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BASICS OF SAFE LIFE
Mental disorders in acute life-threatening situations. Fundamentals of safe life
Directory / Basics of safe life Acute life-threatening situations are characterized by suddenness and, most often, short-term psychogenic effects. With such variants of natural disasters or catastrophes, there are usually various physical phenomena (hum, ground vibrations, destruction of buildings, etc.), which instantly allow us to assess the situation as life-threatening. Destruction, death of people, mass injuries exacerbate the pathogenic impact on a person of an immediate threat to life. Behavior in the acute period of a suddenly developed life-threatening situation is largely determined by the emotion of fear, which, to certain limits, can be considered physiologically normal and adaptively useful, contributing to the emergency mobilization of physical and mental stress necessary for self-preservation. Fear is a natural human reaction to a real or imagined situation that threatens life or health. It cannot be unequivocally stated that fear only harms or only benefits. It all depends on the specific circumstances in which the person finds himself. The same action, performed under the influence of a feeling of fear, in one case can save a person, and in another - hasten his death. Fear not only accompanies an extreme situation, but often anticipates it. At the moment of awareness of the accident as a fait accompli, the feeling of fear reaches its climax. In fact, with any catastrophe that is perceived by a person, anxious tension and fear arise. There are no "fearless" mentally normal people in the generally accepted understanding of this state. It's all about the moments of time needed to overcome feelings of confusion, make a rational decision and take action. For a competent person prepared for an emergency situation, this happens much faster, for a completely unprepared person, persistent confusion determines prolonged inactivity, fussiness and is the most important indicator of the risk of developing psychogenic mental disorders. Clinical manifestations of fear depend on its depth and are expressed in objective manifestations and subjective experiences. The most characteristic motor behavioral disorders, which range from an increase in activity (hyperdynamia, "motor storm") to its decrease (physical inactivity, stupor). However, it should be noted that in any, even the most difficult conditions, 12-25% of people retain their composure, correctly assess the situation, clearly and decisively act in accordance with the situation. According to the observations of scientists and surveys of people who experienced various life-threatening situations and retained self-control and the ability to purposeful actions at critical moments, when they realized the catastrophic nature of what was happening, they thought not about their own survival, but about the responsibility for the need to correct what had happened and save the lives of others. It was this "superthought" in the mind that determined the corresponding actions, which were carried out clearly and purposefully. As soon as the "overthinking" was replaced by panic fear and ignorance of what to do specifically, there was a loss of self-control and various psychogenic disorders developed. Most people (approximately 50-75%) in extreme situations in the first moments are "stunned" and inactive. Immediately after an acute exposure, when signs of danger appear, people become confused, not understanding what is happening. Over this short period, with a simple fear reaction, there is a moderate increase in activity: movements become clear, economical, muscle strength increases, which helps to move many people to a safe place. Speech disorders are limited to the acceleration of its pace, hesitation, the voice becomes loud, sonorous. Mobilization of the will, animation of ideation processes are noted. Mnestic disturbances during this period are represented by a decrease in the fixation of the environment, fuzzy memories of what is happening around, however, one's own actions and experiences are remembered in full. Characteristic is the change in the sense of time, the course of which slows down, and the duration of the acute period seems to be increased several times. With complex reactions of fear, more pronounced motor disorders are noted in the first place. In the hyperdynamic variant, aimless, erratic throwing is observed, a lot of inappropriate movements that make it difficult to quickly make the right decision and move to a safe place. Sometimes there is a stampede. The hypodynamic variant is characterized by the fact that a person, as it were, freezes in place, often trying to "shrink", taking an embryonic position, squatting down, clasping his head in his hands. When trying to help, he either passively obeys or becomes negative. Speech production is fragmentary, limited to exclamations, in some cases there is aphonia. Memories of the event and their behavior in the victims during this period are undifferentiated, total. Along with mental disorders, nausea, dizziness, frequent urination, chill-like tremors, fainting, and miscarriages are often noted in pregnant women. The perception of space changes, the distance between objects, their size and shape are distorted. Sometimes the surroundings seem "unreal", and this feeling persists for several hours after exposure. Kinesthetic illusions (feeling of the swaying earth, flight, swimming, etc.) can also be long-lasting. Acute reactive psychoses end with a sharp drop in mental tone, a partial stupor in the form of paralysis of emotions. Quite often, there are states of prostration, severe asthenia, apathy, when a threatening situation does not cause feelings. After the end of the acute period, some victims experience short-term relief, an increase in mood, a desire to actively participate in rescue work, verbosity, endless repetition of a story about their experiences, attitude to what happened, bravado, discrediting the danger. This phase of euphoria lasts from several minutes to several hours. As a rule, it is replaced by lethargy, indifference, motor retardation, difficulty in comprehending the questions asked, difficulties in performing even simple tasks. Against this background, the level of anxiety increases. In some cases, peculiar states develop, the victims give the impression of being detached, immersed in themselves. They often and deeply sigh, internal experiences are often associated with mystical-religious ideas. Another variant of the development of an anxiety state during this period may be characterized by the predominance of "anxiety with activity." Characteristic are motor restlessness, fussiness, impatience, verbosity, the desire for an abundance of contacts with others. Expressive movements are somewhat demonstrative, exaggerated. Episodes of psycho-emotional stress are quickly replaced by lethargy, apathy. In the course of exposure to stress, along with negative reactions, positive reactions to a traumatic situation can also occur, but, as a rule, they appear much later. These include a growing sense of gratitude, soul-searching, a sense of accomplishment, humor, and so on. Growing gratitude. Some people come to the fact that they begin to see all its best sides in life, give it more significance and appreciate what they live in the world. They also begin to feel that previous or present experiences and anxieties no longer matter much. This often leads to peace with oneself, satisfaction and the ability to empathize with others. Change of world view. Some people begin to appreciate their life more and love it with new enthusiasm: partners, children, friends, colleagues and work seem more meaningful and expensive. Some may even feel anger at the fact that others do not value their lives as highly. Feeling of success. It may be the feeling that personal and internal resources and strengths begin to emerge along with increasing confidence in yourself and others. Some describe their feeling of confidence and feeling good about themselves and the world around them. Humor. Humor is one of the positive ways to overcome trauma and shock; many professionals use it. Other strategies. These include various exercises, including relaxation exercises, diets, tried and tested strategies (how a person coped with this in the past), etc. Author: Mikhailov L.A.
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