Mental disorders

Stupor - causes, symptoms, types, treatment, how to get out of stupor

The stupor of a man is in a literal translationNumbness. In psychiatry a stupor is one of the types of motor impairment. Stuporous state represents total immobility in conjunction with mutism (dumbness or absolute rejection of communications) and weakened responses to all kinds of stimuli-stimuli. An individual suffering from a psychological stupor does not have a reaction to events, and there are also no reactions to common negative messages, such as pain, noise or cold. Such a patient can for a comparatively long period not eat, not talk, quite often at all can be frozen in one position.
Stupor state can become an end result
, Various disorders of the psyche, seriousStress or fright. Often, some stuporous patients lie, not changing their positions, refusing to eat, not responding to questions, for days, or even weeks. Other patients sit or stand, often as if petrified in a strange position, wrapped in a blanket with their heads or turned to the wall, absolutely motionless until they were forcibly transferred to another position.

Causes of Stupor

Stupor is called psychopathologicalViolation, which manifests itself in the form of suppression of various mental operations, in the first turn, motor skills, mental activity and speech. Patients who find themselves in this state are characterized by immobility. Granted, patients
Long are in one position. The addressed questioning phrases either may not respond at all, or they respond, but after a pause, in a slowed pace, interjections, individual words or only occasionally short phrases.
In some cases, the disease can occur in combination with a variety of symptoms of a psychopathological orientation, such as delirium,
, Modified
. In other situations, more rare, stuporThe condition is limited solely to motor immobility and speech retardation. In other words, this state is also called an "empty" stupor.
Stupor, which accompanies the confusion of consciousness is called receptor. The stuporous state observed under conditions of clear consciousness is called lucid or effector.
To the main factors provoking the emergence ofStupor state, include severe psychotraumatic events, stressful situations, mental disorders, emotional negatively colored situations, organically determined lesions of brain structures, various bruises or concussions, intoxication, and infectious disease. However, to this day it is impossible to state with absolute probability that the listed list of reasons is complete.
Specialists with a global reputation in the field of psychiatryEnter into discussions about the possible causes of the development of the disease. Thus, among numerous assumptions, several catatonic stupor that are most characteristic for the formation and formation of a fixed type are singled out. Deficiency in the brain of gamma-aminobutyric acid, which is its key inhibitory neurotransmitter. The lack of this acid can become the cause causing the violations of the musculoskeletal system. And this is the main symptom of catatonia. Catatonic stupor can come as a result of an unexpected stop in the production of dopamine by the body.
In 2004, specialists began to considerFormation of catatonic syndrome as a genetic response that occurs in stress situations or life-threatening circumstances in animals before meeting with a predator. The whole body paralyzes due to fear, as a result of which the animal's organism is reconfigured to a speedy death. Such a reaction of fear on a subconscious level has been preserved in human individuals and to this day manifests itself in exacerbations of psychosomatic diseases or intense attacks
Catatonic stupor, according to thisHypothesis, is expressed in the characteristic reaction of individuals to the inevitable death that haunts him from the onset of the onset of the disease. Thus, these hypotheses cause the emergence of catatonic syndrome as a consequence of the presence of schizophrenia and other psychosomatic diseases.

Symptoms of Stupor

Being in a stupor, people do not contact the environment, they do not have reactions to events or uncomfortable conditions, various inconveniences (for example, noise, dirty bed).
Patients in stupor may not move even whenFire, earthquake or any other natural disasters. They often lie, without changing the position, the musculature is in its tonus. Usually, the tension begins with the chewing muscles, then descends to the cervical region, later distributed on the back, arms and legs. In this state, emotional and pupil response to pain is absent.
Symptoms of stupor include: Obscuration of consciousness, absolute immobility, partial or complete silence (mutism), increased muscle tone, negativism, depression of reflex reactions, lack of
With the surrounding and responding to external stimuli.
Fall into a stupor of an emotional nature moreIs characteristic of the female part of the population. Emotional stupor often comes as a result of intense emotional upheavals (for example, the horror or grief experienced). It is characterized by blocking the motor activity and emotional-affective activity, in addition to this, the thinking function also slows down. Such an attack, in most cases, passes without specific treatment, but sometimes it can lead to a state of panic, during which the patient will strive to perform acts of a chaotic orientation. A consequence of this may be the onset of depression.
Stuporous state of this type can be observed in women who witnessed a catastrophe, or an accident. It may also appear
Due to passing exams or during a battle with soldiers.
Depressive stupor is peculiar to the same extent and the female part of the population and the strong half of humanity. It occurs against the background
And, as a rule, is accompanied by a hunched posture,Grimace of suffering on the face of subjects, lowered gaze. Patients in a similar state can respond to interrogative utterances with monosyllabic phrases in a whisper. This variation of the stupor state can be observed for a couple of hours, and sometimes even weeks. People in this state can refuse food.
Overly sensitive, emotional, vulnerablePeople and creative individuals, characterized by a subtle internal organization, have a mental stupor. It is expressed in the form of apathy, laziness, melancholy, creative crisis, inability to think, feel and inability to act differently. With this state comes a kind of spiritual "stiffness".
Hysterical stupor is more often observed in excessivelyEmotional ladies. It manifests itself usually as an affective impermanence, the cause of which can be the changed environment. This kind of stupor in a difficult environment that threatens the health, life or well-being of a woman can be a protective reaction. It can manifest itself either in absolute immobility, or in active emotionality and psychomotor agitation. Patients suffering this type of stupor is characterized by increased mimicry. So, for example, patients can pointlessly staring, grimacing, crying.
Apathetic stupor is manifested in passivity and immobility, lack of aspirations and interests.

Types of stupor

There are several types of stupor: negativistic, depressive, apathic and catatonic, as well as stuporous state with waxy flexibility or with muscular numbness.
The negative stupor is expressed in the mutism andAbsolute immobility, but any action aimed at changing the patient's posture provokes sharp opposition and resistance. A sick individual is not easily lifted from a bed, but then, lifting it, it is impossible to lay again. Often a passive counteraction is added to the active one. For example, if a doctor extends his hand to a patient, he, in turn, hides behind his back, when he asks to open his eyes, closes his eyes, etc.
With a depressive stuporosis, it is characteristicAlmost complete immobility, along with a depressed expression and a pained grimace. When you manage to contact them, you can get a monosyllabic response. Depressive stupor in a person can suddenly be replaced by an excited state, in which patients jump up and do themselves harm, may injure themselves or roll on the floor with howling (melancholic raptus). With severe depressions of an endogenous nature, a depressive stupor may occur.

Patients suffering from apathetic stupor, likeRule, lie on your back. They also do not observe a reaction to what is happening around, and muscle tone is reduced. Answer monosyllabically to questions and with great delay. However, while interacting with relatives there is an adequate emotional reaction. Sleep disorders and anorexia are noted. Often in bed untidy. Catatonic stupor is a kind of congealing in fright, numbness in fear and helplessness, along with the gravest suffering of the inner "I". Patients with catatonia, sometimes, do not understand whether they are still alive, are capable of producing actions, are not sure of the integrity of their own personality. Therefore, anything that can lead to the re-establishment of the authenticity of the I-experience will play a therapeutic role for the patient.
For example, with loss of self-identity, sometimesYou just need to apply by name to improve the patient's condition. How to get out of the stupor? In the severe course of the disease, a purely verbal therapeutic approach is often insufficient. Other kinds of catatonic stupor appear when delusional experiences load, for example, when the individual is in a state of ecstasy.
When stuporoznom state with waxy flexibility,In addition to mutism and immobility, the patient keeps a dowry for a long time. For example, freezes with a raised hand or freezes in an uncomfortable position. It is often noted that there is a symptom of Pavlov, which consists in the lack of response in the patients to questioning phrases given in a normal voice, but at the same time responds to a whisper. At night sick individuals can walk, sometimes eat and contact with the environment.
Stuporosis with muscular numbnessIs a finding in the fetal position. In such patients the musculature is tense, the eyes are closed, the lips are extended forward. Often, individuals suffering from this kind of stupor, have to feed through a probe, as they refuse to eat. Often, doctors perform amytalcophone disinhibition, and after the muscle numbness weakens or disappears, the patients are fed.

Treatment of stupor

Many people care about the question: "How to get out of the stupor"? Naturally, only specialists - psychotherapists and psychologists - can help in this. However, you should still know how to help a loved one or someone in an environment if there are signs that the subject intends to fall into a stupor or has already entered such a state and needs help.
So, in the first turn, relieve stress will helpMassage special points located exactly in the middle of the pupils, equidistant from the eyebrows and the hair growth line. Massage these points with the help of thumbpads and thumb. In addition, it is recommended to try to provoke an individual in a stupor state, strong emotions, whether positive or negative (better negative). For example, you can give a slap in the face.
Exit the stupor can help flexing the individualFingers of fingers and pressing them with force to the palms, with the thumbs being straightened. So, the answer to the question: "how to get out of the stupor", is hidden in the emotional shake-up of the organism and synchronization of the breathing of the sufferer with the subject who helps him. To this end, you can put your hand on the chest of an individual who has fallen into a stupor and adjust to his breathing pace.
With a stupor, emergency care is limitedSecurity of subjects and prevention of dangerous actions on their part. For example, with a catatonic stuporous state, emergency help will consist in the readiness to cope with unexpected impulsive agitation.
With a depressive stupor - preventionThe probability of sudden development of depressive arousal with a focus on suicide, and the elimination of a refusal to eat. In addition, it should be borne in mind that a stupor can suddenly be replaced by excitement.
Treatment often occurs in a hospital setting. Use barbamyl-caffeine disinhibition. Thanks to which it is possible to detect the peculiarities of the patient's experiences and anxieties, which helps to determine the nature of the stupor state. Such disinhibition is also a therapeutic method that helps with a sustained refusal of food.
Stuporous condition, arising on the background of severe somatic diseases, requires treatment of the underlying disease.
With a stupor accompanied by hallucinations andDelirious use of Stelazine, Trisedal as well as in the treatment of hallucinatory and delusional conditions. In case of depressive stuporosis, disinhibition is also carried out and Melipramine is administered up to 300 mg per day either orally or intramuscularly. When psychogenic stuporosis - diazepam up to 30 mg per day, orally or intramuscularly, Elenium or Phenazepam.

Catatonic Stupor

Psychopathological syndrome, the main manifestation of which are motor disorders, is called catatonic stupor.
Catatonic stupor was first describedKalbaum as an independent mental illness, subsequently Krepelin was referred to schizophrenia. Catatonic stupor is a form of schizophrenia characterized by psychomotor disorders. Such a stupor state can have a duration of several months, and in more severe cases, several years. It manifests itself in the preservation by the subject of an uncomfortable, unnatural position for quite a long period and mutism. At the same time being in a similar situation, a person does not feel fatigue. A stuporous state may be accompanied by an increased plastic tone or extreme strain of the entire musculature.
Catatonic stupor is a form of schizophreniaCharacterized by a condition in which individuals refuse food, defecate themselves. However, at the same time, their consciousness is preserved, so that patients, when they come to, can describe in detail the incidents that occurred during the stupor around them.
At the beginning of the twentieth century, the catatonicThe syndrome was considered, mainly, as a subspecies of schizophrenia. Today, catatonia is understood as a syndrome that develops in affective and other disorders of the psyche, somatic diseases, poisoning. Catatonic syndrome is an alternation of stupor with periods of catatonic excitation.
Catatonic stupor is expressed in motorInhibition, mutism, muscle hypertension. In a clamped state, patients can stay even for several months. In a similar state, all forms of activity, including instinctual ones, are violated. There are the following types of catatonic stupor: with waxy flexibility, negativistic and with stupor.
Catatonic stupor often develops as aManifestations of catatonic syndrome. Being in a stupor state, patients do not contact the environment, they do not have a reaction to the occurring phenomena or various inconveniences (for example, a wet bed). They completely refuse to eat, they do not have dilated pupils as a response to pain.
Patients suffering from catatonic stupor,At first they become silent, they can repeat the phrases pronounced by another individual (echolalia) or not answer questions at all, but still produce the necessary daily (household) actions. Then they cease to move, they freeze in a strange position, for example, resembling the fetal position in the mother's womb (catalepsy), remain in the position given during examination, reveal negativity.
Against this background, short-termExcited states, as well as other psychopathological manifestations: delusions of persecution, auditory hallucinations. There may be impulsive actions that manifest themselves in the form of sudden
With respect to the environment.
Motor retardation occurs inCombination with vegetative manifestations: cyanotic color of the extremities (acrocyanosis), their cooling, increase in sweating along with slowing of the pulse. A thorough examination of internal organs of the catatonic often does not reveal changes that would indicate the presence of a disease of the body.
A sign of catatonic stupor is consideredSymptom of the "air cushion". It represents a prolonged stay of the patient in a position with a raised head (the head is about 15 cm from the pillow). In this case, such a patient lies either on his side or on his back. If you press the patient on your head, then it will go down, but after some time, will return to its original position. This situation can persist for hours and disappears after the onset of sleep.

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