Basic rules for communicating with mentally ill people

Rehabilitation for schizophrenia is one of the most important stages of recovery and socialization of a patient with schizophrenia.

Relatives of a person suffering from schizophrenia have a great responsibility for organizing a meeting between a family member and a psychiatrist, maintaining contact with the attending physician and following all necessary recommendations. Often, close people of the patient lack the most basic information about the behavioral characteristics of the patient with schizophrenia, communication skills with him and knowledge of the rights of the patient with schizophrenia. The Transfiguration Clinic pays special attention to working with relatives, their awareness and psychological assistance to family members of a patient with schizophrenia.

What is the reason that most patients, despite treatment, end up back in psychiatric clinics?

The importance of rehabilitation for schizophrenia

This is mainly due to refusal to undergo rehabilitation for schizophrenia and take maintenance therapy. Violation of the regime during rehabilitation for schizophrenia, independent, uncontrolled reduction of doses of medications taken. The easiest way, of course, is to blame patients for lack of consciousness, placing all the blame on them for the next relapse of the disease. However, considerable blame for the current situation still lies with doctors and the healthcare system as a whole.

Often, after discharge from a psychiatric hospital, a patient undergoing rehabilitation for schizophrenia finds himself virtually left to his own devices and unable to continue to cope with his illness. He faces wary glances from his family and work colleagues or even tries to hide the fact of his hospitalization.

He is left alone with fears for his future, which often seems uncertain. In this case, there is a risk of severe mental illness, such as psychosis, the treatment and rehabilitation of which should be carried out in a specialized hospital.

In addition to such “vivid” symptoms as delusions and hallucinations during an attack, schizophrenia can manifest itself as mood swings, causeless anxiety, and peculiar personality changes. It becomes difficult for patients to communicate with people and correctly understand the world in general.

Thus, the patient needs support and rehabilitation for a long period after the acute episode. Help in the recovery of patients with schizophrenia consists, first of all, in informing the patient and his relatives about the course of the disease and debunking “myths” about the disease.

What kind of rehabilitation is needed for schizophrenia?

A person suffering from schizophrenia often does not fully understand the depth of damage to his psyche, so his closest relatives have to monitor his health, nutrition, appearance and adaptation in society.

Often, if a person does not undergo rehabilitation for schizophrenia, the patient’s personality is destroyed to such an extent that he is not capable of independent life, work and starting a family. In this case, disability due to mental illness is issued: the patient is assigned a pension depending on the group and other social benefits are added. For 5 years, the patient must undergo a medical-labor expert commission annually, undergo rehabilitation for schizophrenia, take prescribed medications and regularly visit his doctor. If after 5 years the condition is not restored, then disability is assigned for life. In the absence of visits to a psychiatrist and refusal of recommended treatment, such behavior of the patient can be interpreted by the medical commission as recovery. In this case, the disability is not extended.

The main rehabilitation for schizophrenia is ensuring regular examinations by a psychiatrist, monitoring the intake of antipsychotic medications, maintaining physical health and undergoing socio-psychological rehabilitation. Such complex therapy can be obtained at the Preobrazhenie Clinic.

Patients need rational employment that allows them not to drop out of society and to feel needed and useful for society. Finally, psychotherapy has an important influence in the rehabilitation of patients with schizophrenia, allowing the patient to understand his illness and consult a doctor in a timely manner to prevent relapses, and adapt to the world around him.

Diagnostic criteria

The requirement for a diagnosis of paranoid schizophrenia is the presence of at least 1 clear manifestation or 2 subtle manifestations from the following group:

• statements about putting in or taking away thoughts;
• delusional beliefs that relate to motor activity, sensations, or actions;
• hallucinations of an audio nature - usually a voice commenting on the patient’s behavior or discussing his actions;
• persistent overvalued delusional ideas - beliefs in superpowers, communication with alien beings, etc.

To make a diagnosis, the following list of symptoms is also used, of which at least 2 manifestations must be present:

• overvalued beliefs that arise every day for a week or month, hallucinatory phenomena of any type;
• disruption of speech and thought processes;
• catatonic syndrome, overexcitation or freezing, stupor;
• symptoms of the negative subgroup - apathy, poor speech, inadequate emotional reactions, problems in social adaptation (signs should not be caused by depression or treatment with antipsychotics);
• behavioral disorders, loss of interests, non-targeted actions, self-absorption like autism.

In many types of schizophrenia, symptoms persist for at least 30 days. To be diagnosed with f25 episodic schizoaffective disorder, a patient must have at least one of the following symptoms for 14 days:

• audio hallucinations;
• delusions of control or influence;
• beliefs about telepathy - a person indicates the reception or transmission of a thought process;
• speech is broken, there are neologisms;
• there are delusional ideas that are not characteristic of any subculture of the patient;
• catatonic type symptoms.

During the diagnostic process, symptoms of a mood disorder must be present. The diagnosis is established if a person does not have organic disorders in the functioning of the brain.

Clinical manifestations

Additional symptoms are divided into positive and negative. Positive psychopathological syndromes:

• Asthenic - weakness, increased fatigue, lethargy.
• Psychopathic-like - increased affective lability, increased sensitivity and excitability, hypomanic behavior, overvalued formations.
• Affective - daily sharp mood swings, depression or mania, oneiroid.
• Hallucinatory - hallucinations, voices in the head, pseudohallucinations.
• Delusional - sensual delirium, paranoia, Kandinsky-Clerambault syndrome.
• Catatonic is a pathology that includes decreased (state of stupor) or increased (excitement) psychomotor activity.

Negative psychopathological syndromes:

• Autism is social isolation, inability to experience empathy, lack of spiritual connection with people and lack of interest in social life.
• A reduction in energy potential or a drop in mental activity - lack of productivity, difficulties in using existing knowledge, problems with the mobility of mental processes.
• Emotional changes - impoverishment of emotional reactions, lack of clear differentiation of emotions.
• The phenomena of drift are increasing passivity, the impossibility of building a “life line.” Patients give an analogy of their life to a “boat” that is sailing in an unknown direction.
• Thinking disorders/speech features - thinking is not purposeful, there is no sequence of thoughts and speech, there is no logic. Thinking is fragmented. Sometimes there is an “influx of ideas”, the content of which is difficult for the patient to articulate.

Dementia of the schizophrenic type is a separate negative syndrome. It occurs at the final stage of schizophrenia. To identify it, tests are used to assess cognitive abilities.

With dementia, there is a significant drop in intelligence. The “core of personality” is destroyed. There is a gross violation of the higher intellectual functions involved in the formation of judgments and conclusions. The patient is not able to adequately comprehend what is happening. He does not know how to apply concepts correctly. His thinking cannot analyze, synthesize, generalize information. Stereotyped statements are noticeable in speech. The stock of knowledge and skills suffers.

It is worth addressing the issue of the appearance of a person with schizophrenia. Patients often neglect hygiene and personal care. This is noticeable in sloppy, wrinkled clothes. The facial expression and gaze are sad, wary or “radiant.” Facial expressions are poor or inappropriate to the situation. In schizotypal disorder, patients' appearance is described as “eccentric,” ostentatious, or strange. Facial expressions are meager and restrained.

What to do if you have schizophrenia

• Find an opportunity to see a psychiatrist.
• Contacting our private psychiatric clinic will completely preserve the anonymity and social rights of any person.
• When establishing a diagnosis and selecting appropriate drug therapy, as well as during exacerbation of schizophrenia, hospitalization is required.
• Keep in constant contact with your doctor. If you notice signs of changes in behavior or thinking, tell your doctor immediately.
• Make sure you take the prescribed medications regularly.
• A patient with schizophrenia must undergo a full course of treatment, including a course of socio-psychological rehabilitation and family psychotherapy.

How to communicate with people with schizophrenia

Patients with schizophrenia usually have a well-developed intellect, but their system of logical constructions, due to mental damage, has a unique character. Such a person understands what you are telling him, but in analyzing and answering your question he relies on his own attitudes, values, or even just a momentary mood.

It is better not to argue with a patient in a state of psychosis or demonstrating delusional symptoms. This is not only useless - you will not be able to convince him of the error of judgment, but also unsafe - you will become his enemy. And then it will be very difficult to establish contact again.

Behavior of a patient with schizophrenia during an exacerbation

Patients with schizophrenia during a relapse of the disease often experience hallucinations, are aggressive, tense and anxious, and have sleep disturbances. Such patients are suspicious in behavior, listen for something, can run away from imaginary enemies, hide, or show hostility and aggression towards those who are considered ill-wishers. Suicide attempts and suicidal thoughts are also possible.

During the period of exacerbation, patients suffering from schizophrenia may leave home, eat almost nothing, express delusional thoughts, and make attempts to protect themselves from “persecution.” Try to arrange a meeting with a psychiatrist for the patient as soon as possible.

Rehabilitation for schizophrenia largely prevents the likelihood of periods of exacerbation of the disease. This preserves the patient's intelligence and cognitive functions.

Speech of a patient with schizophrenia

The statements and speech of patients with schizophrenia directly depend on changes in thinking and the emotional-volitional sphere. Speech becomes grammatically incorrect: neologisms appear - words invented by the patient and devoid of any meaning. Disjointed thinking leads to fragmented speech: despite the apparent orderliness of the words in a phrase, its overall meaning is lost - a lot of words, but nothing about anything, the so-called “verbal hash”.

Violation of phonetic speech is expressed in the placement of incorrect stress in words, unusual intonations in phrases and the replacement of sounds with unusual ones. As the delirium is simplified, speech becomes poorer, and the feeling of communicating with a patient with schizophrenia becomes formal and superficial.

At first, the written expression of the speech function is manifested by its ornateness and fantastic plot, which is then replaced by the stereotypical writing of phrases and numbers with a complete lack of meaning. At the beginning of the disease, handwriting is distinguished by decorations and curlicues, and when the personality is destroyed, it is replaced by simple characters that are not related to each other.

Over time, the speech of patients becomes emotionally colorless, there is no interest in the interlocutor, indifference to the reaction of a stranger.

Rehabilitation for schizophrenia implies that the patient is in the doctor’s field of vision, which allows timely adjustment of drug doses and treatment regimens.

Basic rules for communicating with mentally ill people

Respectful Relationships

Be respectful, talk to an adult like an adult.

What does it mean? This is a relationship of equals. You recognize that even though he is mentally ill, he is your equal. He is the same person as you. With your desires, with your own character traits, with advantages and disadvantages, and you accept him completely as such and appeal to the whole person as a whole.

You emphasize with your respect that he is an adult, even if due to illness he has some changes in perception, defects in thinking and some features of mental life. If this is an adult, then the relationship should be built on the attitude of an adult to an adult, and with a teenager - as a teenager.

As an example: a mentally ill person is similar to a person deprived of: legs, arms, eyes, hearing. Naturally, this gives rise to some behavioral characteristics. Another thing is that a mentally ill person has changes in thinking and perception, and they are invisible. But, nevertheless, they exist, and this is not a subject of ridicule. After all, no one laughs at a blind man. Everyone understands that he suffers from his disability, and he is respected despite the fact that he cannot see. Also in a situation with a mentally ill person, one must respect his opinion, his personality, his experiences, even if he is deprived of any emotional manifestations of feelings.

The principle of calm, certainty and openness.

When communicating with a mentally ill person, it is very important to be calm, clear, specific and open.

What does it mean? This means that you must ensure that your communication with the mentally ill person is extremely simple, clear and understandable.

The rules for communicating with mentally ill people are aimed at the need to build communication with such people, taking into account the peculiarities of their thinking and perception. And their peculiarity is that in their condition it is impossible to perceive complex, emotionally charged phrases; they need very simple, intelligible messages.

You must be ready for any of his actions, to react openly to any of his emotions. Calm and open. If he is aggressive at this moment, you should calmly say that he is now aggressive. And openly admit how you feel about this, that it scares, irritates, and doesn’t like it. Clarity and definiteness mean that you build your communication in unambiguous sentences and phrases. So that the phrase cannot be interpreted in two ways or in another way. Your message to a mentally ill person should be clear and understandable, like an army order.

The principle of consistency and predictability

This principle implies that your communication with the mentally ill person should be consistent and predictable.

If you have some kind of agreement about any behavior, then you consistently fulfill all the points. For example, if you agreed on a daily routine or household chores. That you need to wake up no later than a certain time, make your bed, brush your teeth, wash the dishes after yourself, smoke only on the balcony, take out the trash...

There should be predictable, predetermined rewards for compliance and sanctions for failure to comply with these responsibilities. Your relative should know their responsibilities and the consequences for not fulfilling them. Your relative must understand why he is praised and what complaints are made about him. Relatives, for their part, must also follow these rules and consistently fulfill the framework of the agreement. Thus, your behavior should be orderly and predictable for a mentally ill person.

Clear frameworks, rules and limits of what is expected

You must specifically know the capabilities of a mentally ill relative and set requirements for him and his behavior accordingly.

You must remember the chaotic world of a mentally ill person. Frameworks and rules must be defined. Like at school: lesson 45 minutes - we sit quietly. During recess you are allowed to talk loudly and run around. It’s better to immediately point out: “I don’t like that you smoke, but you can smoke on the balcony and remove the ashtray after that. I want you to get up in the morning, but no later than 11 o’clock.” Such actions support the patient’s inner peace. This principle complements the principles already stated.

The principle of friendly distance

All communications take place in friendly intonations.

The inner world of a mentally ill person is cyclical, changeable and often chaotic. It is very important to keep in mind that a mentally ill person may not always be emotionally stable. He may behave strangely, inappropriately, incomprehensibly. A mentally ill person often evokes negative emotions, can frighten you, irritate you with his aggression, melancholy, and despondency. It is very important not to give in to these emotions. It is important to distance yourself from these emotions, not to join. For example, your relative is experiencing melancholy and despondency. You can tell her: “Yes, you are feeling sad now, but I will be grateful to you if you clean up your things.”

The principle of friendly distance helps to maintain the peace of mind of healthy family members and maintain friendly, comfortable relationships between the mentally ill and healthy relatives.

Remember that he is sick!

It is necessary to react not to the individual, but to the disease.

Mental illness cannot be seen, like, for example, physical illness. For example, if a person does not have an eye, then it is clear that he is blind, that it is difficult for him to take care of himself, that he may be unkempt and sloppy. This is clear to others: the person is blind and he has the right to be sloppy. In mental illness, the defect that the illness causes is not visible. In schizophrenia, thinking, emotions, and volitional qualities are impaired.

A mentally ill person may outwardly look adequate, calm, and physically strong. But still he is sick. Due to his illness, he cannot do some ordinary things. He may react unexpectedly, paradoxically to your requests, statements, conversations. You must be prepared for inappropriate, paradoxical actions, because he is sick. And react not to the person, but to the disease. For example, your brother is sick. You knew him as a kind child, but when he gets sick, he periodically turns into an extremely aggressive, evil monster. And you must understand and take into account that your brother is still kind and affectionate, but due to his illness and during periods of exacerbation, he may change.

Thus, if you always remember that your relative is mentally ill, this will help you correctly and adequately respond to the actions and statements of your relative, thereby again maintaining friendliness in the family.

Separate the disease from the person

You must be good at diagnosing the symptoms of the disease, as well as the manifestations of the person’s personality.

This also helps to maintain a friendly distance, as well as a respectful attitude towards the personality of the mentally ill.

It is important to remember and understand that if your mentally ill relative displays some aggressive or unusual, inappropriate actions during an exacerbation of the disease, then it is not he who is behaving, it is the disease that is expressing itself through him. For example: if a person has drunk alcohol, he behaves aggressively, inappropriately, and irritably. In this case, they simply say - it’s not him, he drank, he’ll sleep it off and be as before. If your mentally ill relative accuses you of turning the knob to the right and thereby influencing him, this must also be taken into account, this is not an attack on his part, this is a symptom of the disease.

If he says that you are very evil, cunning and influence him with some kind of rays, he says this not because he treats you badly, but because the strange, twilight, unpredictable, chaotic mental world forces him to be so.

If your relative is seriously ill, limit contact

It must be remembered that mentally ill people often retreat into their inner world; there are times when they do not need external contacts at all.

And if during these periods you actively begin to interfere in the world of a sick person, then, most likely, the mentally ill person will perceive your desire to help, your participation as an attack on him. If you see that your relative is busy with some kind of internal thoughts, if he is embittered, clearly experiencing an acute mental state, it is better to definitely leave him alone and not touch him. Thus, you reduce and eliminate provoking factors.

This has a good effect, first of all, on the patient’s well-being: when you limit contacts, you reduce the level of conflicts and misunderstandings, and reduce provoking factors that can intensify his psychotic state. On the other hand, when you limit contact, you maintain your peace of mind, your mental health. Contacts can be limited at home or, for example, through hospitalization. Hospitalization occurs when you see that he himself is not able to cope with his internal sensations, then you intervene in the situation, the issue of starting drug treatment in the clinic is decided.

But very often, leaving a mentally ill person alone with his inner world, you get the fact that after a while he calms down, fear and anxiety go away. After this, you can calmly begin communication and clarify the situation, find out how he felt at that moment. And it is quite possible that in this calm state the patient may voluntarily agree to hospitalization if you both consider that he cannot cope with the manifestations of the disease on his own. This way you maintain a friendly and trusting relationship. Your relative sees that you do not allow yourself to forcefully interfere in his personal life. The calm and patient attitude of others has a healing effect on the health of the mentally ill.

Positive attitude, even in the face of failure

It is very important to see even small changes for the better. And always – rejoice in small successes.

Repeated psychotic exacerbation by family and friends is perceived as a failure, as a deterioration in the condition as a whole. But if you have worked hard on yourself and your relationships after the first psychosis, and have established communications with a mentally ill person, during the next exacerbation you will be able to agree on voluntary hospitalization. And voluntary hospitalization is a good indicator of friendly relations in the family. Thanks to you, a mentally ill person quickly adapts to his condition, can understand himself and can convey to you his feelings and experiences. Yes, the disease has a destructive effect on the personality, and the person will no longer be able to function as before. But it is important to tell yourself: “Yes, my brother is sick, but he is sweet, kind, affectionate and can help around the house - these are positive changes.” Your loved one sleeps at night - this is already good. Your loved one gets up on his own in the morning - these are positive changes.

Possibility of maintaining dignity

Behind any unusual act or offensive word there is a person for whom self-esteem is one of the few opportunities to remain human.

We must remember that inappropriate behavior is a symptom of illness. It is important to understand: the patient is very ill at the moment and cannot behave differently.

The main thing is to tell the mentally ill relative at this moment that he is not okay, offer to take medicine, and you need to talk about this incident at another time - when he feels better. In this way, the family helps the person acknowledge the fact that difficult changes are happening to him and offer a solution.

Encouraging positive developments

It is important to see even small changes.

Especially for the better. At the same time, any positive must be verbally indicated. Be sure to talk about it and be sure to celebrate all efforts as real steps towards improving his condition. “It’s good that you remember your household responsibilities. You follow the doctor’s recommendations, take treatment, attend the group.”

Praise and specific comments

Don't be afraid to openly voice your dissatisfaction. But don't forget about a friendly tone.

If you are not happy with something, talk about it. If you see something positive, be sure to point out this fact. Don't be afraid to praise your relative. A written agreement on the rules, which will spell out incentive measures, will help in the relationship.

Reality principle

It's important to focus on what your relative can do right now.

The level of social functioning can vary greatly from low, requiring outside care, to the highest, safe, when the patient can exist quite independently, can study, work, and support his family. It's important to focus on what your relative can do right now. There is no need to think about what he might do in the future or what he might do in the past. The principle of reality allows you to correctly assess the course of the disease, understand the very essence of the disease - in the long term it can worsen the condition, and in the short term it is subject to strong fluctuations both intellectually and emotionally.

Transformation of goals: long-term - into a number of short-term ones

Practice proves: it is more productive to break one task into a number of small ones and gradually, step by step, achieve them.

If you want to achieve some changes in the condition of your mentally ill relative, then it is better not to set global goals for him. “From now on, you are in charge of the house.”

Constant help and support

It must be remembered that mental illness is chronic and it often leads to disability. And solving ordinary everyday issues for your sick relative turns out to be overwhelming. Therefore, it is very important to help him achieve his goals.

To questions regarding long-term goals, answer - I don’t know.

The future of mentally ill people is usually uncertain, the disease usually leads to a deterioration in overall functioning, so it is impossible to talk about any long-term goals.

It is quite possible that before the illness, your relative was engaged in some kind of activity, for example, playing a lot of sports. Having fallen ill with schizophrenia, he continues to be confident that he will do his job, participate in training, win competitions, and prepare for the Olympics. If you answer these plans unequivocally: “No, you will never return to big sport,” interpersonal relationships will collapse, and the person will lose the meaning of life.

It is necessary to select the correct expressions. It would be appropriate to suggest: “Let us do this, first you will wake up in the morning and do morning exercises or jogging, this, in my opinion, is more realistic than participating in the Olympic Games.”

Based on the principles of calm, honesty and openness, it is better to answer: “I don’t know. Let’s do morning exercises today, and we’ll see in the future.” Patients often ask: “Will I be able to recover?” You can answer honestly: “I don’t know, it’s very difficult to say at the moment, but if you do certain things, for example, take pills, attend group therapy, your condition will improve significantly.”

Don't let your relative's illness throw your life into chaos.

You must take care of yourself. If you don’t do this yourself, then who will take care of you, your son or daughter?

A very important recommendation. A frequent strategy of mothers is that if a child gets sick, then all the time, all efforts are directed only at him. It is necessary to realize: even if you live with a mentally ill relative, you must not forget that his life is his life. If a loved one is struck down by illness, this does not mean that your life should turn into chaos, that all your goals should be subordinated to this person’s illness. You shouldn't deprive yourself of your privacy. On airplanes, passengers are always taught the correct behavior in case of disasters: they are taught to put an oxygen mask on themselves first, and then on the child. Professionals understand: if a parent becomes ill, there will be no one to help their child in a general panic. Here is exactly the same rule, ask yourself: “If my life proceeds in chaos, then who will help my child?”

Taking care of yourself should first of all involve putting aside all thoughts about your own guilt in what is happening. The illness is not your fault; it has already happened to your loved one. If you want to help him, then be fine yourself. People living next to mentally ill people are often susceptible to neurotic diseases. Therefore, the relatives and friends of a mentally ill person especially need psychotherapeutic help and support.

The mental health of your relative depends on your mental health.

Be active. Do not involve a sick person in your activities.

Lead an active social life.

Carry on with your old life. You should have your own interests, your own work, communication with friends. You must have your own personal life, you must love and be loved. You should play sports, visit theaters, visit people and go to concerts. However, there is no need to involve your sick relative in such an active life. He may not be able to withstand a lifestyle that is easily tolerated by healthy people. Your mentally ill relative may not be able to withstand those social contacts and the stress that an active life in society causes. Therefore, if you go to visit your friends, it is better to leave your sick relative at home and enjoy communication with friends.

Continue your education on communicating with the mentally ill.

It is necessary to realize that the sick relative will change, and with each new exacerbation his personality changes. And, therefore, at the same time it will be necessary to change your attitude towards it.

A mentally ill person is a qualitatively new person. With illness, he acquires new qualities that may not be clear to you. Therefore, relatives need to learn to communicate with a mentally ill person. You need to see the symptoms of the disease, respond correctly to the symptoms, see the dynamics of the disease, be able to restrain your emotions and maintain a friendly tone in communication, despite the psychotic storms, shocks, and cyclical changes in mood and social functioning experienced by the patient.

There are 2 sides to the problem here. The first is the characteristics of the course of the disease, the second is your state of mind.

Therefore, it is important to constantly talk with those who understand this disease, or with those who have already encountered similar situations. These could be psychiatrists, psychotherapists, support groups, and those people who also have a mentally ill relative in their family. Even though you are not the one who is sick, you also need support. You are constantly in direct contact with the patient, and this is a lot of tension and stress.

There are several opportunities to learn and practice communication skills with a mentally ill person.

1. Self-education. You are reading specialized literature.

2. Conversations with professionals. You receive verbal recommendations.

3. Attending special lectures or trainings on developing communication skills with mentally ill people.

4. Psychotherapy itself. This can be individual or group work. In this format, you will be able to fully master the rules of communication with mentally ill people. It is a well-known fact that relatives of mentally ill people are susceptible to neuroses. Accordingly, they need special rehabilitation so that their quality of life does not decrease. Knowledge allows you to improve your defense mechanisms.

https://psychiatrist.kz/

Rehabilitation for schizophrenia - how to persuade

The patient is closed in on himself and it is almost impossible to reach his consciousness. He can be distrustful even of close people and is sometimes aggressive. A person relies on his own internal logic and it is not possible to convince him using the usual methods.

If you want to achieve the result of resuming treatment, try to establish contact with the sick person. Stop proving them wrong, putting pressure on them and convincing them. Agree with what you can agree with and ignore the rest. While the patient’s thoughts are chained to his painful experiences, it is impossible to switch him to other ideas. Rely on the symptoms that the patient himself complains about. Ask him whether he wants to improve his sleep, deal with disturbing neighbors, or get rid of anxiety, and continue this line. Call a psychiatrist at home under the guise of a psychologist, police officer or neurologist. Everything else is the task of the specialist himself.

If you want to learn to understand your sick family member, come for a consultation with a psychiatrist-psychotherapist. After preliminary training, it will be much easier to persuade a patient to undergo treatment. Our clinic conducts special classes for relatives of patients with endogenous processes.

When a person in a psychotic state refuses to go for a consultation, invite a doctor to your home, or call a mental health team. If a patient turns to a psychiatrist for the first time, along with calling an ambulance, be on the safe side by calling the police, who have a psychiatrist in their structure, or simply confirm the patient’s antisocial and violent behavior. In this case, hospitalization will be carried out involuntarily, and the person will be registered with the PND for monitoring, since he will need rehabilitation prescribed for schizophrenia.

Do people with schizophrenia recognize their illness?

The peculiarity of mental changes during illness is such that patients are not able to fully understand their illness. Moreover, this diagnosis still has a negative connotation in our society. A patient, even during a period of remission, when criticism partially returns to him, may simply be ashamed of his illness and hide it even from loved ones.

A person can understand what changes occur during an illness, become aware of his illness and learn to cope with it through courses of socio-psychological assistance. The Moscow psychiatric clinic Preobrazhenie has developed a special program of psychotherapeutic assistance for patients with schizophrenia.

Is it possible to radically get rid of schizophrenia?

Unfortunately, today it is not possible to get rid of the disorder forever. At any “convenient” moment the process may escalate. This is due, first of all, to the fact that scientists have not definitively established the cause of the disease, and if it is unknown, then it is not clear what to fight. But with proper adequate therapy, a fairly long-term remission can be achieved. That is, a condition in which the main symptoms of the disorder go away or are reduced to such an extent that they do not interfere with the patient’s behavior and activities.

Recovery is said to occur when the patient's condition returns to its pre-illness state. But how can we determine such a condition if, for example, the disease “started” at a young age, systematically manifested itself for 20 years, and suddenly died down at the age of 40? With age, the emotional background basically undergoes changes. How do you understand that a person’s behavior is not symptoms of a disease, but character traits? In this regard, some misunderstandings may arise in the patient's condition. But the fact remains: it will not be possible to get rid of the disorder completely.

Scientists are actively continuing their search for a “magic” way to eradicate the disease. Thus, in the USA they are conducting research on stem cells. As is known, they are able to replace destroyed cells of any tissue. It is assumed that in schizophrenia they will be able to replace altered cellular elements of the brain.

During post-mortem microscopic examination of brain tissue of people who suffered from schizophrenia during their lifetime, certain dispositions of brain cells and changes in their structure were identified. However, their further study showed that these disorders occur even in prenatal, that is, intrauterine development, since these cellular elements lacked glial cells. And they appear when the brain is damaged after birth. These cells changed in utero disrupt the conduction of nerve connections, but this manifests itself in adolescence, when violent outbursts begin in the body.

An experiment on rats showed that the stem cells transplanted into them were able to restore in them exactly those cellular structures that suffer from schizophrenia. Confirming this theory would be a major breakthrough in treating the disorder.

The whole world is involved in studying the disease and searching for effective methods of treating it. The National Institute of Mental Health in Maryland has a schizophrenia research program. Anyone can become a participant, be it a patient or his relative. In some cases, participants are paid for travel and participation in experiments.

Rehabilitation of patients with schizophrenia

• individual selection of an antipsychotic and its form of administration (tablets, prolongs);
• restoration of the patient’s physical health;
• social assistance;
• individual and group psychotherapeutic work;
• obtaining recommendations for observation, treatment and regimen.

Social and psychological rehabilitation of patients with schizophrenia begins with art therapy - a method that allows, through artistic expression, to understand oneself and restore connection with the world.

Rights of a person with schizophrenia

The dignity and rights of a patient with schizophrenia are protected by the law “on psychiatric care and guarantees of the rights of citizens during its provision” of July 2, 1992 No. 3185-I. Additions to the document are contained in federal laws dated July 21, 1998 N 117-FZ, dated July 25, 2002 N 116-FZ, dated January 10, 2003 N 15-FZ, dated June 29, 2004 N 58-FZ, dated August 22, 2004 N 122- Federal Law, dated 07/27/2010 N 203-FZ, dated 02/07/2011 N 4-FZ, dated 04/06/2011 N 67-FZ, as amended by the Resolution of the Constitutional Court of the Russian Federation dated 02/27/2009 N 4-P.

This legislative act describes how mental state examinations should be carried out, the rights of people with mental pathology, when and for how long disability is granted, and a list of contraindications for professional activities for people with mental illness. It also talks about keeping secret the fact of contacting a psychiatrist, consent and refusal to treatment, and the conditions for providing compulsory medical care.

Consultation with a person is possible only with his consent upon reaching 15 years of age. Up to this age - at the request and consent of the parents or guardian. Also, parents or an adult citizen sign an application to accept or refuse advisory supervision. Dispensary observation is established without the consent of the patient, but can be appealed.

By court order, patients are placed in a psychiatric hospital on an involuntary basis who may cause harm to themselves or others, and also when, without treatment, their health may significantly deteriorate or if it is impossible to satisfy their basic life needs (Article 29, paragraph a, b , V). If the condition of the mentally ill person still remains dangerous, then re-examination takes place every month for six months, and then: once every six months. During an acute state of illness, a person is released from responsibility for the offenses he has committed.

The company provides: any type of psychiatric and psychological assistance, help at home and care for disabled people by social workers, support in training and employment, . Each IPA has a free lawyer who will advise sick people and their relatives on all legal aspects.

The purpose of hospitalization is explained to the patient in a language that he understands. He has the right to contact the head of the department and the chief physician on issues of diagnosis, treatment, discharge from the clinic and regarding violations of his rights provided for by this law. The patient can submit any applications and complaints to all authorities without censorship, as well as meet one-on-one with a lawyer and a priest. Along with other citizens, a person with a mental illness has the right to make purchases, receive education and remuneration for his work. While in the hospital, he can subscribe to periodicals, read any books, send and receive parcels and transfers, use the telephone and receive visitors, and wear his own clothes. There is a special commission made up of people outside the health authorities to protect the rights of patients in psychiatric institutions.

Celebrities with schizophrenia

Contrary to the expression: “genius and insanity,” the percentage of people with schizophrenia among celebrities is no more common than in other environments.

Famous schizophrenics

• Vincent Van Gogh - Dutch impressionist artist;
• Syd Barrett - musician, founder of Pink Floyd;
• Nikolai Vasilyevich Gogol - Russian writer;
• John Nash - American mathematician and economist;
• Friedrich Wilhelm Nietzsche - German philosopher;
• Amanda Bynes is an actress from Los Angeles;
• Salvador Dali, a Spanish surrealist painter, suffered from schizotypal disorder.

These people were under the supervision of good doctors. And even at that time, a good doctor could take control of the disease! Nowadays it is much easier to do this, but this requires the experience and knowledge of a specialist. No need to be afraid of illness! Any disease can be treated. And if this disease is taken under control, it can give genius!