When is it time to see a psychiatrist? Many psychiatric and neurological terms (depression, obsession, schizophrenia, etc.) have now acquired a commonly used meaning and are used incorrectly: broadly, generally, or simply incorrectly. At the same time, psychologists can often feel insecure in a decision-making situation. Should the primary client be referred to a physician or continue with non-drug counseling? Should a client who is in long-term psychological counseling be asked to consult a psychiatrist or “I can handle it myself”? Does this particular person need medication support or not? Below is a hint manual that contains all the most important phenomena of your client’s behavior and well-being that you should pay attention to when making these decisions. I hope this will be useful.DepressionExternal signs of depression: sad facial expression, drooping corners of the mouth and eyes, drooping shoulders, head, limp arms, dull eyes, frequent sighs, quiet, weakly modulated voice. Clinical manifestations of depression Slow thinking, the client says, that it is difficult to think, there is “fog” in the head. Movements are slow, the client complains that it is difficult for him to move, lacks strength, arms and legs are heavy, too heavy to lift. Reduced background mood with worsening in the morning (with the exception of hidden depression, when the mood worsens in the morning). evening) When is it time to see a psychiatrist? Lack of improvement during psychotherapy. Persistent sleep disturbances and loss of appetite. Appearance of suicidal thoughtsChanges during treatment While taking antidepressants (AD) for 7-10 days, the client may experience drowsiness, and the person’s reactions may slow down. After abrupt withdrawal of blood pressure, return and/or intensification of symptoms. What diseases are important for differential diagnosis? Schizophrenia. In schizophrenia, thinking is primarily impaired, and mood decline is secondary. Obsessive-compulsive neurosis External signs of obsessive-compulsive neurosis Various types of tics (twitching of the eyelids, face, head turns), involuntary movements. The voice is quiet, sometimes trembling. “Running” look. The face is tense, there is tension in the lower jaw. There may be severe trembling of the hands. The movements are angular, “ragged.” Clinical manifestations of obsessive-compulsive neurosis Obsessive thoughts that the client constantly “replays” in his head, constantly checking whether the lights are off, whether the door is closed, etc. There may be obsessive counting, actions, rituals that “reduce” fears ( for example, you need to make five turns around yourself, then the day will go well) When is it time to see a psychiatrist? Persistent tics and involuntary movements that do not decrease with psychotherapy. Increased symptoms during psychotherapy. Changes during treatment When prescribing tranquilizers, anticonvulsants for 3-4 days - slight drowsiness, speech impairment (fuzzy, blurred diction) What diseases are it important to carry out a differential diagnosis with? With epilepsy With hysterical personality disorder Bipolar affective disorder External signs bipolar affective disorder Alternating episodes of depression and mania. During a manic episode, facial expressions are very lively and do not correspond to statements. Inappropriate laughter. Speech is fast, “porridge in the mouth.” The movements are sweeping. The look is “feverish” (as with a temperature), the eyes may be reddish. Clinical manifestations of bipolar affective disorder Manic triad: Accelerated thinking, a person jumps from one thought to another, never finishes, forgets what he was talking about. Movements are fast, poorly controlled. Increased background mood When Is it time to see a psychiatrist? In any case, see a psychiatrist. Changes during treatment During treatment with antipsychotics for a week, slight lethargy,