Depression. All about the disease, treatment, symptoms.

Strengthening research instinct is manifested by extreme diversity and variability of interests and aspirations: “dramatic circle, the circle of the photo, and I also sing hunting”; also includes dromomania — pathological attraction to a permanent change of habitat, vagrancy (Gypsies and occupational travellers are not in the bill. Well, almost doesn’t count); the oniomania (from the Greek. onios-for sale, mania-madness) – an uncontrollable desire to make purchases, to acquire things without material and personal interest, without looking at the consequences-just to BUY.

Decrease of research instinct-when it is uninteresting not only to do something and learn, it is when you yourself, in General, already uninteresting.

Perversion of research attraction includes kleptomania — pathological attraction to theft, often unnecessary, useless and repetitive things (for example, the twenty-eighth portrait of the President of the country); arson — the attraction to arson or contemplation of the flame.

Therefore, having felt an urgent need for something, do not rejoice prematurely, but ask yourself sternly: “do I need it?»

Hyposexuality — sexual desire or reduced, or absent. In men, this is some form of impotence (when it’s not so much in the problems of the Executive bodies, as in the crisis, what is called “legislative power”), in women — frigidity.

Hypersexuality – increased sexual desire with appropriate behavior in both men (satyriasis) and women (nymphomania).

Sexual perversion

Autoeroticism is Masturbation, Masturbation and narcissism. This should make an important note: a perversion that should be considered when there are episodes caused by the fact that the partner is unavailable or absent, and when, in addition to yourself, no one would EVER need.

Algolagnia (from Greek. algos — pain and lagneia intercourse, lust) — the need to inflict physical pain or moral suffering to achieve sexual pleasure (including orgasm), yourself (masochism) or sexual partner (sadism).

To vicarious forms of sexual perversion previously attributed homosexuality (in men, sodomy, women lesbianism, tribadism), but now, due to certain nuances, as reasoned in the thesis, and politically hard-won, considered it a sign of broadmindedness and their own sexual preferences. There were visionism, voyeurism (spying on naked faces of the opposite sex, stock up on binoculars, as well as drills and micro-cameras), exhibitionism (exposure of the genitals in the presence of persons of the opposite sex — “and look what I HAVE!”), transvestism, fetishism (idol not only created, but also raped), frotterism (that’s really who the crush in public transport just a joy).

Orientation of sexual attraction to inappropriate objects emit:

• Pedophilia – sexual attraction to minors;

• Gerontophilia – sexual attraction to the elderly;

• Bestiality – sexual attraction to animals;

• Necrophilia – sexual attraction to corpses;

• Pygmalionism — sexual attraction to photographs, statues, paintings (ideal place of work-art Museum, such a person can not pay a salary).

Strengthening the instinct of self-preservation can manifest itself in two opposite forms of behavior:

Passive defense — when a person runs from danger, hiding, digging trenches and dugouts, bypasses it for the quarter or pretends to be a hose, a corpse (reaction supposed death).

Active-defense — when the best method of protection is declared an attack, and is now “in the woods, the worst is we.”

The weakening of the instinct of self — preservation — when life becomes uninteresting, indifferent, and even a burden, and even if the mood is not to hell-everything, hide ropes and sharp objects, remove vinegar and medicines.

The perversion of the instinct of self — preservation is when a comrade does not kill himself, but bites hard, suddenly finding something extraordinarily attractive in self-torture, self-mutilation, swallowing all sorts of uneaten items, like family silver. Sometimes, however, the latter has a strictly defined purpose: for example, when a prisoner swallows a piece of razor tied to a thread, in order to cause stomach bleeding and end up in the infirmary, it is no longer a perversion of the instinct of self — preservation, but a simulation and a convict’s ingenuity.

Disorders of drives (needs, instincts) can be manifested in the form of their pathological strengthening, weakening or perversion.

With the increased craving may be in the nature:

a) Intrusive — at the same time encourage the activities occur beyond the will of a patient when he realizes what attracted him in General that are alien, does not correspond to any moral values or interests, even criticism persists to this alien phenomenon, saying, not mine, not mine! A striking example is when alcohol dependence is just beginning to form, and a person feels that he would like to drink, but still realizes that this does not come from within, and he clearly does not agree with it.

b) Compulsive-impulses to activity in this case already dominate, they have destroyed at the root of the struggle of motives: why, when here it is, the desired, and it is vital to me (in other words, has a vital character), give it here! That is, if a drink is not just possible-it is NECESSARY. Ergo bibamus!

C) Impulsive — when wide horizons of consciousness was curled up in a mesh of sight, and the person who received the internal pendel (aka pulse) is taken up, without thinking: wait, wait… It just eliminates the annoying economic-geographical blunder: the money should be in the store, and alcohol — in the body.

The pathology of food craving:

Bulimia (Greek. bulimía from bús — bull and limós — hunger) — a strong irresistible craving for food, the constant feeling of hunger.

Anorexia (from Greek. an-without and orexis-urge to food) – lowering, the lack of appetite or aversion to food.

Parorexia, the perversion of food craving, manifested by eating of inedible substances (earth, lime), — paralexia pregnant peak, Kala (CE). One lady, being pregnant, and did prefer kerosene. It’s hard to say what she thought the husband, from time to time passing her in the hospital a bottle of the coveted fuel, but until the illegal supply of hydrocarbons is not stopped, the lady had to go through several miscarriages.

Can be particularly point to the next basic signs of delirium.

1. Delirium is a consequence of the disease, its product. It is not a mistake, not a self — deception, not a delusion of a healthy person-it is the product of a sick person, the same as, say, fever for an infectious patient or convulsions for an epileptic.
2. Despite the possible validity of certain postulates and fragments, nonsense — always erroneous, not corresponding to reality, a distorted reflection of reality. Claiming that the neighbors are not good to him and saw him in the coffin, the patient may not be so wrong — in terms of guessing the vector of the relationship. But all of that complex structure which he has built on this premise, which has become his ideology, subjugated, changed his identity and has provided many years of holivar (from the English. holy war-Holy war), has nothing to do with reality.
3. Delusional ideas are unshakable, reinforced concrete, they are absolutely not amenable to correction or persuasion. Attempts to dissuade, to convince the patient of the incorrectness of his crazy builds, to give conclusive arguments, including assault and battery, useless. The patient will only further establish himself in his own right, and using your own arguments and arguments as additional evidence in his favor. “What do you mean she’s loyal to me? Why are you telling me this? Well, well, well, something’s not right! Who do we work for?” I understand! You also have access to the body!”By the way, it will not be possible to dissuade such a patient by hypnotic suggestion either.
4. Delusions inherent in the erroneous grounds (“paralogic”, “logic curve”). We touched upon these violations, considering violations of the associative process of thinking.
5. In most cases (with the exception of certain categories of secondary delirium) delirium occurs when the patient’s clear, unclouded consciousness. And this sometimes leads to confusion: as, he quite sensibly says, the dates are not confused… Yes, but only until, while you have not touched the plot of his delusions.
6. Delusional ideas and personality are inextricably linked. Under the influence of delusional ideas, the patient’s personality changes — his self-consciousness, value system, attitude to the environment and to himself. Well, judge for yourself: what might be the attitude of the Emperor of the Galaxy to itself and to its surroundings? A little different than what is expected from the seemingly ordinary unemployed.
7. Delusions are not due to intellectual decline. On the contrary, delusions, especially complex and systematic, tend to indicate that the intellect is all right. And on the contrary — the less intelligent, the less common nonsense. But if she is, then it is easier and not so relevant for the patient. In addition, if dementia increases in a person who had delusional production, the delirium itself becomes simpler, takes up less space in the patient’s experiences, until its complete disappearance. And understandably so — there is nothing to produce.

Delirium is classified by stages of development:

A) delusional mood and delusional belief in changing the, of the inevitability of impending catastrophe, danger: “Oh, that, Oh, my heart feels”;

B) delusional perception delusional interpretation of the values of certain phenomena of reality in view of the looming concern: “These views for a reason, and a handful of citizens is clearly with a purpose, and a car drove up, and with special rooms, not otherwise encrypted»;

C) delusional interpretation — delusional explanation of the perceived phenomena: “It is something they bad started: staring accusingly, whispering with a view to developing an action plan, and the details of the plan are encoded in the rooms and the car drove up”;

G) crystallization of delirium — a certain vitality and the content of delusions, their completeness and logical sequence: “I understand. This community is black transplant! I’m about to be kidnapped and disassembled for parts that will be shipped to America and exchanged for cocaine!»;

D) a stage of attenuation of delirium with the emergence of a critical attitude: “Fuhhh carried by… Well, time in the hospital. And yet, what was it? It couldn’t have been like this, all of a sudden. Or could it?”; e) residual (residual) brad: “And transplant all the same bastards!»

The mechanism of occurrence of isolated nonsense:

1) the primary caused directly by thought disorder in the form of insight, feelings, views, perceptions, beliefs, delusional intuition, delusional interpretation of the recollections and observations of reality (Yes, even about the same black transplant);

2) secondary, sensitive, caused by the hallucinatory, illusionary, affective and other’s experiences: hear from the outlet of the “voices” that threaten to kill, believes that the neighbors banded together in a criminal syndicate;

3) holodilny (option of secondary nonsense), resulting in emotional disorders. So, with a depressive syndrome, the patient can declare that it’s all for a reason, it’s all for his sins (and the list on five sheets can provide), and that in General he is a worm and a mastday. And in the manic — almost Batman, only more serious mission;

4) katatelny, he’s sensitive delirium of attitude arising from the exciting and important for that specific individual emotional experiences from value-added sensitive and psychopathic people (delirium relations, persecution, arising from a paranoid psychopath, delusions of jealousy psychopath epileptic);

5) Arising on the basis of sensations from the internal organs: burning in the chest is deadly neighbours is irradiated with light; became mysteriously gurgle in my stomach — it special agents poisoned the water, and only in my apartment;

6) induced-induced, induced by another person, most often mentally ill. How does it work? Here’s a recipe for the average man in the street: run around the Mall with bulging eyes and ask everyone where they sell salt, matches and cereals. We ship all this in bulk quantities in a shopping cart. To complete the picture, connect a couple of like-minded people. I think the result will not be slow to wait;

7) delirium of the deaf, when a person thinks out what he does not hear. The content is often nonsense attitudes or delusions of persecution.

Since gelatinoso have been listed by the resale nonsense.

The content of delusions can be divided into:

1. Persecutory (from lat. persecutio — chase) nonsense, he is delusions of persecution, which may also include: delusions of influence (rays, radio, hypnotism, telepathy, witchcraft); attitude (usually negative, but there are exceptions), poisoning, jealousy, antagonistic, or Manichaean delirium (when the person believes that it is in the center of confrontation between the forces of good and evil, light and darkness, or when he believes that he fighting two or more competing groups, even States or worlds); nonsense double (when a patient believes that he has a twin that lives beyond his life and committing acts that the patient a disgrace or embarrassing); the delusion of metamorphosis (when the patient believes that under the impact of external influences is he in some turns — into an animal, a tree, piece of furniture); the delirium of obsession (when the patient believes that he possesses someone who controls them).

2) Depressive delusion (delusions low self-esteem) involves the delusion of self-accusation, self-abasement, nihilistic (I’m terminally ill, I have syphilis, AIDS, leprosy, all my organs rotted-withered-scattered in the dust, my misery is eternal and infinite), hypochondriac (I have cancer-sarcoma-another incurable disease, but no one sees and I am here right now will die), dysmorphogenesis (I’m ugly, I stink worse than three-day corpse in the heat, exhalation can be killed on the spot, and emitted gases has long been prohibited by the International Convention on weapons of mass destruction).

3) The group of delirium with higher self-esteem (megalomaniacal nonsense) — delusions of grandeur (from the representative of the President and ending with the Emperor of all galaxies), high birth (really the king, just lost one), invention (Yes, the cure for cancer and the regular teleport also put it on my bill), claim (the theory of relativity, remember? Einstein, bitch, I stole), reformism (well as reorganize rabkrin, not for me to explain), altruistic, or Messianic nonsense — you sit here, the fifth Procurator, at the reception, and lead to person…

4) Mixed forms of delirium include the delirium patronage (we love you prepare for a new crusade, so do not be afraid and never hesitate), brad benevolent influence (here’s five points of charisma, mana, twenty, thirty health and the usual things — agility, resistance to magic), brad staging (the whole world — specifically for this sick theater, all the people in it are actors, and stuff like put that the author would say a few kind), verwandte (litigation), nonsense charges (the patient believe that others look askance at him and despise for what he did not commit at all).

The structure of delirium is divided into systematic and unsystematic.

Systematic nonsense is quite structured externally, it has its own special logic, a system of evidence and arguments in its favor.

Unsystematic nonsense is just a painful statement, devoid of a system of evidence and complex logical constructions: it is so because I know it is so. This is usually secondary to delirium, resulting from patients experiencing hallucinations, senestopatii, either due to depression or mania.

Strictly speaking, the varieties and names of delirium are much more than already given, which is not surprising — because the object on which thinking is directed is the whole world, in all its diversity. But the overall impression is received.

It’s Intrusive, overvalued and delusions, if we consider them according to the degree of aggravation. How to distinguish them?

Obsessions arise involuntarily, against the will, and disorganize the logical course of thinking. Important: they are perceived by the patient as painful, and they remain critical, they do NOT determine the direction of the activities of this person, that is, do not subordinate it to themselves, although they disorganize mental activity as a whole.

• Obsessive thoughts arise in the mind of a person involuntarily and even against his will. While consciousness remains nepomucenum, clear.
• Obsessive thoughts are not in a visible connection with the content of thinking, they are in the nature of something alien, extraneous to the thinking of the patient.
• Obsessive thoughts can not be eliminated by the will of the patient. The patient is unable to get rid of them.
• Obsessive thoughts arise in close connection with the emotional sphere, accompanied by depressive emotions, a sense of anxiety.
• Remaining alien to thinking in General, they do not affect the intellectual level of the patient, do not lead to violations of the logical course of thinking, but their presence affects the productivity of thinking, mental disability of the patient.
• The morbid nature of obsessive thoughts is recognized by patients, there is a critical attitude towards them.

Supervaluable idea. The concept of overvalued ideas was put forward by K. Wernicke (1892). They affectively rich take a large (disproportionate) in the mind of the patient, disrupt his mental activities and dominate in large measure his behavior. Occupying an intermediate position between obsessive and delusional ideas, they, unlike the latter, are always based on their real (not fantastic, not fictional) background, although criticism of them is already formal or not at all.

Delusional ideas are painful, absurd, unshakable judgments and conclusions that do not correspond to objective reality, disorganize mental activity and subordinate the behavior of the patient, not amenable to criticism and correction.

Figuratively speaking, the husband, suffering from obsessions of jealousy, tormented by the question — and does not change his wife, but because he can not find real evidence of that, suffers to himself. Husband with overvalued ideas of jealousy, convinced that his wife is wrong, can cause some very real, albeit indirect, of facts and a considerable part of free time devoted to the Amateur detective, aware that, even having found them, to kill no one. A husband with delusional ideas of jealousy doubts nothing. He KNOWS she has the mayor’s lover. Or downstairs neighbor. Or specially called her a witch, the Incubus. The evidence, therefore you don’t even have to look, but if someone still doubts — here: the color of the clothes in which she went to work, the spirits, who certainly likes not only her cigarette butt with her lipstick, thrown on the lower balcony, as well as traces of astral presence. And essential, volatile, ejaculate. And in case of paraphrenic delirium of the spouse and at all the organizer, the ideological inspirer and the only volunteer of an all-galactic brothel.

Now more

Obsessive phenomena can be divided into ideatory, phobic and motor. Ideational, or obsessions, is abstract obsessive thoughts, obsessive doubts (turned off or not turned off the stove-water-light) and memories, haunting score (and there are nine steps, and for me at the bus stop consisted of five people, and the next eight) and thought, often blasphemous or sacrilegious (and dead-it is better all settled, it is not hot; and there is the girl in black — well, so I would…), obsessive sophistication (at least the goal is to guess whether the mood of watching something dead or alive Schrodinger’s cat).

Motor (volitional) disorders are divided into the following categories:

Obsessive drives — the desire to make unnecessary, antisocial, sometimes dangerous actions, which is accompanied by internal discomfort, if not implemented. Most often they are not implemented, especially those that are dangerous:

Homicidalmaniac — obsessive attraction to murder, often of a close person; suicidaire — obsessive desire for suicide; coprolalia — the desire to flip off as it should. By the way, the obsessive desire to step out of the window or from the balcony belongs to the same group, it is almost never realized.

Obsessive actions — implemented obsessive drives, often ritual (made — obsession has passed). Among them, automania — obsessive hand washing when mysophobia, bacillophobia. There are other self-obsessive actions: autoreplace — pulling out own hair (not to be confused with makeup and autoreplace sacral-ischial region, since the objectives are totally different); onychophagia — nibble nails, burrs, obsessive ticks.

Overvalued ideas — allocate the content dismorphophobia (“my nose is a honker, not the chest, and the two blemishes, the legs are as hereditary cavalry, and authorship over the form of the ears are fighting elves Cheburashka”); hypochondria (“Oh, somewhere, something popped, gurgled, tumbled and capricornus — not otherwise kirdyk on approach”); inventions (“not bosonic engine for flying saucers, something more earthy, like a special feature head rivets, but the patent office zadolbali»); reformism (amendments to the law on pensions, the proposals of various parties about the change of the Charter, leadership and the main line); litigation (querulant, prosecutors in their work calculated volumes and tones); erotic (starting from the desire to bring happiness to a marriage Miss My Hometown and ending with a pathological belief in their own irresistibility and sexual omnipotence); sexual inadequacy (“I do not like human beings and, in General, such as me, is that a good wholesale”).

It is necessary to distinguish super-valuable ideas from dominant, dominant — which occur in mentally healthy people and represent devotion to any scientific, cultural or religious ideal, the idea for the sake of the celebration of which a person is ready to neglect everything else (remember the ardent fighters in the name of anything).

If you are paranoid — it does not mean,

that THEY’re not after you.

Every fighter against punitive psychiatry sincerely wish at least once in his life to be woven into the delusional system of one of our patients. An unforgettable experience is guaranteed, level up (raising the level) in the worldview and impatient “when will these wonderful people come in white coats?”as a free bonus.

Depending on what part of the associative process of thinking has suffered, we can conditiaonally divide these violations as follows.

On rates:

Accelerating the pace of thinking, when a person processes information, makes a decision and generates ideas much faster than others. Characteristic of manic States, where this acceleration can be expressed up to the “jump of ideas”. Slowing down the pace of thinking. Reflection and decision-making is delayed, sometimes so much that the attempt to talk turns into mutual torture for its participants, and if the second interlocutor is also still in a manic state (see the previous paragraph), not far from self-harm.

Mentalism is an involuntary influx of thoughts, when these thoughts invade in addition to the will of a person in his measured thought process, thoroughly interfere with his activities, often completely disorganizing it. How would you like, say, if the influx of thoughts about the fate of the Fatherland caught you watching a porn film?

Stop (blockage, sperrung) thinking — involuntary breakage, stopping the flow, the absence of thought. Thought-thought — and all. Deadlock. Cliff. No thoughts. And no dialogue to continue, no thing to do there is no way. Frozen, waiting for everything to move again.

By mobility, liveliness of the process:

Detail — secondary nonessential details are constantly involved in the thinking process. It is as if you are in a casual conversation about the weather made happy by the classification of clouds and the average annual norms of temperature and precipitation.

Thoroughness — a pronounced detailing with a systematic stuck on the details and side associations. The wind rose, the discussion of the spoiled ecology and the coordinates of the most trustworthy forecast Bureau would surely have been added to the previous details.

Viscosity — a pronounced thoroughness in which thinking becomes unproductive, to track the original thought is not possible, as well as the direction in which the conversation was originally – in General, by the fourth hour of the discussion, you are likely to be painfully decide who to beat the face: Greenpeace, meteorologists or interlocutor.

On the grammatical structure of speech:

Speech stereotypes — stamped turns or use of a question to build an answer; this is when the speech uses cliched, formulaic turns (“so, what I said…”, “well, as they say, let’s go back to our rams”, “as one of my friends said — however, you do not know…”), as well as the use of the question to build an answer: “How is my name? And my name is too well known for me to tell you!”Verbigeration is a meaningless repetition of the same words, phrases, endings of words or individual sounds. Incoherent — “verbal hash”, a set of individual words or phrases, devoid of logical and grammatical structure (not to be confused with the poem “Mom, dad, spoon, cat”).

By focus:

Flowery — in this case, to Express even a simple thought, the patient resorts to a mass of comparisons, excerpts from various sources, metaphors and sayings, formulas and scientific terms. All you have to do is say, “go fuck yourself.” Now imagine how such a person would sound an explanation of love.

Slippage — this disorder can be represented as follows. The patient talks, for example, about cats. Thinks quite coherently and sensibly. Suddenly, clinging to the fact that some of them are gray, recalls the Maxim “in the dark all cats sulfur” and then gives a lengthy discussion on the relationship of cats, darkness, demonic beginning in the cat’s soul… and then as if nothing had happened returns to the discussion of what they are, in fact, cute and fluffy creatures. Why the slippage? Because such a course of thought looks like a patient, walking along the path of reasoning, slipped, leaning on a minor Association, and for a while rode on it, and then returned to the previous, well-trodden path.

Logic-chopping — long-winded philosophizing, the transfusion of a sieve, lengthy torrent minor subject — without a goal, without any direction. Who met with a flood (chatter off topic) in the comments replicas that way for twenty or thirty, I understand.

Formalism of thinking — when all the attention and all the power of the intellect is not thrown to the comprehension of the essence of the issue, but to a clear execution of the Protocol and the letter of the Charter.

Diversity — in this case, the patient can consider the subject or phenomenon from several points of view, based on several evaluation criteria, constantly changing the levels of generalization, but is not able to come to a decision what in this particular situation should be preferred. So, asking him to exclude from the pictures with the image of the castle, castle and hut one thing, you will not get an answer from him. He says that in one way or another all the pictures are interconnected, nothing extra on them, and in General, specifically, whether such an unsolvable puzzle planted?.. Amorphous — fuzzy, contradictory use of concepts. In this case, it is built syntactically and grammatically correct, but it is not possible to understand WHAT it says. There is no main idea, no conclusions — only a set of phrases that seem logical to the patient himself. If you ask him “how is life”, the answer may well be: “Well, how to say? That is to say must. Because you know the difference between that and that. You can’t just go one way. Justice will prevail though, but it’s when we second such a leader will find objective conditions are not impossible to satiate. When the top can’t, the bottom doesn’t want to. And when it’s full, it’s too late to talk. That’s it.”

Paralogical thinking is a violation of the logic of thinking, the so-called “logic curve”, when either the prerequisites or the evidence suffer, or the process of establishing a connection between cause and effect (this distinction is conditional). Example? The patient basically does not drink juices. Why? “Juice is health. Health is sport. Sport is a lot of money. A lot of money — a lot of women. A lot of women is AIDS. AIDS is death. Am I so fucking happy?”Symbolic thinking — thinking based on pseudo-concepts, symbols, the meaning of which is clear and accessible only to the patient. So, he can talk about the special meaning of what colors are dressed today his employees, and that it can mean. Or to say that for him all the numbers have, in addition to the main, more and additional, secret meaning, thanks to which each new date is an encrypted message with a guide to action.

Pathological polysemantism — when a patient discovers a new meaning in words, based on how many vowels or consonants they have, for example, whether they rhyme with a particular word — say, with such as “death”, “love”, “treason»…

Autistic thinking — is thinking, little in contact with the surrounding reality of the patient, clear and accessible only to him, reflecting his world, in which outsiders are not allowed. Thinking fantastic and bizarre, but not devoid of its own pretentious logic, “feast behind closed curtains” E. Bleiler. Here is an example given by Blejleru [18]: “the Patient B. S. in the work of Jung’s early dementia is Switzerland, she is also Ivikov the crane; she is the owner of all of the world and a seven-story factory of Bank bills; it is also double the Polytechnic University and the assistant of Socrates. All this seems, at first glance, complete nonsense, and indeed is nonsense from the point of view of logic. But if we look more closely, we will find clear connections: thoughts are essentially subject to affective needs, i.e. desires, and sometimes fears; the patient is a Willow crane because she wants to be free from guilt and depravity; she is Switzerland because she must be free.”

Archaic thinking — in this case, for the Foundation of the building are the judgments “the times of Ochakov and the conquest of the Crimea”, attitudes and stereotypes, for example, the same dissenters-old believers. Or the Neanderthals — there could be as lucky…

Perseveration (from lat. perseveratio — perseverance, perseverance; from persevere — persevere, continue) — most clearly this disorder is characterized by an anecdote: “Doctor, I do everything four times, four times, four times, I am very tired, very tired, very tired, but the wife is happy, the wife is happy, the wife is happy…” This is a steady repetition or continuation of once started activities, phrases, and this repetition continues even when the context appropriate for him is exhausted. For example: “what’s your name? — Lesha. — How old are you? — Lesha. Are you retarded or something? — Lesha. — Where do you go? — Lesha. — Who are your parents? I’m not retarded.…»

Fragmentation — the lack of logical connection between individual conclusions, judgments, concepts with the formal preservation of the grammatical structure of speech. If the rupture of thinking acquires an extreme degree of severity — begins to suffer and speech. Example: “I believe it is necessary to use extreme geographical, constitutional and obscene terms, that every kind and species, sex, and religion you have understood who could not stop performing our great, horrible, but extremely pleasant mission membership in the Federation Council”.

If the above were described violations of the associative process of thinking concerning how a person thinks, now we will talk about WHAT he thinks.

If all the angry questioning your half repeats the mantra “I debianchangelog”, do not rush to take up kitchen utensils, posing a diagnostic and educational objectives. Perhaps the man really does not remember anything.

Memory disorders can be divided into quantitative and qualitative.

Quantitative memory disorders are hypermnesia, hypomnesia and amnesia.

Hypermnesia (from Greek. hyper — over and mnesis — memory). This does not mean that the subject suddenly acquires a phenomenal memory that allows him to become a superspy or a successful card player. The ability to remember it often does not change. But dramatically increases the playback of memories, against the will of man, begin to invade the consciousness and does not contribute to clarity of thought and clarity of objectives, rather the opposite — desorientiert, muddle.

Hypomnesia (from Greek. hypo — under and mnesis — memory). In this case, the memorization of current information or the reproduction of past events is weakened.

Amnesia (from Greek. a— as a denial and mnesis — memory) is characterized by the lack of the ability to save, reproduce and (in some cases) record the patient experienced events — at a particular time. I would like to emphasize that this is not a weakening of memory, as in hypomnesia, but its complete disappearance for some period. And depending on what it is for the period, there are the following types.

Congrega amnesia (from lat. prefixes con— together and gradior — go) — loss of memories for the period of the darkened consciousness (in most cases — if it was switched off by itself or due to insurmountable external circumstances). Retrograde amnesia — loss of memory of everything that was BEFORE the painful condition (injury, attack, etc.).

Anterograde amnesia is the loss of memories for the period AFTER an injury, attack or acute stage of the disease that caused a violation of consciousness, that is, the recovery period is forgotten. Interestingly, in this period the patient, as a rule, adequately behaves, talks and answers questions, but in the future all this will be erased from his memory.

Anteretrograde, or total amnesia — there’s you know…

Depending on which of the memory functions suffers more, you can also highlight the following types of amnesia.

Fixation amnesia — a strong weakening or complete lack of ability to capture and hold in memory new information, current events (in such cases say, that “memory as sieve”).

Anaktoria (from the Greek. an— + ekphorio — make) — the failure timely to recall a known fact, the inability of the memories without prompting (not to be confused with the state of the student during the delivery of the session!).

According to the dynamics of amnesia is divided into the following:

Progressive— when there is a disintegration of memory in accordance with the law of RIBO, from the current to an increasingly long past; while a person may not remember where he lives, but perfectly list all the neighbors from the village where he lived in his youth. Especially if one of them once owed.

Stationary — when the existing memory impairment is not aggravated, but does not pass. Regressing — when eventually after a pronounced deterioration in memory is gradually improving and memorizing the teachings, and playback of the past. Retarded — when events fall out of memory not immediately, but after a while after an illness or injury.

By object can be selected:

Affectogenimap, or catalkoy, amnesia — when memory fall only special, meaningful human events, resulted in very strong feelings (usually unpleasant, those which this man can not continue to live in peace).

Hysterical amnesia, which is somewhat similar to the previous one, when selectively erased from memory (Freud would say — replaced) only unacceptable for the individual events (with the experience about them, unlike those in catatymic amnesia, may be weak or not at all — whether to worry about what was not!).

Sodomization, which is similar to the previous form of amnesia, her memories fall out partially, the plots but the personality is not the hysteroid.

Epochal — it usually occurs after shock and covers long periods of life (months, years).

Separately it would be possible to allocate an alcoholic palimpsest (from Greek. рalimpsestos — text, manuscript, written on top of that scraped from the parchment — that nothing material to translate, but some of the previous labels you can guess). This is a condition where some of the details and events that took place during the libations are erased from memory, leaving behind only vague hints and a feeling of vague anxiety in half with a painful awareness of his own wrong, but still would remember what exactly… Alcoholic palimpsest — the first bell warning that not far off alcoholic amnesia and other delights of alcoholic brain damage.

Qualitative memory disorder is to many cases of paramnesia. It’s a distortion, a perversion of memories. To paramnesias include pseudoresistance, confabulation and cryptomnesia.

Pseudoresistance (from the Greek. pseudos- — false-, lat. reminiscentia — memory) — usually occur in a patient suffering from fixation amnesia. He tries to fill the gaps in his memory as best he can, eventually filling them with events that REALLY took place in his life, but not at the time he is trying to remember. So, as “patches” may well fit student or even school years, or those of the more recent events that were able to stay in memory.

Confabulation (from lat. confabulari — to talk, to tell) — in this case, the patient fills in holes in the memory of what never existed, and often does could not exist. So, asking to talk about violent youth, you can get the answer a story about the guerrilla actions in the forests of Belarus with the exact personally killed the Nazis, as well as modest mention of the fact that the flight to Mars has been, just for the purposes of secrecy not publicized, and who do you think flew there? Yes, and the defeat of the third intergalactic occupation case don’t forget. With these two hands sword in zero gravity Mahal. There are substitute confabulations — when the holes are filled with something close to reality, everyday-mundane (went to the bath, drank beer, immediately after fishing — this was a bite!). By the way, General Ivolgin in F. M. Dostoevsky’s novel “the Idiot” demonstrates the replacement confabulations. There are fantastic confabulations — it’s just about Mars, checkers and weightlessness.

Cryptomnesia (from Greek. kryptos — hidden, secret and mneme, memory, remembrance) — when it is better not to give up fantasy. And put the TV away. Otherwise you will be told about the adventures in the spirit of the main character of Sapkowski’s novels, with the beheading of all monsters in the vicinity of the promenade and circuses. And strictly to ask, what makes the kitchen the old hag and just what happened to Maria. The patient, being unable to remember or dream up, draws events from those sources of information that are at hand: books, Newspapers, television – without making a distinction between his own life and all other events. What he saw in the dream, by the way, can also be regarded as taking place to be in fact, so that “return back to the Bahamas and the mulatto with lush Breasts.”

Amnesia — when the patient there is a sense that the event is repeated. Most frequently occurs when substance-induced psychosis.

Geopresence (from the Greek. hypo — under, below and rgoah — note), i.e. low attention. It is represented by the following types:

Attrition — reducing the intensity of attention after a certain period of time, while active attention quickly exhausts itself, replacing passive. It’s like making a Sprinter run a marathon. Easier to shoot from considerations of humanity to the end of the first kilometer.

Attention distraction — deterioration of the ability to maintain focus for a long time, the ability to fix it on a given object; this reduces the total amount of attention. It’s like trying to get yourself together after a day of hard work.

Distraction — extreme mobility, rapid change of focus, concentration, intensity of attention with a decrease in its depth. Attention at the same time as if flutters from flower to flower. Or from water Lily to water Lily. Or jump on the supplied volume, the Brownian motion as a crowd of students during recess.

Giperprodukcia (from the Greek. hyper — over, over and prosexis — attention) — pathologically enhanced concentration of attention on individual objects, phenomena, thoughts or sensations, with enhanced predominantly passive, involuntary attention. Often this concentration is one-sided, aimed at what worries the patient most: his ailments, fears, ideas. Often accompanied by such a phenomenon as stiffness – when attention is inert, sticky, fixed, while it is difficult to redirect from one object to another. It resembles an aircraft carrier: a huge tonnage, mind-blowing weapons, but it is better to start dodging the coastal lighthouse with one caretaker and a Canary in advance.

Paraprotex (from the Greek. para — about, past and prosexis — attention) — perversion of attention. Perversion not in the sense that it is fixed on painful experiences, and that there is a discrepancy of expectation to result. How? Man is so intensely and anxiously waiting for some event that when it happens, he is simply not able to notice it. It’s like convincing yourself not to miss the approach of the train and eventually do a fascinating braking distance, evenly distributed over the landscape.

Aprosexia characterized completely turned off by both active and passive, and to attract it is not possible. Usually, this indicates quite a serious illness, unless you guru in Samadhi. However, it all too seriously, but for a different reason.

As a rule, attention disorders do not occur in isolation. They are part of the symptom complex of a wide variety of psychopathology.

According to the levels of complexity of the perception, the symptoms of his disorder can be divided into three groups: a) disorders of sensations; b) disorders of perception itself and C) disorders of representation (or hallucinations). Now on counts.

Disorders of sensations

Hypersensitivity (from the Greek. hyper — excessively and aesthesis — sensation, feeling) — hypersensitivity under the action of ordinary or even weak stimuli, while the sensations are bright, up to discomfort and even soreness. On what senses are involved, allocate hyperesthesia optic, acoustic, gustatory, olfactory and tactile (or cutaneous hypersensitivity of the senses). Accordingly, the first in the eye with a flashlight to Shine on the second not to scream, the third and fourth do not give garlic, fifth not to tickle. And not mistake!

Gipostezii (from the Greek. hypo- — and aesthesis — feeling, feeling) — decrease in susceptibility to external stimuli, when the colors of the surrounding world fade and the sharpness of sensations is dulled. It’s like sex in a wetsuit: the meaning of all these physical exercises is unclear…

Hyperalgesia (from Greek. hyper — excessively and algos — pain) — increasing pain sensitivity. Inquisitor’s dream.

Anesthesia (from Greek. an— negative particle and aesthesis — feeling) — loss of sensitivity. Here it is necessary to allocate separately hysterical neurotic symptoms: mental amblyopia (blindness), mental anosmia (insensitivity to smells; from the point of view of the passenger of public transport in the summer it is already rather good), mental ageisia (loss of sense of taste), mental deafness, mental analgesia (loss of pain and tactile sensitivity, respectively — the nightmare of the Inquisitor). Do not confuse them with neurological symptoms when anesthesia is caused by nerve damage or the corresponding area of the cerebral cortex.

Senestopatii (from lat. sensus — feeling, Greek. pathos — ailment, suffering) — extremely painful and unpleasant, indefinite bodily sensations despite the fact that in reality there is no bodily injury or pathology, that is, the sensations that the patient projects into his own bodily “I”: pain is, suffering is very much there, and there is no organ damage. At the same time, descriptions of suffering are vivid, imaginative and colorful, unusual and pretentious. So, the patient can complain of tightening, tearing, gurgling, clogging, pulsation, drilling, chaining and even biting! Most often, these feelings do not have a clear localization, blurred or migrate through the body. As a rule, with such complaints go anywhere, but not to a psychiatrist, to whom they get already with a plump from the analyzes of an outpatient card and a refrain of mass dance of doctors of other specialties: “NOT OURS, NOT OURS!»

Perception disorders: a) psychosensory disorders; b) illusions.

Psychosensory disorders — when the surrounding objects, your own body or the flow of time are perceived distorted in size, shape, volume, weight or flow rate (for time). At the same time, a person knows for sure that this is the same object (say, a teapot — he is also a teapot in Africa) or that the body is his own, which distinguishes them from illusions. Highlight:

Metamorphosis (from Greek. meta — beyond, after; morphe — form, shape; opsis — vision) distorted in appearance, the perception of magnitude: micro – and macropsia (little people around the small and cockroach in the apartment — just elephant-like); forms: of dysmorphobia (skaloobraznuju uncle with Contrabassoon Auntie); the increase in the number of polyopia (how many moons? and in what number?) and the spatial arrangement of objects.

Derealization is a distorted perception of the world as a whole or its individual objects according to more generalized characteristics. At the same time, the surrounding world can appear dead, lifeless, flat, as if painted, unnatural, unreal. May be extraordinary contrast (Galerija), painting everything around in yellow (xanthopsia) or red (Eritrea, not to be confused with “All red” by I. khmelevskiy [14]). This also includes the phenomenon of “already seen”, or déjà vu, when an unfamiliar place or situation is perceived as having happened before; “never seen”, or jamais vu, when a familiar situation is perceived as completely new and unknown; “already heard”, as well as false recognition of others — a symptom of a positive double (what the hell our brother-in-law does an alcoholic in the state Duma?); symptom of a negative double, when familiar faces are not identified as such (can fill the face, if you have them something borrowed).

Disorders of body scheme (somatopsychic derealization) — when there is an unpleasant, painful sensation changes in the shape, size, quantity, texture, spatial location of body parts: the head is abnormally large, fingers longer than expected, the subject of male pride size and consistency is not satisfied — but you never know!

Deceptions of orientation in space — when the surrounding is seen rotated 90 or 180 degrees in a particular plane. Perhaps even more impressive has got to look the highway, going up into the sky. Or the sea.

Disorders of perception of time — when it begins to flow faster or slower, and loses smoothness and moves in leaps or jerks.

Illusions — perverted sensations and perception realistically (!) of existing objects and phenomena, when the understanding of these objects and phenomena is not true and has distorted the meaning (in contrast to hallucinations, there object, sound, feeling really exist, but are perceived differently). Distinguish the illusion of the physical, physiological, mental.

Mental illusions: auditory — when human voices are heard instead of noise (the same “white noise” of the radio, if you listen to it for a long time) or human speech is distorted (what-what did you call me?); visual and others. There are affective illusions that arise in affective States (fear, anxiety, depression, ecstasy) — then their content is consistent with the current mood; pareidolic illusions in which the play of light and shadow, spots, frosty patterns, cracks, cracks, plexus branches of trees are replaced by fantastic, bizarre images.

Any moron who claimed the Lord God was talking to him actually heard my voice… or his imagination.

K/f “Dogma»
Disorders of representation are, in fact, hallucinations.

Hallucinations are representations that have reached the sensual power and brightness of real objects and phenomena, it is “perception without an object.” That is — entirely the creation of the patient. Not a breakthrough into another reality, like the vents in an alternate Europe, not the machinations of angels and demons (in shifts, according to the approved schedule), not a local materialization of the astral plane (demonstrasi, beta, copyright is missing). Of course, we cannot exclude that at this moment the inhabitants of other realities and plans, coupled with Angelo-demonic community resent or, on the contrary, ugly chuckle — say, wait a minute, let’s see what you say after a century or two… But prevailing in the present opinion of the official science on the nature of the hallucinations I have outlined.

According to the analyzers, hallucinations are divided into auditory, visual, olfactory, tactile, gustatory, visceral (from lat. viscera — insides), kinesthetic.

On complexity — the simplest, ordinary and complex.

The simplest, or elementary, hallucinations are located a little apart. They are United by the incompleteness of what a person sees. Visual — photopsias (from Greek. phōs, phōtos light and opsis — vision) in the form of circles, spots, sparks, balls, etc.; auditory — acousma (footsteps, noises, squeaks) and phoneme (from the Greek. phonema — sound) (inarticulate sounds, calls, syllables, pronouns). That is, separate the fragments, the details of which do not stack in any particular way.

Simple — when hallucinations are born in one analyzer [15]: only auditory, only visual — and not a step aside.

Complex — multiple analyzers connected to the overall plot (see in the courtyard of the assassins, hearing their voices is heard behind the wall that the neighbors are plotting to poison him while smelling poisonous gas).

It is also possible to separate one-sided, or unilateral, hallucinations (visual and auditory), when a person sees or hears them only from one side. They happen when the cerebral cortex is affected in the form of a focus from any of the sides.

Hallucinations with complete objectivity (as opposed to the simplest):

Verbal (verbal) — by belonging: familiar, unfamiliar, male, female, child, belonging to other beings; by volume: quiet, loud, deafening, natural, whispering; by content: threatening, accusing (not to be confused with the voice of conscience), blaspheming (usually with a predominance of profanity), commenting (look — got up; here he went; Opanki — fell; and you — again got up; well, you see — now we swear…), contrast (one voice praise and promise medal, the other a mother and threaten to shoot like a mad dog), stereotypical (every day the same), imperative (those that ordered, the indication for immediate hospitalization, the patient wants that or not); in the form of: monologues, dialogues, conversations in their native and foreign languages; duration: episodic, persistent, SAG; focus — from any direction and distance.

Interesting auditory hallucinations of Allenstyle — when people are tensely waiting for the knock on the door or a phone call and then starts to hear them. Found in healthy people and is regarded as a variant of the “acoustic memory”.

Visual — different colors or without them, moving and motionless, scenic (they are scene-like, where everything that sees the patient, linked to one theme, the scene with a clear plot), landscape, portrait, kaleidoscopic, demonomanic (characters all entirely folklore and mythological orientation); content: threatening (and what is it in a hoodie and with a scythe here is?), apathetic (well worth and worth — maybe waiting for the tram…), accusing (scenes of the court, including Scary); autoscopia (the appearance of hallucinating your DoppelgangeR), negative autoscopia (the disappearance of the reflection in the mirror, may cause the appropriate treatment); largest: normal, midget, giant and other, other, other…

Separately, we can distinguish peduncular hallucinations of lermitt, arising from the defeat of the brain stem (or to be precise, in the area of the legs and the third ventricle): in the evening see moving medium-sized pictures, quickly replacing each other (insects, animals, etc.), while patients are not afraid of what they see, and clearly realize that this is a hallucination; hallucination van Bogart, characteristic of leukoencephalitis [16]: see animals painted in different colors, fish, butterflies, all this is brightly colored with emotions And interspersed with bouts of drowsiness; hallucinations Tibia: on the wall seen the glowing letters written by someone’s invisible hand; hallucinations Peak (if it affects the bottom of the IV ventricle): patients say they can see through the wall: “there is one through it has passed, there he is behind the wall goes, there’s a cat too, through the wall slipped — a nest there, or what?”Tactile: the skin and under the skin; dermatotropnye: the perception of objects, insects, animals, spider webs, ropes; temperature: heat, cold; haptic: the sense of grasping, touching, bumps and shocks from the outside; gigacheck: the feeling of moisture.

Olfactory — often the perception of unpleasant, sharp, stinking odors of decay, decomposition, often as if emanating from the patient (there are two oddities: first, I almost did not meet the description of pleasant olfactory hallucinations-in the form of smells, for example, “Chanel № 5”, and, judging by personal observations, the mass of people have negative olfactory hallucinations on the actual smell coming from them; in any case, with the benefits of civilization in the form of soul and soul deodorant they are in no hurry to get acquainted). Visceral — endoscopic — vision of their internal organs (a dream or nightmare of an endoscopist); hallucinations of transformation — changes in the internal organs, their movement, elongation, shortening (also a dream or a nightmare, depending on the location and character); genital (feeling as if with the genitals do something shameless and obscene).

Kinesthetic — perception, or lack of limbs, or the presence of additional (to the volume of Confucius and the cell phone when you drive), violent movements, including recidivating (feeling the movement of the tongue, uttering words).

Hallucinations often have objective signs, when the occurrence of hallucinations can be determined by the behavior of the patient: when the visual patient looks closely, monitors the hallucinatory way; when hearing listens, closes his ears or talks (you should make sure that the person does not use at this moment a headset for a cell phone or mp3-player); when tactile something shakes off.

One day, walking with his wife in the city, we saw this picture: to meet us, actively gesticulating and enthusiastically talking with an invisible interlocutor, was a lady. As she came up to us, she nodded, pointing at us.:

You know who that is? Doctors, psychiatrists, so behave yourself! she continued her exercise.

Under the conditions under which they occur, hallucinations are divided into:

Functional — often auditory, which occur in the real sound stimulus (in the noise of water — whisper poisoners in the stop of the wheels — the conspiracy of neighbors in the compartment on the theme of “kill-kill”, etc.).

Reflex or reflected — when the action of a real stimulus for the analyzer gives impetus to the beginning of the hallucinations (it is a push, not a constant background, as in functional). Can occur under the action of canalizador: auditory hallucinations, while irritation of the visual, visual hallucinations at acoustic stimulus, etc.

Hypnagogic (from Greek. hypnos — sleep, agogos — causing) — when falling asleep (found normally).

Hypnopompic (from Greek. hypnos — sleep, pompos — accompanying) — upon awakening, as well as in the interval between sleep and wakefulness (can also occur in a healthy person).

Type Charles Bonet — with damage to the peripheral part of the analyzer, for example, “vision” with severe cataracts.

Apperceptive — caused by strong-willed effort (“I said — squirrels! Three lines! On the windowsill!”).

Psychogenic: dominant — saturated with affective experiences, for example, the “voice” of the deceased spouse; the imagination Dupree — when dreams and fantasies, especially easily arise in children and in individuals with painful a keen imagination; induced — inspired hallucinary patients (that is, from one patient to another patient); suggestion (not to be confused with induced) imposed by the physician in the study, for example, in a patient with alcoholic delirium — a symptom of the set, when instigated visual images (“Oh, look, a Goblin!»); a symptom of Aschaffenburg — when a patient in delirium tremens talking on a pre-disconnected phone.

It is characteristic that in childhood there are more visual hallucinations, and if there are auditory, they are often simple or elementary.

Pseudohallucinations differ from the true character of artifice, perceptions, lack of properties of objectivity: if “voices” are sounding inside the head, if the “vision” — something like a movie or cartoon.

Although hallucinations as an isolated symptom can not allow to accurately determine what kind of disease the patient has, nevertheless, their presence (except for hypnagogic, hypnopompic and auditory Alenshtil — these may be normal) is serious and not good. In addition, we can say, for example, that auditory pseudohallucinations are more characteristic of schizophrenia (although can also occur in many other psychotic disorders), and visual hallucinations for the intoxication process, or vascular catastrophes. This sets the direction for further diagnostic search.