Mental health clinic

Private psychiatric hospital

A psychiatric clinic or hospital, contrary to popular belief, is not much different from the usual one. The structure of any clinic includes an inpatient department, a day hospital and consulting rooms. Most of all fears and prejudices are, naturally, a psychiatric hospital. Quite often we hear: “anything you like, just not a psychiatric clinic.”

Fortunately, mental illnesses and disorders are not transmitted by airborne transmission, and from the inside, the department does not resemble a cage or “prison” where people with mental disorders are “locked” and thrown away the key. TV shows and horror films have taught people to be afraid of everything with the prefix “psychiatry”. However, everything is there, as in ordinary life: wards, staff, doctors, medications. No one runs around in a straitjacket, or bangs their heads against the wall (or other heads).

Indeed, some external attributes may be present (bars on windows (we do not take into account the bars on the first and second floors), restrictions on entry and exit), but it is important to remember that this is done in order to protect patients. Not to mention the fact that if a person expressed a desire to be treated in a hospital, and then changed his mind, no one is going to keep him by force (the person must even sign a voluntary informed consent for examination and treatment, where it is indicated that he can refuse at any time).

In addition, hospitals are different in specializations. Even in state psychiatric hospitals, there are not only “acute” and “ordinary” wards, but also departments. The main essence of any department is the ability to provide a full range of diagnostic and therapeutic care. Because with all the desire to provide the full amount of assistance on an outpatient basis is not possible.

Signs of mental disorders

The signs of mental disorders are as diverse as the mental disorders themselves and can be represented by both trivial insomnia and complete “disconnection from reality”. A person can notice these signs himself or they can be noticed by others. These include insomnia, anxiety, constantly depressed mood, panic attacks, lack of appetite, a feeling of complete powerlessness, loss of interest in familiar things, isolation, unreasonable fear, suicidal thoughts, excessive activity, inappropriate statements and actions, psychomotor agitation, aggressive actions, directed at others or at oneself, auditory and visual hallucinations.

In the presence of a mental disorder, it is extremely rare that everything is limited to one symptom. Sometimes the symptoms can be very diverse (in medical language – polymorphic). Also, one of the most common and complicating symptoms of the situation is anosognosia – uncriticality to what is happening or the impossibility of a person, due to disturbances in thinking and perception, to understand that he is sick.

How to understand that you need treatment is a psychiatric clinic?

Having familiarized yourself with the above signs of mental disorders, the reader may have the impression that it is time to run to the hospital of a psychiatric clinic. Fortunately, however, this is most likely not the case. Many signs, such as episodes of insomnia, anxiety, low mood, are familiar to all of us. The episodic occurrence of individual symptoms does not yet speak of a mental illness, but when the severity of these symptoms goes beyond certain limits, it is necessary to consult a specialist.

For example: one sleepless night is unlikely to bring many problems, but when it comes to a week or two or even more, especially if it is accompanied by anxiety, fear, depressed mood, a sense of hopelessness and despair – it’s time to see a psychiatrist.

If close people begin to notice inadequacy in statements or behavior, they should also make every possible effort to persuade them to seek help. The subjective severity of internal experiences does not always correspond to the severity of the condition from a clinical point of view. Based on this, at the initial consultation, the psychiatrist offers the most optimal options for solving the problem. Naturally, when it comes to problems that must be solved by medication, the hospital will be offered first.

Psychiatrist - narcologist
Ivan Vladimirovich Brednev

Psychiatrist - narcologist

The reason for this is simple – in a hospital clinic, it is possible to observe a person’s reaction to medications, you can adjust the prescription scheme at any time so that it gives the desired result and does not create excessive discomfort. Not to mention the fact that it is possible to use intravenous and intramuscular medication. If a person does not have the ability or desire to go to the hospital and the problem can be solved on a clinic basis, home treatment is prescribed.

Quite rarely, but there are situations when a doctor may insist on inpatient treatment of mental disorders. However, this insistence does not mean forced hospitalization (and cannot mean, according to the law of Ukraine “On psychiatric care”). This means that the psychiatrist does not see an opportunity to resolve the situation on a clinic basis, or believes that prescribing medication at home may be unsafe for the patient, or the patient’s condition is too serious to cope with on a clinic basis.

In this case, if the patient refuses clinic treatment, the doctor can give general recommendations, referral to hospitalization, but he cannot (and does not want to) take responsibility (and the appointment of clinic treatment is also a responsibility). Further, the person himself is determined with a plan of action. When it comes to mental disorders, the need for emergency assistance is possible. In this case, it is possible to call an ambulance team. Naturally, in order to get to a private psychiatric hospital, it is necessary to call a private ambulance (the public service in these cases does not have the right to deliver people to the psychiatric hospital of a private clinic).

Methods for treatment of mental disorders

There are several treatments for mental disorders. The choice of method, or often a combination of methods, depends on the nature of the disorder and the patient’s wishes. Treatment methods can be divided into three large groups: psychopharmacotherapy, psychotherapy and conventionally “others” (for example, physiotherapy, diet, normalization of lifestyle, etc.). Next, we will analyze them in more detail:

Psychopharmacotherapy

The essence of the method consists in the appointment of both specific psychopharmacological drugs and neurological, tonic. There are several types of psychopharmacological drugs that can be used both in monotherapy (therapy with one drug) and in combination (two or more).

Psychopharmacological drugs are divided into several groups: antipsychotics, antidepressants, anticonvulsants (normotimics), antidepressants, tranquilizers. Before starting to describe them, I would like to comment on the standard request of many patients: “Assign me something new and modern.” Of course, in pre-psychopharmacology, there are drugs that are literally and morally outdated, but very many rightfully occupy a certain niche, regardless of when they were synthesized. In other words: the date of the first hit of the drug on the commercial market does not always mean that it is more effective in all cases.

Neuroleptics

A group of drugs that are diverse in nature and scope. The main task of a neuroleptic in therapeutic doses is to normalize the processes of thinking and perception and, as a result, to eliminate delusional and hallucinatory symptoms (reduction of the psychotic state). They are conventionally divided into typical and atypical antipsychotics.

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Typical antipsychotics include, for example, drugs such as haloperidol, chlorpromazine, truxal, clopixol, tisercin. Despite the fact that they were synthesized a long time ago, they still occupy the niche of relief of acute psychotic conditions all over the world and are used as maintenance therapy in the form of prolonged-release drugs (haloperidol-decanoate, clopixol-depot). Haloperidol, chlorpromazine and tizercin exist in an injectable form, which makes it possible to use them drip or intramuscularly, which is much more effective than taking pills in the acute phase of treatment. Many myths and prejudices in society are associated with these drugs, however, they have a short duration of action, allow the psychotic state to be eliminated as quickly and effectively as possible (without harm to the patient).
psychotherapist
Irina Viktorovna Kruchkovskaia

Psychiatrist of the highest category, psychotherapist

Atypical antipsychotics were synthesized later and have a less understood and studied mechanism of action. These include Leponex, Zyprexa, Rispolept, Seroquel, Eglonil, Abilify, etc. They are characterized by a wider spectrum of action, softer and better suited for supportive treatment. Some exist in injectable form, but these forms are often not available on the Ukrainian market. All antipsychotics can be conditionally assessed by two effects: sedative (sedative, hypnotic) and incisive (the ability to eliminate mental disorders, and not just cause a hypnotic effect). In this regard, two antipsychotics can be used simultaneously: one eliminates psychotic symptoms, the second has a sedative and anti-anxiety effect. Antipsychotics have found themselves not only in the treatment of mental disorders. Many are used as non-addictive mild hypnotics (eg. quetiapine), antidepressant therapy (aripiprazole, sulpiride), and gastrointestinal problems (eglonil). Therefore, if a doctor prescribes an antipsychotic, this does not mean that you are automatically mentally ill. In such cases, it is worthwhile to overcome fear and ask the doctor what he was guided by, I think you will be pleasantly surprised.

Anti-depressants

As the name suggests, they fight depressive symptoms. They are divided into groups according to their chemical structure: tricyclic, tetracyclic, SSRIs (selective serotonin reuptake inhibitors), SSRIs (selective serotonin and norepinephrine reuptake inhibitors), MAOIs (monoamine oxidase inhibitors).

One of the first antidepressants, amitriptyline, is a classic example of the market launch date not always indicating obsolescence. It is the drug of choice for episodes of severe depression, one of the few injectable antidepressants. All antidepressants have their own antidepressant effect. The problem is that they do not give this effect immediately, but at the end of the first 10-14 days of therapy or even later (cumulative effect).

All antidepressants also have secondary effects (activating, anti-anxiety, hypnotic, sedative, etc.), which actually appear after the first dose. Sometimes these secondary effects are enough for a person to feel comfortable before the onset of a full-fledged antidepressant effect, if not, additional antipsychotics or tranquilizers are prescribed for a short period. Antidepressants are used not only directly for depression. They are used as hypnotics, anti-anxiety drugs, an auxiliary component in the complex therapy of panic attacks.

Anti-convulsants (normotimics)

Originally used as a treatment for epilepsy (seizures and their equivalents). Over time, it was found to have a stabilizing effect on the affective (emotional) sphere and the central nervous system in general. Allow to reduce or eliminate emotional fluctuations and swings. At the same time, they do not have a significant sedative effect and do not drown out emotions.

They are used as a component in the treatment of many disorders and diseases. In this case, we are talking not only about bipolar or schizoaffective disorder, but also about minor disorders, emotional instability, and a tendency to seasonal emotional changes. A great variety of drugs, various in their chemical structure, belong to normotimics. Some of the most used are valproate, carbamazepine, lamotrigine, lithium salts, pregabalin. Since they often do not create discomfort for the patient and are good at preventing affective fluctuations, they are very often a component of supportive therapy.

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    Tranquilizers

    By their chemical nature, they are benzodiazepines. These include both gidazepam, which is widespread in society (one of the lightest benzodiazepine tranquilizers), and heavy artillery in the form of sibazone (diazepam). They have an anti-anxiety and, to a lesser extent, hypnotic effect. They are used in short courses to relieve anxiety symptoms and as an ambulance for psychomotor agitation, status epilepticus. In short courses or occasionally because with prolonged use they cause “addiction”: increased tolerance (the need to increase the dosage to achieve the same effect), withdrawal symptoms or breaking symptom (the occurrence of unpleasant symptoms when the drug is stopped).

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    Psychotherapy

    The system of therapeutic effects on the psyche and through the psyche on the human body. It is often defined as an activity aimed at getting rid of a person from various problems (emotional, personal, social, etc.). It is carried out, as a rule, by a specialist psychotherapist by establishing deep personal contact with the patient (often through conversations and discussions), as well as the use of various cognitive, behavioral, drug, hypnotic and other techniques.

    It is a complex and multifaceted process that takes time and hard work to achieve the result. There are many directions or “schools” of psychotherapy, which differ in their approaches and methods. Often the hardest part of psychotherapy is getting started. There are many factors that stop a person from starting psychotherapy. For example, lack of faith that something can be changed, doubts about effectiveness, fear of opening up in their experiences in front of another person. The opposite position is often encountered, when a person believes that the psychotherapist “will tell me how to make everything so good”.

    Unfortunately, this is often impossible, but in the process of work, a psychotherapist can help a person understand what and how can be done to improve the quality of life. In general, psychotherapy is an important component of the treatment of any mental and psychological disorder and can be effectively used in conjunction with drug therapy. However, it is worth remembering that while a person is in a psychotic state, to put it mildly, he has no time for psychotherapy.

    “Other”

    Normalization of lifestyle – sleep hygiene, work-rest balance, dosed physical activity.

    Diet – Food affects not only our weight but also our psychological well-being.

    Physiotherapy – ozone therapy, xenon therapy, massage, physiotherapy exercises.

    Treatment of mental diseases in a clinic

    The psychiatric clinic, as mentioned above, is not much different from the “usual” one. It all starts with an initial consultation with a doctor, where the patient and, if necessary, relatives describe their complaints and situation. During this, the plan and nature of treatment, approximate terms and projections are discussed.

    Before the formal beginning of hospitalization and treatment, the future patient signs a voluntary informed consent for examination and treatment in a psychiatric clinic, which describes the patient’s rights (and again yes, it indicates the patient’s right to refuse to provide assistance at any time). After that, the necessary examinations and treatment begin. If a person is in a life-threatening condition, the procedure is more accelerated, but still respects human rights.

    It is possible to forcibly hospitalize a person in a hospital only in exceptional cases provided for by Section 14 of the Law of Ukraine “On Psychiatric Care” and whether a person needs compulsory inpatient treatment or not is decided by the court, and not by the psychiatrist.

    Medication appointments are not made even a day in advance and are often adjusted several times a day, depending on the patient’s condition. The main advantage of the hospital is round-the-clock (with the observance of privacy, of course) monitoring the patient’s condition. Thanks to this, it is possible to use intensive courses of treatment in order to bring a person out of a painful state as quickly as possible. Intensive drug treatment is accompanied by the risk of side effects, but within the hospital, these side effects are easily eliminated and the treatment regimen is adjusted.

    It is not possible to implement this on a clinic basis and one has to give preference to milder, but less effective methods. The terms of treatment depend on the person’s condition and therefore are very individual (from several days to several weeks or even months). Inpatient treatment is almost always followed by a maintenance phase. It is necessary to maximize the consolidation of the result and prevent the recurrence of the disorder. Consists of taking supportive medications and periodic visits to the doctor (supportive treatment is selected so as not to interfere with the person’s normal life).

    Marchenko
    Alexander Viacheslavovich Marchenko

    Physician psychiatrist

    Clinic treatment of mental disorders

    Most mental disorders and illnesses, including severe ones, are amenable to clinic treatment. Clinic treatment begins with an initial consultation within the framework of which diagnostics are carried out, additional examination methods are recommended if necessary, and, in fact, drug therapy is prescribed. Medical treatment is selected as carefully as possible and taking into account the lifestyle (in order to create minimal discomfort).

    Subsequently, the patient comes for a visit at a certain frequency to assess the condition and make appropriate adjustments in the appointments. The frequency of meetings is determined individually, depending on the condition, but on average, no more than once every 1-2 weeks. Timely clinic psychiatric treatment very often prevents hospitalization (and a person’s separation from their usual life / work).

    Treatment of psychiatry in Ukraine

    For a long time, the state was a monopoly in the field of psychiatric care (both inpatient and outpatient). This created many problems, both bureaucratic and everyday (the patient’s lack of a choice of a psychiatrist, conditions of treatment and stay). Not to mention the fact that the psychiatric hospital was obliged to send the patient’s discharge to the neuropsychiatric dispensary at the place of residence, which could subsequently complicate the patient’s fate.

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    In our time, a private psychiatric clinic is no longer a fantasy. The MEDLUX clinic became a pioneer in the provision of private psychiatric and narcological services and is rightfully considered the best paid psychiatric clinic in Kyiv. This also confirms the presence of not only a license, but also official accreditation for the provision of this service sector.

    The clinic has a wide range of diagnostic and treatment services (both inpatient and outpatient). Inpatient care is all-inclusive, except in rare cases, the patient or his relatives do not have to run to the pharmacy every day to buy medicines (this also applies to food, water, personal hygiene items). The clinic has absolute respect for the patient’s right to confidentiality not only of treatment, but also of the very fact of seeking help.

    Cost of psychiatry treatment in private clinic MEDLUX

    Payment for inpatient treatment is done on a daily basis, there is no need to pay for the entire period of treatment in advance. The format and quality of treatment does not depend on which ward the patient is in.

    Author </br> Brednev Ivan
    Author
    Brednev Ivan

    Psychiatrist, narcologist

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