Rehabilitation for schizophrenia. Take control of your disease

Rehabilitation for schizophrenia is one of the most important stages of recovery and socialization of a patient with schizophrenia.

Relatives of a person suffering from schizophrenia have a great responsibility for organizing a meeting between a family member and a psychiatrist, maintaining contact with the attending physician and following all necessary recommendations. Often, close people of the patient lack the most basic information about the behavioral characteristics of the patient with schizophrenia, communication skills with him and knowledge of the rights of the patient with schizophrenia. The Transfiguration Clinic pays special attention to working with relatives, their awareness and psychological assistance to family members of a patient with schizophrenia.

What is the reason that most patients, despite treatment, end up back in psychiatric clinics?

The importance of rehabilitation for schizophrenia

This is mainly due to refusal to undergo rehabilitation for schizophrenia and take maintenance therapy. Violation of the regime during rehabilitation for schizophrenia, independent, uncontrolled reduction of doses of medications taken. The easiest way, of course, is to blame patients for lack of consciousness, placing all the blame on them for the next relapse of the disease. However, considerable blame for the current situation still lies with doctors and the healthcare system as a whole.

Often, after discharge from a psychiatric hospital, a patient undergoing rehabilitation for schizophrenia finds himself virtually left to his own devices and unable to continue to cope with his illness. He faces wary glances from his family and work colleagues or even tries to hide the fact of his hospitalization.

What kind of rehabilitation is needed for schizophrenia?

A person suffering from schizophrenia often does not fully understand the depth of damage to his psyche, so his closest relatives have to monitor his health, nutrition, appearance and adaptation in society.

Often, if a person does not undergo rehabilitation for schizophrenia, the patient’s personality is destroyed to such an extent that he is not capable of independent life, work and starting a family. In this case, disability due to mental illness is issued: the patient is assigned a pension depending on the group and other social benefits are added. For 5 years, the patient must undergo a medical-labor expert commission annually, undergo rehabilitation for schizophrenia, take prescribed medications and regularly visit his doctor. If after 5 years the condition is not restored, then disability is assigned for life. In the absence of visits to a psychiatrist and refusal of recommended treatment, such behavior of the patient can be interpreted by the medical commission as recovery. In this case, the disability is not extended.

The main rehabilitation for schizophrenia is ensuring regular examinations by a psychiatrist, monitoring the intake of antipsychotic medications, maintaining physical health and undergoing socio-psychological rehabilitation. Such complex therapy can be obtained at the Preobrazhenie Clinic.

Patients need rational employment that allows them not to drop out of society and to feel needed and useful for society. Finally, psychotherapy has an important influence in the rehabilitation of patients with schizophrenia, allowing the patient to understand his illness and consult a doctor in a timely manner to prevent relapses, and adapt to the world around him.

When your husband has a bad temper

I married for great love! We didn’t meet for that long, yes, and I didn’t really think about the specifics of his behavior. I wanted one thing - to be with him. After 10 years, I have not changed my decision, especially since our relationship has undergone a colossal test of strength, which I would not wish on anyone. After the honeymoon, that same life began on the reefs of which boats of love so often break. I began to notice obvious abnormal forms of behavior, which at first even frightened me.

My husband periodically seemed to be cut off from reality; he fenced himself off from everything that surrounded him, including me. What was more scary for me was a kind of emotional decline. He showed amazing coldness towards all people close to him. I could not calmly watch how indifferent he was to everything that had the most direct relation to him. Gradually, he left all his hobbies in the past, no longer collected models, did not want to play football with friends, or go fishing. He didn’t care at all what they would say about him, so he became unclean and sloppy in everyday life.

I am a logical person, but what I saw defied any explanation. He could love and hate at the same time. It’s hard to explain, you just had to see his gaze. His actions and aspirations were ambiguous, sometimes incomprehensible to himself. Of course, this was not always the case in the beginning. At other moments it was still the same person whom I fell in love with, but still a little different.

Hello schizophrenia

Returning again to childhood memories, I can hear laughter at the word “schizophrenic.” It's so funny, isn't it? Until you come face to face with this disease. As it turned out later, it was possible to write a scientific paper on my husband, since he showed almost all the signs of the disease.

He plunged into a world of experiences that were incomprehensible to anyone. He could not and did not want to establish contact, which caused me pain. All attempts to maintain conversations were immediately canceled out.
When my beloved cat, whom he also loved very much, died, he laughed. When my sister gave birth to her first child, he cried... My relatives said that they were afraid for me, and it was time to see a doctor. But we were still far from taking this step. The point did not come when I realized everything. Although even then I saw that he was completely indifferent to the grief of loved ones. Then I was angry and furious, not understanding the reasons. Can you imagine what it’s like to suddenly realize that your loved one... just has an evil heart (sounds pretentious, but think about the meaning!).
Over time, his facial expression also changed. He became... stupid! At least that's what it seemed like from the outside. He spoke reluctantly, squeezed out every word as if from a half-empty tube of toothpaste, and most often sat motionless. He had already been fired from his job at that moment, since the sales manager could not constantly remain silent in solitude. He was tolerated for so long.
His indifference and inactivity reached their climax. He didn’t care that he had lost his job, he didn’t want to look for another job, and what can I say - he was too lazy to get up to go relieve himself or get a drink. He could remain silent for several days, looking out the window.
He often refused to do what I asked him to do, such as eat, wash his face, or go for a walk. There was no motivation, he simply senselessly opposed me, which pushed me towards terrible emotions and suffering, probably without even knowing it. Sometimes it even seemed to me that he simply did not understand what I was saying, and it was like footage from a horror movie.
When he did go out for a conversation, which happened infrequently, the speech was chaotic and “torn”, a kind of vinaigrette. He would come up with some words and raise his eyebrow in surprise, seeing that I did not understand what the conversation was about.
Also, in moments of “frankness,” he loved to spend hours fruitlessly discussing some topics that were completely distant and incomprehensible to him. Moreover, they were illogical, such as why should a parrot wear a rabbit fur coat?
A little later, I seriously began to think that he was possessed by a demon, since a complete illusion was created that someone was controlling him. But more often I thought that he was simply unbearably bored and difficult to live with me - an unloved, uninteresting woman.
The next stage did not surprise any of his relatives - the husband said that he was being watched by a secret government, which at the same time was trying to kill him using the most sophisticated methods.
And then he started hearing voices, and only after that we realized that we needed help.

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I would like to note that all this did not develop all at once, but gradually, slowly. As they later explained to us, it was a simple form of schizophrenia. But it is simple only in name, and not in content, alas. He also experienced remissions, that is, at moments when “everything passed,” he was absolutely adequate, looked for work, and lived an eventful life. And at these moments I was absolutely happy, I thought that he had simply come out of a prolonged depression. It seemed to me that I had finally found the key to making him happy, and he stopped hating his life. And then everything came back.

What to do if you have schizophrenia

Find an opportunity to see a psychiatrist.
Contacting our private psychiatric clinic will completely preserve the anonymity and social rights of any person.
When establishing a diagnosis and selecting appropriate drug therapy, as well as during exacerbation of schizophrenia, hospitalization is required.
Keep in constant contact with your doctor. If you notice signs of changes in behavior or thinking, tell your doctor immediately.
Make sure you take the prescribed medications regularly.
A patient with schizophrenia must undergo a full course of treatment, including a course of socio-psychological rehabilitation and family psychotherapy.

How to communicate with people with schizophrenia

Patients with schizophrenia usually have a well-developed intellect, but their system of logical constructions, due to mental damage, has a unique character. Such a person understands what you are telling him, but in analyzing and answering your question he relies on his own attitudes, values, or even just a momentary mood.

It is better not to argue with a patient in a state of psychosis or demonstrating delusional symptoms. This is not only useless - you will not be able to convince him of the error of judgment, but also unsafe - you will become his enemy. And then it will be very difficult to establish contact again.

Behavior of a patient with schizophrenia during an exacerbation

Patients with schizophrenia during a relapse of the disease often experience hallucinations, are aggressive, tense and anxious, and have sleep disturbances. Such patients are suspicious in behavior, listen for something, can run away from imaginary enemies, hide, or show hostility and aggression towards those who are considered ill-wishers. Suicide attempts and suicidal thoughts are also possible.

During the period of exacerbation, patients suffering from schizophrenia may leave home, eat almost nothing, express delusional thoughts, and make attempts to protect themselves from “persecution.” Try to arrange a meeting with a psychiatrist for the patient as soon as possible.

Rehabilitation for schizophrenia largely prevents the likelihood of periods of exacerbation of the disease. This preserves the patient's intelligence and cognitive functions.

Speech of a patient with schizophrenia

The statements and speech of patients with schizophrenia directly depend on changes in thinking and the emotional-volitional sphere. Speech becomes grammatically incorrect: neologisms appear - words invented by the patient and devoid of any meaning. Disjointed thinking leads to fragmented speech: despite the apparent orderliness of the words in a phrase, its overall meaning is lost - a lot of words, but nothing about anything, the so-called “verbal hash”.

Violation of phonetic speech is expressed in the placement of incorrect stress in words, unusual intonations in phrases and the replacement of sounds with unusual ones. As the delirium is simplified, speech becomes poorer, and the feeling of communicating with a patient with schizophrenia becomes formal and superficial.

At first, the written expression of the speech function is manifested by its ornateness and fantastic plot, which is then replaced by the stereotypical writing of phrases and numbers with a complete lack of meaning. At the beginning of the disease, handwriting is distinguished by decorations and curlicues, and when the personality is destroyed, it is replaced by simple characters that are not related to each other.

Over time, the speech of patients becomes emotionally colorless, there is no interest in the interlocutor, indifference to the reaction of a stranger.

Rehabilitation for schizophrenia implies that the patient is in the doctor’s field of vision, which allows timely adjustment of drug doses and treatment regimens.

Symptoms of schizophrenia

To understand the characteristics of the mental state of a person suffering from schizophrenia, you need to know the main signs of the disorder. Several syndromes may be hidden behind the varied symptoms of the disease. The famous Swiss psychiatrist E. Bleuler used the plural in his description and called the disease schizophrenia.

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Patients have a different outlook on life, fractured and conditioned by the internal mental processes they experience. And, although in a state of remission it is difficult to distinguish them from healthy people, during an exacerbation it is still possible to identify several obvious signs of the disease.

German pathopsychologist and psychiatrist, K. Schneider indicated the main symptoms characteristic of schizophrenia:

The sound of thoughts, the feeling that others can hear them.
Voices in the head commenting on the patient’s actions and thoughts. And also talking to each other.
Delirium of influence of external forces on a sick person.
Sincere belief that someone is stealing thoughts from his head or, on the contrary, putting them into it.

The reliability of these signs in diagnosing schizophrenia is currently questioned, but they are still taken into account when selecting criteria.

One of the most obvious symptoms of schizophrenia is hallucinations, often lasting several years and occurring in approximately 50% of patients. From the outside, it seems that a person is talking with himself, but in reality - with invisible interlocutors or voices.

Rehabilitation for schizophrenia - how to persuade

The patient is closed in on himself and it is almost impossible to reach his consciousness. He can be distrustful even of close people and is sometimes aggressive. A person relies on his own internal logic and it is not possible to convince him using the usual methods.

If you want to achieve the result of resuming treatment, try to establish contact with the sick person. Stop proving them wrong, putting pressure on them and convincing them. Agree with what you can agree with and ignore the rest. While the patient’s thoughts are chained to his painful experiences, it is impossible to switch him to other ideas. Rely on the symptoms that the patient himself complains about. Ask him whether he wants to improve his sleep, deal with disturbing neighbors, or get rid of anxiety, and continue this line. Call a psychiatrist at home under the guise of a psychologist, police officer or neurologist. Everything else is the task of the specialist himself.

If you want to learn to understand your sick family member, come for a consultation with a psychiatrist-psychotherapist. After preliminary training, it will be much easier to persuade a patient to undergo treatment. Our clinic conducts special classes for relatives of patients with endogenous processes.

When a person in a psychotic state refuses to go for a consultation, invite a doctor to your home, or call a mental health team. If a patient turns to a psychiatrist for the first time, along with calling an ambulance, be on the safe side by calling the police, who have a psychiatrist in their structure, or simply confirm the patient’s antisocial and violent behavior. In this case, hospitalization will be carried out involuntarily, and the person will be registered with the PND for monitoring, since he will need rehabilitation prescribed for schizophrenia.

Do people with schizophrenia recognize their illness?

The peculiarity of mental changes during illness is such that patients are not able to fully understand their illness. Moreover, this diagnosis still has a negative connotation in our society. A patient, even during a period of remission, when criticism partially returns to him, may simply be ashamed of his illness and hide it even from loved ones.

A person can understand what changes occur during an illness, become aware of his illness and learn to cope with it through courses of socio-psychological assistance. The Moscow psychiatric clinic Preobrazhenie has developed a special program of psychotherapeutic assistance for patients with schizophrenia.

Rehabilitation

When receiving a diagnosis of schizophrenia and undergoing treatment, it is necessary to realize that this is a chronic disease.
Now you will have to constantly take maintenance medications to protect against attacks. Under no circumstances should you reduce the dosage prescribed by a psychiatrist or discontinue the drug yourself, even if you feel very well.

In addition, during the period of remission, rehabilitation of the patient is necessary, the goal of which is adaptation to the new state. It involves the participation of loved ones.

Modern trends in psychotherapeutic treatment are based on the following concept. The patient is a holistic person with his own characteristics and views on the world. He has the right to a full life.

The task of a psychotherapist is to relieve symptoms and teach the patient to independently solve life problems, interact with society, and adapt socially. The specialist motivates the schizophrenic to do both, using the following methods:

individual - often in the form of role-playing games, cognitive therapy. The individual is persuaded not to listen to voices, taught how to check the correspondence between reality and sensations, and how to shake off apathy. He gains an understanding of how important it is to take medications and other skills;
family - tactics are developed for relations between the patient and his loved ones, smoothing out emotional tension and tolerance. Relatives must have complete information about the disease, be able to convince the patient to take medications and control this process, etc.;
group – situations that take place in everyday life are modeled, and skills of normal behavior are instilled.

After rehabilitation, a person can continue to work as before, but the load should be reduced. If work skills are lost, you can master another profession that requires performing simple tasks.

Rehabilitation of patients with schizophrenia

individual selection of an antipsychotic and its form of administration (tablets, prolongs);
restoration of the patient’s physical health;
social assistance;
individual and group psychotherapeutic work;
obtaining recommendations for observation, treatment and regimen.

Social and psychological rehabilitation of patients with schizophrenia begins with art therapy - a method that allows, through artistic expression, to understand oneself and restore connection with the world.

Rights of a person with schizophrenia

The dignity and rights of a patient with schizophrenia are protected by the law “on psychiatric care and guarantees of the rights of citizens during its provision” of July 2, 1992 No. 3185-I. Additions to the document are contained in federal laws dated July 21, 1998 N 117-FZ, dated July 25, 2002 N 116-FZ, dated January 10, 2003 N 15-FZ, dated June 29, 2004 N 58-FZ, dated August 22, 2004 N 122- Federal Law, dated 07/27/2010 N 203-FZ, dated 02/07/2011 N 4-FZ, dated 04/06/2011 N 67-FZ, as amended by the Resolution of the Constitutional Court of the Russian Federation dated 02/27/2009 N 4-P.

This legislative act describes how mental state examinations should be carried out, the rights of people with mental pathology, when and for how long disability is granted, and a list of contraindications for professional activities for people with mental illness. It also talks about keeping secret the fact of contacting a psychiatrist, consent and refusal to treatment, and the conditions for providing compulsory medical care.

Consultation with a person is possible only with his consent upon reaching 15 years of age. Up to this age - at the request and consent of the parents or guardian. Also, parents or an adult citizen sign an application to accept or refuse advisory supervision. Dispensary observation is established without the consent of the patient, but can be appealed.

By court order, patients are placed in a psychiatric hospital on an involuntary basis who may cause harm to themselves or others, and also when, without treatment, their health may significantly deteriorate or if it is impossible to satisfy their basic life needs (Article 29, paragraph a, b , V). If the condition of the mentally ill person still remains dangerous, then re-examination takes place every month for six months, and then: once every six months. During an acute state of illness, a person is released from responsibility for the offenses he has committed.

The company provides: any type of psychiatric and psychological assistance, help at home and care for disabled people by social workers, support in training and employment, . Each IPA has a free lawyer who will advise sick people and their relatives on all legal aspects.

The purpose of hospitalization is explained to the patient in a language that he understands. He has the right to contact the head of the department and the chief physician on issues of diagnosis, treatment, discharge from the clinic and regarding violations of his rights provided for by this law. The patient can submit any applications and complaints to all authorities without censorship, as well as meet one-on-one with a lawyer and a priest. Along with other citizens, a person with a mental illness has the right to make purchases, receive education and remuneration for his work. While in the hospital, he can subscribe to periodicals, read any books, send and receive parcels and transfers, use the telephone and receive visitors, and wear his own clothes. There is a special commission made up of people outside the health authorities to protect the rights of patients in psychiatric institutions.

Celebrities with schizophrenia

Contrary to the expression: “genius and insanity,” the percentage of people with schizophrenia among celebrities is no more common than in other environments.

Famous schizophrenics

Vincent Van Gogh - Dutch impressionist artist;
Syd Barrett - musician, founder of Pink Floyd;
Nikolai Vasilyevich Gogol - Russian writer;
John Nash - American mathematician and economist;
Friedrich Wilhelm Nietzsche - German philosopher;
Amanda Bynes is an actress from Los Angeles;
Salvador Dali, a Spanish surrealist painter, suffered from schizotypal disorder.

These people were under the supervision of good doctors. And even at that time, a good doctor could take control of the disease! Nowadays it is much easier to do this, but this requires the experience and knowledge of a specialist. No need to be afraid of illness! Any disease can be treated. And if this disease is taken under control, it can give genius!