Jun 29

You’re psychotic!‘ That’s supposed to be the ‘polite’ form of the phrase ‘You’re insane!’, used by some when they can’t explain the actions of a person.

In deeply nature-bound cultures, people whose behavior strongly deviated from what was perceived as ‘normal’, were treated by magicians and shamans. In the West, however, they were locked up in so-called ‘insane asylums’ where they often received cruel treatment. Only in the 1930s, psychiatrist Karl Birnbaum introduced a first definition of the medical term ‘psychosis’: according to his theory, biological roots defined the form of the disease, while its severity, beginning and course would be strongly influenced by psychological factors, so new ways of treatment were experimented with.

The importance of the factors involved in psychiatric diseases was subjected to historical changes: while the ‘mentally ill’ were considered as uncurable before psychiatry became a medical science, after Birnbaum and Freud, psychotherapy had its heyday. Currently, we are again in a phase with an emphasis on physical (neurological) theories and treatments. Sometimes, treatment is so focused on pharmacological prescriptions that even patients feel that ‘something is missing’. The most successfull concepts in modern therapy therefore involve a multi-strategic approach of pharmacological, psychotherapeutic and social therapeutic aid.

People experiencing psychosis or psychotic episodes may report hallucinations or delusional beliefs, and exhibit personality changes and confusion. Depending on its severity, this may be accompanied by unusual or bizarre behavior, as well as difficulty with social interaction and impairment in carrying out every day activities due to feelings of anxiety, irritation, moodiness, and passive or indifferent behavior.

As patients are often intimidated about having to fight mental problems or might perceive their own situation in a distorted way, it is essential that friends or relatives do their best to help them get a proper diagnosis and therapy. If treatment starts early, the chances of stabilization and returning to a balanced and stable life increase significantly.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

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