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What is real and what only exists in my head? Many psychosis patients ask themselves this question, because hallucinations and delusions are among the most common symptoms of a psychotic disorder. Here you can find out what psychosis is and how you can recognize it.

What is psychosis?
What are the causes of psychosis?
What are the symptoms?
How does the doctor recognize a psychosis?
How is psychosis treated?
Can I prevent psychosis?
What are the chances of recovery?

What is a psychosis?

Be called "psychosis" various mental disorders summarized. They all have in common that those affected are the environment or their own self perceive distorted. Their nature changes, but they themselves do not notice it. You feel persecuted for no reason. Or they hear voices that no one else can hear.

Many mistake psychosis for schizophrenia. But there is a difference between the clinical pictures. Strictly speaking, schizophrenia is a sub-area of ​​psychoses. These are divided into primary and secondary psychoses.

To the primary psychosis (also called endogenous psychoses) include:

  • Schizophrenic psychoses: This includes all forms of schizophrenia. Probably the best known is that paranoid schizophreniain which people suffer from delusions and hallucinations.
  • Affective psychoses: They affect the mood of the person. Well-known examples are bipolar disorder, depression or manic behavior.
  • Schizoaffective disorders: They are a hybrid of schizophrenic and affective psychoses and express themselves through symptoms of both types.

> Schizophrenia: Causes and Symptoms

To the secondary psychosis (also called exogenous psychoses) are diseases that are triggered by a change in the brain. They are divided into:

  • Acute psychoses: They usually appear suddenly and only last a short time.
  • chronic psychosis: they persist over the long term as a result of permanent brain damage.

While acute secondary psychoses can usually be treated well and disappear completely, chronic psychoses usually remain lifelong. Get sick around the world, for example 3 to 4 percent of the population at least once in a lifetime from a psychosis. The mental illness occurs most frequently between puberty and the age of 35, and in older age as part of dementia or other brain disorders. Men and women are equally affected.

What are the causes of psychosis?

The mental illness can have an organic cause such as a change in the brain, but it can also occur completely without a trigger. The causes of primary psychosis are an interplay of various factors such as

  • drastic life events, e.g. separation, loss of a loved one
  • excessive stress
  • Inheritance
  • Environmental influences
  • Viral infections
  • Imbalance of messenger substances in the brain, the so-called neurotransmitters

Deep grief can trigger psychosis. (c)
Syda Productions / Fotolia

Secondary psychoses, on the other hand, are mainly due to organic causes and diseases of the brain or nerves, such as

Often the cause is buried even in childhood. Brain damage in early childhood can often only lead to sequelae in adulthood.

Special forms of psychosis

A special form is that drug-induced psychosis. It is only through the consumption of drugs that psychotic disorders occur. The condition can be limited to the duration of the drug trip, but in rare cases it can persist afterwards and become permanent. Well-known drugs that cause psychosis are, for example LSD and cannabis. Side effects from medication, excessive alcohol consumption, or lack of fluids can also trigger the symptoms.

Another special case is the passage syndrome. It often shows up in patients after surgery and usually goes away quickly after a few days. The cause of this is usually the anesthesia, the after-effects of which disappear again.

> Capgras Syndrome: The fear of doppelgangers

What are the symptoms?

There is no uniform clinical picture, every psychosis has a different course and manifests itself through different symptoms. However, the most common are:

  • Hallucinations, e.g. hearing voices, seeing things
  • Delusions, e.g. paranoia
  • Distorted perception of reality
  • limited ability to think
  • confusion
  • Difficulty concentrating
  • Tendency to compulsive acts
  • unfounded fears
  • Mood swings
  • Listlessness
  • sudden inability to move
  • limited responsiveness
  • Difficulty understanding, changed language

Since sick people usually lose touch with reality and fear a non-real threat, they can put themselves and others in danger. It is therefore important for relatives and friends to be attentive and to recognize the change in personality. If the person concerned does not want help, relatives can also ask a doctor for advice.

> Hallucinations and Loss of Reality: Alice in Wonderland Syndrome

How does the doctor recognize a psychosis?

If the disorder is suspected, a psychiatrist is the right place to go, and the family doctor can also help if the first symptoms appear. In a conversation, the symptoms are asked, also the previous medical history, the living conditions and the social environment. The relatives are also often questioned. This information is important for the diagnosis, because a different therapy is determined depending on the type of disease.

To determine whether it is a secondary psychosis, the doctor will conduct additional examinations:

  • Blood test
  • EEG (electroencephalogram)
  • EKG (electrocardiogram)
  • MRI (magnetic resonance tomography)

If organic causes can be excluded, there is a high probability that it is a primary psychosis.

How is psychosis treated?

There are the following options for treating primary psychosis:

  • Psychotherapy: A good treatment option is behavior therapy from a specialized psychologist. In this way, those affected learn to deal with their fears and to cope better with stressful situations.
  • medication: Medicines that are used to treat psychosis are called Antipsychotics. The most common active ingredients are haloperidol, resperidone, clozapine or aripipazole. The medication can eliminate the symptoms; continued use should prevent them from recurring. Some patients even take the medication for life to prevent relapse.

In secondary psychosis, the diseases that are the trigger for the psychotic disorder are primarily treated.

Usually psychotherapy and the administration of medication go hand in hand. However, treatment without medication is also possible. Recent studies have shown that Fish oil capsules can provide lasting protection against illness through the omega-3 fatty acids it contains.

Therapy in the clinic or on an outpatient basis?

The therapy can be in a day clinic take place in a practice or in very severe cases in a inpatient treatment. The duration of treatment depends on the type and severity of the disease and can last several weeks or months. Chronic psychoses should be treated over the long term.

Psychosis patients are characterized by a certain thinness. You react excessively to environmental stimuli. To be able to deal better with stress and overstimulation, there are a number of other forms of therapy, such as Relaxation therapy, sociotherapy and occupational therapy. The treating psychiatrist decides which therapy is useful for which type of psychosis.

Support groups for psychosis

Attending a self-help group can contribute to the healing process in addition to the professional treatment. If alcohol or drugs are the cause, withdrawal is recommended. Usually the symptoms go away with it. For the success of the therapy should be one stable social environment to be available. A regular daily routine, support from other people and a regular job situation contribute a lot to a faster recovery.

It is not possible for most of those affected to treat the mental disorder entirely themselves, as they often do not recognize their condition. After successful therapy, however, patients can take countermeasures in good time if the first signs reappear.

Can I prevent psychosis?

Preventing psychosis is almost impossible. Still there are some Early warning signthat can help you identify primary psychosis. Behavioral problems usually become noticeable months or years before the disorder:

  • Difficulty concentrating
  • sleep disorders
  • Listlessness
  • Mood swings
  • Drop in performance
  • nervousness
  • depressions
  • Anxiety
  • lack of interest in social contacts
  • Change of nature
  • excessively aggressive behavior towards other people
  • confused mental leaps

A psychiatrist should be consulted immediately at the first signs in order to prevent the onset of the disease as far as possible.

A self-test can also provide initial information. Here you can answer questions for yourself such as

  • Has your mood changed?
  • Have you noticed that your performance is deteriorating?
  • Do you often lose the thread of your thoughts?

What are the chances of recovery?

Whether a psychosis is curable depends on its type. While an acute psychosis can be cured quickly with the right treatment, a chronic psychosis usually lasts for a lifetime and ends in dementia in the long term. With a targeted therapy, the disease is nowadays easily treatable, even if that means a lifelong discussion of the topic. Drug-induced psychoses usually subside after withdrawal and only reappear when there is a relapse.

In general, the earlier the symptoms are recognized and treated, the better the chances of recovery.

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