Let’s talk about psychotherapy
Psychotherapy is also called spiritual therapy. It is different from chemotherapy and physical therapy. In a broad sense, it includes the improvement of the patient's environment and living conditions, the language effects of the people around him (including doctors), special arrangements, and specialized psychotherapy techniques implemented by doctors. In a narrow sense, it specifically refers to the psychotherapy techniques and measures implemented by doctors on patients, including reasoning therapy, suggestion therapy, sports therapy, music therapy, painting and modeling therapy, etc. In short, through treatment, people's psychological activities are affected, thereby changing people's emotions. Then, some physical states are affected and changed through emotions.
Psychotherapy can alleviate some illnesses. Human beings are a unified living body, determined not only by chemical, physiological, and neurological factors, but also by mental, emotional, and social factors. These two aspects have a dialectical relationship that is interconnected and interacts with each other. Biochemical and physiological changes in the human body can cause psychological and spiritual changes. For example, people with liver disease tend to be angry and prone to losing their temper. In turn, changes in people's psychology and spirit can also cause physiological and biochemical changes in the human body, and even lead to death. For example, there was a soprano singer who was married to a famous conductor for 54 years. Her husband died in 1981. On the night of her husband's funeral, she suddenly fainted in bed and never stood up again. She only outlived her husband. 69 days.
Psychotherapy in old age should be significantly different from that in early childhood, adolescence, and adulthood. Doctors need to understand the entanglements, accidental trauma, and depression that occurred in elderly patients during childhood, adolescence, and adulthood. It has been pointed out that the length of history of neurosis is more important than age. In addition, the elderly always have some form of functional decline, both mentally and physically. Compared with adults, mental stress can easily manifest physical disorders, and minor physical disorders can easily lead to mental manifestations of hypochondriasis. What is a viable situation for ordinary people will become a problem for the elderly. Special excitement. Finally, we must also consider the unique personality changes in old age: excessive introversion, depressive tendencies, indifference to desire and sex, excessive extroversion, aggression, etc. The following introduces several commonly used clinical psychotherapies:
Conversation method
It is also called persuasive reasoning therapy. In contact with patients, doctors must first understand the patient's onset of illness, clinical manifestations, personality characteristics and psychological contradictions, and then influence the patient's psychological activities through language, sometimes with the help of expressions, postures, attitudes and behaviors. Doctors in ancient my country, ancient Greece, and ancient Egypt all used language as a treatment tool. This therapy can be regarded as the oldest tool in mankind's fight against disease. Today, with the development of science, doctors engaged in psychotherapy should use the wonderful function of language to fight against diseases. If medical staff make careless remarks during treatment, it will cause psychological stress to the patient and affect the curative effect.
Attention shifting method
This method does not directly change the patient's personality, but allows the patient to establish new interests, hobbies and connections in life.
There are many ways to divert attention: organize patients to engage in knitting to the best of their ability, participate in dancing, singing, acting, etc., as well as carry out various sports activities.
Suggestion method
A method that uses language, gestures, expressions, etc. to influence the patient's psychology and behavior with the patient's cooperation. Depending on the patient's needs, patients may also be prescribed placebos, which are tablets or liquids with no therapeutic value. At the same time, medical staff are warm and considerate to patients, speak cautiously, and behave appropriately, which has important implications and influence on patients. The University of Los Angeles Hospital Treatment Center conducted an experiment: they secretly tied testers to the left lower arms of 54 male and female patients with heart rhythm disorders in order to accurately measure and record the patients' heart rhythms. Then, let the amiable nurse come to the patient's bed three times a day. Hold their hands, feel their pulse, and talk to them cordially for a few days. As a result, these patients, who were disturbed by inner fear, had a heartbeat rate as stable as that of healthy people within a few minutes of feeling the tenderness and caring of the female nurse. In the process of psychotherapy, the doctor must enjoy a high prestige in front of the patient and make the patient fully trust you. At the same time, he must be very particular about language, be patient, and the treatment must be gradual. Psychotherapy is only a part of treatment and must be combined with physical therapy and drug therapy.
Depression in the Elderly
Case: Patient; Male, 73 years old, his wife passed away five years ago. He currently lives with his son and daughter-in-law, and has no brothers or sisters. Chief Complaint: Extreme anxiety every day, feeling restless when listening to loud noises, always worrying about some disease or whether he is about to die. Onset and course: After retiring three years ago, he stayed at home, tidying up the yard, and lived a quiet life. Later, he felt lonely. Two years ago, he began to feel uneasy about the sound of the tram, and his heart beat abnormally.
This old man suffers from depression. Because he could not adapt to the changed environment, he was isolated from the outside world after retirement. As a result, he felt emptiness and loneliness in his heart. His son and daughter-in-law were busy working all day long, which made him feel that he had become a redundant person and even a burden to others. , and therefore felt sad and hopeless, and gradually suffered from depression. Among the clinically seen mental illnesses in the elderly, depression has the highest incidence rate.
Senior depression is generally more severe in the morning, and symptoms lessen from the afternoon to evening. Patients are often accompanied by strong feelings of restlessness and anxiety. I always feel that it doesn’t matter whether I sit or stand. 60% of patients are accompanied by persistent hypochondriasis. The objective reason is that the body is indeed somewhat unwell or unhealthy. They complain about being sick all day long. Among them, the largest number of people complain about digestive system diseases, accounting for 32%, and 25% have attempted suicide. After some patients become ill, they even wonder whether their bodies have begun to decay or are dying.
Physical symptoms include thirst, loss of appetite, insomnia, fatigue, constipation, headache, palpitations, difficulty breathing, etc.
Mild patients with geriatric depression do not need to be hospitalized and can receive outpatient treatment. However, people with complications from physical illnesses and those with strong suicide attempts must be hospitalized.
Elderly patients with depression are often misunderstood by those around them. Some people blame patients for being stupid, some encourage them to cheer up, and some advise them to engage in recreational activities that are beyond their capabilities. These are all wrong. The patient should avoid stimulation and take adequate rest.
There are effective drugs for treating depression and it is easy to cure, but it must be detected early. In particular, psychotherapy is particularly effective in treating this disease. As long as the 71-year-old elderly patient mentioned earlier pays attention to changing the environment, returns to warm human interactions, and has heart-to-heart conversations with old friends, the patient's mental symptoms and insomnia will disappear.
Women's menopausal hygiene and health care
Women in menopause are at a time when the tree of life is mature and fruitful. They have made certain contributions to their careers and accumulated rich experience. They are the backbone of the workplace, the backbone of society, and the backbone of the family. In order to ensure that menopausal women can survive this period smoothly and enable them to contribute to the realization of the four modernizations, we must pay attention to menopausal hygiene and health care.
1． Popularize menopausal health knowledge. First of all, we need to strengthen mental health guidance so that women understand that menopause is a normal physiological process and the symptoms are temporary, usually after 1 to 2 years. It can be relieved on its own. On weekdays, be sure not to be angry or angry, be open-minded, and don't hold things in your heart. Menopausal women especially need friendship and love, which is of great help in improving symptoms and improving health. Therefore, leaders, family members and colleagues at all levels should also have knowledge about menopause and be aware of it in work and life. They care, love, understand and comfort.
2. The rules of life. We should strive to have time for daily life and balance work with rest. We should prevent overloading of work and try to avoid excessive mental stimulation. But you should also pay attention to physical exercise, regularly participate in cultural and sports activities, and adjust your life. You can use walking, Tai Chi, Ao Qigong, etc. to adjust nerve function and improve sleep.
3． Check regularly. If some symptoms of menopausal syndrome occur, in addition to using drugs to relieve the symptoms, necessary examinations should be carried out to rule out organic diseases in the body. Have regular gynecological examinations every other year to detect organic gynecological diseases as early as possible, such as cervical polyps, cervical cancer, uterine adenocarcinoma, ovarian tumors, etc.
4． Prevent calcium deficiency. Because menopausal women have osteoporosis and are prone to fractures, they should pay attention to their calcium intake from food. Consciously eat foods rich in calcium, such as soybeans, tofu, rapeseed, celery, amaranth, kelp, seaweed, black fungus, milk, eggs, preserved eggs, fried pumpkin seeds, etc. At the same time, outdoor activities should be strengthened.
5. Proper sex life. Women's sexual desire has little to do with the female hormones secreted by the ovaries. The maintenance of sexual desire and the stimulation of sexual impulses after sexual heat are mainly related to thinking and contact with sexually sensitive parts, so sexual desire will not be affected after menopause. However, during menopause, kidney qi is weak and excessive labor in the house will damage the kidney qi. At this time, you must know how to maintain your vitality and have appropriate sexual control. At the same time, you should also pay attention to contraception, because the ovarian function is still active during menopause, and you can get pregnant if you are not careful. If you have an artificial abortion at this time, the damage to the body will be greater.
The psychology of menopause in middle-aged men
Everyone knows that women will enter menopause around the age of 50, but not many people know that men also have menopause. Therefore, men should pay attention to their own "menopausal phenomenon" in order to successfully pass the age transition and ensure physical and mental health.
From an endocrine perspective, the most obvious symptom of menopause is that the male hormone secreted by the testicles begins to decline, which directly affects the maintenance of sexual function. Secondly, the main manifestations of male menopausal syndrome are: poor physical activity tolerance, irritability and insomnia, loss of appetite, memory loss, emotional instability, irritability, agitation, mental fatigue, itchy skin, numbness of limbs, and dizziness; Psychologically, you may have many doubts and worries. You may subjectively believe that someone is laughing at or framing you behind your back, and you may feel uneasy and anxious all day long.
The above-mentioned male menopausal syndrome is usually most noticeable between the ages of 55 and 60. However, due to the influence of social environment such as work pressure and life burden, male menopause tends to occur earlier, and some people begin to experience it in their forties or fifties. Everyone's symptoms are different, some are mild, some are severe, some are slow, and some are urgent. If not treated in time, it will have a negative impact on work, family, and society. Those with obvious symptoms can take methyltestosterone pills to promote endocrine balance. When autonomic nervous system symptoms are severe, vitamin B, oryzanol and other drugs can be taken for treatment.
In addition, pay attention to psychological balance, make friends and avoid loneliness. Paying attention to your daily diet and participating in some cultural and sports activities can help reduce or even eliminate the disease.
(1) Pay attention to the balance between work and rest
Only those who know how to rest will work better. Especially middle-aged women have heavy burdens on work, family, and society. In order to better handle these matters, it is necessary to take some time to have fun. In addition to the function of active rest, play also has cultural functions such as cultivating temperament, increasing intelligence, broadening horizons, improving aesthetic taste, harmonizing interpersonal relationships, etc.
(2) Maintain an optimistic mood
When a person is unhappy and frowns, more than 30 muscles in the head and face will contract, and hundreds of enzymes in the body will change, which is very costly. big. In the face of difficult reality, it is better to worry than to solve the problem calmly and calmly. When people are alive, they must constantly eliminate various psychological obstacles and always maintain optimism. Kant has a famous saying: "Look at everything with a smile." This sentence of Kant should be remembered.
Alzheimer's disease
According to statistics, the incidence of Alzheimer's disease increases, usually after the age of 70. The incidence rate is 2% for those aged 60 to 69 years old, 2.6% for those aged 70 to 74 years old, 6.1% for those aged 75 to 79 years old, 13.7% for those aged 80 to 84 years old, and about 27.8% for those aged 85 to 85 years old. That is, more than 1 in 4 people suffer from this disease.
For a long time, the medical community has believed that senile dementia is caused by blood circulation disorders in the brain of the elderly and is an inevitable phenomenon in the aging process. In 1906, Alzheimer, a German neurologist, discovered a peculiar case: the patient was a female, and although she was only 50 years old, she had severe symptoms of dementia - memory loss, disorientation, and frequent hallucinations. After the patient died, Alzheimer's dissected her body and found that there were many nerve fibers tangled into blocks in the brain, which he called "neurofibrillary tangles." Such cases discovered by Alzheimer's are named "Alzheimer's disease." For nearly 50 years, Alzheimer's disease has been considered a very rare disease, mainly occurring in middle-aged people aged 40 to 50, so it is also called "Presenile dementia" . In the late 1960s, with the help of electron microscopes, researchers discovered the same neurofibrillary tangles in the brain tissue of Alzheimer's patients. Only then did the medical community understand that Alzheimer's disease was neither "progeria" nor "progeria". rare. Therefore, some people also refer to senile dementia as Alzheimer's disease. However, recent literature reports that Terry found that 30 to 40% of the deceased who were clinically diagnosed with Alzheimer's disease did not find the typical lesions of Alzheimer's disease at autopsy.
Japanese Mototaka Murakami and others classified Alzheimer's disease into cerebrovascular disorder dementia and brain atrophy degenerative dementia, and classified Alzheimer's disease as a brain degenerative disease similar to senile dementia. .
Memory loss is the most common early symptom. Patients cannot remember people's names and often ask for the other person's name again after being introduced. I can't remember very simple things. Sometimes I go out without knowing why. As it progresses, it may even become difficult to maintain functions, that is, it is difficult to reproduce past memories, forget one's place of birth, and even be unable to recognize relatives who live together day and night. The language has also lost its fluency, and he often mumbles words whose meanings are unclear and whose preface and follower are inconsistent. Unable to perform calculations correctly, sometimes the answer to a simple calculation like 1+3 is 100. When memory loss affects work, social activities and daily life, it is often a dangerous omen.
In addition, some patients complain that there is something wrong with their eyes because they cannot read. They want to get a glass of milk from the kitchen, but somehow they can’t help but walk into the bedroom. Some patients are making mechanical movements. Sometimes, such as combing hair, I also feel unable to do what I want and my movements are uncoordinated. This is the so-called "apraxia". Dr. John Crowton of Massachusetts General Hospital in Boston pointed out: The difference in early symptom manifestations mainly lies in the different parts of the brain that are damaged.
After early symptoms appear, the patient will gradually develop dementia. The first is poor judgment. In the middle of winter, patients have to wear midsummer clothes, which is a relatively typical behavior. Patients may burn themselves by confusing the cold water switch with the hot water switch when taking a shower. Sometimes pesticides are mistaken for beer and drank. As the condition worsens, the patient will urinate everywhere, not knowing where to go, use the toilet, where his home is, what season it is, or even who his wife is. Some patients may become irritable and fearful of meeting new people.
Some also steal, beat people randomly, expose their private parts in public places, and play with their own urine and feces. When the condition reaches this point, the patient requires round-the-clock care.
In the late stages, some patients almost completely lose their ability to speak and move, and are bedridden all day long, with muscles and skin on the face, arms, and legs shrinking. In the throes of death, some patients' whole bodies curl up like a fetus. The speed of the disease development mainly depends on the initial speed of onset. If the onset is fast, the condition will worsen quickly. If the onset is slow, the condition will worsen slowly. The final direct cause of death is often pneumonia (pneumonia caused by food being inhaled into the lungs).
In addition to mental decline, Alzheimer's disease is also accompanied by loss of will and initiative, as well as various mental symptoms, most often symptoms of nocturnal delirium (temporary disturbance of consciousness that attacks at night, presenting delusions and hallucinations) , confusion, etc.). States such as depression, wandering, suspicion, and restlessness are also often seen. According to the survey, the proportion of dementia accompanied by mental symptoms is as follows:
Nocturnal delirium 24.2% Depressive state 12.1%
Hallucinations and delusions 14.8% Wandering 11.1%< /p>
Suspiciousness 10.1% Fire-making 3.9%
Restless and anxious 9.9% Unclean behavior 2.2%
Aggressive behavior 4.4% Suicide attempt: 1.1%
Dementia in the elderly is more common in the sequelae of stroke (cerebral hemorrhage, commonly known as stroke), followed by high blood pressure. According to a survey by the Tokyo Metropolitan Government, 45% of the elderly with dementia have sequelae of stroke, 34% have high blood pressure, 30% have hemiplegia, and more than 60% have lethargy or falling asleep and waking up suddenly, and have incontinence of urine and feces. Accounting for about 40%.
——Quoted from "Disease Prevention Master" by Yanbian People's Publishing House