Inhibited state of cause. Causes, symptoms and treatment of endogenous depression. How does apathy manifest itself?

It should be said that in most situations these disruptions are temporary and can be explained by natural factors: fatigue or nervous exhaustion. However, there are cases when the awkwardness of movements, inhibition of thinking and the mental sphere - pathological process, the causes of which must be promptly identified and appropriate therapy selected.

Features of bradypsychia

Pathological inhibition of thinking is called bradypsychia. This phenomenon has no parallels with apathy or inertia of thinking, but suggests mental and pathophysiological disorders.

Bradypsychia is considered as a kind of neurological symptomatology, which in most cases develops in people in old age. But sometimes people at a young age, as well as children, experience inhibition in their thinking processes.

Poverty and insufficiency of mental processes is a symptom of many psychological or physiological pathological processes, manifested as a decrease in reaction speed, slow speech, slow thinking and motor activity. In difficult situations, the individual is not able to react to what is happening and remains for a long time in an apathetic state or stupor. The following types of inhibition are distinguished:

Thought processing can be impaired at any age

Retardation also occurs in speech and thought, which has psychological factors. Weak and involuntary movements can cause motor retardation. Memory problems and failures appear. In many cases, such conditions are provoked by a neurological disease, constant fatigue, or psychological pathological processes.

Slowness of movements and emotional inhibition is a pathological process, the causes of which only specialists can detect. They also recommend proper therapy.

Associated disorders

Bradypsychia is the result of damage to the central nervous system, responsible for brain activity. Depending on the element of the lesion, different types of disorders develop. These include:

bradybasia - slow walking;

Bradykinesia is characteristic of parkinsonism

When bradypsychia is a consequence of Parkinson's disease, it is necessary to focus on the symptoms of the underlying pathological process. These include feelings of fatigue, anxiety, sleep disorders, etc.

Provoking factors and diseases

The pathophysiology is very complex and not fully understood. It is only known that thinking, behavior, emotional component and other functions of the human brain are associated with the activity of the limbic system. In everyday practice, only conditions are identified - diseases, during which bradypsychia and accompanying deviations are observed:

Vascular diseases of the brain. Acute, often chronic disorders of blood flow in the brain, which arise due to progressive atherosclerosis, hypertension, embolism and vascular thrombosis, are a factor in the destruction of substances in the brain. The structures that are responsible for quick thinking are also susceptible to disruption.
Parkinson's disease. A common cause, the characteristic manifestation of which is slow thinking. In addition to such depressing symptoms (patients at a late stage of development of this pathological process do not tend to notice any changes), there are a large number of other unpleasant manifestations. For example, thoughts will become not only slow, but also viscous; the patient will be characterized by importunity and slow, confused speech.
Epilepsy. At a late stage in the development of the disease, when experts observe the destruction of personality as a result of a progressive disease, inhibition may be noted, as well as other symptoms of altered thinking.
Schizophrenia. As during epilepsy, bradypsychia is not considered in schizophrenia initial symptom pathological processes, but develops gradually over time.
Depression. Mental illness, which is characterized by a large number of symptoms, often disguised as somatic complications - including toothache or ischemia. These also include sluggish thinking.
Hypothyroidism. Improper functioning of the thyroid gland. With this disease, the symptoms are extremely pronounced and are one of the first to occur.
Toxic lesions. This subgroup of diseases in international classification does not exist. However, the term best describes the causes of painful symptoms - intoxication of the body.

The short-term effect of lethargy appears after lack of sleep, due to exhaustion of the body, or as a result of the use of drugs and alcohol that inhibit thinking and movement. The reasons can be divided into those that block brain activity and those that reduce the possibilities for its implementation.

Naturally, with such an abundance of provoking diseases, treatment can also be different.

What does it look like?

The image of a “inhibited” patient falls under the typical characteristics of a melancholic person: weakness, slowness, drawn-out speech, every word is pronounced with effort.

There may be a feeling that the thought process takes a large amount of strength and energy from a person who does not have time to react to information or is completely plunged into a stupor.

In addition to a decrease in the speed of speech and thought processes, muffled words are observed - a very quiet and calm voice, sometimes breaking the silence. Weakness is visible in movement and facial expressions; posture is often too relaxed.

A person has a desire to constantly find support or lie down.

Not all symptoms are always observed. Just one thing is enough to recommend a person to seek medical help from specialists.

Diagnostic criteria and methods

People with speech rate disorders, including bradyllalia, need comprehensive medical, psychological and pedagogical diagnostics carried out by a specialized specialist. During the examination, the patient’s medical history should be studied in detail, which concerns previous illnesses and brain lesions, as well as the presence of disturbances in the rate of speech in relatives.

In certain situations, in order to find out the organic basis of the disease, it is necessary to conduct instrumental studies, including:

Study oral speech implies an assessment of the structure of the organs of articulation and the state of motor skills, expressive speech (pronunciation of sounds, syllables, words, tempo-rhythmic side, voice characteristics, etc.). Diagnostics of written speech involves performing tasks such as copying text, writing from dictation, and reading. In addition to a diagnostic examination of speech function, a study is carried out general condition, manual motor skills, sensory functions, intelligence.

When making a diagnosis, it is necessary to differentiate this disease from dysarthria and stuttering.

What does modern medicine offer?

To carry out proper treatment of the disease, you must first consult with a specialist. He will recommend effective treatment, and will also warn about the presence of contraindications to the use of certain methods of therapy or any medication.

The following methods of therapeutic and preventive action are used more often than others:

Activation of thinking processes. For these purposes, you need to read new books, study foreign languages, engage in the creative process or solve various puzzles. This technique helps train the brain and activate thinking.
Neuroprotectors and nootropics are prescribed. Drug therapy that is aimed at restoring and strengthening nerve cells and tissues.
Treatment vascular pathologies. Products are used that make it possible to cleanse the vascular walls, which is necessary for proper brain function. As a result, mental and physical activity is activated.
Psychotherapy. She acts as an auxiliary drug therapy. Modern healing techniques contribute to counteracting the effects of stress, adjusting personality assessment, and forming the necessary models of response to specific situations.
Sports activities and walks fresh air. Moderate physical stress and walks give the brain the opportunity to rest and the nerve cells to recover thanks to the influx of oxygen.

If emotional and mental retardation is caused by tranquilizers, then discontinuation of any drugs is required. In most cases, reactions recover over time.

Summing up

The prognosis is relatively favorable with an early start of correction and the presence of psychological causes of disorders of motor activity and speech motor skills. However, after regaining your skills, you should be observed by doctors for a long time and constantly independently monitor your movements and train of thoughts.

As preventive measures, damage to the central nervous system should be prevented, head injuries should be avoided, and asthenic syndrome should be detected in time.

Pathological inhibition of thinking involves various mental and pathophysiological disorders. This phenomenon should be qualified as a symptom that in most situations occurs in older people. But in certain cases, such a problem can manifest itself in childhood and among young people.

If you notice that your thinking processes are slow, you should immediately seek advice from a doctor. It is likely that this condition is the result of dangerous disruptions in the functioning of the central nervous system and requires special correction.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

Lethargy

Lethargy is a symptom of certain diseases, usually of the central nervous system and brain, or a consequence of severe psycho-emotional shock. This state of a person is characterized by the fact that he has a decrease in the speed of reaction to actions addressed to him or performed by himself, a deterioration in concentration, more extended, with long pauses in speech. In more complex cases there may be complete absence reactions to surrounding events.

This state of a person should not be confused with apathy or a chronic depressive state, since the latter is more likely psychological factor rather than physiological.

The true causes of lethargy can only be determined by a qualified doctor. It is strongly not recommended to carry out treatment at your own discretion or ignore such a symptom, as this can lead to serious complications, including irreversible pathological processes.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

under alcohol or drug intoxication;
with chronic fatigue and constant lack of sleep;
with frequent nervous tension, stress, chronic depression;
under circumstances that cause a person to feel fear, anxiety and panic;
with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

Depending on the underlying factor, this condition in a child can be temporary or chronic. It goes without saying that if such a symptom appears in children, you should immediately consult a doctor, since the cause of the pathology can be dangerous to the baby’s health.

Classification

Distinguish the following types lethargy according to the clinical picture:

bradypsychia – inhibition of thinking;
mental or ideational inhibition;
motor or movement retardation;
emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are damaged, the following clinical picture may be present:

drowsiness (hypersomnia), lethargy;
headaches, which will intensify as the pathological process worsens. In more complex cases, elimination pain syndrome impossible even with painkillers;
memory impairment;
decreased quality of cognitive abilities;
the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
illogical perception of speech or actions addressed to him;
speech becomes slow, the patient may have difficulty finding words;
nausea and vomiting, which is most often observed in the morning;
impaired coordination of movements;
unstable blood pressure;
rapid pulse;
dizziness.

In a child, the general clinical picture with this kind of pathology may be complemented by moodiness, constant crying or, on the contrary, constant drowsiness and apathy for usual favorite activities.

It should be noted that the above-described symptoms are also observed after a stroke. If you suspect that a person is having a seizure, you should call emergency medical attention and rush them to hospital. It is from the urgency and coherence of the primary medical events After a stroke, it largely depends on whether a person survives or not.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

insomnia or drowsiness, which is replaced by an apathetic state;
unreasonable attacks of aggression;
sudden change in mood;
causeless attacks of fear, panic;
suicidal mood, in some cases, actions in this direction;
state of chronic depression;
visual or auditory hallucinations;
nonsense, illogical judgments;
neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
excessive suspicion, the feeling that he is being watched;
deterioration or total loss memory;
incoherent speech, inability to express one’s point of view or specifically answer simple questions;
loss of temporal and spatial orientation;
feeling of constant fatigue.

You need to understand that this human condition can progress quickly. Even if the patient’s condition improves temporarily, it cannot be said that the disease has been completely eliminated. In addition, such a person’s condition is extremely dangerous both for him and for the people around him. Therefore, treatment under the guidance of a specialized doctor and in an appropriate institution is, in some cases, mandatory.

Diagnostics

First of all, a physical examination of the patient is carried out. In most cases, this should be done with a person close to the patient, since due to his condition he is unlikely to be able to answer the doctor’s questions correctly.

In this case, you may need to consult the following specialists:

Diagnostic measures include:

general clinical lab tests(blood and urine examination);
study of the level of pituitary hormones;
CT and MRI of the brain;
EEG and Echo-EG;
cerebral angiography;
psychiatric tests.

Depending on the diagnosis, the issue of hospitalization of the patient and further treatment tactics will be decided.

Treatment

In this case, the treatment program can be based on both conservative and radical treatment methods.

If the cause of such a person’s condition is a tumor of the brain or central nervous system, then an operation is performed to excise it, followed by drug treatment and rehabilitation. The patient will also need rehabilitation after a stroke.

Drug therapy may include the following drugs:

painkillers;
sedatives;
antibiotics if the disease is of an infectious nature;
nootropic;
antidepressants;
tranquilizers;
drugs that restore glucose levels;
vitamin and mineral complex, which is selected individually.

In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

Subject to timely and correct start therapeutic activities, their complete implementation, almost complete recovery is possible even after serious illnesses– oncology, stroke, psychiatric illnesses.

Prevention

Unfortunately, there are no specific prevention methods. You should follow a rest and work schedule, protect yourself from nervous experiences and stress, and begin treatment for all diseases in a timely manner.

“Retardation” is observed in diseases:

Alalia is a speech function disorder in which the child cannot speak partially (with a poor vocabulary and problems in constructing phrases) or completely. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received in early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Apathy is a mental disorder in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This state very often comes into a person’s life unnoticed, since it does not manifest itself. pain symptoms- a person may simply not notice deviations in mood, since absolutely anyone can be the cause of apathy life process, and most often a combination of them.

Status asthmaticus – prolonged attack bronchial asthma, due to the progression of which severe respiratory failure occurs. This pathological condition develops as a result of swelling of the bronchial mucosa, as well as spasms of their muscles. In this case, it is not possible to relieve an attack by taking an increased dose of bronchodilators, which, as a rule, are already taken by a patient with asthma. Status asthmaticus is a very dangerous condition that can lead to the death of the patient, so it requires emergency medical attention.

Affective disorders (syn. mood swings) are not a separate disease, but a group of pathological conditions that are associated with a violation of the internal experiences and external expression of a person’s mood. Such changes can lead to maladjustment.

Bacterial endocarditis is an inflammatory process in the inner lining of the heart caused by the influence of pathological microorganisms, the main one of which is streptococcus. Often, endocarditis is a secondary manifestation that develops against the background of other diseases, but it is bacterial damage to the membrane that is an independent disorder. It affects people of any age group, which is why endocarditis is often diagnosed in children. A distinctive feature is that men suffer from this disease several times more often than women.

All over the world, many people suffer from a disorder called bipolar disorder. The disease is characterized by frequent mood swings, and a person’s mood changes not from bad to good, but from extremely depressed and sad, to a feeling of euphoria and the ability to perform feats. In short, mood swings in patients with bipolar disorder colossal, which is always noticeable to others, especially if such fluctuations are frequent.

Legionnaires' disease or legionellosis is bacterial infection, which most often appears in the form severe form pneumonia. A characteristic expression of the disease is intoxication and dysfunction of the central nervous system and kidneys. Sometimes, during illness, damage to the respiratory and urinary systems occurs.

Acute intestinal infection caused by a bacterial environment and characterized by the duration of fever and general intoxication of the body is called typhoid fever. This disease is a severe ailment, as a result of which the main area of damage is the gastrointestinal tract, and when it worsens, the spleen, liver and blood vessels are affected.

Hypernatremia is a disease characterized by an increase in serum sodium levels to 145 mmol/L or higher. In addition, a reduced fluid content in the body is detected. The pathology has a fairly high mortality rate.

Hypersomnia is a sleep disorder characterized by increased rest periods and daytime sleepiness. In this case, the duration of sleep is more than ten hours. It rarely occurs as an independent disorder - it is often a complication of certain diseases. After a long sleep, there is no improvement in the general condition, but there is constant drowsiness and problems waking up.

Hypertensive crisis is a syndrome in which there is a significant increase in blood pressure. In this case, symptoms of damage to the main organs develop - the heart, lungs, brain, etc. This condition is very serious and requires emergency care, as otherwise serious complications may develop.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is quite dangerous look diseases caused by human passivity and depression.

Diabetic coma is an extremely dangerous condition that develops against the background of diabetes mellitus. If it progresses, metabolic processes in the human body are disrupted. This condition threatens not only the health, but also the life of the patient.

Cardiogenic shock is a pathological process when a failure occurs contractile function left ventricle, blood supply to tissues and internal organs deteriorates, which often ends in human death.

Ketoacidosis is a dangerous complication of diabetes mellitus, which, without adequate and timely treatment can lead to diabetic coma or even death. The condition begins to progress when the human body cannot fully use glucose as an energy source because it lacks the hormone insulin. In this case, it is activated compensatory mechanism, and the body begins to use incoming fats as an energy source.

Tick-borne encephalitis is a severe infectious disease that is transmitted to humans from encephalitis ticks. The virus makes its way into the brain and spinal cord adult or child, causes severe intoxication and affects the central nervous system. Severe encephalitic forms without timely treatment can lead to paralysis, mental disorders and even death. How to recognize the symptoms of a dangerous pathology, what to do if you suspect a tick-borne infection, and what is the importance of vaccination in the prevention and treatment of a deadly disease?

False croup is a pathology of an infectious-allergic nature, causing the development of laryngeal edema with subsequent stenosis. Narrowing of the airways, including the larynx, leads to insufficient air supply to the lungs and poses a threat to the patient’s life, so help in this condition should be provided immediately - within minutes after the attack.

Waldenström's macroglobulinemia (syn. primary macroglobulinemia, macroglobulinemic reticulosis) is extremely rare disease, at which in bone marrow a tumor consisting of lymphocytic and plasmacytic cells is formed.

Metabolic acidosis is a pathological condition characterized by a violation acid-base balance in blood. The disease develops against the background of poor oxidation of organic acids or their insufficient removal from human body.

Myxedema is the most severe form of hypothyroidism, which is characterized by the development of skin edema and subcutaneous tissue. The pathology begins to progress in the human body as a result of insufficient secretion of thyroid hormones. Women are most often susceptible to this disease during the period of hormonal changes, that is, during menopause.

Cerebral edema is a dangerous condition characterized by excessive accumulation of exudate in the tissues of the organ. As a result, its volume gradually increases and increases intracranial pressure. All this leads to disruption of blood circulation in the organ and to the death of its cells.

Quincke's edema is usually defined as an allergic condition, expressed in its rather acute manifestations. It is characterized by the occurrence of severe swelling of the skin and mucous membranes. Somewhat less frequently, this condition manifests itself in the joints, internal organs and meninges. As a rule, Quincke's edema, the symptoms of which can appear in almost any person, occurs in patients suffering from allergies.

A disease that is characterized by the formation of pulmonary insufficiency, presented in the form of a massive release of transudate from the capillaries into the pulmonary cavity and ultimately promoting infiltration of the alveoli, is called pulmonary edema. In simple terms, pulmonary edema is a situation where fluid stagnates in the lungs and has leaked through the blood vessels. The disease is characterized as an independent symptom and can develop on the basis of other serious ailments of the body.

Pancreatic necrosis of the pancreas is a dangerous and severe pathology in which the organ itself begins to actively digest its own cells. This, in turn, leads to certain areas of the gland becoming necrotic. This pathological process can provoke the progression of a purulent abscess. Pancreatic necrosis also negatively affects the functioning of other vital organs. If timely and complete treatment is not carried out, this disease often leads to the death of the patient.

Overwork is a condition that not only adults, but also children often face today. It is characterized by decreased activity, drowsiness, impaired attention and irritability. Moreover, many people believe that overwork is not a serious problem, and that it is enough to get a good night’s sleep for it to go away. In fact, it is impossible to get rid of such a disorder by sleeping for a long time. It's the other way around - constant desire sleep and the inability to recover after sleep are the main symptoms of fatigue.

Hepatic encephalopathy is a disease characterized by a pathological process that occurs in the liver and affects the central nervous system. The result of this disease is neuropsychiatric disorders. This disease is characterized by personality changes, depression and intellectual impairment. You won’t be able to cope with hepatic encephalopathy on your own; you can’t do it without medical intervention.

Multiple organ failure is a severe pathological process that occurs as a result of severe injury, severe blood loss or any other condition. In this case, we are talking about disruption or complete cessation of the functioning of several systems of the human body at the same time. In 80% of cases, death occurs if the necessary medical measures are not taken in a timely manner to normalize the functioning of the organs. This high mortality rate is due to the fact that damage to systems or organs occurs at such a level that the ability to maintain the life of the body is lost.

A disease characterized by inflammation of the joints due to infectious diseases of various organs and systems is called reactive arthritis. Often, inflammation of the joints occurs due to infection of the genital organs, urinary system, or even the gastrointestinal tract. After the body is infected with infections, the development of reactive arthritis may be observed in the second to fourth week.

Itsenko-Cushing syndrome is a pathological process, the formation of which is influenced by high levels of glucocorticoid hormones. The main one is cortisol. Therapy for the disease should be comprehensive and aimed at stopping the cause that contributes to the development of the disease.

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With help physical exercise and abstinence most of people can do without medicine.

Symptoms and treatment of human diseases

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Questions and suggestions:

Lethargy is a pathological condition that is a symptom of physiological or mental illness. Manifested by such signs as: reduced human reaction; extended speech; slow flow of thoughts and movements. Sometimes the patient may involuntarily ignore the world around him and remain in a state of stupor for a long time.

When thinking is impaired, this symptom is called ideation, and if it manifests itself in speech, then motor.

Inhibited behavioral reactions of a person, as well as all mental processes occurring in the body, can be provoked for various reasons: diseases of various nature; ; the action of tranquilizers that cause such a reaction; stressful conditions; and sadness.

In medicine, this condition is noted as bradypsychia (many mistakenly assume apathy). However, this is a different disease with different mental and pathophysiological basis. Bradypsychia is often diagnosed in older people. But, it also occurs in young people, and there are reasons for this.

Etiology and classification

To date, the reasons for its appearance have not been fully studied. Disturbances in behavior, thinking and psychological states can occur in various brain diseases. In some patients, this manifests itself due to disorders in the nervous system. That's why the following diseases are indicated as reasons.

Diseases of the blood vessels: acute or chronic pathologies of cerebral blood flow with atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head. Such diseases affect the parts of the brain responsible for the speed of thinking.

The specialist conducts and prescribes the following examination:

visual examination of the patient;
collection of anamnesis of the disease (carried out to clarify the brain injuries received, neuroinfections suffered and to find out about the presence of such pathology in the patient’s closest relatives);
laboratory blood and urine tests;
identifying the level of pituitary hormones;
cerebral angiography;
psychiatric tests;
electroencephalography;
rheoencephalography;
positron emission tomography;
magnetic resonance imaging of the brain;
lumbar puncture and many other methods.

Diagnosis of speech changes is carried out by assessing the structure of the organs of voice formation and speech production.

The letter is checked by copying the text, writing a dictation and reading. In addition, the patient’s manual motor skills, sensory abilities and intellectual development are studied.

Before making a diagnosis, you should differential diagnosis, the difference between inhibition and stuttering and dysarthria.

Depending on the cause of this condition, the doctor will decide on the method of therapy and hospitalization of the patient.

Treatment

Therapy for this pathology is carried out using conservative treatment and radical measures.

Radical refers to surgery if such a patient has a tumor of the brain or nervous system. During treatment, removal is carried out followed by appointment medicines. Afterwards, the patient undergoes rehabilitation.

The following medications are prescribed to him:

painkillers;
sedatives;
antibiotics in the treatment of an infectious disease;
nootropic;
antidepressants;
tranquilizers;
means for restoring glucose levels;
complex of vitamins and minerals (selected individually).

Psychotherapy is carried out as an addition to drug treatment. Modern methods Such therapy will help to establish the true cause of inhibition. The doctor forms new behavior for the patient during stressful situations, and also corrects the personal assessment.

Self-medication is strictly prohibited, so as not to aggravate an already difficult situation. Before visiting a psychotherapist, you can apply preventive measures. All drug prescriptions and dosages should be performed only by a qualified specialist. Therefore, you should definitely consult a doctor for medical help.

If the patient fully follows all the doctor’s recommendations and prescriptions, provided that the treatment was started in a timely manner and correctly selected, then his full recovery is possible.

If necessary, take medications to reduce it. If the phenomenon appears after taking strong sedatives, then it must be stopped by stopping their use. In this case, the inhibition will go away without a trace and all reactions will be restored.

Prognosis and prevention

The prognosis for this condition will be favorable if it was diagnosed in the early stages of development, and if correction of the condition was started in time.

As a preventive measure, the main thing is to prevent damage to the central nervous system during puberty. The same applies to head injuries, infectious diseases and asthenic syndrome. It is important that the child learns to speak correctly, and for this, role models are needed.

The main thing to remember is that the work of the brain depends on its workload. Unused cells die off because they are no longer needed. Because of this, naturally, the “reserves” of the psyche decrease. Throughout his life he must be loaded with work. For example: learn a new language, master science.

In addition, you should adhere to a work-rest regime, avoid stressful situations and nervous tension, carry out timely treatment of diseases of various nature.

35 years .

Education:1975-1982, 1MMI, san-gig, highest qualification, infectious disease doctor.

Science degree: doctor of the highest category, candidate of medical sciences.

Such a cardinal symptom as psychomotor retardation, found in our material in the majority of patients, and in circular patients with schizophrenic and reactive depression this can sometimes be shown as clearly as in adult patients. But with epilepsy and in some cases of non-circular schizophrenia, lethargy gives way to great agitation. This latter has nothing to do with the elements of mania and leads its way from great internal anxiety, extreme tension, which finds no other way out than motor discharges and disinhibition. Patients in a state of infectious and post-infectious depression do not show much inhibition either. If at first, due to physical weakness, one sees lethargy and passivity, then later, despite the general asthenic-depressive background, patients do not show inhibition; they do not feel any physical difficulty in acting.

IV. Fears

Fear manifests itself differently and, apparently, has a different origin in one or another painful form. It is quite clear that with reactive depression, fear usually has a psychological Tenesis. Often fear is associated with an experience that served as a source mental trauma.

Fear in schizophrenia or manic-depressive psychosis has a completely different character. This fear is completely unaccountable, unreasonable, coming “from within”, and cannot be explained. We always get the impression that such amorphous fear arises physiologically. We have not had such vivid cases of vital fear associated and localized with a specific part of the body. However, its complete lack of accountability and colorlessness, its appearance in connection with severe somatic sensations, indicate the vitality of this feeling. Sometimes fear arises in children as a primitive defensive reaction.

V. Course of the disease

Consideration of the course of the disease further strengthens our understanding of the differences between individual depressive syndromes. In manic-depressive psychosis and circular schizophrenia we have a phasic course, and in epilepsy it is often paroxysmal. In infections and reactive conditions, the course of depression depends on the pathogenic causal factors: mental and physical (exhaustion).

And infectious dysthymia has an unequal course, which is determined by the pace and intensity of the underlying disease, acute or chronic.

VI. The role of personality

A number of authors distinguish two types of depression - endogenous, or vital, and reactive. K. Schneider attributes additional symptoms of vital depression to personality characteristics. The dejected-sad background of depression is conveyed by syntonic properties, irritated-dissatisfied - by schizoid components.

Analysis of the clinical picture indeed confirms the presence of two depressive forms - endogenous and reactive. However, endogenous depression is by no means uniform, but has different pathogenesis. And constitutional data cannot yet explain the entire diversity of depressive states.

If the question concerns infectious conditions, then the importance of the constitutional factor is small. The psychopathological picture in these cases is quite monotonous, as is the course, and yet the premorbid background is different. Consequently, the role of the individual is small compared to the significance of the infectious-toxic moment.

In epilepsy, these relationships are much more difficult to trace. Epileptic mood disorders are difficult to associate with any premorbid personality characteristics. With great right, the psychopathological picture of epileptic depression and the features of its course, as well as its genesis, can be attributed to the features of the process itself.

We get clearer connections with premorbid characteristics in manic-depressive psychosis and circular schizophrenia. Constitutional data define here

phasic course, isolated manic attacks. The openness and accessibility that are characteristic of circular depressions also depend, perhaps, on the premorbid syntonic character.

As for reactive depression, the material reviewed allows us to join those who believe that reactive mood disorders can appear on a different constitutional basis. However, depressive reactions in children are favored by elements of instability, affective lability, sensitivity, and vulnerability in the patient’s personality.

Summarizing our clinical data, we can say with some probability that the mechanisms of depression are not the same in different nosological forms. True, our knowledge regarding the pathogenesis of depressive states is still very limited. A number of researchers have discovered endocrine and metabolic disorders in endogenous depression. This includes changes in the activity of the pituitary gland, gas exchange disorders, etc. (Omorokov, Bondarev, Chalisov, Ewald, etc.).

The data that is available modern science, lead us to assume that changes in emotional life are most associated with disorders of the endocrine-vegetative sphere, which has a predominant localization in the subcortical zone (thalamic and hypothalamic regions).

In conclusion, it is necessary to answer in advance the reproach that can be made regarding the fact that the question of pathogenesis cannot be completely resolved on the basis of one clinic. Of course, comprehensive laboratory examination in accordance with possible anatomical findings will help to finally clarify the issue. However, with the current level of our knowledge clinical trial is one of the most important ways to resolve this issue, which has not been sufficiently developed in a child psychiatric clinic.

Let's move on to the second part of the final chapter - to features of childhood depression.

The key to understanding these features lies in the anatomical, physiological and mental uniqueness of children.

The fact that the cerebral cortex finally develops in the extrauterine period, while the subcortical centers are formed at the time of birth, does not go unnoticed. For a long time, the relatively greater importance of the activity of the subcortical zone and the physiological weakness of delays have been established in children. A tendency to disinhibition in children has also been noted

by old clinicians (Kovalevsky) and is confirmed in all new works.

The same age-related physiological phenomena include increased value life of drives and lability of emotions. Affective instability leaves its mark on the structure of the syndrome and, to one degree or another, affects the picture and course of psychosis.

As a result of these factors, the child’s personality remains for a long time(before puberty) not fully formed either emotionally, volitionally, or intellectually. It is clear that the child is not capable of sufficient intrapsychic processing of his perceptions, sensations, and feelings. His feelings are “naked” in nature, his experiences are more primitive than those of an adult.

1 . Nakedness of feelings very clearly visible in vital depression. Melancholy is completely amorphous, vague, unaccountable in nature. That's why she doesn't seem so strong. Of the two components - vital feeling and reactive processing on the part of the personality - in children there is mainly one immediate “deep” affect. Reactive deposits are kept to a minimum. How younger child, the more this point is emphasized. We have already said that in schizophrenia, procedural inactivity and lethargy overshadow the affect of melancholy. But even with reactive depression, sadness also does not have much brightness. It is not unconscious, but at the same time monotonous and manifests itself in a low-intensity form.

2. In addition to the simplicity and nakedness of affect in childhood depression, it is also necessary to point out poverty of psychopathological phenomena. Where in adults, especially with circular depression, delusional ideas of persecution, self-abasement, etc. are observed, in children we only sometimes see elements of ideas of self-blame; They do not go further than ideas of relationship in a very primitive form. At depressive reactions The children's statements are also very poor.

3. Many symptoms found in adults are found in children rudimentary condition. Children are not able to fully process individual ideas and concepts. The older child says that he has become “weird”, feels confused, helpless and is somehow aware of this. In a more complete form, this phenomenon would be called depersonalization.

Extremely often, with circular and schizophrenic depression, one encounters uncertainty in sick children,

indecision, anxiety, suspiciousness, low self-esteem.

A similar psychasthenic syndrome often appears in a child as a vestige of ideas of self-accusation. This is explained

[I believe that the child is not able to intrapsychically process those changes in well-being, those experiences of inhibition that give him the idea of his own inferiority.

4. A very characteristic feature of childhood depression is its instability And short duration. Children are more easily distracted from difficult experiences than adults. Even endogenous mood disorders can often be mitigated and switched to other tracks. A melancholy child sometimes suddenly gets involved in school activities and easily starts working in the workshop. The younger the child, the more often his depression changes several times during the day to an even mood. The physiological lability of affect is probably important here. It must also have an effect on the short duration of depressive phases. Their duration in manic-depressive psychosis and circular schizophrenia, especially at the onset of the disease, rarely exceeds 5-15 days. We see the same thing in other painful forms. If depression drags on, then we need to look for additional factors accompanying the underlying disease (general exhaustion, etc.), or focus on studying premorbid personality traits.

The general part indicated that somatic instability and lability of the affective sphere in a prepsychotic state favor a protracted course of depression.

5. It feels like fear, often manifests itself in children various forms. But it is precisely in children that one can observe unaccountable, incomprehensible, unmotivated fear, such a feeling of fear is akin to vital melancholy. In children, fear arises especially easily and as a primitive defensive reaction. Where the child does not understand, but in his own painful sensations He doesn’t understand a lot, and there he begins to be afraid. The frequency of fears in childhood depression is indicated by Emmingaus, Ziegen, Kovalevsky, Homburger, Gilyarovsky, Sukhareva, Vinokurova.

6. In the picture of childhood depression, it should also be noted that there is less irritability, comparative rarity of general dissatisfaction and anger, which so often colors the depression syndrome in adults.

Elements of general dissatisfaction and irritability can be observed only in epileptic mood disorders. This observation cannot be explained in the same way in all cases. In reactive states, apparently, the answer lies in the simplicity of children’s experiences, their primitiveness, and the absence of additional layers.

In epilepsy, aggression, anger, and irritability are apparently associated with the main process and its impact on the patient’s personality.

In general, if there is general discontent in a child, it manifests itself not in anger, but in capriciousness.

7. Among the interesting and important properties of childhood depression is its external paradoxicality. The younger the child, the more reason to expect it. This is understandable, since in younger children the lability of affect and the tendency to disinhibition are most clearly represented; At the same time, a change in the life of instincts often comes to the fore.

More clear manifestations of this paradox are observed in reactive depression. We described sharp changes in character (pranks, rudeness) after severe mental trauma with the subsequent appearance of sadness as a new unpleasant experience in one patient. In another case, significant disinhibition and fussiness were discovered, which made it difficult for a 9-year-old boy to study at school after the death of his father, whom he loved very much and whose loss, as it turned out, he was very worried about; however, the affect of melancholy was not immediately detected.

8. Daytime fluctuations in well-being and mood in children are in the reverse order compared to adults. In the morning, children feel better, but in the evening their condition worsens.

In conclusion, I express my great gratitude to Professor G. E. Sukhareva for her constant leadership in this work.

A. I. Golbin

SLEEP AND WAKE DISORDERS IN CHILDREN WITH VARIOUS DISEASES AND ANOMALIES 1

SLEEP DISORDERS IN NEUROSIS

The important place of sleep disturbances in the clinical picture of neuroses is not disputed in any of the main sources.

Neurosis is defined as “...a psychogenic disease, which is based on an unsuccessful, irrational and unproductive contradiction resolved by the individual between him and the aspects of reality that are significant for him, causing painfully painful experiences for him” 2 . One of the main manifestations emotional disturbances with neurosis there is anxiety. Most researchers consider anxiety as a homogeneous condition with a single pathogenetic mechanism. It is generally accepted that the difference in objective data between different groups subjects is determined only by the severity of anxiety. However, in last years it has been suggested that anxiety cannot be equated healthy person in an objective stressful situation and anxiety of a patient with neurosis. V. S. Rotenberg (1975), I. A. Arshavsky, V. S. Rotenberg (1976) showed that the anxiety of a healthy person, as an emotionally adequate reaction, is mobilizing and differs from neurotic anxiety that arises as a result of an unresolved conflict. The latter is not aimed at finding a way out of a behavioral conflict, but at abandoning the search when one of the motives is actively ignored. This is the demobilizing effect of neurotic anxiety. The main manifestations of physiological and neurotic anxiety are similar - pulse lability, fluctuations blood pressure, GSR enhancement, etc.

Modern research showed that to differentiate the two types of anxiety, one should turn to the analysis of sleep structure. It turned out that paradoxical sleep (PS), which is associated with dreams and plays an important role in psychological adaptation, changes differently in these two types of anxiety. For example, with moderate anxiety in a healthy person on the first night of a sleep study, PS decreases by

I" Golbin A. I. Pathological sleep in children. L., 1970, pp. 45-69. 2 Myasishchev V.I. Personality and neuroses. L., 1960, p. 241.

compared with subsequent nights (extension of the latent period of its appearance), which indicates a decrease in the need for PS. In neurotics, in half of the cases there is a tendency to reduce the latent period of PS, which indicates an increased need for PS. The mechanisms that reduce anxiety include primarily PS mechanisms (Rotenberg V. S., 1975; Arshavsky I. A., Rotenberg V. S., 1976). These mechanisms are functionally defective in neurotics.

It seems to us that the insufficiency of sleep mechanisms, in particular PS, is included in the content of the concept of the biological basis of neuroses and therefore sleep changes in neuroses differ from sleep disturbances in other pathologies. This, in our opinion, can explain the spread of sleep disorders in neuroses.

If we believe that in children all forms of neuroses are reduced to three main forms (neurasthenia, hysteria, obsessive neurosis), as in adults, then sleep disorders are described in each of them. Leading researchers on the problem of neurosis obsessive states(Ozeretskovsky D. S., 1950; Skanavi E. E., 1962; Simson T. P., 1955; Garbuzov V. I. et al., 1977) emphasizes the special importance of the moment of transition from wakefulness to sleep. It is believed that the ease of education conditioned reflexes in a dormant state (for example, playing with hair while feeding) creates a “hearth” with pathological inertia. In a drowsy state, obsessive actions such as thumb and tongue sucking, hair pulling, and obsessive fears begin. Characterizing neurasthenia as a separate form of neurosis, most authors believe that the main place in the clinic of neurasthenia consists of disturbances in the level of wakefulness and sleep, and frequent symptoms are insomnia, terrible dreams, and night terrors (Sukhareva G. E., 1974). It is believed (Garbuzov V.I. et al., 1977) that sleep disturbance is one of the early and even specific manifestations of neurasthenia, its leading clinical sign. V. I. Garbuzov considers neurasthenic sleep disorders to be restlessness in children aged from one and a half months to 5-6 years, when children rush about in bed, sprawled and constantly changing position, as well as sleep talking, night terrors, somnambulism, sometimes nocturnal enuresis. The characteristics of sleep in hysterical neurosis are described (Rotenberg V.S. et al., 1975). V.I. Garbuzov (1977) believes that such pathological manifestations in sleep as somnambulism, sleep-talking, night terrors, insomnia, enuresis and even rocking in sleep are a form of “night hysteria.” With the “night hysteria” syndrome in children, V.I. Garbuzov notes that

“The mannerism and pretentiousness of children’s behavior during this period is noteworthy. They, as a rule, wring their hands, bend over in the arms of their parents, scream, cry or laugh “to the point of hysteria,” pound their fists on the bed, on the parents’ face, squirm, squeal, roll their eyes, perform a rudimentary hysterical arc, and grab themselves by the throat , as if something is bothering them, they pinch themselves and those around them, i.e. they demonstrate it in a dream hysterical symptoms" V. I. Garbuzov notes similar behavior, such as “hysterical somnambulism,” in 10% of the patients with hysterical neurosis he observed (V. I. Garbuzov et al., 1977).

Disturbance in falling asleep in neurotic children manifests itself in pronounced prolonged whims and agitation in younger children, fears and rituals in schoolchildren. There is restless sleep with an abundance of movements, often children even fall out of bed. Our studies revealed a high frequency of special postures in sleep, of which, first of all, we should mention a long stay on the stomach and the tendency to lower the head down, so that the head hangs from the bed, while the legs lie on the pillow. Sleep disorders in the form of paroxysmal phenomena in neurotics are most often represented by drooling (which is not at all associated, as is sometimes believed, with worms), grinding teeth (bruxism), and shuddering. Night terrors and nocturnal enuresis are not so common in neurotics compared to other sleep disorders. Stereotypical movements in sleep most often manifest themselves in the form of finger and tongue sucking, hair twitching, and head shaking.

Violation of wakefulness is characterized by lethargy, instability of attention and activity during the day with agitation in the evening. Disorders of wakefulness are also expressed in fainting, affective narrowing of consciousness when excited, drowsiness to the point of complete inversion (i.e., insomnia at night and drowsiness during the day), the occurrence of “paradoxical drowsiness” (Epstein A.L., 1928; Shpak V.M., 1968 ), when children become excited with a strong need to sleep.

The abundance of dreams in neuroses in children can confirm the hypothesis (Rotenberg V. S., 1975; Arshavsky I. A., Rotenberg V. S., 1976) about a compensatory increase in dream activity when refusing to resolve the situation during the day, avoiding the situation, or an inadequate way to resolve it - in dreams the situation is presented in a favorable light.

Often, in the dreams of children with neuroses, a conflict situation in the family is symbolically reflected (“the gypsies attacked, they were looking for mother first, they didn’t find her, but they found me, everything

they cut and cut, but they couldn’t cut it because the knife was dull”, “as if our house had exploded”, “I’m fighting snakes, black snakes bite me in the chest, and while I’m fighting, a big snake with glasses sits on a tree stump , who leads everyone, then I fight with him, he bites me painfully, and I die"). When there are conflicts between parents, the following dreams are typical: someone “stabbed someone”, “there is a war going on”, “as if our house had exploded”, etc.

In general, dreams with neuroses in children are characterized by an abundance of bright scenic pictures, often in color, symbolically reflecting internal conflicts. These dreams differ from the calm dreams of the control group of primary school children. In addition, attention should be paid to the fact that in patients with neuroses, dreams are detected at an earlier age than in the control group of children. One of our patients, aged 1 year 3 months, after being frightened during the day by a cat jumping on her in a state of sleep, said “shoo, shoo, shoo” several times and made movements with her hands, like her mother, driving away the cat. Usually, the first dreams are told by children from the age of 3-3/2 years. Our studies of the structure of sleep in neuroses in children confirm the data available in the literature on the extension of the latent period of falling asleep, more frequent awakenings, increasing the duration of light stages of sleep, decreasing the duration of deep sleep and increasing PS. Normally, at the age of 10 years, the duration of PS is about 30% of the total sleep duration. PS increases from the beginning of the night to the end, while in patients with neuroses the duration of PS has a peak in the middle of the night and then decreases. Total time PS in the first half of the night is less in neurotics; The “first night effect” is especially indicative in laboratory conditions - all sleep indicators change almost completely, and the inherent pathological sleep phenomena (enuresis, sleepwalking, etc.) almost always, even in the most severe cases, disappear. This is associated with the extreme complexity of studying pathological sleep in children and the need for consistent multi-day observation in the process of adaptation to laboratory conditions. It is interesting that before the onset of the first PS, short-term outbreaks of a “test” PS appear, which is explained not by a lack of a “triggering” mechanism, but by affective instability (Leygonie et al., 1974). Paradoxical sleep is a very vulnerable stage, and it is primarily affected by affects

day. In children, reciprocity may be observed between the duration of PS and the intensity of neurotic manifestations, in particular the intensity of neurotic fears (Leygonie et al., 1974). Thus, sleep disorders in neuroses are very extensive and pronounced.

Clinical observations show that many forms of abnormal sleep can occur after acute or chronic mental trauma. When describing individual forms of pathological sleep, we will cite cases of psychogenically caused nocturnal enuresis and nocturnal vomiting, insomnia and nightmares, etc. However, our experience convinces us that no less significant is Feedback neurosis and sleep disorders, that not only a psychogenic reaction leads to a disruption of the normal flow of the biorhythm, but, perhaps, on the contrary, pathological sleep leads to a neurotic reaction during the day. An interesting and unexpected fact was big number sleep disorders in parents that match the type of sleep disturbance in the child. N.A. Kryshova (1946) pointed out the inheritance of some sleep characteristics, which can serve as further evidence in favor of the primary biological basis of sleep disorders in neurotics. In the same regard, the high frequency of disturbances in the formation of the sleep-wake biorhythm can be considered. early childhood up to 3-6 months (67%), expressed either in very restless sleep with an inconsolable causeless cry, or inversion of sleep and wakefulness, when children sleep well during the day, and at night they do not sleep and play quietly, or in extremely severe drowsiness, when it is difficult to wake up baby for feeding (a detailed discussion of these issues is presented in the sections on sleep inversion and childhood insomnia).

Literature data and our own observations allow us to say, with slight exaggeration, that neurosis does not exist without sleep disorders, and sometimes these disorders are the only manifestation of neurosis.

Thus, the connection between neurotic reactions and sleep disorders is very complex, and perhaps a productive approach will be in which some psychopathological manifestations during the day will be considered as part of a general disruption of biorhythm. Intimate neurophysiological mechanisms of sleep and wakefulness, which, according to modern ideas, are directly involved in emotional reactions; with delayed maturation of sleep in ontogenesis, they can be the biological basis of a neurotic reaction.

There are several types of inhibition:

comprehensive;

Retardation can be verbal and mental, that is, it has psychological causes. Sluggish and untimely motor reactions are caused by motor retardation. Problems with memorization and memory lapses may occur. In most cases, such conditions are caused either by illness, chronic fatigue, or psychological pathologies.

Motor and emotional inhibition is a pathology, the causes of which only doctors can identify. They also prescribe adequate treatment.

Causes and symptoms of slow thinking

A person’s behavior, thinking, and psychological state can be disrupted due to pathologies of the nervous system and brain. Ideation inhibition is also caused by:

Parkinson's disease. With complex brain pathology, an additional symptom is also revealed - slowness of thinking. The patient himself does not notice any changes. As the disease progresses, his mental activity not only slows down. The patient becomes intrusive, meticulous, and clingy. His speech becomes confused and incoherent.

All of these diseases, the symptom of which is inhibition of thinking, must be diagnosed and treated. Temporary inhibition of movements and thinking appears after severe stress, fatigue, with prolonged lack of sleep.

Suppression of motor and mental processes typically manifests itself after drinking alcohol, even once. The same symptoms sometimes cause psychotropic drugs, as well as strong sedatives. When they are cancelled, the inhibition goes away.

Causes and symptoms of motor retardation

Motor, as well as mental retardation, manifests itself as a result of psychological disorders, as well as various diseases. Lethargy is sometimes or always felt in the patient's facial expressions and movements. The posture is usually relaxed; there is often a desire to sit down, lie down in bed, or lean on something.

Lethargy in a child

This symptom is also typical for children. It can be chronic in some neurovegetative disorders, for example, cerebral palsy, or appear spontaneously at high temperatures, after severe stress or impression. Lethargy in children often results from:

vascular pathologies of the brain;

Diagnosis of lethargy

In case of psychological disorders, as well as physiological pathologies caused by inhibition of mental, motor or speech reactions, a thorough diagnosis is necessary, that is, a medical and psychological examination.

Diagnosis of written and oral speech is also carried out. Perhaps the person suffers from stuttering, defects in sound pronunciation, which lead to speech inhibition. The patient’s intellectual development, the state of sensory functions, general motor skills, and the condition of joints and muscles are also studied.

Treatment of lethargy

Activation of thought processes. To do this, they read new books, master languages, engage in creativity or solve mathematical problems. Such actions train the brain and activate mental activity.

If the lethargy is temporary and caused by high fever, then you should take tablets or syrups that reduce the temperature. Temporary inhibition caused by medications and strong sedatives can be stopped by abandoning such drugs. Usually it passes without a trace, the body’s reactions are completely restored.

Inhibition of emotions and movements (video)

What is inhibition of emotions and movements? How to correctly identify and treat pathology, we will learn the doctor’s recommendations from the video.

Prevention of lethargy

The pathology usually goes away without a trace if treatment is started in the early stages, when the underlying disease is identified. After competent psychological assistance, with correct medicinal support, a person’s reactions improve, both emotional and physical.

Lethargy

Retardation is a decrease in an individual’s reaction speed, a slower flow of thought processes, and the appearance of protracted speech with long pauses.

IN extreme cases a person may even stop reacting to others and remain long time in a daze. Inhibition may not be complex, but relate only to thinking or speech. In the first case it is called ideational, and in the second – motor.

Diseases accompanied by lethargy

Retardation is observed when:

Inflammation of the brain (meningitis);

Mental disorders (schizophrenia);

Borderline states (depression, neurosis);

Presence of a brain tumor;

Hypoglycemia (decrease in blood glucose levels);

Fatigue, exhaustion of the body;

Intoxicated with drugs or alcohol.

Causes of lethargy

As you can see, the reasons that cause this condition are usually associated with brain damage and pathology that interfere with its functioning.

The temporary effect of inhibition in speech and thinking occurs due to lack of sleep, when the body is already exhausted, or due to the use of drugs and alcohol, which inhibit mental and motor processes. That is, the reasons can be divided into those that block activities and those that reduce the possibilities for its implementation.

According to some versions of psychiatrists, inhibition is nothing more than a peculiar reaction to stress in many ways similar to anxiety, but acting in the opposite way. Proof of this is the disappearance of symptoms when patients use antidepressants and minor tranquilizers, which are supposedly aimed at reducing anxiety.

Symptoms of lethargy

An individual may have a desire to constantly lean on something or lie down. It is not necessary that all manifestations of inhibition be observed. Just one is enough to claim that a person needs medical attention.

Treatment of lethargy

First, they try to determine the true cause of this condition, and then prescribe treatment. For lethargy, nootropic drugs (for example, Piracetam) are often prescribed, which improve metabolic processes in the brain. In case of hypoglycemia, they try to restore the glucose level and maintain it with special substances.

In case of meningitis, they try to destroy the causative agent of the disease and eliminate the inflammatory process, although even after this they will have to undergo a restorative course of therapy. If the cause of inhibition is cancer, then all efforts are devoted to overcoming it.

The information presented on the site is for informational purposes only. To make a correct diagnosis and choose the right treatment tactics, you need to seek help from a doctor.

Lethargy

Inhibition of a person’s mental processes and behavioral reactions can be caused by various reasons: fatigue, illness, exposure to tranquilizers that slow down organic processes, negative emotional states such as stress, depression, sadness, apathy.

Retardation is a decrease in an individual’s reaction speed, a slower flow of thought processes, and the appearance of protracted speech with long pauses. In extreme cases, a person may completely stop reacting to others and remain in a daze for a long time. Inhibition may not be complex, but relate only to thinking or speech. In the first case it is called ideational, and in the second – motor.

Suppression of thinking is scientifically called “bradypsychia”. Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Causes of slow thinking

The pathophysiology of the process is extremely complex and not fully understood. Thinking, behavior, emotional background and many other achievements of the human mind are associated with the work of the limbic system - one of the sections of the nervous system. And the limbicus cannot be properly deciphered. Therefore in everyday practice We can only name conditions - diseases in which bradypsychia is noted, but cannot answer the question of why it appears.

Vascular pathologies. Acute and more often chronic disorders cerebral circulation, arising as a result of the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for the people around the patient (the patients themselves are late stages the development of this type of pathology does not notice any changes) there are many others, no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.
Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, lethargy occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, in schizophrenia bradypsychia is not early sign pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still describes as clearly as possible the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Of course, with such a large number of diseases, the number of types of treatment should also be large. Unfortunately, until scientists have finally figured out how the brain works, there are not as many of these species as we would like. The temporary effect of inhibition in speech and thinking occurs due to lack of sleep, when the body is already exhausted, or due to the use of drugs and alcohol, which inhibit mental and motor processes. That is, the reasons can be divided into those that block activities and those that reduce the possibilities for its implementation.

Symptoms of lethargy

The image of the patient fits into the classic description of a melancholic person: lethargy, slowness, drawn out speech, every word seems to be squeezed out with effort. It feels like thinking takes a lot of strength and energy from this person. He may not have time to react to what is said or may completely plunge into a stupor.

In addition to a decrease in the rate of speech and thinking, there is a muffledness of what is said - an extremely quiet and calm voice that occasionally breaks the silence. Lethargy is noticeable in movements and facial expressions, and posture is most often too relaxed. An individual may have a desire to constantly lean on something or lie down. It is not necessary that all manifestations of inhibition be observed. Just one is enough to claim that a person needs medical attention.

Diagnosis of bradyllalia

Persons with speech tempo disorders, including bradyllalia, need a comprehensive medical and psychological-pedagogical examination, which is carried out by a neurologist, speech therapist, psychologist, and psychiatrist. When examining a patient with bradyllalia, a detailed history must be taken regarding past diseases and brain damage; presence of speech tempo disorders in close relatives. In some cases, to clarify the organic basis of bradyllalia, instrumental studies are required: EEG, REG, MRI of the brain, PET of the brain, lumbar puncture and etc.

Diagnosis of oral speech in bradyllalia includes assessment of the structure of the organs of articulation and the state of speech motor skills, expressive speech (sound pronunciation, syllabic structure of the word, tempo-rhythmic aspect of speech, voice characteristics, etc.). Diagnostics of written speech involves completing tasks for copying text and independent writing from dictation, reading syllables, phrases, and texts. Along with diagnostic examination speech, with bradylalia, the state of general, manual and facial motor skills, sensory functions, and intellectual development is studied.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

General preventive measures. The more the brain is loaded, the better it works. Nerve cells that are not used during life happily die off as unnecessary in the literal sense. Accordingly, the mental reserve decreases. Learning new things is possible at any age, but after thirty years it is significantly complicated by the slowdown in the development of new interneuronal connections. You can load your brain with anything, as long as it is not familiar to it. Learning a new language, solving mathematical problems, mastering new sciences, studying historical archives and understanding them. But! Solving crossword puzzles, scanword puzzles, and the like is like memorizing a large Soviet encyclopedia. Dry information only occupies cells responsible for memory, but not for thinking. Physical activity also helps keep the brain in “working” condition. It’s difficult to say what this is connected with.

Vascular therapy. It is impossible to bring the vessels to a state corresponding to the age of twenty, however, partial restoration is possible, which is what doctors use by prescribing appropriate medications.

Nootropics and neuroprotectors. More specific treatment, which helps nerve cells recover.

Psychotherapy is carried out only as a secondary addition to drug therapy. Modern psychotherapeutic techniques help to identify and eliminate the true cause of the disorder, form a new model of response to stressful situations, and correct personal assessment.

Before visiting a psychotherapist, the patient can only engage in prevention - all drug treatment has a significant number of contraindications, which the specialist takes into account when choosing one or another remedy. In case of bradypsychia, it is imperative to consult a doctor - there is not a single “easy” reason for such a mental state.

Forecast and prevention of bradyllalia

The prognosis for overcoming bradyllalia is most favorable with an early start of correctional work and psychological reasons speech tempo disturbances. But even after developing normal speech skills, long-term observation by specialists and constant self-monitoring of the rate of speech are necessary.

To prevent bradyllia, it is important to prevent perinatal lesions of the central nervous system, head injuries, neuroinfections, and asthenic syndrome. It is necessary to take care of the child’s normal speech development and surround him with the right role models.

Muscle fasciculation

Anxiety

Dysphoria

Irritability

Dementia

Apathy

Hallucinations

Depression

Emotional lability

Paresthesia

Iatrogenesis

Drowsiness

Yactation

Phobias

The information on the site is provided for informational purposes only. Do not self-medicate, be sure to consult your doctor.

Retardation of thinking, movements and the mental sphere: causes, symptoms

From time to time, every person may notice that the brain is not functioning fully. Such a disorder is expressed in difficulty performing movements (bradykinesia) and in remembering information, inhibition of reactions and thinking disorders (bradypsychia).

It should be said that in most situations these disruptions are temporary and can be explained by natural factors: fatigue or nervous exhaustion. However, there are cases when the awkwardness of movements, inhibition of thinking and the mental sphere is a pathological process, the causes of which must be promptly identified and appropriate therapy selected.

Features of bradypsychia

Pathological inhibition of thinking is called bradypsychia. This phenomenon has no parallels with apathy or inertia of thinking, but suggests mental and pathophysiological disorders.

Thought processing can be impaired at any age

Slowness of movements and emotional inhibition is a pathological process, the causes of which only specialists can detect. They also recommend proper therapy.

Associated disorders

Bradypsychia is the result of damage to the central nervous system, which is responsible for brain activity. Depending on the element of the lesion, different types of disorders develop. These include:

bradybasia - slow walking;

Bradykinesia is characteristic of parkinsonism

Provoking factors and diseases

Vascular diseases of the brain. Acute, often chronic disorders of blood flow in the brain, which arise due to progressive atherosclerosis, hypertension, embolism and vascular thrombosis, are a factor in the destruction of substances in the brain. The structures that are responsible for quick thinking are also susceptible to disruption.
Parkinson's disease. A common cause, the characteristic manifestation of which is slow thinking. In addition to such depressing symptoms (patients at a late stage of development of this pathological process do not tend to notice any changes), there are a large number of other unpleasant manifestations. For example, thoughts will become not only slow, but also viscous; the patient will be characterized by importunity and slow, confused speech.
Epilepsy. At a late stage in the development of the disease, when experts observe the destruction of personality as a result of a progressive disease, inhibition may be noted, as well as other symptoms of altered thinking.
Schizophrenia. As with epilepsy in schizophrenia, bradypsychia is not considered an initial symptom of pathological processes, but develops gradually over time.
Depression. A mental illness that is characterized by a large number of symptoms, often disguised as somatic difficulties - including toothache or ischemia. These also include sluggish thinking.
Hypothyroidism. Improper functioning of the thyroid gland. With this disease, the symptoms are extremely pronounced and are one of the first to occur.
Toxic lesions. Such a subgroup of diseases does not exist in the international classification. However, the term best describes the causes of painful symptoms - intoxication of the body.

Naturally, with such an abundance of provoking diseases, treatment can also be different.

What does it look like?

The image of a “inhibited” patient falls under the typical characteristics of a melancholic person: weakness, slowness, drawn-out speech, every word is pronounced with effort.

There may be a feeling that the thought process takes a large amount of strength and energy from a person who does not have time to react to information or is completely plunged into a stupor.

A person has a desire to constantly find support or lie down.

Not all symptoms are always observed. Just one thing is enough to recommend a person to seek medical help from specialists.

Diagnostic criteria and methods

In certain situations, in order to find out the organic basis of the disease, it is necessary to conduct instrumental studies, including:

The study of oral speech involves assessing the structure of the organs of articulation and the state of motor skills, expressive speech (pronunciation of sounds, syllables, words, tempo-rhythmic side, voice characteristics, etc.). Diagnostics of written speech involves performing tasks such as copying text, writing from dictation, and reading. In addition to a diagnostic examination of speech function, a study of general condition, manual motor skills, sensory functions, and intelligence is carried out.

When making a diagnosis, it is necessary to differentiate this disease from dysarthria and stuttering.

What does modern medicine offer?

The following methods of therapeutic and preventive action are used more often than others:

Activation of thinking processes. For these purposes, you need to read new books, study foreign languages, engage in the creative process, or solve various puzzles. This technique helps train the brain and activate thinking.
Neuroprotectors and nootropics are prescribed. Drug therapy that is aimed at restoring and strengthening nerve cells and tissues.
Treatment of vascular pathologies. Products are used that make it possible to cleanse the vascular walls, which is necessary for proper brain function. As a result, mental and physical activity is activated.
Psychotherapy. It acts as an auxiliary drug therapy. Modern therapeutic techniques help counteract the effects of stress, adjust personality assessment, and form the necessary models of response to specific situations.
Sports activities and walks in the fresh air. Moderate physical stress and walks give the brain the opportunity to rest and the nerve cells to recover thanks to the influx of oxygen.

If emotional and mental retardation is caused by tranquilizers, then discontinuation of any drugs is required. In most cases, reactions recover over time.

Summing up

As preventive measures, damage to the central nervous system should be prevented, head injuries should be avoided, and asthenic syndrome should be detected in time.

Pathological inhibition of thinking involves various mental and pathophysiological disorders. This phenomenon should be qualified as a symptom that in most situations occurs in older people. But in certain cases, a similar problem can manifest itself in childhood and young people.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

Lethargy

Lethargy is a symptom of certain diseases, usually of the central nervous system and brain, or a consequence of severe psycho-emotional shock. This state of a person is characterized by the fact that he has a decrease in the speed of reaction to actions addressed to him or performed by himself, a deterioration in concentration, more extended, with long pauses in speech. In more complex cases, there may be a complete lack of reaction to surrounding events.

This human condition should not be confused with apathy or a chronic depressive state, since the latter is more a psychological factor than a physiological one.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

under alcohol or drug intoxication;
with chronic fatigue and constant lack of sleep;
with frequent nervous tension, stress, chronic depression;
under circumstances that cause a person to feel fear, anxiety and panic;
with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

Classification

The following types of retardation are distinguished according to the clinical picture:

bradypsychia – inhibition of thinking;
mental or ideational inhibition;
motor or movement retardation;
emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are damaged, the following clinical picture may be present:

drowsiness (hypersomnia), lethargy;
headaches, which will intensify as the pathological process worsens. In more complex cases, pain relief is impossible even with painkillers;
memory impairment;
decreased quality of cognitive abilities;
the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
illogical perception of speech or actions addressed to him;
speech becomes slow, the patient may have difficulty finding words;
nausea and vomiting, which is most often observed in the morning;
impaired coordination of movements;
unstable blood pressure;
rapid pulse;
dizziness.

It should be noted that the above-described symptoms are also observed after a stroke. If you suspect that a person is having a seizure, you should call emergency medical attention and rush them to hospital. It is the urgency and coherence of primary medical measures after a stroke that largely determine whether a person will survive or not.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

insomnia or drowsiness, which is replaced by an apathetic state;
unreasonable attacks of aggression;
sudden change in mood;
causeless attacks of fear, panic;
suicidal mood, in some cases, actions in this direction;
state of chronic depression;
visual or auditory hallucinations;
nonsense, illogical judgments;
neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
excessive suspicion, the feeling that he is being watched;
deterioration or complete loss of memory;
incoherent speech, inability to express one’s point of view or specifically answer simple questions;
loss of temporal and spatial orientation;
feeling of constant fatigue.

Diagnostics

In this case, you may need to consult the following specialists:

Diagnostic measures include:

general clinical laboratory tests (blood and urine tests);
study of the level of pituitary hormones;
CT and MRI of the brain;
EEG and Echo-EG;
cerebral angiography;
psychiatric tests.

Depending on the diagnosis, the issue of hospitalization of the patient and further treatment tactics will be decided.

Treatment

In this case, the treatment program can be based on both conservative and radical treatment methods.

Drug therapy may include the following drugs:

painkillers;
sedatives;
antibiotics if the disease is of an infectious nature;
nootropic;
antidepressants;
tranquilizers;
drugs that restore glucose levels;
vitamin and mineral complex, which is selected individually.

In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

Provided that therapeutic measures are started in a timely and correct manner and are fully implemented, almost complete recovery is possible even after serious illnesses - oncology, stroke, psychiatric illnesses.

Prevention

“Retardation” is observed in diseases:

Alalia is a speech function disorder in which the child cannot speak partially (with a poor vocabulary and problems in constructing phrases) or completely. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Apathy is a mental disorder in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This condition very often comes into a person’s life unnoticed, since it does not manifest itself as painful symptoms - a person may simply not notice deviations in mood, since the causes of apathy can be absolutely any life process, and most often a combination of them.

Status asthmaticus is a prolonged attack of bronchial asthma, the progression of which causes severe respiratory failure. This pathological condition develops as a result of swelling of the bronchial mucosa, as well as spasms of their muscles. In this case, it is not possible to relieve an attack by taking an increased dose of bronchodilators, which, as a rule, are already taken by a patient with asthma. Status asthmaticus is a very dangerous condition that can lead to the death of the patient, so it requires emergency medical attention.

All over the world, many people suffer from a disorder called bipolar disorder. The disease is characterized by frequent mood swings, and a person’s mood changes not from bad to good, but from extremely depressed and sad, to a feeling of euphoria and the ability to perform feats. In a word, mood swings in patients with bipolar disorder are enormous, which is always noticeable to others, especially if such fluctuations are frequent.

Legionnaires' disease, or legionellosis, is a bacterial infection that most often manifests as a severe form of pneumonia. A characteristic expression of the disease is intoxication and dysfunction of the central nervous system and kidneys. Sometimes, during illness, damage to the respiratory and urinary systems occurs.

Hypersomnia is a sleep disorder characterized by increased rest periods and daytime sleepiness. In this case, the duration of sleep is more than ten hours. It rarely occurs as an independent disorder - it is often a complication of certain diseases. After a long sleep, there is no improvement in the general condition; there is constant drowsiness and problems with waking up.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is a rather dangerous type of disease, caused by a person’s passivity and depression.

Cardiogenic shock is a pathological process when the contractile function of the left ventricle fails, the blood supply to tissues and internal organs deteriorates, which often ends in human death.

Ketoacidosis is a dangerous complication of diabetes mellitus, which without adequate and timely treatment can lead to diabetic coma or even death. The condition begins to progress when the human body cannot fully use glucose as an energy source because it lacks the hormone insulin. In this case, the compensatory mechanism is activated, and the body begins to use incoming fats as an energy source.

Tick-borne encephalitis is a severe infectious disease that is transmitted to humans from encephalitis ticks. The virus makes its way into the brain and spinal cord of an adult or child, causing severe intoxication and affecting the central nervous system. Severe encephalitic forms without timely treatment can lead to paralysis, mental disorders and even death. How to recognize the symptoms of a dangerous pathology, what to do if you suspect a tick-borne infection, and what is the importance of vaccination in the prevention and treatment of a deadly disease?

Waldenström's macroglobulinemia (syn. primary macroglobulinemia, macroglobulinemic reticulosis) is an extremely rare disease in which a tumor consisting of lymphocytic and plasmacytic cells forms in the bone marrow.

Metabolic acidosis is a pathological condition characterized by an imbalance in the acid-base balance in the blood. The disease develops against the background of poor oxidation of organic acids or their insufficient removal from the human body.

Myxedema is the most severe form of hypothyroidism, which is characterized by the development of edema of the skin and subcutaneous tissue. The pathology begins to progress in the human body as a result of insufficient secretion of thyroid hormones. Women are most often susceptible to this disease during the period of hormonal changes, that is, during menopause.

Cerebral edema is a dangerous condition characterized by excessive accumulation of exudate in the tissues of the organ. As a result, its volume gradually increases and intracranial pressure increases. All this leads to disruption of blood circulation in the organ and to the death of its cells.

Overwork is a condition that not only adults, but also children often face today. It is characterized by decreased activity, drowsiness, impaired attention and irritability. Moreover, many people believe that overwork is not a serious problem, and that it is enough to get a good night’s sleep for it to go away. In fact, it is impossible to get rid of such a disorder by sleeping for a long time. It's the other way around - a constant desire to sleep and the inability to regain strength after sleep are the main symptoms of overwork.

Rh conflict during pregnancy is a pathological process that manifests itself in a situation where the mother has a negative Rh factor and the father is positive, and the child acquires the positive Rh factor of the father. If both parents are Rh positive or Rh negative, Rh conflict is not detected.

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With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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All information provided is subject to mandatory consultation with your attending physician!

Questions and suggestions:

Causes of slow thinking

The pathophysiology of the process is extremely complex and not fully understood. Thinking, behavior, emotional background and many other achievements of the human mind are associated with the work of the limbic system - one of the sections of the nervous system. And the limbicus cannot be properly deciphered. Therefore, in everyday practice, we can only name conditions - diseases in which bradypsychia is noted, but cannot answer the question of why it appears.

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.
Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, lethargy occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still describes as clearly as possible the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Symptoms of lethargy

Diagnosis of bradyllalia

Persons with speech tempo disorders, including bradyllalia, need a comprehensive medical and psychological-pedagogical examination, which is carried out by a neurologist, speech therapist, psychologist, psychiatrist. When examining a patient with bradyllalia, a detailed examination of the medical history regarding previous diseases and brain injuries is necessary; presence of speech tempo disorders in close relatives. In some cases, to clarify the organic basis of bradyllalia, instrumental studies are required: EEG, REG, MRI of the brain, PET of the brain, lumbar puncture, etc.

Diagnosis of oral speech in bradyllalia includes assessment of the structure of the organs of articulation and the state of speech motor skills, expressive speech (sound pronunciation, syllabic structure of the word, tempo-rhythmic aspect of speech, voice characteristics, etc.). Diagnostics of written speech involves completing tasks for copying text and independent writing from dictation, reading syllables, phrases, and texts. Along with a diagnostic examination of speech, for bradyllalia, the state of general, manual and facial motor skills, sensory functions, and intellectual development is studied.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

General preventive measures. The more the brain is loaded, the better it works. Nerve cells that are not used during life happily die off as unnecessary in the literal sense. Accordingly, the mental reserve decreases. Learning new things is possible at any age, but after thirty years it is significantly complicated by the slowdown in the development of new interneuronal connections. You can load your brain with anything, as long as it is not familiar to it. Learning a new language, solving mathematical problems, mastering new sciences, studying historical archives and understanding them. But! Solving crossword puzzles, scanword puzzles, and the like is like memorizing a large Soviet encyclopedia. Dry information only occupies cells responsible for memory, but not for thinking. Physical activity also helps keep the brain in working condition. It’s difficult to say what this is connected with.

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Forecast and prevention of bradyllalia

The prognosis for overcoming bradyllalia is most favorable with an early start of correctional work and psychological reasons for the violation of speech tempo. But even after developing normal speech skills, long-term observation by specialists and constant self-monitoring of the rate of speech are necessary.