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Awareness Disorder - Causes and Therapy
contents
- Brain tumors
- The meningitis
- vegetative state
- Near-death experiences
- Dissociation and trauma
- drugs
- Mental disorders
- Paranoid schizophrenia
- manias
A brief unconsciousness for up to a minute means fainting; A long-lasting unconsciousness is a coma. In a qualitative disturbance of consciousness, the contents of consciousness change: they are clouded, narrowed or shifted. In a quantitative disturbance of consciousness, alertness increases as in delirium or decreases as in drowsiness.
Drowsiness shows through slowed thinking and acting, orientation problems, loss of concentration and fatigue. The so impaired but still responds to external stimuli, for example, if someone appeals to him loud. Heavier is the extreme drowsiness. The victim only responds to strong external stimuli such as pain. He does not really wake up. In coma, the person affected no longer responds, and his life is in danger.
Awareness disorders have a variety of causes: A stroke, the circulation of the brain overrules, even an epileptic seizure or low blood sugar in diabetics are widespread. Concussion, traumatic brain injury, cerebral hemorrhage and cardiovascular disease are associated with impaired consciousness. Brain diseases also limit awareness. These include meningitis, brain inflammation and brain tumor. Kidney and liver failure disturb the consciousness equally. Hormonal disorders also change the consciousness. These include thyroid over- and under-function. Drugs change consciousness as well as mental disorders.
Brain tumors
Brain tumors are tumors in the brain. One in three is malignant, including the glioblastoma. It arises in the supporting cells. Other tumors spread in the meninges; they are called meningiomas.
A brain tumor triggers various complaints, depending on where it lies: the balance is disturbed, as well as the emotional world. The nervous system takes damage, to blurred vision and paralysis.
Brain pressure arises because the tumor displaces the healthy tissue. The volume of the skull remains the same, and therefore the pressure in the cranial cavity increases. This skull pressure shows up in headache, vomiting and nausea as in a flu infection.
The meningitis
Meningitis is an inflammation of the soft skins of the brain and spinal cord. Bacterial meningitis primarily affects children and adolescents; It is common in Africa and South America and is characterized by high fever and headache, the neck becomes stiff. It is followed by convulsions, the sick vomit. They are sleepy, confused and their consciousness is clouding. Then they lose their consciousness and can even die.
vegetative state
Waking coma is caused by the disturbance of the cerebrum; the brain stem remains unhurt. The person is unconscious, can not respond to external stimuli, act and probably not think; but the functions of the body are fine, the patients sleep and breathe. Above all, they can no longer react emotionally; The body works, but they do not make contact with other people.
It is disputed whether the patients have no emotions or can not express them. Doctors who operated soldiers without anesthesia in the First World War had a bad experience because they considered them conscious and painless. Alleged nervous lapses of one of the so dissected dissected turned out to be the Morse code of the former radio operator, who pleaded to leave him alone. Awakened coma patients repeatedly report that, as if in a dream, they were aware of their environment. Also because of these reports, the physicians today attach importance to the subjective circumstances: What relationship do the caregivers have to the patient, what stimuli could trigger healing processes? What atmosphere could contribute to its healing?
Healing coma patients show that despite neurobiology, brain research and high-tech medicine, we know little about the brain. Often referred to as biologically infamous neurobiology, which reduces the social being human to its biochemical processes, proves that the brain is a social organ. The synapses connect and grow depending on social circumstances.
Relatives of sentinel patients often think that the breathing, sleeping and even eating partner, son or father hears everything. This is probably not the case, and this perception results from the psychic need for parents to musically preserve the rooms of deceased children, to compensate for the loss in which the parents of missing persons cling to the possibility that they might still be there Hope to meet the loved one after death again. Return does not have to mean a perfect world, waking coma, which wake up, sometimes remain severely mentally handicapped. (Nydahl, Peter (Ed.): Wachkoma: Care, Care, and Support of a Man in a Surgeon's Coma.)
Near-death experiences
Near death, whether felt or actual, leads to a changed consciousness. Soldiers talk about how, in the face of death, they displayed extraordinary calm, changed their perceptions of time and space, discussing casualties, the moment seemed infinite, the motorcycle racing against the lamppost, the burning clothes raging Torn off the body or saw the precipice approaching the fall - even though it was seconds.
In the moment they receive help, the very severely wounded often utter the last words and die like the runner who reported victory and defeat after the Battle of Marathon and then sank dead. Medically, "near-deaths" that fulfill a final task can be explained: Every long-distance runner knows that he has to walk a distance to reach the target, so that he does not break down - the consequences are more dramatic for those seriously injured: The movement keeps the system upright and a stop of this movement leads to death.
People on the verge of death report leaving the body and looking at it from the outside, meeting ghosts, or watching their own lives go by. Christians interpret this experience as an encounter with the hereafter, as an assignment to return to earthly life. A tunnel at the end of which a light stands, the feeling of harmony and peace, well-being and warmth emerge in so-called near-death experiences.
"Otherworldly Slips" also appear in the shamanic journey, but shamans, who are trance by drumming, substances or fasting, are not near death. The tunnel flooded with light, the encounter with spirits and the answer to questions of meaning are core elements of the shamanic journey. Instead of life after death, the near-death reports show that the unconscious produces similar images
Psychology explains alleged hereafter as psychic splits - as well known from shamanistic ideas as from psychiatric symptoms. Every epileptic knows transitions into a supposedly different world before his seizure, voices appear to schizophrenics. To "free oneself from the body", to look at one's own body from the outside, is a reaction to trauma such as sexual abuse. Any therapist who cares for alcoholics in delirium tremens knows hallucinations of beings, animals and other worlds.
The change of time and space is associated with increased memory and supposedly extrasensory experiences. This neurophysiological process inhibits biological functions to strengthen others - pain insensitivity and mental performance. The memory of childhood or the deceased can be interpreted as a regression to escape the situation, happiness as a wish projection that protects against the hopelessness. So-called near-death experiences coincide with the reactions to a trauma.
Dissociation and trauma
A trauma is an experience that overwhelms the psyche and that can not be integrated. Traumatized people suffer from helplessness and can not control their anxiety. In a hopeless situation in which the person concerned can neither fight nor flee, a survival strategy sets in: The consciousness splits off the threat.
Dissociation is firstly not a disturbance of consciousness, but the ability to come out of extreme situations, for example, when an accident victim does not feel his injuries, calls the ambulance and later hardly remembers. However, children who are exposed to violence can develop these divisions into a life structure. They depend on the perpetrator and develop an everyday self that works. They divide the experience of violence so far that it remains only as a fragmentary memory or even as a feeling of powerlessness without memory. However, other parts of the personality develop independently.
In extreme cases, different "personalities" in a person arise, which behave independently of each other. Triggers, situations that are similar to the trauma, cause the functioning ego to be flooded by the experience of violence - even as the personality changes. Man speaks with a different voice, he thinks differently, he behaves differently. Some people who suffer from this disorder are aware of their part personalities, others are "next to each other". Her everyday I do not know what her alter ego did in the time of the change.
They have no memory of why they wear these clothes, how they got to a place, or who they talk to. Her own body feels unreal to her. They have flashbacks, the actions of the participants appear as images and feelings in the everyday consciousness. They hear the part personalities as voices in their heads. They can not control their movements; they hurt themselves; you take drugs; they go bankrupt.
One person concerned reports: "I have phases in which I have totally stepped away, no longer notice anything of the environment and feel outside the space and time. I then feel like a dead person, like a ghost, I leave my body, see my body from outside, have no access to it anymore. Extreme pain is a way to get back into my body and perceive it. "
Healing means for the person concerned to first get to know the part personalities and to communicate with them in an inner dialogue. Ultimately, it's about integrating the traumatic experience until the violence comes to an end and memories come to mind as memories rather than flashbacks. (Deistler, I., Vogler, A: Introduction to Dissociative Identity Disorder, Paderborn 2002.)
drugs
Drugs also override normal consciousness. The use of substances such as alcohol, cannabis, LSD, heroin, cocaine leads to dizziness (alcohol) or to increased alertness (cocaine).
Alcohol in small amounts increases the mood and releases inhibitions. However, larger amounts lead to irritability and aggression. The more alcohol in the blood, the more distorted the perception. The poisoning impairs the judgment, language and motor skills, then dizziness follows. Very large amounts of alcohol cause coma or death.
Alcohol enters the brain with the blood and influences the information of the nerve cells there, little alcohol stimulates the transmission, higher blocks it. In the process, the neurotransmitter dopamine is released, which ensures pleasant feelings.
Heroin euphorates, relaxes and limits the consciousness. At the same time, it dampens fears. Heroin quickly leads to physical dependence. In addition, the threshold for poisoning is low and even 5 mg can be fatal. Heroin poisoning leads to unconsciousness and circulatory failure.
Mental disorders
Psychoses are mental disorders; they involve delusions and loss of reality. Those affected hear, see, feel and smell things or living things that do not exist. These include voices that give them "wisdom" or commands. Psycho-believers are convinced of ideas that can not be true: they believe that other people would conspire against them, that someone else lives in them, that Internet or television send secret signals. Those who suffer from a psychosis avoid their own friends, who recognize these delusions - they themselves are considered part of the conspiracy.
In a psychosis, it is difficult to cope with everyday life. Transferring the rent, getting the garbage out of the apartment and even getting up in the morning are hardly surmountable hurdles.
Awareness disorders manifest in a psychosis as confusion and fragmented thinking; those affected forgot what they wanted to say. They no longer know who they are, their own thoughts seem whispered to them from the outside, they believe that others know what they think and can steal their thoughts from them. The perception of other people, objects and the environment is distorted: A familiar environment seems strange, bigger or smaller.
They think they have to do things they do not want to do and blame invisible others for doing so. Some believe they are on a mission to save the world, think they are communicating with aliens, or are persecuted for having supernatural abilities.
Listlessness is part of the psychosis. The sufferers lie in bed for days and fail to get active, do not wash themselves and can not get out of their room. At the same time, emotions change. Previously unknown fears are accompanied by aggression. Often they talk with "strange voices."
The delusions require inappropriate behavior: aggressiveness towards supposed enemies and panic towards the distorted perceived environment. The feeling that someone is directing their actions from outside leads to inner unrest and eruptive gestures to ward off these "invisible enemies".
The victims sometimes put themselves and others at risk. The supposed defense against alleged enemies provokes fights. Some sufferers hurt themselves to fight the "enemies" who "nestle in their bodies", for example by cutting themselves into the skin. Affective actions can end fatally: in psychoses, people jump from skyscrapers and run onto the highway.
Paranoid schizophrenia
Schizophrenia is a special form of psychosis. Although it is a disturbance of consciousness, the clarity of consciousness and intellect are not limited - rather the perception is disturbed. The suicidal risk is great.
It starts with the thoughts ripping off, those affected "talking", feeling a diffuse threat and feeling that the "atmosphere is changing". The lack of drive typical of other psychoses rarely occurs, as well as speech and movement disorders that characterize other schizophrenia. The most important characteristic, however, is the persecution mania. The patients are firmly convinced that they are controlled. They suspect that their home is bugged, neighbors become spies and passersby become agents. They distrust everyone: When people talk in the cafe, the affected person means that he is at stake.
The thoughts tear off, those affected "talk wrong", they feel a diffuse threat that the "atmosphere changes".
manias
Manias are also mental disorders that distort perception. However, the manician finds this pleasing: in a manic phase, he is on the move day and night, has innumerable ideas to save the world, and his ego increases to megalomania. He talks uninterruptedly, chasing after his own thoughts, while being distracted by everything that happens around him.
All people know phases of euphoria in which everything seems possible. When we are freshly in love, everything seems like cotton wool; begins a new project, we rush to work with zeal. Reality puts the excitement right: The Dream Prince has its rough edges, and the new project is only tenacious.
In a mania, however, the euphoria is out of all proportion to the objective circumstances. Your mood is superb, without an occasion in the outside world. With this "positive attitude" they can sweep up the needy. Manicists consider themselves superhumanly capable and start a lot of projects without ending them. They are not only "in a good mood", but also extremely irritable. They take no account of the needs of others and no responsibility for their actions. Who brings their flood of ideas on the ground, is considered an enemy who wants to restrict it. Breaks keep them from their "thirst for action".
Manicans do not take themselves for being impaired, but their bodies and their homes are neglected. Hygiene and nutrition are irrelevant if the manist is just overriding the laws of nature.
Manicists have an increased libido and keep thinking of being in love again and again, immortal. In a mania, the person loses the distance to his fellow man and can rip it, if his thinking is not yet completely confused - up to banks that grant him large loans or excessive sexual experiences. Ill maniacs feel pleasant during mania; the limitations of everyday life seem to have been lifted and fantasies can supposedly be realized. Hallucinations belong to a "full-grown mania"; the person concerned thinks he is a millionaire or considers himself a famous person.
When the mania is over, the disillusionment follows. The patient has burned out, and his previous megalomania seems strange to him, his "enterprises" leave behind astronomical debts.
In most mental illnesses, the suffering is great, so that the affected people accept help to free themselves from their condition. For manicans in a manic phase this is usually not true. Although they see, when they are "normal" again, what damage they inflicted on themselves and others, the euphoria increases again, they no longer accept the medicines and can not be "restricted"..
Serious mania make psychiatric care necessary because the person is at risk and others. Limiting the patient in an acute mania brings little. The therapist and the social environment can reduce external stimuli and restrict the patient's freedom as little as possible. If possible, they should direct their thoughts in "safe" ways and discourage him from fatal acts, such as persuading him to take a walk in the forest when he is about to book a world tour.
Manic phases alternate with many sufferers with depression - one then speaks of bipolar disorder. In depression, the patient falls into the opposite of his previous megalomania: he no longer dares to leave the house, does not manage to get up, he feels paralyzed, and everyday life weighs on him like a leaden weight.
Depression does not cloud consciousness, but focuses it on "too realistic a perception". Mentally stable people spend a large part of their time with dreams and ideas that they almost never realize, and they know it. They revel in virtual worlds, and repress that they will one day die. While the bipolar mania believes in implementing these fantasies at once, it is incapable of even developing them in depression. (Dr. Utz Anhalt)
Literature:
Bock, T .: roller coaster of emotions. Living with mania and depression. Bonn 2010)
Bock, T .; Koesler, A .: Bipolar Disorders. Understand and treat mania and depression. Bonn 2005
Bräuning, P .; Dietrich, G .: Life with bipolar disorders. Stuttgart 2004