The rules of treatment of mental disorders

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The basic rules to be followed in the therapy of mental disorders and diseases include:

  • early identification of symptoms and interventions to prevent progression of disorders,
  • counteracting the recurring episodes of disease,
  • individual selection of treatment methods and multilateral approach,
  • education of the patient and his/her family and their active participation in therapy,
  • support of healing and participation in family and social life,
  • preference for home versus hospital environment for therapy administration.

Early diagnosis and therapy of mental disorders

Early identification of signals, indicating mental balance deterioration, followed by immediate seeking for medical or psychological counselling. The signals, which should be noted and consulted with a physician or a psychologist, are very different and may occur either individually or simultaneously.

The following symptoms should focus our attention:

  • states of tension,
  • states of anxiety, fear,
  • fatigue,
  • feeling of discouragement,
  • feeling not satisfied with life,
  • excessive irritability, rowdiness,
  • loss or change of interest,
  • difficulties in communication with other people,
  • odd and/or unclear statements and behaviours,
  • feeling of being lost,
  • fear of unclear danger,
  • lost sense of security,
  • loss of confidence,
  • increased tendency to associate facts or events, even from distant past,
  • sleep disorders (problems with falling asleep, shallow, broken sleep, nightmares, early wake ups in the morning, decreased or increased demand for sleep),
  • appetite changes,
  • mood/well-being increase or decrease,
  • activity increase or decrease,
  • difficult or easy, hasty decision taking,
  • strange auditory, visual, tactile sensations: rumble, crackles, flashes, voices of non-existent persons, currents, waves, changed scents and flavours.

It is worth knowing that...

These symptoms may be a consequence of exhaustion, stress, somatic disease or mental disorders.

Sometimes, to make the symptoms recede, it is enough to take some rest, change diet, modify lifestyle, explain some misunderstanding with close relatives/friends, solve a conflict, obtain acceptance and emotional support. in some cases, an additional support of a professional may be necessary, including psychological or psychotherapeutic counselling or internal neurological, endocrine or psychiatric treatment.

At the early stages of the disease, treatment may be provided in outpatient environments, either without interrupting daily routines or during sick-leave periods.

Remember!

Early diagnosis and therapy of initial mental disorders may prevent their further progression and exacerbation, which would require inpatient care, provided at psychiatric hospital ward. All mental disorders and diseases can be diagnosed and treated outside the hospital - either at an outpatient clinic or a day ward - provided their symptoms are not excessively exacerbated and do not induce behaviours which may be hazardous for the affected patient or for other persons.

The same applies to recurrent episodes of mental disease. After completed inpatient psychiatric therapy, subsequent disease relapses, if they occur, should be diagnosed and treated at an outpatient clinic, early enough to prevent return to hospital.

Prevention of relapse

Disease relapses may occur in certain mental diseases even after their successful treatment outcome; a treated disease may recur after several months or even years of full health.

It is observed in certain conditions from the schizophrenic group, in some types of depression (recurrent depression) and in the bipolar (manic-depressive) diseases.

Remember!

The use of proper psychotropic medicines is significant in prevention of disease relapses, as well as appropriate forms of psychotherapy and training sessions plus psychoeducation, i.e. the acquisition of knowledge on the disease, its symptoms, risk factors, prodromes of recurrence and the ways to manage them.

The patient's environmental conditions are also substantial:

  • the atmosphere of friendliness, goodwill and acceptance in family and in the circle of friends and colleagues,
  • regulated everyday life,
  • a possibility for occupational activity or any other daily activity,
  • proper leisure time occupation,
  • access to various forms of recreation, culture and entertainment.

Conscious involvement of the patient in collaboration with a doctor or a psychologist is also important in prevention of disease recurrence. It often happens that a patient, facing remission of acute symptoms, feels healthy and wants to forget about the disease; it is then difficult for such patient to accept the proposals of medication or participation in psychotherapy because he/she would like to be treated as a normal, healthy person.

While the proposal of prophylactic therapy, aimed to prevent disease relapses, is not at all to further see that person as patient. The objective of such therapy, after the experienced episode of psychosis or depression, is to provide the affected person, as that who is susceptible to disease relapse, with measures to prevent that relapse, as well as with necessary knowledge how to use the measures.

Remember!

A treatment, counteracting disease relapse, is not to become a barrier, but a support in normal life. However, it requires active involvement and collaboration of the patient.

Individual selection of treatment methods and multilateral approach

The selection of treatment method depends on obtained diagnosis. If mental disorders are manifestations or consequences of somatic disease, e.g., brain tumour, infection of the central nervous system, hypertension, anaemia, hormonal disorders (hypo- or hyperthyroidism, hypo- and hyperadrenalism, hypo- and hyperparathyroidism, hypo- and hyperthyroidism), the treatment of mental disorders involves the treatment of the underlying somatic disease (surgical intervention, the administration of antibiotics, hormonal compounds, blood pressure controlling agents, anaemia treating medicines), possibly supported by psychotropic drugs.

Whereas in the therapy of mental disorders and diseases, which are not associated with any somatic diseases, biological and psycho-social methods are applied.

Biological methods:

  • pharmacotherapy,
  • electric shock therapy,
  • phototherapy.

Psychosocial methods:

  • psychotherapy,
  • socio-therapy,
  • training,
  • occupational therapy.
The above-mentioned methods do not exclude one another but are mutually complementary. While combining the methods, they should be tailored to the type of disorders, the stage of disease, psychological, family, social and nursing problems of the patient. Therefore, participation of various professionals is necessary in the therapeutic team, including a physician, a psychologist, a social worker, a psychotherapist, an occupational therapist, a nurse and an environmental worker (therapist).

Remember!

Development and evaluation of a therapeutic plan should also involve a multi-professional team with participation of the patient and, if possible, of his/her family.

Psychoeducation and the active participation in treatment of the patient and his/her patient.

The implementation of a long-term therapeutic plan - especially in chronic diseases, which impair functioning, as well as in diseases, regarded as relapses of disorders - requires conscious participation and active involvement of the patient and his/her family.

It is worth knowing that...

Psychoeducation, understood, first of all, as a process of acquisition of the knowledge about the disease and its treatment, both by the patient and his/her family, plays therefore a very important role in psychiatric therapy.

Psychoeducation is, in addition, associated with gaining the skills to make use of the experiences of past disorders. This ability positively influences the control of the course of disease and supports better coping with day-to-day life, despite burdens which accompany a give medical condition.

The ability to share with other people their knowledge and experience, gained in the course of disease (their own or of their family member), as well their strength and hope to regain health, play a significant role in psychoeducation.

Do you know that...

It is good when psychoeducation, conducted by a professional/specialist, is carried out in a group, where patients (or the members of their families) share with one another their experiences, associated with mental disease, providing one another with support and encouragement.

Support of healing and participation in family and social life

Pathogenesis is defined as a process of medical condition development, together with mechanisms which shape its symptoms. During recent decades, more and more attention has been paid to the healing process, in which strengthening of health potential and enrichment of health resources are of major significance.

Do you know that...

The process of strengthening of health potential and enrichment of health resources is called salutogenesis. In salutogenetic approach, building of mental health resources is equally important as the elimination of disease symptoms.

CEE_SCHIZO_disease_01_F
Stock photo. Posed by model.

The same applies in case of infectious diseases - an antibiotic is administered to a child to kill bacteria but the same result may be obtained by strengthening the body and its immune system so that it could fight and eliminate the infection by itself. In case of mental diseases, the role of such "strengthening factors" for mental health is played by:

  • building good relationships with other people,
  • proper leisure time occupation,
  • various forms of social participation (occupational activity, hobby, entertainment, participation in cultural and religious life),
  • in other words: building of healthy lifes independently or despite of disease.

Remember!

The basis for such understood healing process is a support from close relatives and assistance of professionals, together with the acceptance of the fact of disease, regaining one's self-esteem and effectiveness, as well as hope and the sense of life.  It is very important do develop skills of setting up realistic and satisfying life objectives and of achieving satisfaction when the goals are fulfilled.

Therapy in home environment instead hospital

The support of such understood healing after the episode of mental disorders requires meeting of a few conditions:

  • collaboration of the patient, his/her family and a multi-professional therapeutic team,
  • accompaniment of the patient in his/her real life,
  • collaboration with extra-medical institutions which provide support to patients (social care, local government institutions, non-governmental organisations, businessmen from the labour market).

It is worth knowing that...

Meeting of the above conditions is possible only in the natural patient's environment. Therefore, various forms of environmental therapy are preferred in psychiatric therapy, with a tendency to limit inpatient treatment to a necessary minimum.

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