.

Phobic reactions are excessive fears of something, observed in timid, timid natures. It is important that such patients do not know how to assess the true extent of the danger and do not have sufficient personal experience in dealing with dangerous situations. They are not able to adequately control their fears. The best form of fear control is coping skills in threatening situations. For example, a person sees someone drowning. He runs along the shore in fear and calls for help. Another person silently rushes into the water and saves the drowning man, without feeling any fear. Phobic reactions are not obsessive, although the patient fruitlessly struggles with them, is burdened by them, would like to get rid of them, while understanding that they are something not entirely normal. In addition, he is also ashamed of his fears and tries not to tell anyone about them. V.V. Kovalev defines such fears as overvalued and exaggerated.

Hypophobia is a lack of feeling of fear, leading to an underestimation of the degree of danger or threat of any situations. Described in patients with schizophrenia, in alcoholic intoxication, and with neuroses - “thenic sting of a psychasthenic.” There are cases of complete absence of fear - anaphobia. A 30-year-old patient claims that she does not know what fear is and has never experienced it under any circumstances. She says that during her school years she went to the cemetery alone at midnight, even before school she visited the anatomy class, visited the morgue, and even took her friends there out of curiosity. She never had fears in her dreams, no matter what she dreamed. From the very beginning, she watched horror films completely calmly and said: “I don’t understand what people find scary in them.” She jumped from a parachute and “wasn’t afraid at all, even the instructor was surprised,” she drowned and “wasn’t scared at all: if I drown, I’ll drown, so that’s how it’s supposed to be.” “I wasn’t afraid of the psychiatric hospital, I came myself, what’s there to be scared of.”

Without fear, she walked at night along the unlit streets of the city, where “I know they killed, robbed, and raped.” “I’m not brave, no, I just don’t have developed fear. Well, there are people without legs, I have something similar to this.” There is also a known phenomenon called contophobia - the desire to get into dangerous situations for the sake of acute impressions that are not accompanied by fear.

Satomura syndrome (1979) is a peculiar fear of superiors or other high-ranking officials. This is the fear of appearing funny or unpleasant in their eyes. It is considered as a neurosis characteristic of the Japanese. Apparently, it occurs not only among them.

Disorders of the sense of humor are the inability to see something worthy of compassion behind the comical, playful form. First of all, the sense of humor changes when perceiving real life situations of a humorous nature. At the same time, the sense of humor in relation to oneself suffers. The perception of humor in corresponding images (cartoons, etc.) seems to be preserved to a greater extent (Bleicher, Kruk, 1986).

According to our preliminary impressions, the loss of a sense of humor first manifests itself, apparently, in the fact that when an individual meets an object of humor, he becomes very happy, his mood rises, so that he himself is not averse to making someone laugh, and then having a pleasant time the rest of time. The second, hidden level of humor is not distinguished, light sadness and in-depth reflections about human nature, and about oneself usually do not exist. The next stage of a sense of humor deficit occurs when an individual becomes funny, very funny, when he encounters manifestations of humor. He is sometimes filled with Homeric laughter, and he does not think about anything serious.

Once he starts laughing, he will do it all evening (for example, at a laughter concert) and at very dubious jokes. As soon as you provoke some “decoy duck” to laugh, the rest of the humor lovers begin to laugh together, as if on command. A funny person resembles a stoned drug addict who laughs at everything you show him. A. Maslow, meanwhile, noticed that people with a genuine sense of humor usually do not have fun and laugh, only a sad smile runs across their face. Statistics say there are only 1–3 such people per hundred. The continuing degradation of the sense of humor is expressed in the fact that the individual will laugh with pleasure when someone is laughed at. But he does not accept jokes directed at himself; moreover, he may be offended by this or, worse, get angry. Finally, humor dies when it is taken “seriously,” that is, not taken at all.

The lack of a sense of humor is especially acute in patients with schizophrenia, who are educated, intelligent, knowledgeable, but who take jokes and allegories very literally. The best sense of humor, as is well known, is developed among pessimists, who see the weaknesses and shortcomings of people better than others and, nevertheless, treat them with particular delicacy and care. However, in depressed patients, their sense of humor, like other high feelings, is blocked, which makes it extremely difficult for them to survive depression - they are deprived of the internal support that only helps people in misfortune. Patients with epilepsy are deprived of a sense of humor once and for all.

With their rigidity, getting bogged down in trifles, they do not have time to notice how this spark of God flashes over them - a moment of humor. With alcoholism, the sense of humor degrades to banality, vulgarity, cynicism with an indispensable element of greasiness - mentions of betrayal, meetings with passionate beauties and something else like that. One would like to call such humor genital. “Black humor” has only one similarity with genuine humor - the use of a comic configuration. In its depths lies not compassion, not high sadness, but merciless cynicism, ready to strike all the saints and everything that is called the existential, enduring and eternal values ​​of human existence.

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Mixed emotion and behavior disorder

It is characterized by a disorder of emotions and behavior equally, where a person exhibits excessive aggressiveness, suffers from a persistent depressive state, and increased anxiety.

Emotional disorder in children

A child, compared to an adult, perceives all events more acutely, and therefore reacts much more emotionally. Accordingly, when an emotional disorder occurs, the symptoms manifest themselves much more intensely.

In order to prevent pathological development of the situation in the future, it is recommended to use play therapy. This will help avoid underdevelopment at the psychic and mental levels. Also, game simulators that replicate life conditions will help the child adapt better and realistically perceive the surrounding aspects.

Psychodynamic work is also often used, which is accompanied by a psychologist. Psychoanalysis involves identifying the causes of the formation of emotional disorders.

Treatment of mood disorders

Therapy is complex. Initially, it is aimed at stopping an acute depressive and/or manic period. Depending on the symptoms and their intensity, the doctor selects the necessary medications. In most cases, treatment is carried out on an outpatient basis, but in severe situations, inpatient treatment is recommended.

After stabilization of the patient's condition, he must undergo psychotherapy. This is individual, group or family therapy. Its goal is to help a person understand the disease, as well as teach behavioral techniques to control their emotional state.

Treatment of affective disorders involves lifestyle changes, namely:

• reduction of external stress factors;
• proper nutrition;
• adequate activity;
• avoid mental or physical stress;
• exclusion of alcohol and other toxic substances.

After the main treatment, maintenance therapy for affective disorders is recommended. It is aimed at maintaining a long period of remission and preventing relapses.

Treatment may take several months, but if you consult a doctor in a timely manner, the prognosis is favorable.

Emotions and emotional disorders

A physiological state of the body, characterized by subjective coloring, which is expressed in types of experiences, ranging from positive to sharply negative manifestations.

Regarding emotional disorders, this is a whole complex of manifesting symptoms, which are often characterized by irritability, aggression, sudden changes in mood, a tendency to deviant behavior, as well as the inability to control one’s own actions.

Mixed behavioral and emotional disorder in children

Mixed behavioral and emotional disorder in children has similar symptoms as in adult patients. Behavior is often deviant in nature, deviating from social norms. As a result, the child becomes more aggressive, signs of depression are often observed, as well as increased anxiety.

Before starting treatment, you first need to be tested by a psychologist and psychotherapist. If a primary neurotic or mental illness is diagnosed, against which a mixed disorder develops, physiotherapy, complex work of psychotherapists and psychologists, and auxiliary medications are most often used.

Kinds

Psychiatry classifies as affective disorders all mental disorders that are based on frequent changes in mood in the direction of its increase or decrease.

Let's look at the ones that occur most often:

1. Depression is characterized by a constant feeling of hopelessness and despondency for at least 2-3 weeks. Hobbies and past interests do not bring joy. A serious illness that requires referral to a specialist.
2. Dysthymia is a chronic type of depression that results in daily depressed mood. The symptoms are not as severe as those of a clinical depressive episode. This diagnosis is made if despondency and apathy do not leave a person for 2 years or more.
3. Bipolar disorder is an affective mood disorder that was previously known as manic depression. It is characterized by 2 main phases: depressive and manic. They can alternately replace each other or mix into one state. In this case, the person exhibits signs of depression with motor activity or delusional thoughts.
4. Cyclothymia is a series of constant changes in mood and physical activity, without depression or manic agitation. At the same time, a person is quite capable of maintaining social activity, even experiencing difficulties with well-being. Without treatment, it can progress to bipolar disorder.
5. Manic syndrome - this type of disorder is characterized by an excited state, euphoria, and motor activity. Rapid speech, insomnia, and confusion of thoughts are often observed. It occurs in the form of attacks, the duration of which depends on the stage of the disease.

Anxiety disorders are also identified. Its main feature is a constant feeling of restlessness and anxiety for no apparent reason. This group includes various phobias and panic attacks.

Development mechanism

In psychology, there are two groups of factors contributing to the development of psycho-emotional disorders: internal conditions and external influences. Internal conditions include features of the cognitive sphere: thoughts, ideas, fantasies. A negative assessment of events provokes negative emotions. Another group of internal factors are the psychophysiological characteristics of the body. The biological basis of emotions is the neurohumoral processes of the limbic and diencephalic systems of the brain, the exchange of serotonin, adrenaline, norepinephrine, and dopamine. An imbalance of these substances leads to the development of affective disorders.

Reactions to external environmental conditions can be innate and conditioned. Genetically embedded ways of responding - fear, aggression - are the basis for the formation of more complex emotional and behavioral patterns. During life, the development of affective disorders is facilitated by the processes of experiencing and consolidating traumatic experiences. Repetition or partial similarity of current events with past ones that caused negative experiences becomes the cause of psycho-emotional disorders.

Causes and provoking factors

The main cause of emotional problems is considered to be organic damage to brain structures.
And:

• heredity - if one of a person’s close blood relatives suffered from behavioral disorders, the risk of similar problems increases by 50%;
• history of infectious brain damage (encephalitis, meningitis);
• previous head injuries;
• bad habits;
• endocrine diseases, for example, diabetes;
• a difficult childhood caused by traumatic situations provoked by relatives;
• prolonged stress;
• experienced violence.

If there are several factors influencing at the same time, this significantly increases the likelihood of developing emotional problems.

Impulsive option

The impulsive type of emotionally unstable personality disorder manifests itself in preschool age. It is manifested by increased emotional excitability and a tendency to engage in various types of actions without assessing their consequences. Children with the disease are aggressive, often raise their voices, and are embittered towards the people around them. They are characterized by the following symptoms:

• children are capricious, easily offended by any words of their parents or peers;
• irritability and cruelty towards people, patients are vindictive and vindictive;
• a gloomy mood and negative emotions prevail;
• the patient tries to be a leader in the team, otherwise he shows aggression;
• tendency to conflict, intransigence;
• study and work do not arouse interest and become uninteresting.

Affective disorders are characteristic of the impulsive type of disorders. They manifest themselves in outbursts of cruelty and aggression. Patients do not think about the consequences of their actions. As a rule, the actions of patients are dangerous for others. People with emotionally unstable personality disorder often experience sexual deviations.

Disease prevention

There is no specific way to prevent emotionally unstable personality disorder. This is due to the fact that the specific cause of the pathology has not been established. Prevention of the disease is divided into primary and secondary. Primary prevention is carried out in healthy people who have risk factors for developing the disease.

This includes the following actions:

• Avoiding physical punishment of the child.
• The family must maintain positive, trusting relationships. Any aggression and cruelty are completely excluded.
• When communicating with a child, it is necessary to support his independence and help him identify his own “I”.

Secondary prevention is carried out for patients diagnosed with emotionally unstable personality disorder. It allows you to prevent the progression of pathology and the development of complications. To do this, a person must adhere to the following recommendations:

• Reduce stress levels in life. To do this, it is recommended to eliminate stressful situations and meditate regularly.
• Eliminate bad habits, primarily alcoholism and drug use.
• Follow doctor's orders.
• Change jobs if there is excessive workload and a toxic team.

If you experience any symptoms of a personal disorder, you should immediately contact a psychiatrist. The specialist will conduct an examination and promptly select comprehensive treatment.

Forecast

The most favorable prognosis is for patients whose emotional disorders are not associated with brain damage and severe dependence on alcohol and drugs. The sooner professional assistance is provided to the patient, the better the prognosis. With neurological diseases, it will not be possible to achieve a complete cure. However, proper treatment, support from loved ones and the creation of a favorable psychological climate will significantly improve the patient’s psycho-emotional state and quality of life.

Clinical manifestations

ENRL in humans can occur in two variants – borderline and impulsive. The impulsive type is characterized by a violation of one's own self. This leads to uncertainty of intentions and internal preferences. The first signs of the disorder appear in adolescence. These include:

• Frequent fantasizing. Fantasies are of a different nature, often associated with the patient’s family and loved ones.
• Unreasonable change of mood. Emotional lability progresses with the course of the disease.
• A teenager often changes hobbies, for example, clubs and sections he attends.
• Failure to comply with the rules established in the team, disregard for the norms and rules prevailing in school, college, university, friendly company and other social institutions.
• Relationships with others are unstable. The child does not have permanent friends, and he cannot gain a foothold in the team.
• A normal level of intelligence is accompanied by poor performance in educational institutions.

As a patient with a borderline form of emotionally unstable personality disorder grows up, the clinical manifestations change. The following symptoms come to the fore:

• A person tries to do his job as well as possible. Perfectionism can lead to the patient sabotaging his own activities and missing deadlines.
• Emotional reactions are pretentious and exaggerated.
• Self-determination is violated, self-identification suffers. A person has doubts about the chosen educational institution, work or his own personal life. It constantly seems to him that he is making a mistake that can ruin his life.
• Life goals, values, and moral guidelines are constantly changing.
• A craving for psychoactive substances, alcohol, and psychoactive drugs appears.
• It is easy to instill in the patient any ideas by presenting them “with the right sauce.”
• Suicidal tendencies appear.

Patients retain the ability to socially adapt. With a compensated disorder, patients experience a good mood and increased performance. However, dysthymia soon develops. This is a condition characterized by emotional lability and progressive depression.

Classification and properties

These mental processes have quite a lot of qualities and characteristics. We will touch only on the main ones.

The following forms of emotional responses are distinguished:

• By direction of reaction: positive (positive) and negative (negative).
• Characterizing the psychophysical state: sthenic - increasing activity, asthenic - decreasing it.
• Fundamental: joy, sadness, anger and fear.

Diagnostics

A psychiatrist diagnoses emotional problems. To make a diagnosis, a list of typical manifestations of pathology is taken into account:

1. Inadequacy of emotions.
2. Lack of self-control.
3. Behavioral disorders affect all areas of life.
4. There were problems with social adaptation.
5. The patient had previously been diagnosed with organic brain lesions.
6. The man has experienced psychological trauma.

If the disorders correspond to at least three points on the list above, the psychiatrist will diagnose emotional disorders and develop an individual treatment regimen.

A look from the inside

Hysterical psychopaths are very trusting, suggestible, and are easily drawn into deception. Often they do not have their own opinion, giving in to someone else’s. They easily get involved in adventures. Endowed with a rich imagination, it is difficult for them to separate reality from fantasy, so they are often accused of lying.

People with hysterical disorder do not like to work, especially where high professionalism, refined skills and perseverance and effort are required.

The woman, in her words, developed a tremor (trembling) throughout her body, her legs gave way, her tongue fell out, she mumbled and growled, and there was a short-term loss of consciousness while working in the garden. The reason, in her opinion, was fatigue and overwork.

Such individuals choose easy, uncomplicated work. They love to attend social events and talk about beauty. They prefer a hedonistic lifestyle, seeking to gain benefits and pleasure.

There is an opinion about hysterical psychopaths as immature, frivolous, “empty” individuals.

The thinking of a patient with histrionic disorder is called “wishful thinking,” known as wishful thinking. His mental activity is driven by his own desires. They take over the mind so much that they can distort thoughts so that they do not correspond to reality. In other words, everything that goes against what he wants is ignored. Everything he wants is correct, the rest is complete delusion, incorrect, insignificant.

People with hysterical disorder love to extol themselves and exaggerate their merits. They try to appear super-erudite and gifted, using a few simple pieces of knowledge. They boast about meeting famous people.

The Russian poetess Zinaida Gippius, the decadent Madonna as her contemporaries called her, suffered from this disorder. “I love myself like God,” says Zinaida Nikolaevna in one of her poems called “Dedicated.”

The poetess expressed her desire to amaze and conquer in everything. She put on such bright, expressive makeup that her face looked like a mask. It looked very unnatural and atypical for the late 19th century. Gippius' movements were affected by mannerism and absurdity. She was ready to go to any lengths to attract attention and admiring glances.

Having been married for 10 years, Zinaida Nikolaevna remained a virgin, which she flaunted at every opportunity. She considered herself bisexual: “in my spirit I am more of a man, in my body I am more of a woman.” Some contemporaries considered her a hermaphrodite.

Hysterical individuals with pathological fantasies are dangerous to society. They make excellent swindlers, healers, and fortune tellers. At a young age, they are so immersed in their fantasies that they invent non-existent situations: how they developed secret weapons, carried out complex operations, are able to confess to a murder they did not commit.

By depth and strength of response:

1. Reactions. They appear at the moment of action of a stimulus that causes a mental response. They are short in time, but can be intense in level.
2. States. Longer-term manifestations of moderate severity are mood or passion, often controlling the actions and actions of the individual.
3. Properties. The most stable forms of responses characteristic of certain types of human characters. These include: excitability with a quick “on” response to a stimulus, lability – polar fluctuations from cheerfulness to depression, from sympathy to complete indifference, etc. Rigidity is a viscous and stable type of experience.

general characteristics

Emotions are mental states that reflect a person’s attitude to current events, to people and to himself.
Emotional reactions consist of three components: a feeling of experience, changes in physiological processes and the appearance of external expressive complexes. In other words, a person feels an emotion (joy, anger, fear, sadness), experiences changes in the functioning of the body (sweating, heartbeat) and expresses his state with the help of facial expressions and gestures. Emotional states become pathological when their duration, intensity and content do not correspond to the situation and bring physical and psychological discomfort. Psycho-emotional disorders are characterized by unreasonable and inadequate affect, do not fit into the usual time frame, interfere with the performance of social functions, are perceived as painful or are not recognized by the person himself.