Stupor man - This is a literal translation numbness. In psychiatry, stupor is one of the types of motor disorders. Stuporoznoe state is a total immobility in conjunction with mutism (dumbness or absolute rejection of communication) and weakened response to all sorts of stimuli, stimuli. An individual suffering from psychological stupor does not respond to current events, and there are also no reactions to common negative messages, such as pain, noise or cold. Such a patient may not eat for a relatively long period of time, do not talk, and often can even stand in one position.

Stuporoznoe state can become the end result of depression, various mental disorders, serious stress or fright. Often, some stuporous patients lie without changing positions, refusing to eat, not responding to questions, for days or even weeks. Other patients sit or stand, often, as if fossilized in a strange position, wrapped in a blanket with their heads or turned away from the wall, absolutely motionless until they are forcibly transferred to another position.

Causes of stupor

A stupor is a psychopathological disorder, which manifests itself in the form of the suppression of various mental operations, in the first turn, motility, mental activity and speech. Patients who find themselves in this state are characterized by immobility. Left to themselves, the sick individuals are for a long time in one position. On the reversed question phrases, they may either not respond at all, or they will respond, but after a pause, in slow motion, interjections, single 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 delusions, hallucinosis, stupefaction, altered affect. In other situations, more rare, the stuporous state is limited exclusively by motor immobility and speech inhibition. In other words, such a condition is also called an “empty” stupor.

Stupor, which is accompanied by stupefaction called receptor. The stuporous state observed in the conditions of clear consciousness is called lucid or effector.

The main factors provoking the onset of the stuporous state include severe stressful events, stressful situations, mental disorders, emotional negatively colored situations, organically determined damage to brain structures, various bruises or concussions, intoxication, and an infectious disease. However, to this day with one hundred percent probability one cannot argue that the listed list of reasons is complete.

Specialists with a worldwide reputation in the field of psychiatry enter into discussions about the possible causes provoking the development of the disease. So, among the numerous assumptions, several of the most characteristic for the formation and formation of a fixed type of catatonic stupor are distinguished. The deficiency in the brain of gamma-aminobutyric acid, which is its key inhibitory neurotransmitter. The lack of this acid can be the cause, causing violations of the musculoskeletal system. And this is the main symptom of catatonia.
A catatonic stupor may occur due to an unexpected cessation of dopamine production by the body.

In 2004, specialists began to consider the formation of catatonic syndrome as a genetic reaction that occurs in situations of stress or in life-threatening circumstances in animals before meeting with a predator. The whole body is paralyzed as a result of fear, as a result of which the animal's body is retuned for early death. Such a fear reaction at the subconscious level has been preserved in humans and is still manifested in acute exacerbations of psychosomatic diseases or intense bouts of schizophrenia.

Catatonic stupor, according to this assumption, is expressed in the characteristic reaction of individuals to the inevitable death, which has been haunting him since the onset of the illness. 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 are not in contact with the environment, they have not observed reactions to current events or uncomfortable conditions, various inconveniences (for example, noise, dirty bed).

Patients in a stupor may not move, even in case of fire, earthquake, or other natural disasters. They often lie, without changing position, musculature is in good shape. Typically, tension begins with the masticatory muscles, then falls to the cervical region, and later it is distributed along the back, arms and legs. In this state, the emotional and pupillary response to pain is absent.

The symptoms of stupor include: clouding of consciousness, absolute immobility, partial or complete silence (mutism), increased muscle tone, negativity, depression of reflex reactions, lack of verbal communication with others and response to external stimuli.

To fall into a stupor of an emotional nature is more characteristic of the female part of the population. Emotional stupor often occurs due to intense spiritual upheavals (for example, experienced horror or grief). It is characterized by blocking of motor activity and emotional-affective activity, besides this, the mental function also slows down. Such an attack, in most cases, passes without specific treatment, but sometimes can lead to a state of panic, during which the patient will seek to perform actions of a chaotic orientation. The consequence of this may be the onset of depression.

Stuporous state of this type can be observed in women who have witnessed some kind of disaster or accident. There may also be a stupor in children as a result of examinations or during a battle with soldiers.

Depressive stupor peculiar to the same extent and the female part of the population and a strong half of humanity. It arises against the background of deep depression and, as a rule, is accompanied by a hunched posture, a grimace of suffering on the subjects' faces, and a lowered look. Patients in this condition may respond to question statements with a monosyllabic phrase in a whisper. This variation of the stuporous state can be observed for a couple of hours, and sometimes weeks. People in this condition may refuse to eat.

Excessively perceptive, emotional, vulnerable people and creative personalities characterized by subtle inner organization are characterized by mental stupor. It is expressed in the form of apathy, laziness, longing, creative crisis, inability to think, feel and inability to act differently. In this condition, a kind of spiritual "ossification" begins.

Hysterical stupor often occurs in overly emotional women. It usually manifests itself as an affective impermanence, the cause of which may be a changed environment. This type of stuporous state in difficult conditions that threaten the health, life or well-being of a woman can be a defensive reaction. It can manifest itself either in absolute immobility, or in active emotionality and psychomotor agitation. Patients suffering from this type of stupor are characterized by enhanced facial expressions. So, for example, patients can senselessly goggle eyes, grimace, cry.

Apathetic stupor manifests itself in passivity and immobility, the absence of aspirations and interests.

Types of stupor

There are several types of stupor: negativistic, depressive, apathetic and catatonic, as well as stuporous state with waxy flexibility or muscular stupor.

A negative stupor is expressed in mutuality and absolute immobility, but at the same time any action aimed at changing the patient's posture provokes a sharp opposition and resistance. It is not easy to lift a sick individual out of bed, but then, lifting him up, it is impossible to lay him down again. Often, an active is added to the passive resistance. For example, if a doctor extends a hand to a patient, he, in his turn, hides behind his back, when asked to open his eyes, he squints his eyes, etc.

In the depressed stuporous state, almost complete immobility is characteristic, along with depressive facial expressions and a pained grimace. When you can contact them, you can get a monosyllabic response statement.

A depressive stupor in a person can suddenly be replaced by an agitated state in which patients jump up and hurt themselves, can injure themselves or roll on the floor with a howl (melancholic raptus). In severe endogenous depressions, a depressive stupor may occur.

Patients suffering from apathetic stupor, as a rule, lie on his back. They also have no response to what is happening around, and the muscle tone is reduced. They answer in monosyllables on questions and with a big delay. However, while interacting with relatives, there is an adequate emotional reaction. There is a disturbance of sleep and anorexia. Often in bed are untidy. Catatonic stupor is a kind of freezing in fear, a stupor in fear and helplessness, along with the terrible suffering of the inner "I". Patients with catatonia, sometimes, do not understand whether they are still alive, whether they are capable of producing actions, they are not sure of the integrity of their own personality. Therefore, everything that can lead to the re-creation of authenticity of the I-experience will play a therapeutic role for the patient.

For example, with the loss of I-identity, sometimes it is enough just to contact by name to improve the patient’s condition. How to get out of stupor? In severe illness, a purely verbal therapeutic approach is often insufficient. Other types of catatonic stupor occur when busy delusional experiences, for example, when the individual is in a state of ecstasy.

In the stuporous state with waxy flexibility, in addition to mutism and immobility, the patient holds the dowry position for a long time. For example, freezes with a raised hand or freezes in an uncomfortable position. The presence of Pavlov’s symptom is often noted, which consists in the patients ’lack of response to question phrases set in a normal voice, but at the same time responding to a whisper. At nights, sick individuals can walk, sometimes eat and contact with their surroundings.

Stuporous state with muscular stupor is the presence in the fetal position. In such patients, the muscles are strained, eyes closed, lips stretched forward. Often, individuals suffering from this type of stupor have to be fed through the probe, as they refuse to eat. Often, doctors perform amitalkofein rastormazhivanie, and after the muscular numbness weakens or disappears, feed the patients.

Stupor treatment

Many people are concerned about the question: "how to get out of the stupor"? Naturally, only specialists - psychotherapists and psychologists can help in this. However, one should still know how to help a loved one or someone in the environment, if there are noticeable 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, massage of special points located exactly in the middle above the pupils, equidistant from eyebrows and hairline, will help relieve tension. Massage these points should be using the pads of the index finger and thumb. In addition, it is recommended to try to provoke strong emotions in an individual in a stuporized state, whether positive or negative (better than negative). For example, you can slap.

Bending the individual fingers and pressing them firmly against the palms can help to get out of the stupor, while the big fingers remain straight. So, the answer to the question: "how to get out of stupor," is hidden in the emotional shake-up of the body and the synchronization of the breathing of the sufferer with the subject helping 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 rate.

In a stupor, emergency care is limited to ensuring the safety of subjects and the prevention of dangerous acts on their part. For example, in the case of a catatonic stuporous state, emergency care will consist in the readiness to stop unexpected impulsive agitation.

When a depressive stupor - preventing the likelihood of unexpected development of depressive arousal with a focus on suicide, as well as the elimination of the refusal of food. In addition, we must bear in mind that the stupor may suddenly be replaced by excitement.

Treatment often occurs in stationary conditions. Use barbamil-caffeine liberation. Thanks to which it is possible to detect the features of the patient's experiences and anxieties, which helps to determine the nature of the stuporous state. Such a disinhibition is also a therapeutic method that helps with a steady rejection of food.

Stuporoznoe condition arising on the background of severe somatic ailments, requires treatment of the underlying disease.

When stupor accompanied by hallucinations and delusions use Stelazin, Trisedal as well as in the treatment of hallucinatory and delusional states. In the depressed stuporous state, disinhibition is also performed and Melipramine is used up to 300 mg per day orally or intramuscularly. When psychogenic stuporous state - Diazepam up to 30 mg per day orally or intramuscularly, Elennium or Fenazepam.

Catatonic stupor

Psychopathological syndrome, the main manifestation of which are disorders of motor orientation, called catatonic stupor.

The catatonic stupor was first described by Calbaum as an independent mental illness, subsequently Kraepelin was attributed to schizophrenia. Catatonic stupor is a form of schizophrenia characterized by psychomotor disorders. Such a stuporous state may have a duration of several months, and for a more serious course, several years. It manifests itself in the preservation by the subject of an uncomfortable, unnatural posture over a rather long period and mutism. At the same time being in a similar position, the person does not feel fatigue. Stuporous state may be accompanied by increased plastic tone or extreme tension of the whole musculature.

Catatonic stupor is a form of schizophrenia characterized by a state in which individuals refuse food, defecate by themselves. However, their consciousness is preserved, as a result of which the patients, having recovered, can describe in detail the incidents that occurred during a stupor around them.

At the beginning of the twentieth century, catatonic syndrome was considered primarily as a subspecies of schizophrenia. Today, catatonia is understood as a syndrome that develops in affective and other mental disorders, somatic ailments, and poisonings. Catatonic syndrome is the alternation of stupor with periods of catatonic arousal.

Catatonic stupor is expressed in motor inhibition, mutism, muscle hypertonus. In the clamped state, patients can sometimes even stay for several months. In this state, all forms of activity are violated, including the instinctive one. The following types of catatonic stupor are distinguished: with wax flexibility, negativistic and with stupor.

Catatonic stupor often develops as a manifestation of catatonic syndrome. Being in a stuporous state, patients do not contact with the environment, they do not have a response to occurring phenomena or various inconveniences (for example, a wet bed). They completely refuse to eat, they have no pupil dilation in response to pain.

Patients suffering from catatonic stupor, first fall silent, can repeat phrases uttered by another individual (echolalia) or not answer questions at all, but still produce the necessary everyday (everyday) actions. Then they stop moving, freeze in a strange position, for example, resembling the fetal position in the womb of the mother (catalepsy), remain in a position, a dowry upon examination, show negativity.

Against this background, short-term excited states may occur, other psychopathological manifestations are also found: delusions of persecution, auditory hallucinations. Могут наблюдаться импульсивные действия, которые проявляются в виде внезапной агрессивности в отношении окружения.

Motor inhibition occurs in combination with vegetative manifestations: bluish color of the limbs (acrocyanosis), their cooling, increased sweating, along with slowing the pulse. A thorough examination of the internal organs of the catatonica often does not reveal changes that would indicate the presence of a disease of the body.

A sign of catatonic stupor is considered a symptom of "airbag". It is a long stay of the patient in a position with a raised head (the head is located at a distance of about 15 cm from the pillow). In this case, such a patient lies either on the side or on the back. If the patient is pressed on the head, then it will drop, but after some time, will return to its original position. This situation can persist for hours and disappears after the onset of sleep.