A small educational program on mental health issues

In modern society, people are too busy with personal complexes and constant attempts to prove their success to pay attention to their internal state. And it often leaves much to be desired. Residents of megacities are like walking collections of neuroses; you won’t be able to point to anyone, but you will definitely encounter something special. But few people seek to visit a specialist in order to resolve their internal conflicts. Indeed, in our society it is very shameful to admit weakness and abnormality. Although normality is a very relative concept. In fact, contacting a psychiatrist is an adequate response to noticed mental disorders.

When do you need a psychiatrist?

The hero of one famous film said: “The head is a dark object and cannot be examined.”
Today's reality largely refutes his statement. In many countries of the world, scientists are discovering the mechanisms of development of certain mental disorders, creating new drugs, and, for better or worse, knowledge about the work of the psyche and the treatment of mental illnesses is growing. However, the causes of mental disorders remain largely unclear to this day. This means that no one can accurately predict the onset of mental illness.

Consequently, every time a mental disorder occurs unexpectedly. And you need to know its signs in order to consult a doctor in time and begin treatment.

These are the signs:

• decreased mood for several weeks or months;
• lack of desire to do anything, including things that previously brought pleasure or were a subject of passion;
• inappropriately elevated mood for several weeks or months;
• sleep disorders (difficulty falling asleep, shallow or interrupted sleep, nightmares, daytime sleepiness);
• isolation, isolation, combined with apathy or inappropriate or aggressive behavior;
• memory disorders;
• strange statements including ideas of persecution, greatness, influence, death;
• sudden loss of ability to work or learn;
• inappropriate emotional reactions (for example, laughter in a neutral or sad situation; or sadness and despondency in a situation of well-being);
• speech in the form of a monologue addressed to an interlocutor who does not exist in reality (“voices”);
• sad-angry mood, aggression, including for no apparent reason;
• apathy, melancholy, indifference;
• fear accompanied by inappropriate behavior in the period after the end of the binge;
• severe unreasonable anxiety, fear or panic;
• obsessive thoughts, ideas, feelings, actions that you cannot get rid of on your own;
• suicidal (related to suicide or causing any harm to oneself, mutilation) thoughts or statements or actions;
• emerging or emerging inability to use previously acquired knowledge or skills;
• mental agitation, inability to sit still, agitation, panic, aggression;

This list is far from complete, but it reflects the most common symptoms of the onset of mental disorders.

The appearance of any of these signs in a person requires calling a psychiatrist for diagnosis and subsequent therapy. Because without treatment, these conditions can quickly become life-threatening and health-threatening. And not only the patient himself, but also the people around him.

What to do before seeing a psychiatrist

There is the opposite type of people who, being very impressionable, are ready to visit all doctors at once, because they are sure of the presence of many pathologies. There is no need to rush here either. Before rushing to a psychiatrist, take a number of actions:

• Try to get enough sleep and spend the weekend in a state of complete peace. Sometimes external factors are very exhausting, a person lives in tension and the situation can be resolved by proper rest and restoration of physical strength
• Get a physical examination to determine the physical causes of your unwellness. For example, hormonal imbalances can cause a similar effect
• Do some introspection, maybe you are just overthinking things. Although in this case such a trait can serve as a sign of neurosis.

If, after completing all the above measures, you still feel unstable and also experience emotional discomfort, then look for a good specialist. Among psychologists, psychotherapists and psychiatrists, there are many half-educated people who, instead of helping, can harm the psyche.

Types of psychiatric care. Where to contact

Emergency psychiatric care

When called, a team consisting of a doctor, paramedic, orderly and driver leaves; Instead of a paramedic, a second paramedic may be present. The reason for calling a psychiatric team is acute mental disorders, or chronic ones in case of exacerbation. A mental health emergency dispatcher may not accept a call if the mental disorder is not accompanied by a person being dangerous to himself or others.

Outpatient psychiatric service. Calling a psychiatrist to your home

The outpatient psychiatric service is represented by local psychiatrists from psychiatric dispensaries, as well as doctors from private psychiatric services. The difference between the former and the latter is that calling a doctor from a dispensary is free for a patient or his relatives, while a commercial doctor will need to pay for his visit. However, dispensary doctors rarely make house calls, preferring to delegate the right to provide home care to ambulance workers.

Psychiatrists from commercial psychiatric services make house calls in all cases where psychiatric examination, treatment or consultation is required.

Just dial +7(965) 152-76-09 and make a call.

Symptoms of mental disorder

Like any disease, mental disorder has its own symptoms and treatment methods. To be sure that the time has come to seek help from a psychiatrist, conduct an analysis based on the following signs:

• apathetic mood lasts continuously longer than 14 days
• total laziness
• absent-mindedness
• insomnia
• increased level of anxiety
• irritability, etc.

If everything in life has suddenly become black and white, and more often than not you are on the dark side, then it may make sense to consult a psychiatrist. Especially if you are experiencing obvious mental health problems. Experts recommend sharing your experiences with a loved one, since it is quite difficult to overcome such difficulties alone.

Is it possible to consult a psychiatrist online? Consultation with a psychiatrist via Skype

Remote counseling is certainly possible. The prior informed consent of the person believed to be suffering from a mental disorder will be required for such consultation.

Our Skype login: psychosphera.ru

During the consultation process, the doctor can diagnose the condition, prescribe or adjust treatment, and even send a certified copy of the prescription in the form of a graphic file.

For any questions, please call us in advance:

+7(965) 152-76-09

All materials on the site are presented for informational purposes only, approved by certified physician Mikhail Vasiliev, diploma series 064834, in accordance with license No. LO-77-005297 dated September 17, 2012, by a certified specialist in the field of psychiatry, certificate number 0177241425770.

What exactly does a psychologist do and where can one get the appropriate education?

Psychology, like any scientific discipline, has its own object and subject of study. The object of psychology is a person, which is indisputable. But there are different opinions about the subject, varying historically and depending on the directions of psychological research.

At first it was the soul, then consciousness, adaptability, mental activity, behavior, the unconscious in the psyche, personal and practical experience, receipt and analysis of information, as well as other aspects. All this led to the emergence of a huge number of directions and branches in psychological science. Among the main ones we can highlight such as fundamental general psychology and many applied branches of practical importance: • clinical (medical); • gender; • children's room; • military; • criminal; • judicial; • legal; • engineering; • economic; • oncopsychology.

This includes the psychology of sports, work, parenting and many other areas. In short, they are legion. But the main thing that is important for a psychologist is the practical application of acquired knowledge, the ability to help a person solve problems that arise in the family, at work, in creativity, science, study or business. The task of a psychologist is not so much to give practical advice as to help a person himself understand the current specific situation and make a choice of the correct model of behavior and attitude towards it. This approach will allow the patient to more consciously and objectively assess negative situations in the future and try to resolve any problem without entering a stressful state and making enemies. A psychologist must teach a person to resist the challenges of the modern, extremely urbanized surrounding reality, to make his psyche stable and at the same time flexible, not breaking under the influence of constant stress, but capable of finding a way out of any difficult situation with minimal losses.

In fact, an experienced psychologist can become the best assistant in solving problems of finding one’s place in life, interaction with society and spiritual comfort.

A psychologist can act in different roles, specializing in psychodiagnostics or as a consultant, trainer, coach, or psychotherapist. But the main thing is to obtain a fundamental psychological education on the basis of state universities - Moscow State University, the Russian University for the Humanities, the Higher School of Economics Research Institute; in clinical medical psychology you can get an education at medical universities named after Sechenov and Pirogov. In St. Petersburg, psychologists are trained by St. Petersburg State University, State Pedagogical University named after. Herzen. Knowledge in clinical psychology can be obtained through program training at the St. Petersburg State Pediatric Medical University, St. Petersburg State Medical University named after. Pavlova.

In addition, a psychologist's education can be obtained at regional humanitarian universities. By the way, education is one of the key points that distinguishes a psychologist from a psychiatrist. Psychiatry is a branch of medicine that requires compulsory medical education, which allows a psychiatrist to prescribe treatment and write prescriptions for medications.

The psychologist is deprived of this right and solves the problems of the patient’s interaction with the outside world using purely psychological methods.

Now a psychologist

This is a specialist with a completely different diploma and a completely different way of thinking. He is not competent to provide medical assistance, he cannot provide treatment, he is primarily determined to study your personality, your psyche and your life in its psycho-social aspect. It is aimed at understanding the structure of your worldview, your principles, to see your temperament, resource characteristics, to evaluate your vision of a particular situation and, through an assessment of your psychological parameters, to help you organize your life in a difficult situation.

This situation may be related to work, family, relationships with friends or enemies, and perhaps only to your internal psychological and mental processes. Or it may be related to illness. But in these cases, the task of the psychologist is to detect this in time and establish cooperation with the psychiatrist, and with the patient to deal not with eliminating this disease, but to find options for adapting to the life that has developed in connection with the disease. This is very important, but not enough to get rid of the disease.

Diagnostic methods and tests

When visiting a psychiatrist, the patient will need to undergo some tests so that the specialist can correctly diagnose and prescribe treatment appropriate to the health condition.

The main types of tests for psychiatric treatment include:

• tests that determine the condition of the thyroid gland: the presence of antibodies to peroxidase and thyroglobulin, the level of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, thyroglobulin;
• analysis of the detailed formula of pituitary hormones: prolactin, adrenocorticotropic hormone, thyroid-stimulating hormone, somatotropin;
• analysis of adrenal hormones: androstenedione, adrenaline, cortisol, aldosterone, norepinephrine, metanephrine.

Often, to clarify the details of the diagnosis, psychiatrists also use neurophysiological studies, such as encephalography, angiogram of cerebral vessels, magnetic resonance imaging and others. In addition to material changes in brain activity, psychiatrists in their work pay a large role to the mental state of their patients. That is why clinical diagnosis of psychiatric diseases is the most common and effective method in the work of psychiatrists.

The clinical diagnostic method in psychiatry consists of interviewing the patient and observing changes in his mental states during this conversation. These changes perfectly characterize the occurrence, course and symptoms of mental illness. During this conversation, the psychiatrist pays attention to the patient’s facial changes, the intonation with which he says certain things, and the person’s reaction to an attempt to establish contact with him.

Sometimes, to diagnose a disease in psychiatry, a group discussion of the signs of the disease seen by a group of doctors at a consultation is used.

The essence of the clinical method for diagnosing psychiatric disorders is to interview the patient and his relatives. Each person is interviewed individually in order to understand how honest each interviewee is and to exclude any influence on what was said during the conversation. The first part of the survey asks general introductory questions about age, marital status, etc. Based on the complaints received, the psychiatrist can identify an incipient disease during the interview process. At the same time, he is obliged to very gently manage the current conversation so as not to cause isolation or hostility of the interlocutor.

During the interview, the doctor pursues the following goals: he identifies the patient’s attitude towards his own illness, clarifies what, in the patient’s opinion, provoked the onset of his illness, determines the syndromes and symptoms of a mental disorder, recognizes the patient’s personality characteristics, identifies the nature of the disease, its characteristics and attitude patient for upcoming treatment. When interviewing the patient’s relatives, the psychiatrist can clarify for himself their vision of the time of onset of the disease, determine what the patient himself may be hiding from him, what are the true causes of the disease, visible from the outside, how close relatives treat the patient and whether they are inclined to help him in treatment.

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Monitoring the patient. A psychiatrist observes a patient to determine his level of susceptibility to the suspected disease. In this case, gestures, facial expressions, actions, intonations, reactions to all kinds of events are important. Also, the doctor can easily identify the differences between how a person describes himself when describing himself, and how he really is. The purpose of this observation is to identify topics and questions that acutely concern and interest the patient, to determine his ability to independently care for himself, to identify and analyze his daily actions and interactions with society.

At the same time, it is important to understand that the correctness of the diagnosis and, as a consequence, the effectiveness of psychiatric therapy will largely depend on the diagnostic technique.

Psychoanalyst

This is a specialist who may be a psychotherapist or a psychologist-psychotherapist. Psychoanalysis

is a well-known technique that has existed for many decades and has long established itself as an absolutely proven technique in both psychiatry and psychology. Modern psychoanalysis can be called an independent discipline, based on the key principles of the architecture of the human psyche, discovered by Sigmund Freud and his followers and based on the theory of the unconscious. Once you see a psychoanalyst, you will have the opportunity to discover a lot of new things in the content of your mental life and direct its course in a direction that is comfortable for you.

Practical approach to work

In reality, things are often not as they really are. Therefore, there are no clear rules here, and everything very much depends on the specialist: I have seen psychologists illegally recommending drugs (very competently and successfully), and psychiatrists conducting openly psychotherapeutic sessions (which, in theory, is also haram), and psychotherapists refusing to combine psychiatry with pills. But these are exceptions, and we will look at the general trend. The psychiatrist will most likely feed you pills, give you injections and give you IVs. In most cases, he frankly doesn’t care about your rich inner world, he is interested in the absence of productive (delusions, hallucinations) and (less often) negative (emotional-volitional defect) symptoms. How well (subjectively) you will feel after life-giving haloperidol is of no concern to him (of course, there are good specialists who do not, but in my provincial sample there are vanishingly few of them). The psychologist will most likely talk to you. Ask something about your childhood, analyze your thoughts, feelings and somehow interpret them. In principle, all the psychologists I know (both personally, on the Internet, and in literature) have given up on the ban on engaging in psychotherapy and are actively pursuing it. The only “but” is that en masse they are afraid of real psychos. Those. If a psychologist is able to recognize a schizo, most likely he will refuse to work with him. No, no, if you have OCD, bipolar disorder, autism or something else, you shouldn’t rejoice - usually psychologists don’t really understand the types of psychos and are afraid of everyone the same. A clinical psychologist will work with you to diagnose, test and determine what and who you are. And, of course, psychocounseling. And even psychological correction (see below). And then, quite possibly, he will send you to a psychiatrist, psychologist or psychotherapist with specific recommendations, which can be very useful. A psychotherapist can feed you pills, and then, in fact, work either in the format of psychotherapy (word treatment) or psychology (increasing awareness, helping in self-knowledge and understanding of others). But in practice, they are still either psychiatrists at heart and base treatment on drug therapy, or psychologists (we remember that in reality psychologists do not hesitate to use psychotherapy methods, although, in theory, they should not).

What diseases does a psychiatrist work with?

The first step towards curing diseases of the soul is for a psychiatrist to study the mechanisms of occurrence of a particular disorder in the psyche of a particular person, diagnose the disease and prescribe appropriate treatment.

Psychiatrists can consult both sick and healthy patients; their competence also includes the process of examining mental health when determining legal capacity or the level of mental instability.

All psychiatry is divided into several areas, in each of which there are doctors who most often deal with the specific mental specifics of human health: organizational, developmental, forensic psychiatry, narcology, psychopharmacology, social psychiatry.

It is impossible to name all the diseases that a psychiatrist can cure, since their list is very long, and it is constantly expanding with emerging new forms of psychiatric abnormalities. In addition to the above reasons for contacting psychiatrists, we can name several more classic psychiatric diseases that are within the competence of this medical specialist:

• epilepsy;
• Alzheimer's disease;
• delirium tremens;
• phobias of various types, severe depression;
• unreasonable long-term psychosis, frequent hysterical seizures, schizophrenic states;
• mental disorders arising in post-traumatic syndrome;
• various forms of insurmountable addictions (alcoholism, for example);
• bulimia and anorexia.

Only a good psychiatrist can finalize the diagnosis of people suffering from the above and many other diseases; all subsequent treatment with medications and therapeutic agents must be coordinated with him.

Areas of psychiatry

In modern psychiatry there are several main directions:

• Organizational psychiatry. Resolves issues of organizing care for the mentally ill, studies epidemiology, and develops ways to reduce the incidence of neuropsychiatric disorders.
• Forensic psychiatry. The section is in charge of mental disorders related to problems of criminal law.
• Psychopharmacology. The direction is devoted to the study of the therapeutic effects of medicinal substances on human behavior and mental activity.
• Social psychiatry. Determines methods of rehabilitation and adaptation of mentally ill people in society.
• Developmental psychiatry. Studies abnormalities in children, adolescents and the elderly (gerontopsychiatry).
• Narcology. Provides assistance to people suffering from various pathological addictions.

About clinical/medical psychologists

I promised to write about them separately. First of all, they are the same thing. They are called clinical in their diploma, and medical in their work, when they work in a psychiatric hospital. They have some features that ordinary psychologists don’t have (or few of them): 1. They do study psychiatry. And psychotherapy too. 2. They study pathopsychology, so they can work with real psychos. 3. They carry out psychological correction - i.e. recovery using non-drug methods. How is this different from psychotherapy? Basically the name. And, yes, a real clinical psychologist studied in medical school. institute/university, just not at the medical department, but at the clinical psyche.

This article was published in the blog “A Psycho Consultant Writes,” 01/08/17.

Author: ya_schizotypic

Drug therapy

A psychologist does not write out or prescribe funny pills. And sad ones too. Even medical. If he recommends accepting something, then he goes beyond his formal rights. In current realities, this does not mean that he is necessarily wrong, but you must understand that he is exceeding his authority. On the contrary, both a psychiatrist and a psychotherapist have the right to prescribe pills. In practice, the former, as a rule, limit themselves to only this, while the latter often refuse this opportunity, preferring treatment with words. On the other hand, both a psychiatrist and a psychotherapist have the right to use non-drug methods of influence (the same therapeutic conversations in all their diversity).

At an appointment with a psychiatrist

You can see a psychiatrist privately or at the precinct. A referral to a local doctor is issued by any specialist who suspects a patient has a mental disorder. You can also make an appointment for an outpatient psychiatric appointment yourself. The local doctor sees you at a psychoneurological or narcological clinic at your place of residence, in a psychiatric office of a clinic or hospital.

Consultation with a local psychiatrist is free.

A private psychiatrist sees patients in private specialized clinics, of which there are a sufficient number. Here you can find specialists and narrow profiles described above. Private clinics also provide psychiatrist services for psychiatric examinations provided to various authorities.

A consultation with a psychiatrist begins with a conversation. The doctor asks the patient about complaints, lifestyle, communication with friends, relatives and colleagues, assesses the general condition, and, if necessary, communicates with relatives.

For examination, the psychiatric office has a couch, a tonometer, and a phonendoscope. An additional device is a breathalyzer to determine blood alcohol. Using a neurological hammer, the doctor determines the severity of reflexes. A set of aromatic products allows you to assess the level of smell. In addition, the doctor uses special psychological techniques to assess the patient’s mental activity.

After a conversation and examination, the doctor makes a conclusion about the patient’s condition, makes a diagnosis and determines treatment tactics. Prescribes appropriate therapy.

If necessary, for further examination, the psychiatrist gives a referral to the patient for testing. Their list may include:

• EEG;
• rheoencephalography;
• ECG;
• MRI, CT;
• blood and urine tests;
• Ultrasound;
• specific psychiatric studies;
• consultations with other specialists - neurologist, endocrinologist, cardiologist, urologist, therapist, etc.

After consultation, the psychiatrist prescribes outpatient or inpatient treatment to the patient.

When seeking psychiatric help in a private clinic, a person has the opportunity to receive not only a doctor’s consultation, but also undergo an examination. Moreover, today private psychiatric institutions have a wide arsenal of methods with a specific focus. Naturally, here you will receive individual treatment. Some clinics even have an inpatient department.

A psychiatrist also conducts clinical examinations of people suffering from chronic mental illnesses.

How to understand if a given specialist is good

This section will be pure IMHO. The surest way: study yourself at least at an intermediate level in psychopharmacology, psychiatry, psychotherapy and psychology and talk to a specialist. Long, expensive, high quality. Attention : this method does not work for people with delusional concepts: if your reality testing is seriously impaired, then for you there is only one answer - nothing. If this is not possible, then there are a few simple rules: 1. Your specialist must have at least an approximate idea of ​​what evidence-based medicine is (even if he is just a psychologist), and how his methods are perceived by her. You can quite successfully work with a specialist who uses methods that do not have proven effectiveness (for example, psychoanalysis), but knowledge of what EBM is, why it is needed, why it is important is a certain general cultural level of a specialist, and if it is not there, talk about nothing. 2. Your specialist should not be intimidated by the words Pubmed and Cochrane. It’s even better if he knows what it is and why he needs it (or convincingly prove that he doesn’t need it, although there are possible options here). 3. Your specialist himself undergoes personal therapy. Even if he is a psychiatrist. Personal therapy is an awesome experience that cannot be replaced by anything. 4. Your specialist knows English at a level sufficient to read professional literature. Simply because all the most interesting and new things are published on it (or quickly translated into it), and if a specialist does not speak this language, he will be on the sidelines of progress. Titles, categories, diplomas, studies and the like don’t mean anything. Experience. Experience is a good thing, but it must be properly integrated and interpreted. And it’s not like “the same clinical mistakes repeated for 20 years.” Reviews... You need to be careful with reviews. This is an area where, in addition to the usual “everyone lies” glorified in House, there is also a lack of awareness. And one discreetly positive review from a schizoid can mean more than ten emotionally enthusiastic praises from a hysterical person (or it may not mean that). How to evaluate the quality of reviews? See the first sentence of the section.