home Other

The meaning of the word “stupor.” Stupor. Definition and types of this condition Emotional stupor

In psychiatry, stupor is a movement disorder in which the patient falls into complete immobility, accompanied by mutism and an almost complete absence or extreme weakening of the reaction to external stimuli. This phenomenon is one of the few that can cause a lot of anxiety for those who encounter it for the first time. But to understand the phenomenon, you need to arm yourself with some knowledge.

In order to answer the question “Stupor - what is it?”, it is necessary to list the main types of this condition that modern psychiatry identifies.

Catatonic stupor

The most common type of pathology, characterized by the patient's numbness in a position with awkwardly bent limbs. That is, the position of the body is not entirely characteristic of a person. The patient stops contacting others, does not pay attention to what is happening around him, as if under hypnosis, even if the situation poses a clear threat to life. The most striking examples characterizing catatonic stupor and what it is are, for example, cases when the patient remained lying in an unnatural position in a room engulfed in fire, without showing any signs of anxiety and without reacting to pain. Anyone can fall into a stupor under stress.

This manifestation of catatonic syndrome begins, as a rule, with the masticatory muscles, later descending to the cervical region, and ends with numbness of the limbs. Such nervous paralysis can be caused by any stressful situation, for example, fear, shock, fright.

Stupor with waxy flexibility

A type of disorder when the patient freezes, for example, with an awkwardly raised leg, arm, or both arms. The person also does not react to what is happening around him and stops answering questions uttered in an ordinary measured voice. However, the patient can communicate in a whisper, and at night get up, move around the room, take care of himself, eat, and even answer questions. That is, in an unconscious state, he can come out of a state of stupor.

Negativistic stupor

Quite often, a medical history in psychiatry includes the term “Negativistic stupor.” This type of stupor is distinguished by the fact that the patient resists all attempts to change his position. It is very difficult to force him to leave the bed, but if this is possible, then it is even more difficult to put the patient back. Often a negativistic stupor is accompanied by an exacerbation of the patient’s spirit of contradiction and even

Stupor of muscle numbness

As a rule, answering the question “Stupor - what is it?”, professional psychiatrists invariably note the numbness of the patients’ muscles. The most pronounced condition is classified as stupor with muscle numbness. With it, the patient most often assumes an intrauterine position, all his muscles are tense, and his eyes are closed. The position of the embryo in this case was not chosen by chance, thereby creating a kind of numbness of protection. This posture is closely associated with a feeling of security and peace. This is inherent in a person at the genetic level. Most of these patients refuse to eat.

Depressive stupor

Depressive stupor - what is it? Another condition that psychiatry history knows very well. Depressive stupor is a consequence of severe endogenous depressive disorders. In addition to torpor, it is characterized by a pained or melancholic patient.

However, he continues to look after himself, perform all functions and sometimes even makes contact. Often, numbness and detachment are replaced by unexpected bouts of activity and bursts of energy. Suffice it to remember how grief or depression is depicted in films: the hero, sitting by the window, looks at one point. At the same time, he can drink tea or smoke, seeking salvation and peace in this.

Apathetic stupor - what is it?

Its symptoms are somewhat similar to those of depression. However, such stupor can be called one of the mildest forms of the disorder. As a rule, the patient lies in a static position, although he answers questions, but in a monotonous, monosyllable manner, with a long time delay. The quality of appetite and sleep is significantly impaired.

When visiting relatives or friends, the patient shows quite adequate emotions, is able to answer questions and independently compose phrases quickly and meaningfully.

Stupor can be classified as caused by a strong nervous shock that arose as a protective reaction of the body to an irritant.

Treatment of the disease can be carried out both at home and in a hospital. However, the main condition is mandatory consultation and observation by a psychiatrist or psychoanalyst.

Stupor(from the Latin stupor “numbness, stupor”) - in psychiatry, one of the types of movement disorder, which is complete immobility with mutism and weakened reactions to irritation, including pain.

What is stupor

There are various types of stuporous states: catatonic, reactive, depressive stupor. Catatonic stupor is the most common; it develops as a manifestation of the catatonic syndrome and is characterized by passive negativism or waxy flexibility or (in the most severe form) severe muscle hypertension with numbness of the patient in a pose with bent limbs.

Being in a stupor, patients do not come into contact with others, do not react to current events, various inconveniences, noise, wet and dirty bed. They may not move if there is a fire, earthquake or some other extreme event.

Patients usually lie in one position, the muscles are tense, the tension often begins with the masticatory muscles, then goes down to the neck, and later spreads to the back, arms and legs. In this state, there is no emotional or pupillary response to pain. Bumke's syndrome - dilation of the pupils in response to pain - is absent.

Causes of stupor

Women are much more likely than men to fall into emotional stupor. This condition usually occurs due to intense mental shocks:

fear;
horror;
grief;
disappointment.

In this case, motor activity and affective activity are blocked, and mental activity also slows down.

This condition can go away without treatment and without any special consequences, or it can lead to a panic state, during which the sick person will rush to perform chaotic actions (run, scream). The consequence of this may be depression.

A state of stupor of this type can appear in a woman who has witnessed a catastrophe, an accident, or someone else's suffering. It can occur in soldiers during combat, and also in children, for example, during exams.

Stupor may be a symptom of the following diseases

Types of stupor

Stupor with waxy flexibility

In case of stupor with waxy flexibility, in addition to mutism and immobility, the patient maintains the given position for a long time, freezes with a raised leg or arm in an uncomfortable position. Pavlov's symptom is often observed: the patient does not respond to questions asked in a normal voice, but responds to whispered speech. At night, such patients can get up, walk, put themselves in order, sometimes eat and answer questions.

Negativistic stupor

Negativistic stupor is characterized by the fact that with complete immobility and mutism, any attempt to change the patient’s position, lift him or move him causes resistance or opposition. It is difficult to get such a patient out of bed, but once raised, it is impossible to put him back down.

When trying to be brought into the office, the patient resists and does not sit down on the chair, but the seated person does not get up and actively resists. Sometimes active negativism is added to passive negativism.

If the doctor extends his hand, he hides his hand behind his back, grabs food when it is about to be taken away, closes his eyes when asked to open, turns away from the doctor when asking him a question, turns and tries to speak when the doctor leaves, etc.

Stupor with muscle numbness

Stupor with muscle numbness is characterized by the fact that patients lie in the intrauterine position, muscles are tense, eyes are closed, lips are pulled forward (proboscis symptom). Patients usually refuse to eat and have to be fed through a tube or undergo amytalcaffeine disinhibition and feed at a time when the manifestations of muscle numbness decrease or disappear.

With depressive stupor with almost complete immobility, patients are characterized by a depressed, pained expression on their face. You manage to make contact with them and get a monosyllabic answer. Patients in a depressive stupor are rarely untidy in bed.

Important: such a stupor can suddenly be replaced by an acute state of excitement - melancholic raptus, in which patients jump up and injure themselves, can tear their mouths, tear out an eye, break their heads, tear their linen, and can roll on the floor howling.

Depressive stupor is observed in severe endogenous depression.

Apathetic stupor

With apathetic stupor, patients usually lie on their backs, do not react to what is happening, and muscle tone is reduced. Questions are answered in monosyllables with a long delay. When contacting relatives, the reaction is adequate emotional. Sleep and appetite are disturbed. They are untidy in bed. Apathetic stupor is observed with prolonged symptomatic psychoses, with Gaye-Wernicke encephalopathy.

Catatonic stupor

Catatonic stupor is understood as freezing in fear, fright and helplessness during severe suffering of the Self - consciousness in its various dimensions. Anyone who does not know whether he is still alive, whether he is able to act, is not sure of the unity and separation of his personality from the surroundings, is capable of freezing in a stupor.

Therefore, anything that leads to the restoration of the authenticity of the self-experience can be of therapeutic value for catatonic stupor. So, if self-identity is lost, sometimes calling by name is enough to improve the patient’s condition. Another patient can be helped to regain the feeling of his activity by doing physical exercises, breathing exercises, etc. with him.

It is clear that in severe cases a purely verbal therapeutic approach is often insufficient. But purely neuroleptic therapy or ECT is not sufficient; the patient must be perceived as an individual. Some patients can only be brought out of their stupor with great difficulty. But even if they are not objectively responding, it is still useful not to leave them alone in this state, but to stay and talk to them.

Sometimes it is possible to take a couple of steps with them - and this is the first therapeutic success on the road to a generally meaningful world. Other types of catatonic stupor occur when loaded with hallucinatory and delusional experiences, for example, in ecstasy.

How to get out of a stupor

Only specialists—psychotherapists, psychologists, psychiatrists—know exactly how to overcome stupor. But if you see that a person close to you is in this state how to get out of the stupor, he definitely needs help, here are a few ways:

Emergency care for stupor

Emergency care for stupor comes down to preventing dangerous actions and ensuring the safety of the patient. With catatonic stupor, this is a readiness to stop sudden impulsive excitement.

Important: in case of depressive stupor, it is necessary to prevent the possibility of sudden development of depressive agitation with a desire for suicide, as well as to eliminate refusal to eat.

It should be borne in mind that psychogenic stupor can be replaced by psychogenic agitation. Emergency care for catatonic stupor in out-of-hospital conditions does not make sense, since attempts to disinhibit the patient can cause agitation and thereby create additional difficulties.

Treatment for stupor

In a hospital setting, thanks to barbamyl-caffeine disinhibition, it is possible to identify the characteristics of the patient’s experiences and thereby determine the nature of the stupor. It also serves as a method of treatment and helps with persistent refusal to eat.

At the beginning, 1-2 ml of a 20% caffeine solution is administered, and after 3-5 minutes, 5-10 ml of a 10% barbamyl solution is administered slowly intravenously, monitoring the patient’s condition, and at the first signs of disinhibition, the infusion is stopped so as not to exceed the individual disinhibition dose for this patient and do not induce normal sleep.

The administration of barbamyl is stopped at the moment when the patient opens his eyes or when facial, motor or vegetative reactions (in the form of paleness or redness of the face, sweating, etc.) begin to appear; in this case, it is necessary to stimulate the patient’s disinhibition in every possible way: contact him with questions, slow him down, lightly pat on the cheek, etc.

In a psychiatric hospital, catatonic stupor is treated with intramuscular administration of frenolone at a dose of 5-15 mg/day; for lucid stupor, mazeptil is prescribed orally up to 60 mg/day; Barbamilcaffeine disinhibition is also effective. The psychostimulant sydnocarb up to 30-50 mg/day orally is also effective. For stupor with delusions and hallucinations, stelazine (triftazine), haloperidol, and trisedal are used according to the same principles as the treatment of delusional and hallucinatory states.

For depressive stupor, barbamyl-caffeine disinhibition is carried out, melipramine is used up to 200-300 mg/day orally or intramuscularly. For psychogenic stupor, use diazepam (Seduxen, Relanium) up to 30 mg/day orally, preferably intramuscularly; elennium up to 50 mg/day orally, preferably intramuscularly; phenazepam - 3-5 mg/day orally.

Stupor in severe somatic diseases requires intensive treatment of the underlying disease. Hospitalization is necessary in a psychiatric hospital for all types of stupor, except for somatogenic stupor, the treatment of which is carried out in the same department where the patient is diagnosed with a somatic disease.

Questions and answers on the topic "Stupor"

Good day. I am 21 years old. When I start communicating with someone, I feel some kind of stupor, I can’t say anything, I can’t carry on a conversation, there’s some kind of mess in my head. If I want to tell something, I often forget the words and get lost. I’m afraid to stay with a person one-on-one, I think that he will be bored with me. In the company of friends, all I do is listen, although when there is a conversation about something, I understand that I can tell a lot, express my opinion . Sometimes I think that I am inattentive and “stupid”. I myself am interested in psychology, football, technology, but when these topics are discussed, I am still afraid to say something. It feels like a cockroach is sitting in your head and doesn’t allow you to get used to the information and express yourself competently. The problem started back in school, when conflicts with classmates began, then the situation improved a little, but I became a boring person who is often silent, and when he wants to say something, he blurts out some nonsense, but only then do I realize it. Tell me what could be the problem?

The problem is the fear of other people’s assessment of their statements, actions, and deeds. Fears inhibit communication, and this “inhibition” makes one feel ashamed. Shame is an affective feeling; it practically paralyzes both the thinking and the active processes. Anger at oneself and lack of self-acceptance appear. Perhaps this is roughly what is happening to you. You might want to take individual or group classes to reduce your fears and discover that you are not the only one, many experience similar feelings. Then it will be easier to accept yourself and cope with your fears.

When the teacher asks something, I can’t say anything, because it’s like there’s some kind of stupor. I speak normally with my friends, no problem. It also happens that in a minibus I have to tell them to stop at the bus stop, but I can’t say a word, or in a store. How to deal with this?

It seems to me that the fear of speaking appears in situations where you do not feel that you are on equal terms with the interlocutor (as happens with friends: you are on the same level with them). In frightening situations, there is a feeling that you should be evaluated (by the teacher or people on the minibus). Perhaps this fear of evaluation (most likely, a low evaluation) causes stupor: it is better not to say anything than to “blurt something stupid” and embarrass yourself. In such cases (if this is your case, of course) you can work with self-esteem, self-acceptance - non-judgmental. Maybe you are too hard on yourself? In addition, there are a lot of tricks that, for example, speakers use when speaking in front of a large audience. The fact is that the fear of public speaking is inherent in a huge number of people. To calm down before going out in public, speakers use different things: breathing (several deep breaths, exhalations, for example), visualization (imagine that you are among friends - just chatting carefree). There are special exercises to help improve diction, including for moments when your throat gets dry. You can combine the practice of such exercises and work to increase self-esteem and self-confidence.

The expression “fall into a stupor” is quite common even in everyday life, meaning sudden lethargy, disorientation, depression.

If we talk about its purely medical significance, then it should be taken into account that stuporous states in intensive care practice associated with somatic diseases differ from those that occur in psychiatry. These are qualitatively different states, however, both of them fit into the definition of stupor, that is, in both cases there is depression of consciousness with a decrease in orientation and inhibition of the patient’s reaction to stimuli.

Stupor-stupor-coma in intensive care practice

In resuscitation, stupor is one of the emergency conditions with depression of consciousness preceding stupor and coma.

The differences between stuporous, soporous and comatose states manifest themselves in the depth of the patient’s disturbance of consciousness:

Stupor: drowsiness and disorientation in place and time are noted. The condition resembles alcohol intoxication, the reaction to external irritations is reduced. The patient answers questions slowly and sluggishly, often immediately falling asleep and falling into a stupor.
Stupor: the patient is unconscious, reacts only to strong stimuli (prick, shout, shaking), responding with purposeful actions. The condition resembles deep sleep.
Superficial coma: the patient is unconscious and responds to strong painful stimuli with erratic actions.
Deep coma: the patient is unconscious, there is no reaction to any external stimuli.

Stupor, stupor or coma can occur due to a number of diseases, such as infections of the brain and its membranes, acute cerebrovascular accidents, diabetes mellitus, liver and kidney diseases, severe traumatic brain injuries, acute poisoning, overdose of drugs, alcohol, some medicines, etc.

As a result, the state of stupor can occur in the practice of doctors of various specializations: neurologists, infectious disease specialists, endocrinologists, general practitioners, etc.

Stupor in psychiatry

In contrast to the above, various forms of blockage encountered in psychiatry do not arise as a result of the general serious condition of the patient, but are a consequence of psychopathological processes and diseases. Stupor in psychiatry is considered as a movement disorder, consisting of inhibition of motor and speech activity, without any attempts on the part of the patient to overcome this condition.

The reasons leading to the occurrence of such a condition can be organic (schizophrenia, epilepsy, acute psychosis, intoxication, damage to brain structures) or functional (stress, emotional shock, depression, prolonged fear, hysteria, apathy, etc.).

However, the specific biochemical and neurophysiological mechanisms of stupor have not been sufficiently studied to date. It is assumed that it can occur against the background of a deficiency of gamma-aminobutyric acid in the structures of the brain, with a sharp lack of dopamine in the body and some other processes.

Motor retardation during stupor can manifest itself in varying degrees - from moderate limitation in movements to complete immobility. Stupor is also characterized by mutism - partial or complete absence of speech activity.

The patient makes no attempts to get out of this state, and there is no volitional direction in his actions. The duration of stupor can range from a few minutes or hours to many months.

Types of stuporous states

There are quite a lot of different forms of stuporous movement disorders identified in psychiatry, and they differ both in the causes of occurrence and in clinical manifestations:

Depressive stupor - occurs against the background of severe depression or manic-depressive psychosis. In this case, the patient is characterized by almost complete immobility, melancholy, depressed facial expression, hunched posture, and downcast gaze. Possible refusal of food. Sometimes patients may show some reaction to questions, especially those asked in a whisper. An attack of depressive stupor lasts for a long time, sometimes up to several weeks, and in some cases it can suddenly turn into the so-called melancholic raptus - a state of acute frantic excitement with auto-aggression and a desire for suicidal actions.
Hysterical (dissociative) stupor - usually occurs in emotional individuals with hysterical tendencies (much more often in women). The patient is characterized by almost complete immobility with minimal reaction to external stimuli. The patient often does not answer questions; in rare cases, he may answer with a significant delay, in short monosyllabic phrases. Spontaneous speech on one's own initiative is absent, mental processes are slow and lack clarity.
Hallucinatory - a state of stupor is combined with auditory and visual hallucinations, which, in turn, cause an appropriate facial reaction of the patient: joy, anger, fear, anxiety, surprise, etc. This type of stupor is observed in organic psychoses, neurotoxic poisoning, and some forms of schizophrenia.
Manic stupor - along with motor retardation and mutism, lively facial expressions, elevated mood and a certain interest in what is happening are noted. Patients may observe their surroundings, smile for no apparent reason, and weakly resist passive movements under external influence. This type of stupor can occur in manic-depressive psychosis, but is now rare due to advances in the treatment of mania.
Apathetic stupor - the patient usually lies on his back, indifferent to what is happening around him, inattentive to his appearance. Answers questions with a long delay, using monosyllabic phrases. Muscular hypotonia, sleep and appetite disturbances are noted. There may be some manifestation of emotions during contacts with relatives. This type of stupor is observed in some long-term forms of psychosis, as well as in Wernicke encephalopathy.
Emotional (post-shock) stupor - occurs against the background of severe mental trauma (loss of a loved one, threat to life), severe stressful situations (for example, among soldiers in battle), disasters (fire, explosion, flood, earthquake) and other serious psychotraumatic factors. With this type of stupor, there is a dulling of emotions and a slowdown in mental processes. Emotional stupor is more typical for women; its duration can be from several hours to several days. It often goes away on its own, without treatment, but can turn into panic or depression.
Exogenous stupor - occurs with toxic or infectious lesions of the subcortical structures of the brain, for example, with some forms of encephalitis or poisoning with antipsychotics. In terms of its clinical picture, it is close to catatonic stupor (see below), but stands out as a separate form, since in this type there is a clearly established cause of the pathology and localization (subcortical nodes).
Epileptic stupor - can develop against the background of epileptic psychoses, as well as after grand mal seizures, especially serial ones. Often combined with frightening hallucinations and delusions. The depth of motor disturbances in this type of stupor can be different - from slight inhibition to complete immobilization of the patient. The duration of epileptic stupor is often short-lived - from several minutes to an hour or a little more, but sometimes it can reach several days. In some cases, there is a sudden exit from the state of stupor, giving way to impulsive speech and motor agitation with aggressive actions.
Negativistic stupor - characterized by complete immobility of the patient and resistance to any attempts to change the position of the body. For example, it is very difficult to lay a patient down or sit down, and then it is no less difficult to get him back on his feet (passive negativism). Sometimes the patient, when trying to force him to act, performs the exact opposite action, for example, when asked to open his eyes, he closes them (active negativism).
Cataleptic stupor (or stupor with waxy flexibility) - the patient holds a position given from the outside for a long time (hours or even days), even if the position is very uncomfortable (for example, with a raised leg and arm). Characteristic are the “air cushion symptom” (the head, raised above the pillow, remains in this position for a very long time), and sometimes Pavlov’s symptom (the patient does not answer questions asked in a normal tone, but answers if asked in a whisper). Some patients show some activity at night: they can get up, move around, eat, answer questions, etc.

Catatonic stupor - as the most common form

The catotonic form of stupor is the most common and has several varieties, as a result of which it is worth dwelling on it in more detail. The word catatonia comes from the Greek catatonos, which means “tense” or “tense.”

Thus, stupor is catatonic, in which motor and speech inhibition is accompanied by significant muscle tension.

A similar type of stupor is observed in schizophrenia and some psychoses. In severe cases of catatonic stupor, the patient makes no attempts to make any movements, he is completely motionless.

The photo shows a patient who fell into a catatonic stupor.

He does not try to respond to pain or other irritations, answer questions, shouts, etc. Such patients do not react to events around them, all kinds of inconveniences, loud noises, bright lights, wet clothes, dirt. They can remain motionless during explosions, fires, earthquakes and other emergency events.

There is no reaction to pain, including Bumke's symptom (dilation of the pupils when exposed to pain). Catatonic stupor is one of the manifestations of the catatonic syndrome (along with catatonic agitation). There are three varieties of it: negativistic, cataleptic (stupor with waxy flexibility) and stupor with numbness.

Stupor with muscle numbness is the most severe form of catatonic stupor, in which maximum motor retardation is combined with severe muscle tension. Patients assume the fetal position and remain in it for a long time without the slightest movement. The proboscis symptom is often noted - the jaws are tightly closed and the lips are pulled forward. There is no speech activity.

Forms of catatonic stupor can transform into each other, and also alternate with catatonic excitation. Their duration can be significant - a person can be in a stupor from several hours (in mild cases) to several weeks or even months.

Treatment of stuporous conditions

Treatment of stupor should be carried out in a hospital. In all cases, it is necessarily carried out against the background of therapy for the underlying disease.

If the diagnosis is unclear, additional examinations may be required to clarify it (EEG, computed tomography, laboratory tests, etc.). This is also important in cases where there is a need to determine whether stupor is the result of somatic or mental illness.

Treatment of the underlying disease should be quite intensive, taking into account the seriousness of the condition. At the same time, this is a prevention of relapses of stupor in the future. Of course, the range of drugs may be different: for example, antipsychotics if a patient has schizophrenia, anticonvulsants for epilepsy, antidepressants for depression, etc.

For functional pathologies (hysteria, stress, neuroses, etc.), psychotherapy can have a good effect.

Along with this, it is necessary to use drugs that disinhibit and stimulate the activity of the central nervous system. For these purposes, activating agents and psychostimulants (caffeine, Frenolone, Sidnocarb, etc.) are successfully used. As an additional therapy, the prescription of nootropic drugs (Piracetam, Encephabol, Phenotropil, etc.) can be considered appropriate.

In a psychiatric hospital, barbamyl-caffeine disinhibition is successfully used to treat many types of stupor (catatonic, depressive, etc.): intravenous administration of 1-2 ml of a 20% caffeine solution, and after 3-5 minutes 5-10 ml 5 % barbamyl solution. This method is also effective when patients refuse to eat.

For catatonic stupor, intramuscular administration of Frenolone at a dose of 5-15 mg per day is also used. For hallucinatory stupor, neuroleptics are used - Mazeptil, Triftazin, Haloperidol, etc. In the treatment of emotional, apathetic, hysterical stupor, tranquilizers - Diazepam, Phenazepam, etc. can be used.

In general, the specific choice of drugs and dosage are determined by the attending physician, based on the form of the disease and the severity of the patient’s condition.

Some of the possible complications of stupor have been mentioned above. In particular, emotional stupor can lead to the development of panic neurosis and depression.

Depressive, catatonic and epileptic forms of stupor can suddenly turn into a state of agitation with aggressive actions towards oneself and others. Stupor due to somatic diseases can be complicated by transition to stupor and coma.

Many of these conditions pose a threat not only to the health, but also to the life of the patient, and are also dangerous to others, which makes intensive treatment for stupor mandatory.

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

How to get out of a deadlock. 16 words to eliminate internal stupor

Has it ever happened to you that the result you want to achieve motivates you, all the steps are planned, but something inside stops you from taking action - and it’s completely unclear what? For example, there is a clear plan on how to make money, you have strength, and you really need money, but you just can’t bring yourself to start...

Or this: something fascinated you, and then suddenly began to depress you. For example, an excellent salesman suddenly fell out of love with selling, an inspired teacher became annoyed with teaching lessons, and a good student became irritated with studying...

If you want to know why this happens, and most importantly, what to do about it, then this article is for you.

My personal experience

I grew up in a poor family, in the provinces, and went through many life crises, including bankruptcy, health problems, moving to study in another country without a grant, with two hundred euros in my pocket, and a complete change of activity :)

And this is not just personal experience. I have been actively researching the technique that I want to offer you for two and a half years, involving more than two hundred participants. So I’m responsible for the quality :)

Why do we suddenly fall into a stupor?

Often the reason is hidden associations and internal emotional charge.

My spontaneous research, which began as an experiment and an internal game, led to my acquaintance with modern neurobiology and cognitive linguistics.

Here's what they say about the structure of our thinking:

Our brain is designed in such a way that when we need to remember something, it is encoded by a set of visual images, information from the senses and associated emotions and sensations in the body - that is, what is already in our long-term memory. All these “pieces of memory” are also, in turn, encoded by a similar set, which is why the activation of one of the memories activates entire circuits. This is how associations and chains of associations work.

Add to this the knowledge that we remember best what is emotionally charged. Whether the coloring is positive or negative is not so important for the brain, the main thing is the presence of the emotion itself. This mechanism has been developed by evolution over millions of years: if something frightens or pleases, it means it is important and you need to react, but you don’t have to worry about something neutral and don’t waste resources on it.

In order to identify the causes of internal stupor and be able to overcome it on your own, I propose to identify deep associations to the desired concept or situation and see what emotional charge they carry.

The “16 Associations” exercise helps you do this quickly, gently and cunningly. After all, our brain loves to build psychological defenses to protect us from truly unpleasant and mentally painful things. This is an exercise based on Jung’s method of free association, and here I have also supplemented it with the tricks and keys that I found during my research.

What results should I expect?

In a narrow sense, this exercise is aimed at finding a deep association with one word, concept or image that is important to you. More broadly (I like to do this) - this is a way to rewrite the “mental code”, to reprogram your own thinking.

With “16 associations” you can:

· build a map of your associative connections

· catch destructive associations, like computer viruses

· see the root of the problem

You will need a piece of paper, a pen and about half an hour of free time in silence.

Place the sheet horizontally and put numbers from 1 to 16 in a column on the left - this will help you focus and not get confused when doing the exercise.

First stage

Create a request. To do this, describe in a word or phrase a problem or task that worries you, and the solution of which will improve the quality of your life in the near future. Formulate it in one word or short phrase. For example, you just can’t sit down to write a thesis - then take the word “diploma”. Your current job has begun to cause negativity—take the word “work.”

To make the result deeper, straighten your back, take a couple of deep breaths and exhales and move your attention inward, to your lower abdomen. Believe me, it works.

The first self-coaching question is: What am I most concerned about right now?

Write down the word at the top of the sheet that you used to describe your problem/task.

Second phase

Inhale and exhale and look at the written word. Think about this concept - both as something that is relevant to you personally and as an abstract concept. Now write down 16 associations for this word that come to your mind. Let yourself go, write down all the words. Don’t throw away a word, even if it seems inappropriate to you - since it came to your mind, it means it’s your association.

Third stage

Now connect the words in pairs, as in the photograph: the first with the second, the third with the fourth, and so on.

This is when the real work begins. There are two rules in it, and the first is honesty. The more honest and sincere you are with yourself, the more powerful the effect you will get as a result. The second rule is that words should not be repeated. If a word appears two or more times during the exercise, write it down separately at the bottom of the page. Then I'll tell you what to do with it.

When the words are combined, start working with each pair separately, without reference to the main word (the one that represents your request).

For each pair of words, find a common association - a word that unites the two for you personally. Remember about inner honesty? Look for that common association that will be exactly yours. Listen to yourself - and to your body. Does the word you found resonate with you? Is this exactly it - or can it be formulated more precisely?

Use nouns, verbs and adverbs.

How to help yourself if there is no unifying association

Visualize - imagine each word from a pair as an image, mentally step back and look at them from the outside. What do they have in common? Maybe they are (or aren't) part of something bigger? Maybe each of these images has a common piece, a common part? What image is this? How to call it in one word?

Listen to the sensations in your body - straighten your back, relax your shoulders, turn your attention to your lower abdomen and legs. If you are a poor visualizer, you can look for a unifying association through sensations: feel what sensations in your body does the first word of the pair evoke? And now - what sensations does the second word evoke? What do these sensations have in common? What are they associated with? Describe it in one word.

Honesty check

When you have found a unifying association for a pair of words, listen to yourself and your sensations in your body: is this the same word? Or is there something more precise - just for you?

Fourth stage

You have eight words. Combine them again with brackets in pairs and repeat the same as in the third step. Remember that words should not be repeated (if a word is repeated, write it down below and look for another association). Look for your exact words.

When you get four words, repeat the same thing. Pay attention to the sensations and emotions that arise in your body. Record them as an outside observer and continue working.

Now combine the resulting two words into one.

This last word is your deepest association.

All photos show my actual request. I gave my personal example.

Some time ago, I caught myself that the mailing list coming to me with announcements about interesting master classes and webinars began to spoil my mood. And I couldn’t bring myself to call the university to find out more about the new programs...

I made my favorite “16 associations” and got a deep association - depression!

Oops, what an unexpected result! Yes, it made sense - studying began to make me depressed. This is exactly how I felt.

Okay, so what should we do about it?

How to work with the results:

The first and most important thing is to separate the “flies” and “cutlets”. Remember that all these words are just associations. Depression actually has nothing to do with studying.

The second is to look at the final word and ask yourself the question: am I comfortable with such a deep association or not? If I associate school with depression, how does this affect me and my actions?

The final word can also be positive - and then it can become a resource: that association and that image that gives you strength and desire to act.

By looking at the results of the exercise, you can become aware of what influences your perception and subconscious attitude towards the situation. This alone usually has a transformational effect.

Third, identify the negative and positive associations in each column.

Let me remind you that there are five of them, the last one is one word. What does each of the columns mean?

The first (16 words) are stereotypes and beliefs formed in the process of upbringing or under the influence of the environment.

The second (8 words) is the mental level: subconscious thoughts.

The third (4 words) is the level of emotions. Pay special attention to the emotional connotation of each of these four words.

The fourth level (2 words) and the final word make up what I call the “decision triangle.”

The final word is a deep association, and the pair of words from which it emerged may be strategies for solving a query or key issues that need to be resolved, or carry information about a choice that needs to be made.

See which column has more negative associations? What caused them? Where do negative associations come from?

Where is there more positivity? How can these positive associations help you resolve your request? Yes, yes, coaching questions have already begun :)

Fourth - rewrite the “destructive code”

The more new associations we attach to the word meaning request, the more the associative chain launched by this word will change. The brighter the positive images are, the more pleasant they are for us (including physically - goosebumps, tingling, a feeling of freedom in the shoulders, etc.), the stronger the “overwriting” effect will be.

You can simply cross out negative words and replace them with positive ones.

The effect will be stronger if we find “turning points” on our map (the first negative words in a horizontal chain), replace them with positive ones and derive new unifying associations up to replacing the final word.

The effect will be even more powerful if, before looking for new unifying associations, you enter a resource state (for example, through meditation). I like this method, and in the case of “studying” I used it. Having “recharged” myself with meditation, I found a new unifying association to replace the negative one - and re-created the entire chain from it to the final word. And the very next day I participated in the webinar with pleasure.

Fifth, look at the positive associations and ask yourself if they are limiting you? What do I mean: for example, you worked with the request “money” and received the word “achievements” in the final and the feeling that yes, receiving money for you is recognition of achievements, and achievements bring income... But how else can you get money ? Are you missing out on cash gifts, finds, winnings and other ways? For example, at my master class, I invited participants to write themselves a written permission to earn income in different ways, and before that we got creative on the topic of what these different ways could be. This method helps to expand consciousness and remove boundaries.

Sixth, record positive associations. For example, using a bright collage or drawing. By the way, creating a collage on the theme of the positive associations found is guaranteed to add insights to the topic of your request.

Advice: save the written sheet, putting a date on it, and do “16 associations” again with the same query word three months later - this way you can track what has changed.

Chief, what should you do if during the exercise a certain word appears twice or more often?

For example, you worked with the word “money” and the word “power” was repeated.

My experience and my research show that when a word is repeated, this means that the chain of associations it sets off influences the perception of the main word (query). In the above example, the internal perception of power influences the attitude towards money.

Do the exercise again, but with this (repeated) word as a query, and look at the results.

Modern scientists argue that when we remember an event, we activate the same neurons that were involved in remembering it. The more often we remember something, the stronger the neural connections (and associative chains). It follows that by changing one of the links in the chain, we change the entire chain. And when we do this consciously, we literally reprogram our own thinking - and train our brains!

All participants in my study who began to independently and regularly use the “16 Associations” technique noted significant changes for the better in each of the areas being worked on. And when I asked my coaching clients, “What exercise or technique gave you the first powerful push to move forward?” - they all called “16 associations”.

The articles you are interested in will be highlighted in the list and displayed first!

Stupor: causes, symptoms and treatment of this disorder

Stupor (from the Latin “numbness”, “stupefaction”) is a psychopathological movement disorder in which patients do not move, do not react to stimuli and do not communicate with others.

Also, stupor is a condition that occurs when consciousness is impaired in seriously ill people, characterized by a lack of response to stimuli and severe depression of the patient.

In psychiatry, there are several forms of stuporous state - dissociative, somnolent, depressive, catatonic, and so on.

Any type of stupor is a life-threatening condition that requires immediate medical intervention, so it is very important to know the main differences between the different forms of stupor and be able to provide assistance if any of them occurs.

Causes

There are many similarities and many differences between psychiatric and general stupor: their clinical picture seems very similar, but the cause and outcomes can be completely different.

In psychiatry, stupor develops as one of the types of mental disorders; its development can be caused by:

stressful situations;
psychotraumatic situations;
diseases of the nervous system;
character traits.

Most often, such a condition as stupor develops in people who are emotionally unstable, impressionable, prone to exaggerating events, who have experienced severe nervous shock, or who have become a participant or witness to some frightening events (catastrophe, accident, violence). A stuporous state can develop in people with diseases of the nervous system, depression, schizophrenia or neurosis.

Damage to brain cells during trauma, severe infectious diseases, and intoxication causes a cascade of reactions that successively causes stupor, stupor, and coma.

These stages of impaired consciousness differ from each other in the severity of the patient’s condition. So, with a disorder such as stupor, the patient reacts to strong stimuli, with certain efforts comes into contact with others and performs some actions.

With stupor, the reaction only to painful stimuli persists; it is almost impossible to get out of this state on your own, and if the patient is not given help, his condition will worsen and he will develop a coma. Coma is a severe disorder of consciousness in which the patient does not respond to external stimuli, including pain. This condition is considered borderline and it is impossible to bring the patient back to life without intensive medical care.

Symptoms

Determining that a person has developed stupor is quite simple. He stops responding to stimuli, does not answer questions, may stop moving, or his actions become chaotic and undirected.

The patient can remain in this state of stupor for days: he does not move, does not answer questions, does not eat, does not react to hunger, thirst, cold and other irritants. This clinical picture is typical for most types of stupor, but each of them has its own characteristics.

Varieties

There are quite a lot of varieties of such a phenomenon as stupor. The most common forms of the disease are:

Depressive stupor - develops in patients with depression; they can remain in this state for hours, not reacting to others, not answering questions, crying or looking at one point. Characteristic is a pained expression on the face, a lowered head, and stiff posture.
Catatonic stupor is one of the most severe. Patients seem to “freeze” in fear and denial of their own “I”. In this state, they do not answer questions or react to their surroundings. The patients’ body is characterized by “waxy” flexibility: the raised limbs remain in this position until they are lowered again. The patient can be given any position, which he will not change until he recovers from such a disorder as stupor. As a rule, it is impossible to exclude catotonic stupor on your own and patients need inpatient treatment.
Psychogenic or dissociative stupor - occurs due to severe psycho-emotional shock, in the absence of physical or neuropsychic pathologies. Typically, patients do not dive “deeply” into themselves and are easily brought out of this state. A person in this state seems “inhibited”, he reacts slowly to what is happening, speaks quietly, does not move or moves slowly, his reactions seem inadequate, and his behavior seems too calm.
Sleepy stupor or sleep paralysis is a very unpleasant condition in which temporary paralysis of all muscles occurs before falling asleep or after waking up. The patient is aware of everything, but cannot move or say anything. After some time, this condition goes away on its own.
Negative stupor. The patient actively or passively resists any attempts to change his condition, bring him out of his stupor, somehow help or interact with him. With negativism, the patient does not move, does not speak, lies or sits, staring at one point, but at the same time does not allow himself to be transferred to another place, and may react aggressively to attempts to “stir up” him or bring him out of this state.

Whatever form of stupor is observed in the patient, he definitely requires a full examination and the help of qualified doctors. Even if the episodes of stupor were short-lived and did not leave visible consequences, the patient should definitely consult a doctor, since they may be the first signs of such dangerous pathologies as a concussion, formation of nervous tissue or epilepsy.

The patient must undergo a full examination and consult a psychiatrist or psychotherapist in order to exclude the presence of somatic pathologies and psychopathic conditions.

Treatment

It is almost impossible to cope with such a disorder as stupor on your own. Treatment should be carried out by specialists: psychiatrists, psychotherapists or neurologists.

Therapy includes the administration of stimulants and disinhibitors, neuroleptics, sedatives:

caffeine solution - to stimulate the nervous system;
barbamyl solution - to activate the nervous system.

These two drugs are used for almost all types of illness such as stupor. They help to bring the patient out of stupor and stimulate vital processes.

Neuroleptics are used for psychiatric pathologies accompanied by disorders such as stupor, hallucinations, delusions, and affective disorders.

Calming and relaxing, helps reduce nervous tension and muscle spasms.

When treating a disorder such as stupor caused by an infectious disease or damage to the nervous system, treatment of the underlying disease and additional brain stimulation are of utmost importance. Most often, such treatment is carried out in intensive care or intensive care units, so the main help for a patient in this condition is to transport him to a medical facility as quickly as possible.

Treatment at home

If the state of stupor is not too deep, you can try to bring the patient out of it yourself. But such withdrawal can be short-term, so even when the patient comes out of the stupor, it is important to immediately seek help from professionals.

At home you can:

Massage active points. Using your fingertips, you can massage your forehead above your pupils, hairline, earlobes, and so on.
Bend your fingers, pressing them to your palm. Sometimes this simple action helps to bring the patient out of the stupor, while the thumbs should remain straight.
Evoke strong emotions - any, even negative, emotions can help bring the patient out of his stupor. To do this, they tell the patient important news, try to start a conversation on a topic of interest, or provoke emotions.

First aid

The most important thing is to protect a person who has fallen into a stupor from the possible consequences of such a state. Under no circumstances should the patient be left alone; he may develop an attack of agitation or aggression, during which he may cause serious injury to himself and others, attempt suicide, or commit other dangerous actions.

At the slightest suspicion of the onset of a stuporous state, you should immediately seek medical help and constantly monitor the patient’s condition until doctors arrive.

Find a free psychotherapist in your city online:

When copying materials from this site, an active link to the portal http://depressio.ru is required!

All photos and videos are taken from open sources. If you are the author of the images used, write to us and the issue will be promptly resolved. Privacy Policy | Contacts | About the site | Site Map

Anal stupor

Anal stupor is a state of extreme mental inhibition that occurs in a person with anal vector, experiencing super-stressful pressure from the outside.

A stress factor for anal sufferers is the need to act and react extremely quickly, to adapt to new living conditions, for example, in emigration or in a new workplace. Stress also occurs when the anal sufferer is rushed, not given the opportunity to complete the work he has begun, when he is forced, in principle, to change something. Often the frantic pace of a big city is itself a significant stress load.

An anal sufferer naturally reacts to superstress with stupor, that is, it slows down to the maximum mentally, mentally and physically. By slowing down, the mental anal seeks to neutralize stress, return to balance, and calm down.

In a state of stupor, the anal sufferer’s normal ability to think is switched off, he loses the ability to adequately assess the current situation, and lets what happens take its course.

Overstress puts the anal sufferer into a state in which he is essentially incapable of active action and, on the contrary, unconsciously strives for inaction. Under prolonged stress pressure, which is not uncommon in a modern city, the anal area can become permanently psychologically immobilized, i.e. fall into a constant inadequate “standby mode”.

For example, trying to get a job in such a state of stupor, he sends two of his resumes to open vacancies, then waits a week for a response to them. If the answer does not come, this causes dissatisfaction and frustration; the feeling of being underpaid, the feeling of inadequacy, and the reluctance to continue further job searches accumulate more and more. That is, in a state of stupor there is no strength, no energy, no incentive to take active action necessary to switch to a state of anality that is normal for this person.

Often the cause of complete psychological inhibition is resentment. Resentment manifests itself as a rigid, viscous emptiness inside, and occurs only in anal people. This destructive state is often not realized by a person, but it is precisely this that prevents him from developing and enjoying life. Without immediately compensating for the resulting offense, a person harbors a faint hope that sooner or later justice will prevail, the offenders will get what they deserve or will crawl on their knees to ask for forgiveness. So life passes in anticipation of being avenged, and the inner emptiness from resentment grows and accumulates, resulting in frustration and hatred.

Getting out of a state of stupor

From a sudden short-term stupor (for example, when he is greatly hurried by a skin person), the anal patient usually recovers naturally, calming down when the stress factors themselves disappear.

It is much more difficult to cope with prolonged stupor on your own. Consciousness always throws up rationalizations and justifications for any personal state and behavior, and stupor is no exception. Being in this state for a long time creates a real psychological swamp around a person. At the same time, it is difficult for an anal person to think purposefully, and if he does think, it is usually an idle and fruitless elaboration of personal problems and dissatisfaction, in fact, simply rationalizing his state. It is by nature difficult for anal to initiate action, but in a stupor this reaches its absolute limit. In order to undertake something on his own, he needs someone’s stimulation from the outside, someone must guide him, start action for him.

Being in a stupor, the anal sufferer can perform routine work on his own, which does not require special mental effort from him. That is, he does what he’s used to, automatically, and even then with difficulty. Feels unbearable and doesn’t want anything.

An urban anal sufferer today is most often a person with anal-cutaneous ligament vectors. It is extremely difficult for an anal without skin or urethra to adapt to the urban landscape. In an anal-skin person, it is the anal vector that is often more pronounced, especially if the properties of the skin vector are poorly developed. Such a person is mentally more adaptive and flexible and is often able to stir himself up and push himself to action with the help of his skin properties. However, often such an anal-skin “tank” sits in a stupor in front of the TV, having neither work nor social status. Even if he understands the complexity of his own situation and tries to somehow resolve it, the efficiency of his efforts is extremely small. This is despite the fact that the anal sufferer personally seems to be constantly doing something for this.

Permanent stupor, as a rule, indicates a certain degree of underdevelopment of the properties of the anal vector, the cause of which for the majority is childhood resentment.

The energy of other people can help you get out of your stupor. To use it, you need to be in contact with socially active members of society. However, an anal person in a stupor is attracted precisely to his own kind, that is, to anal people with similar states of vectors, similar frustrations. Such contacts often only aggravate the situation; the anal sufferer gets even more bogged down in his own psychological swamp.

Psychological stupor

Stupor in a person is literally numbness. In psychiatry, stupor is a type of movement disorder. The stuporous state is a total immobility combined with mutism (muteness or absolute refusal to communicate) and weakened responses to all kinds of irritating stimuli. An individual suffering from psychological stupor does not respond to current events, and there are also no reactions to common negative messages, such as pain, noise or cold. Such a patient may not eat or speak for a relatively long period, and often may even freeze in one position.

A stuporous state can be the end result of depression, various mental disorders, serious stress or fear. Often, some stuporous patients lie without changing position, refusing to eat, and not responding to questions, for days or even weeks. Other patients sit or stand, often as if petrified in a strange position, wrapped in a blanket over their heads or turned to the wall, absolutely motionless until they are forcibly transferred to a different position.

Causes of stupor

Stupor is a psychopathological disorder that manifests itself in the form of suppression of various mental operations, primarily motor skills, mental activity and speech. Patients who find themselves in this state are characterized by immobility. Left to themselves, sick individuals remain in one position for a long time. They either may not respond to question phrases at all, or they answer, but after a pause, at a slow pace, with interjections, individual words, or only occasionally in short phrases.

In some cases, the disease can occur in combination with a variety of psychopathological symptoms, such as delirium, hallucinosis, confusion, and altered affect. In other situations, more rare, the stuporous state is limited solely to motor immobility and speech retardation. In other words, this state is also called “empty” stupor.

Stupor, which is accompanied by confusion, is called receptor stupor. A stuporous state observed in conditions of clear consciousness is called lucid or effector.

The main factors provoking the occurrence of a stuporous state include severe psychotraumatic events, stressful situations, mental disorders, negatively emotional emotional situations, organically determined lesions of brain structures, various bruises or concussions, intoxication, and infectious disease. However, to this day it cannot be said with one hundred percent probability that the listed list of reasons is complete.

World-renowned specialists in the field of psychiatry enter into discussions about the possible causes provoking the development of the disease. Thus, among the numerous assumptions, there are several that are most characteristic of the formation and formation of an immobile type of catatonic stupor. Deficiency of gamma-aminobutyric acid in the brain, which is its key inhibitory neurotransmitter. A lack of this acid can cause disorders of the musculoskeletal system. And this is the main symptom of catatonia.

Catatonic stupor can occur due to an unexpected stop in the body's production of dopamine.

In 2004, experts began to consider the formation of catatonic syndrome as a genetic reaction that occurs in situations of stress or life-threatening circumstances in animals before meeting a predator. The whole body is paralyzed due to fear, as a result of which the animal’s body is reconfigured for imminent death. This reaction of fear on a subconscious level has been preserved in humans and to this day manifests itself during exacerbations of psychosomatic diseases or intense attacks of schizophrenia.

Catatonic stupor, according to this assumption, is expressed in the characteristic reaction of individuals to the inevitable death that haunts him from the onset of the disease. Thus, the listed hypotheses determine the emergence of catatonic syndrome as a consequence of the presence of schizophrenia and other diseases of a psychosomatic nature.

Symptoms of stupor

Being in a stupor, people do not contact the environment, they do not have reactions to ongoing events or uncomfortable conditions, various inconveniences (for example, noise, dirty bed).

Patients in a stupor may not move even during a fire, earthquake or other natural disaster. They often lie without changing position, the muscles are in good shape. Typically, tension begins in the masticatory muscles, then moves down to the cervical region, and later spreads to the back, arms and legs. In this state, there is no emotional and pupillary response to pain.

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

Falling into an emotional stupor is more typical of the female part of the population. Emotional stupor often occurs as a result of intense mental shock (for example, experienced horror or grief). It is characterized by a blocking of motor activity and emotional-affective activity; in addition, the mental function also slows down. Such an attack, in most cases, goes away without specific treatment, but sometimes it can lead to a state of panic, during which the patient will strive to perform chaotic actions. The consequence of this may be the onset of depression.

A stuporous state of this type can be observed in women who have witnessed some kind of catastrophe or accident. Stupor may also occur in children as a result of taking exams or during battle in soldiers.

Depressive stupor is characteristic equally of the female part of the population and the stronger half of humanity. It occurs against the background of deep depression and, as a rule, is accompanied by a hunched posture, a grimace of suffering on the face of the subjects, and a downcast gaze. Patients in this condition may respond to interrogative statements with monosyllabic phrases in a whisper. This variation of the stuporous state can be observed for a couple of hours and sometimes weeks. People with this condition may refuse to eat.

Overly receptive, emotional, vulnerable people and creative individuals characterized by a subtle internal organization are characterized by mental stupor. It is expressed in the form of apathy, laziness, melancholy, creative crisis, inability to think, feel and inability to act differently. In this state, a kind of mental “ossification” occurs.

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

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

Types of stupor

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

Negativistic stupor is expressed in mutism and absolute immobility, but at the same time, any action aimed at changing the patient’s posture provokes sharp opposition and resistance. It is not easy to lift a sick individual out of bed, but then, having lifted him, it is impossible to put him back down. Often active resistance is added to passive resistance. For example, if a doctor extends his hand to a patient, he, in turn, hides his hand behind his back, when asked to open his eyes, he closes his eyes, etc.

A depressive stuporous state is characterized by almost complete immobility along with a depressed facial expression and a pained grimace. When you manage to establish contact with them, you can get a monosyllabic response.

A person's depressive stupor may suddenly give way to an excited state, in which patients jump up and hurt themselves, may injure themselves, or roll on the floor howling (melancholic raptus). In severe depression of an endogenous nature, depressive stupor may occur.

Patients suffering from apathetic stupor usually lie on their backs. They also do not react to what is happening around them, and their muscle tone is reduced. They answer questions in monosyllables and with a long delay. However, during interactions with relatives, an adequate emotional reaction is observed. There are sleep disorders and appetite disturbances. They are often untidy in bed. Catatonic stupor is a kind of freezing in fear, numbness in fear and helplessness along with severe suffering of the inner “I”. Patients with catatonia sometimes do not understand whether they are still alive, whether they are capable of performing actions, and are not confident in the integrity of their own personality. Therefore, everything that can lead to the reconstruction of the authenticity of the self-experience will play a therapeutic role for the patient.

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

In a stuporous state with waxy flexibility, in addition to mutism and immobility, the patient holds the crouched position for a long time. For example, he freezes with his hand raised or freezes in an awkward position. The presence of Pavlov's symptom is often noted, which consists in the absence of a reaction in patients to question phrases asked in a normal voice, but at the same time responds to a whisper. At night, sick individuals can walk, sometimes eat and interact with the environment.

A stuporous state with muscle numbness represents being in the fetal position. In such patients, the muscles are tense, the eyes are closed, and the lips are extended forward. Often, individuals suffering from this type of stupor must be fed through a tube because they refuse to eat. Often, doctors perform amytalcaffeine disinhibition, and after the muscle numbness weakens or disappears, they feed the patients.

Treatment of stupor

Many people are concerned about the question: “how to get out of the stupor”? Naturally, only specialists - psychotherapists and psychologists - can help with this. However, you should still know how to help a loved one or someone around you if signs become noticeable that the subject is about to fall into a stupor or has already entered such a state and needs help.

So, first of all, massage of special points located exactly in the middle above the pupils, equidistant from the eyebrow arches and hairline, will help relieve tension. These points should be massaged using the pads of the index finger and thumb. In addition, it is recommended to try to provoke strong emotions in an individual in a stuporous state, no matter positive or negative (preferably negative). For example, you can slap someone in the face.

It can help to get out of the stupor by bending the individual’s fingers and pressing them forcefully against the palms, while the thumbs remain straight. So, the answer to the question: “how to get out of a stupor” is hidden in the emotional shake-up of the body and the synchronization of the breathing of the sufferer with the subject helping him. For this purpose, you can put your hand on the chest of an individual who has fallen into a stupor and adjust to his breathing pace.

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

In case of depressive stupor - preventing the possibility of unexpected development of depressive agitation with a focus on suicide, as well as eliminating food refusal. In addition, you need to take into account that stupor can suddenly give way to excitement.

Treatment often occurs in an inpatient setting. Barbamyl-caffeine disinhibition is used. Thanks to which it is possible to detect the characteristics of the patient’s experiences and anxieties, which helps to determine the nature of the stuporous state. This disinhibition is also a therapeutic method that helps with persistent food refusal.

A stuporous state that occurs against the background of severe somatic illnesses requires treatment of the underlying disease.

For stupor accompanied by hallucinations and delusions, Stelazine and Trisedal are used as well as in the treatment of hallucinatory and delusional states. In case of a depressive stuporous state, disinhibition is also carried out and Melipramin is used up to 300 mg per day orally or intramuscularly. For a psychogenic stuporous state - Diazepam up to 30 mg per day orally or intramuscularly, Elennium or Phenazepam.

Catatonic stupor

The psychopathological syndrome, the main manifestation of which is motor disorders, is called catatonic stupor.

Catatonic stupor was first described by Kahlbaum as an independent mental illness, and was later classified as schizophrenia by Kraepelin. Catatonic stupor is a form of schizophrenia characterized by psychomotor disorders. Such a stuporous state can last several months, and in a more serious course - several years. It manifests itself in the subject maintaining an uncomfortable, unnatural posture for a fairly long period and in mutism. At the same time, being in a similar position, a person does not feel tired. The stuporous state may be accompanied by increased plastic tone or extreme tension of the entire musculature.

Catatonic stupor, a form of schizophrenia, is characterized by a condition in which individuals refuse food and defecate on themselves. However, at the same time, their consciousness is preserved, as a result of which the patients, having come to their senses, can describe in detail the incidents that happened around them during the stupor.

At the beginning of the twentieth century, catatonic syndrome was considered primarily as a subtype of schizophrenia. Today, catatonia is understood as a syndrome that develops with affective and other mental disorders, somatic illnesses, and poisoning. Catatonic syndrome is an alternation of stupor with periods of catatonic excitement.

Catatonic stupor is expressed in motor retardation, mutism, and muscle hypertonicity. Patients can sometimes remain in a constrained state for several months. In such a condition, all forms of activity are disrupted, including instinctive. The following types of catatonic stupor are distinguished: with waxy flexibility, negativistic and with numbness.

Catatonic stupor often develops as a manifestation of the catatonic syndrome. Being in a stuporous state, patients do not contact the environment, they do not respond to ongoing phenomena or various inconveniences (for example, a wet bed). They completely refuse to eat, and their pupils do not dilate in response to pain.

Patients suffering from catatonic stupor initially become silent, may repeat phrases uttered by another individual (echolalia) or not answer questions at all, but still perform necessary everyday (everyday) actions. Then they stop moving, freeze in a strange position, for example, reminiscent of the position of a fetus in the womb (catalepsy), remain in the position given during examination, and display negativism.

Against this background, short-term excited states may occur, and other psychopathological manifestations are also detected: delusional ideas of persecution, auditory hallucinations. Impulsive actions may be observed, which manifest themselves in the form of sudden aggressiveness towards the environment.

Motor retardation occurs in combination with vegetative manifestations: bluish coloration of the extremities (acrocyanosis), their cooling, increased sweating along with a slow pulse. A thorough examination of the internal organs of a catatonic patient often does not reveal changes that would indicate the presence of a disease in the body.

A sign of catatonic stupor is considered to be the “air cushion” symptom. It involves the patient staying in a position with his head elevated for a long time (the head is at a distance of about 15 cm from the pillow). In this case, such a patient lies either on his side or on his back. If you press on the patient's head, it will lower, but after some time it will return to its original position. This situation can persist for hours and disappears after sleep.

9 comments on the entry “Stupor”

I have the consequences of injuries and chronic alcoholism, and sometimes I disconnect from the world on the street. There are attacks of anger that are simply uncontrollable and some kind of fetid smell appears, sometimes it fills the sense of smell on the MRI; signs of replacement hydrocephalus; brain atrophy from injuries and alcoholism. There is also a tremor in the arms, legs, and the head; the eyelid twitches. Could this be an alcoholic tremor or is it not visible on the EEG or is it still latent epilepsy? Six years ago I had an EEG, Petit was small, but took carbamazepine for 6 years. I started quitting drinking after 6 years, how can I stop drinking tremors in my arms, legs, and head? I abused it heavily for 10 years and the binges were major.

EEG today made moderately pronounced diffuse EEG changes with slow waves of the delta range with a decrease in the threshold of convulsive activity. I have the consequences of injuries and chronic alcoholism, sometimes I disconnect from the world on the street. There are attacks of anger that are simply uncontrollable and some kind of fetid smell appears, sometimes it fills the sense of smell on the MRI; signs of replacement hydrocephalus; brain atrophy from injuries and alcoholism. There is also a tremor in the arms, legs, and the head; the eyelid twitches. Could this be an alcoholic tremor or is it not visible on the EEG or is it still latent epilepsy? Six years ago I had an EEG, Petit was small, but took carbamazepine for 6 years. I started quitting drinking after 6 years, how can I stop drinking tremors in my arms, legs, and head? I abused it heavily for 10 years and the binges were major.

EEG today made moderately pronounced diffuse changes in EEG with slow waves of the delta range with a decrease in the threshold of convulsive activity. Maybe I'm in a stupor?

Hello. My name is Fatima. I’m 46. Lately, during quarrels, if my husband is rude to me, I fall into a stupor. I stand as if I had been dug out, looking at one point. Speech becomes slurred and sluggish. Afterwards I want to lie down and sleep. For several days I feel a state of emptiness, although I try to keep myself busy with work. Afterwards everything goes away, but it repeats itself again. Which doctor should I see?

After a week of depression, my mother was admitted to the hospital with a suspected stroke: her right arm and leg were weak, her speech was slurred, they did a CT scan three times - her head was clear, all tests were normal, on the 7th day of her stay in the hospital she fell into a stupor, stopped moving, clenched her jaw, why then the temperature appeared. I’ve been in neurology for 2 weeks now, a psychiatrist looked at me but they didn’t transfer me to psychiatry, I don’t know what to do. Mom is a young, strong woman, has never suffered from nervous disorders, 49 years old. I don’t know what to do, tell me!

Hello. My name is Azat, almost exactly the same symptoms are happening to my wife. She is constantly silent, often blinks her eyes, practically withdrawn, loss of memory, for example - how she forgot her phone password and practically does not recognize anyone, she recognizes only when she sees a person and then with difficulty. Thoughts about suicide, and often asks everyone for forgiveness as if feeling guilty. He answers the questions asked after some time and then repeats the same thing. She doesn’t sleep at night, often cries, and if you don’t feed her she doesn’t even want to eat. I'm wondering what type of stupor is this?

Hello, Azat. It is necessary for your wife to get a face-to-face consultation with a psychiatrist (psychotherapist). After examination and diagnosis, the type of stupor will be determined.

Azat and everyone else. When a person gets scared, an unexpected cry or an unpleasant conversation, a scandal (fear of it), that is, the body is under strong tension, anxiety - there is a sharp release of adrenaline, which sharply raises blood pressure and pulse, the person has difficulty breathing, there is a veil before the eyes, minor jitters appear, the body perceives this as a danger and, in order to save the brain and heart, activates the process of glucose entering the body (oxygen), into the tissues, and for those who eat poorly and are very thin, this is a threat to life. Using a simple example: “grandfather is lying there, he doesn’t want anything, he’s getting ready for the next world, they give him glucose, he gets up and immediately has a hundred plans for the whole day.” But you need to understand what worries your loved one, measure fasting blood sugar + lack of the joy hormone (dopamine).

Please tell me if the negative state is similar to stupor, but not so strong. That is, there is negativism, difficulties in communication, clouding of consciousness, but there are no other “strong” symptoms and this state lasts no more than a few hours. Is this also a stupor?

I often experience a similar state at my job and “the brain switches off” and it is very difficult to continue to work productively. How can you help yourself in this case?

Thanks in advance for your answer!

Hello, Kirill. In your situation, you need to get advice and adequate treatment with a diagnosis from a neurologist.

– a movement disorder that occurs against the background of mental trauma. It manifests itself as mutism and complete or almost complete immobility, while there are no physical or mental disorders that could cause such a condition. Develops as a result of excessive acute stress, severe social or interpersonal problems. The duration usually ranges from a few minutes to several hours. The diagnosis is made based on clinical symptoms and data on the traumatic event. During the diagnostic process, other mental and somatic pathologies are excluded. Treatment – psychotherapy, drug therapy.

ICD-10

F44.2

General information

Dissociative stupor is a stupor resulting from a traumatic situation. Along with dissociative fugue, dissociative amnesia, dissociative identity disorder, depersonalization and derealization, it is part of the group of dissociative disorders - conditions that develop against the background of severe stress and are accompanied by the alienation of one’s own thoughts, memories and other mental processes.

Short-term stupor lasting a few seconds occurs quite often (in everyday life, such stupor corresponds to the expression “frozen in place with horror”) and does not require special treatment. Longer stupor is a fairly rare mental disorder. Typically, cases of such stupor are detected during natural disasters, industrial accidents and other similar events. Treatment of dissociative stupor is carried out by specialists in the field of psychiatry.

Causes of development of dissociative stupor

The cause of development is always a psychotraumatic situation, but the nature, duration and objective significance of such situations can vary significantly. Most often, clinically significant stupor occurs during large-scale destructive phenomena that pose an immediate threat to human life. Such phenomena include floods, earthquakes, hurricanes, house collapses, industrial accidents, train crashes, wars, etc.

Along with the danger to life, the high probability of developing dissociative states in such situations is due to the peculiarities of perceiving oneself as small, helpless and insignificant compared to natural forces or other similar phenomena (insignificance in the face of fate). In addition, stupor can occur during tragic events that pose a threat to a specific person: car accidents, criminal incidents (especially those involving violence), etc.

Sometimes the cause of stupor is situations that do not pose a threat to life, but are of extremely high significance for the patient: the death of a loved one, a breakup with a loved one, bankruptcy, dismissal. Brief dissociative stupor, without clinical significance, can occur with any sufficiently intense acute stress, for example, the threat of an attack by a large dog or the threat of a car accident. In children, such conditions can appear during exams, conflicts with peers and other stressful situations.

The likelihood of development, depth and duration of stupor depend on three factors: the severity of the threat (including subjectively assessed), the type and characteristics of the reactivity of the patient’s nervous system, his psychological and physical state at the time of the traumatic situation. Assessing the seriousness of a threat and psychological readiness for sudden stress is determined by professional and life experience (children often perceive threats more seriously than adults, people in “peaceful” professions more seriously than rescuers, military personnel or emergency doctors).

Stupor often occurs in people who are predisposed to “freezing” and indecisive behavior in unforeseen circumstances. Physical fatigue or exhaustion due to too much work, lack of sleep, or acute or chronic medical illness increases the risk of developing the disorder. An unfavorable role is played by psychological exhaustion caused by constant tension or internal conflicts. Childhood traumatic experiences matter.

Symptoms and diagnosis of dissociative stupor

The patient is passive, practically motionless, remains in the same position for a long time, does not react or almost does not react to signals from the outside world (sounds, changes in lighting, touch, pain), does not answer questions addressed to him or answers very briefly, monosyllable, with a noticeable delay. Spontaneous speech is usually absent. Based on observations of the patient, assessment of his body position, muscle tone, respiratory rate and other indicators, it can be stated that the patient is awake and not in an unconscious state.

Consciousness during stupor is preserved, but peculiarly narrowed. Patients are able to accept and process external impressions, and to a certain extent orient themselves in place and time, but mental processes become unclear, slow, and “blurred.” Emotional reactions may vary. Some patients experience detachment and self-absorption. For others, facial expressions indicate significant affect (despair, suffering). The mention of tragic events causes tears, increased heart rate, and trembling of the facial muscles.

The diagnosis is made based on examination of the patient and information provided by accompanying persons: relatives, ambulance officers, police or rescue services. Three criteria are required to make a diagnosis of dissociative stupor. The first is the presence of stupor (immobility, mutism, decreased or lack of response to external signals). The second is the absence of a somatic, neurological or mental disease that could cause the listed symptoms. The third is data on psychological trauma.

Differential diagnosis is carried out with other types of stupor (catatonic, depressive, etc.), primary and secondary (due to other diseases) organic lesions of the nervous system. used amytal-caffeine (barbamyl-caffeine) disinhibition, however, for ethical reasons and due to the inclusion of barbamyl in the list of narcotic drugs, this method is currently considered obsolete. After emerging from stupor, patients are helped to respond to their experiences during the traumatic event. The main methods of treatment are psychoanalysis and short-term psychotherapy (usually rational therapy, behavioral therapy).

Long-term treatment in the absence of clear indications is not recommended - the longer the patient feels sick, the worse dissociative disorders respond to treatment. The prognosis is favorable. The exit from the state of stupor can be sudden or gradual, followed by transient asthenia of varying degrees of severity. Sometimes dissociative stupor develops into other forms of stupor, and some patients develop depression.

Stupor is a movement disorder characterized by immobility, mutism (silence), and lack of response to external stimuli, including painful ones. Literally translated from Latin as "numbness".

Most often, when talking about stupor, they mean an extreme manifestation of this condition, which should be treated by a psychiatrist in a hospital setting, or the highest degree of confusion, when a person, as they say, can't say a word. In fact stupor is all of the above and many more intermediate states. It can occur to us once in a state of extreme excitement, or it can be repeated with enviable regularity.

Sometimes we can cope with stupor on our own, but more often we need the help of a specialist - a qualified psychologist who will either deal with the situation himself or refer us to a general practitioner or a psychiatrist.

Types of stupor and its symptoms

Akinetic. This condition is characterized by maintaining the body position in one position for a long time and resisting its change.
Apathetic. It is characterized by a lack of motivation for any activity, both motor and mental, disorientation, and paucity of experiences.
Affective, depressive, melancholic stupor. It is observed with deep depression and is usually accompanied by a mournful expression on the face and posture.
Hallucinatory or hallucinatory-paranoid stupor is accompanied by hallucinations, either auditory or visual.
Catatonic. It is a manifestation of catatonic syndrome and is characterized by passive negativism or waxy flexibility, and in the most extreme manifestation – muscle numbness in the fetal position.
Manic. Combined with the patient's extremely agitated mood.
Negativistic. In this state, the patient is in a daze, but resists attempts at external influence.
Effective or empty. There are no other psychopathological disorders.

There are conditions that are clearly caused by traumatic experiences:

Hysterical, psychogenic, pseudocatatonic, emotional stupor occurs as a result of severe mental trauma, for example, the loss of a loved one, being in a war zone, captivity, rape.
Post-shock. Occurs after a natural or man-made disaster: fire, tsunami, car accident, etc.

Stupor can be a symptom or consequence of a mental illness or severe brain damage, either organic, chemical or infectious:

Receptor. Occurs against the background of schizophrenic delirium.
Exogenous. This condition occurs against the background of toxic or infectious damage to the brain.
Epileptic. Brief stupor lasting from several hours to several days in epileptics.
Stupor, apparent or Westphalian pseudostupor, occurs against the background of severe mental disorders and is directly associated with them.

Causes of stuporous state

If we consider all the underlying causes of stupor, we can conclude: this is nothing more than capitulation to danger. Scientists believe that it is human nature to respond to danger in one of two possible ways, namely:

Fight.
Run.

Often danger leaves us no time to think (otherwise we would try to avoid it) and our subconscious mind independently and instantly sends a signal to our body exactly what it needs to do. But there are situations when neither flight nor fight will help; the simplest example is a passenger in a falling plane.

Stupor is a sentence that an individual has passed on himself. The body capitulates to a danger that can neither be avoided nor reduced, and it is the experience of fatal helplessness that causes this state.

But it happens that a person falls into a stupor, as they say, out of nowhere. The situation that led to it is neither particularly traumatic for the psyche nor dangerous for physical health. Here past experience can play a cruel joke on us.

In any situation, a person makes a decision on how to act in a given situation, guided by:

intuition;
your feelings;
based on past experience.

Moreover, this decision is often made unconsciously and many times a day, automatically and instantly.

Imagine that you come to a reputable restaurant and the waiter comes up. Naturally, any person in such a situation expects that he will accept the order. Instead, he stuck out his tongue and poured a glass of water on your head. Here even a person with the healthiest psyche will fall into a stupor.

This is, of course, a joke, but it perfectly demonstrates that in those cases when we acted in a situation familiar to us and received a result that did not correspond to our past experience, we end up with stupor. Although not something that deserves hospitalization or an urgent visit to a psychiatrist, it is also a stuporous state.

Biological basis

Man is not as far removed from the animal as we would like to think. This condition also occurs in the animal kingdom, and is not so rare. Let's remember the rabbit, who, in a daze, waits to be swallowed by a boa constrictor. Or a chicken that will freeze if you put its head under its wing.

In the animal world stupor is mercy, he gives the possibility of a painless death, turning off the sensitivity of the victim, who has no choice but to surrender. In this state, the pain subsides and a merciful insensitivity appears.

For man mental trauma can be unbearable, the situation is perceived as hopeless and hopeless - this is the decisive component that causes stupor.

How to help a person get out of a stupor

Naturally, in case of extreme manifestations, immediate hospitalization is necessary, where a specialist will prescribe the necessary drug treatment. But if you witness a situation where a person has fallen into a stuporous state, you can immediately try to take the following actions:

In an even, calm voice, clearly and quietly tell the person things that can evoke strong emotions, any, even negative ones.
Give the person several slaps, and hit him hard.
Press the person's fingers firmly into the palm, keeping the thumbs straight.

Even if your efforts are crowned with success, the person subsequently needs to consult a specialist.