Why do people go crazy and how to maintain sanity until old age?

From time to time, the media publishes chilling stories about people who suddenly went crazy and committed terrible crimes or committed suicide. And almost every person over 30 years old can remember a similar story heard from one of his acquaintances or something that happened directly to one of his friends or relatives. And watching another story on TV about a man who attacked passers-by on the street, or a woman who harmed her own child, every viewer involuntarily wonders why people go crazy and how to maintain their sanity so that one terrible day they do not become the hero of such news?

What is madness?

A hundred years ago, when psychology and psychiatry had just begun to develop as sciences, the terms “madness” or “insanity” were used to describe all possible mental disorders, from phobias to schizophrenia, bipolar mental disorder and suicidal tendencies. Now, in official practice, these terms are not used, since psychotherapists involved in the study, diagnosis and treatment of mental disorders argue that inappropriate behavior, popularly called madness, is a symptom of one or another mental illness.

In modern language, madness is the loss of the ability to adequately assess the world around us and behave within the framework of accepted social norms. However, this definition is incomplete, since there are a number of mental disorders that occur in different forms and manifest themselves with a wide variety of symptoms. But still, according to the nature of its course, modern psychiatrists distinguish the following three main forms of insanity:

Melancholy
– a state of apathy, depression and loss of interest in life inherent in many mental disorders
Mania is an obsession with any material or intangible object, accompanied by physical activity, hyperexcitability, inadequate emotional reactions and strong and sudden mood swings from apathy to euphoria
Hysteria is a mental disorder characterized by strong excitability, aggression and complete control of the patient over himself.

Depending on the frequency and severity of attacks, all mental disorders are divided into three groups according to severity: mild, serious and acute. Mental disorders in a mild form, as a rule, are not very noticeable to others and are often attributed to the characteristics of a person’s character, but serious and acute insanity can cause a real tragedy.

According to statistics, the most common mental disorders in the modern world are depression, schizophrenia, phobias, eating disorders, obsessive-compulsive disorder, panic attacks, bipolar disorder and neurasthenia. Therefore, with a probability of more than 95%, people who, according to others, have gone crazy, actually suffer from one of the above diseases.

“I slept all autumn and winter, perhaps that saved me”

Alisa, 29 years old

Bipolar II disorder, borderline personality disorder, phobic anxiety disorder

I recovered from Covid in July 2021. The first two weeks I felt only physical discomfort, I did not experience anxiety or fear. Self-isolation did not frighten me, I was even happy inside, since I have agoraphobia and social phobia. After three weeks [of self-isolation], I finally received a negative Covid test. But after a week the joy was replaced by constant anxiety, which was difficult to control even with medications. I almost stopped sleeping, practically refused to eat. A deep depressive episode began. For the first time, I decided to stop fighting and commit suicide. The decision was balanced and, as it seemed to me, quite reasonable. I was saved. But the depression lasted until April 2021.

My daily dose of antipsychotic was increased and another antidepressant was added. Throughout the years that I have been sick, I have often developed resistance to certain drugs, and there was very little choice among drugs. Now I take an antipsychotic, a mood stabilizer, two antidepressants and an anxiolytic.

I slept through the entire fall and winter, and perhaps that saved me.

Most psychiatrists attributed the deterioration [of mental health] to anxiety due to the pandemic. My psychiatrist simply shrugged his shoulders and said that “it’s hard for everyone now, and with your course of the disease, an exacerbation is quite understandable.” He insisted on returning to [talk] therapy because “borderline personality disorder cannot be cured with pills alone.” The fact that coronavirus causes “side effects” in mentally ill people was not initially studied at any biological level.

AlisaPhoto: Alena Agadzhikova

Now my condition is unstable, but much better than it was. In addition to the aggravation, Covid affected the financial sector: I lost my job. But I have a very understanding family, so now I live with my parents. The most frightening thing is the consequences of coronavirus. I worry about my parents - their age, chronic illnesses, my mother also lives with a mental disorder.

For those who may be experiencing post-Covid symptoms, I would like to advise, first of all, not to be afraid to feel sorry for yourself, turn to those close to you and ask for help if you can’t cope yourself. If you have the strength, read about mental enlightenment; many [Telegram channels] have a chat where you can share your feelings and fears. Another attack was saved by the girl on the hotline. We talked for three hours, and I decided to postpone the suicide until later. Every day I told myself that I could do this tomorrow. That's how I got out. Remember: “Everything passes, and this too shall pass.”

Why do people go crazy?

Mental illnesses can be either congenital or acquired. We should talk about a congenital disease in the case when the diagnosis was made at an early age, and the child inherited the disease from one of the parents. As a rule, a tendency to schizophrenia and epilepsy, and sometimes to alcohol and drug addictions, is transmitted at the genetic level. But still, more often than not, people go crazy not because of the characteristics of their DNA, but under the influence of external factors and life circumstances. And all the causes of madness can be divided into three groups: physiological and psychological.

Physiological reasons

Physiological causes of insanity include all factors that can cause brain damage, as a result of which the functionality of the central nervous system will be impaired and the human psyche will suffer. As a rule, the following reasons can lead to serious consequences for the psyche:

Traumatic brain injury. After experiencing trauma, certain areas of the brain may be damaged and neural activity will be impaired. The consequences of TBI in different cases manifest themselves differently and depend on which part of the brain is affected: in some, coordination of movements is impaired, hearing and vision deteriorate, in others memory deteriorates, and in others, schizophrenia develops, panic attacks occur, aggressiveness and tendency to hysteria, etc.
Effects of chemicals on the brain. The use of alcohol, drugs and certain medications can cause the destruction of neural circuits and disruption of brain function. Depending on which functions are impaired and how severe the brain damage is, a person may develop mild or severe forms of depression, paranoia, mania, neurasthenia, or another mental disorder.
Age. In old age, few people can boast of a healthy heart and blood vessels, and vascular disease is one of the main causes of senile dementia. With atherosclerosis and other vascular diseases, the brain does not receive the required amount of oxygen and nerve cells die, as a result of which the brain ceases to cope with all functions. Similar changes in the brain occur in Alzheimer's disease, which is popularly called senile insanity.

Psychological reasons

According to psychologists and psychiatrists, up to 30% of residents of large cities are constantly in a state of chronic stress, which is also considered a borderline mental state - that is, the mental state is no longer normal, but there is no severe disorder yet. Borderline mental states are dangerous because in their presence, even the most insignificant irritant can become the “last straw” and serve as a trigger for mental illness. But the reasons why a person finds himself on the “threshold” of insanity are most often the following:

Constant failures
Emotional burnout at work (workaholism)
Psychological trauma caused by an event that significantly affected a person’s life (experienced violence, difficult divorce, betrayal of a loved one, etc.)
Loss of what a person considered the meaning of his life (business bankruptcy due to a financial crisis, death of a child, dismissal from work, etc.)
Social isolation (loneliness and boredom)
Love addiction.

Whatever the reasons for stress, the mechanism of development of mental disorders is similar in all cases. First, negative emotions accumulate, then at a certain stage sensitization develops (increased sensitivity to stimuli), and after a relatively short period of time the human psyche loses stability and flexibility. If a person does not turn to a psychologist in time or does not restore his psyche on his own, sooner or later he will have a nervous breakdown, manifested either by constant hysterics, increased aggressiveness and mania (in choleric and sanguine people), or melancholy and depression (in phlegmatic and melancholic people).

“I lost sleep, I started crying more”

Anastasia, 26 years old

Borderline personality disorder

I am a nomad from Nizhny Novgorod. For the last three years I have been living in Moscow, working as a journalist and makeup artist, and I have a wonderful cat, without which I can hardly imagine my life.

It was the pandemic that exposed my mental disorders. When I remained isolated from the outside world, the emotional swings began to fly faster, I began to cut myself and even attempted suicide.

I knew that something was not quite right with me, because I studied to become a psychologist (irony), but the negative experience of working with a psychologist during my school years and training cut off my desire to contact them again. Fortunately, I overcame myself: I found a psychiatrist and psychotherapist. It turned out that I have borderline personality disorder.

I got sick with Covid twice. At least with symptoms. After the first time, I was happy that I was alive, I was very seriously ill. But this was very shortly before the Moscow lockdown. The second time I got sick was when I was already hospitalized. Then the sense of smell and touch disappeared. And post-Covid was terrible: I began to quickly gain weight, calcium metabolism was disrupted, my nails began to break, my hair dried out and began to fall out. I can run my hand over my head and collect a mop... But from the point of view of mental health, I did not feel any changes, because I was on good therapy.

A strange thing happened after vaccination. On the same day that I was given the first component of Sputnik, I lost sleep. This was about a month ago. I couldn’t connect the loss of sleep with anything else; there were no other irritants at that time. It was possible to fall asleep only after six in the morning, sometimes it was not possible at all. The psychiatrist was not sure that the vaccine was to blame. But the emotional swings have also intensified. I started crying more. Soon they supplied me with the second component. There were no side effects at all, I even managed to fall asleep.

AnastasiaPhoto: Alena Agadzhikova

But a day later the dream disappeared again, and a day later an unpleasant situation occurred. We sat in the company of friends, drinking tea. All was good. And suddenly my facial muscles twitched. Then a trembling began throughout the body. I couldn't speak or smile. My hands were pressed to the sofa. It was impossible to move. The guys thought I had a stroke. I was losing consciousness. The intensive care unit has arrived. The doctor said that the vessels in the head do not transmit blood well, but all that happened was a panic attack. And that if there are any mental characteristics, the vaccine can aggravate them. My psychiatrist also said that after the vaccination, some of his [mental] characteristics worsened.

It is important in this story that when I came to install the second component, I told the doctor about my sleep problems. To which she first said that this was not good, and then that I was the only one like that. When I filled out the consent for vaccination, the list of medications did not include those that I take, which may not be very compatible with the vaccine. For example, a friend of mine with OCD, who takes Zoloft, like me, cleans every day after vaccination and feels shame for the extra speck of dust on the table. It is unclear why the list of drugs in the document does not include sedatives and antidepressants.

I had to increase my medication dosage. How am I feeling? I simultaneously want to lie in bed under the covers and not stick out anywhere and at the same time run away somewhere very far away. The lockdown brought me to thoughts of death. And it's terrible and scary. My biggest fear is that these thoughts may return. It’s scary to feel like we’ll never defeat it [coronavirus].

How not to go crazy?

No one is immune from nervous shock, stress and psychological trauma, but every person has the power to make sure that the risk of going crazy becomes minimal. But for this it is not enough to avoid conflict and stressful situations, because there are many factors that can cause madness. Therefore, psychotherapists argue that the best prevention of mental disorders is to take care of the health and functionality of your nervous system. And in their opinion, the following will help maintain a stable, healthy psyche for many years:

Proper nutrition.
Food is a source of macro- and microelements necessary for the functioning of all body systems, including the brain. With a lack of certain substances, malfunctions in the functioning of organs occur: for example, with a lack of B vitamins, a person becomes irritable, absent-minded and quickly gets tired, and a deficiency of any macroelements leads to loss of strength, loss of performance and the development of harmful processes in all organ systems, including including in the brain. Therefore, food rich in vitamins and minerals will ensure that the brain receives all the substances necessary for stable functioning.
Rejection of bad habits. Nicotine, alcohol and drugs are brain poisons that kill nerve cells and destroy neural connections. Therefore, those who want to remain sane and sober for a long time need to give up bad habits and not poison their body with their own hands.
Taking care of your health. Diseases suffered “on the feet” can cause complications on the nervous system, as a result of which brain functions will be impaired. It is especially important not to postpone a visit to the doctor if dizziness and migraines regularly occur, constant drowsiness and loss of strength are felt, coordination of movements and speech are impaired - as a rule, this is how the first signs of a pathological process in the brain appear.
Optimistic outlook on life.
Optimists are much less likely to go crazy than pessimists, since they know how to find positive aspects in almost any event and tend to believe in the best even when the situation is far from being the best. Pessimists live in constant stress and anxiety, so they risk sooner or later developing depression, phobia or other mental disorders.
Expanding your circle of friends. Humans are social creatures, and even introverts need people with whom they can at least occasionally communicate. But friends are necessary not only for communication, but also as support and support, because the very knowledge that in case of trouble there will be someone to turn to for help can give strength to survive a traumatic situation.
Constant self-development. Learning new information, searching for interesting activities and hobbies, self-improvement and mastering new useful skills - all this not only gives a feeling of happiness and fulfillment in life, but also allows you to train the brain and significantly slow down the age-related deterioration of the central nervous system.
Self confidence. A person who is confident in his own abilities and has adequate self-esteem copes with difficulties and experiences stress much easier than people with low self-esteem. The reason for this is simple: those who believe in themselves know that they can ultimately find a way out of any situation and survive temporary difficulties, therefore, in difficult periods of life, self-confident people mobilize and make every effort to solve the problem constructively. “Whiners,” on the contrary, experience severe stress at the slightest difficulty and fall into melancholy and depression.

“Anxiety, tearfulness, hysterics appeared”

Ksenia, 21 years old

ADHD, anxiety-depressive disorder

As soon as I got sick, weakness appeared in my body. Obvious mental problems appeared a week later, when I was in the hospital. I have ADHD and anxiety-depressive disorder. During Covid, I stopped taking my antidepressant. I can’t trace exactly whether it was after or before, but it hit my nervous system hard: wild tremor, trembling, constant anxiety, I had a couple of hysterics in the hospital, and they injected me with an antipsychotic to calm me down. I don’t know what to call it correctly, but I was shaking all over for another three or four days after being discharged.

KseniaPhoto: Alena Agadzhikova

In the hospital, I began to have vivid, but very negative, disturbing dreams. And at home I now dream of horror films with my participation. Anxiety, tearfulness, and hysterics appeared. Depression set in again, but, as I mentioned above, this can be affected by drug withdrawal. On the other hand, I lowered it smoothly, as the psychiatrist said.

Now I am worried about headaches that radiate to my eyes. I'm waiting for a new scheme and hope that this whole nightmare will end. My diagnosis after discharge was astheno-neurotic syndrome - I think Covid contributed.

What to do at home in quarantine when you're bored: make the most of your time

Boredom is perhaps the most easily solved problem during the quarantine period. Time spent within the walls of the house can be made interesting and useful at the same time. Choose an activity that really captivates you and won’t get boring.

Things to do:

take a training course that has been in your plans for a long time, but you didn’t have enough time - right now discounts are offered for many trainings and courses;
do things that evoke positive emotions for free: dance, sing, draw, sew, knit, sculpt, etc.;
clean up - order in the surrounding space helps to maintain calm and mitigate the manifestations of stress;
learn what will be useful in life after self-isolation: master new dishes, improve your knowledge in your specialty, gain useful practical skills (sewing, knitting, minor repairs);
start learning a new foreign language or improve your knowledge;
remotely visit free broadcasts of world-famous museums, galleries, theaters: the Hermitage, Louvre, Tretyakov Gallery, Bolshoi Theater, Vienna Opera and others.

A little advice: if useful things seem boring and annoying to you, choose conditionally useless ones. Some people can only fight boredom by watching edgy TV shows and listening to their favorite music. Don’t blame yourself for being idle – do something that will help you survive being in a confined space.

"Powerlessness, nightmares, derealization"

Vsevolod, 29 years old

Bipolar affective disorder, anxiety-depressive disorder

After Covid, my emotional swings intensified (changes between mania and depression), anxiety was no longer relieved by any anxiolytics and antipsychotics that I had, anxiety sometimes turned into either panic or a feeling of animal horror. Derealization, complete devaluation of oneself and feelings of guilt for any action, obsessive suicidal thoughts, insomnia, alcohol abuse and a tendency to self-harm (cutting hands, then neck), fragmented memory, missing remission phases. The phases themselves began to change very quickly, moving closer to depressive ones. Complete powerlessness, loss of energy, nightmares and depressive dreams. When the illness overtook me, I was looking for work. As a result, I was unable to go to interviews. I think that I would not have survived the exacerbation of my mental diagnosis if I had not gone to the clinic. My mother also helped me tremendously by flying here and not leaving me alone when I was completely on the edge.

VsevolodPhoto: Alena Agadzhikova

I barely remember about four months of my life. My memory returned a short time after treatment at the clinic, where I was given IV drips, the antidepressant and mood stabilizer were changed, and several sessions of electroconvulsive therapy were performed. I had very significant improvements, but after the vaccination there was a strong regression. Fate is not without irony. Now, in order to continue working in the organization, I must get vaccinated and try with all my might not to fall into the hell that I experienced during the exacerbation against the backdrop of Covid itself.

After vaccination (only the first component so far), the phases of depression deepened, mixed phases became more frequent again, and severe anxiety returned, reaching the point of panic. Tranquilizers are weak, but they can help, the antipsychotic simply turns me off to sleep more successfully, and does not help with anxiety. [I am experiencing] a return of suicidal thoughts, feelings of guilt, despair, loneliness. But this time I have more self-control, I no longer drink alcohol at all, and I don’t cut myself (although such thoughts have appeared again).

Because of all these exacerbations, you feel even more “defective” and unnecessary. Even facial expressions and gestures change due to a greatly destabilized psyche, and now simply by appearance they are labeled as abnormal (or mysterious, depending on your luck).

About normality in the morning and madness in the evening

Some people develop delirium—confusion of consciousness—right in the intensive care unit of an infectious diseases hospital. If it develops, it is a poor prognostic sign for the course of the disease. In fact, this is a harbinger of imminent death. Most often, such conditions occur in patients 70-80 years old. Due to their condition, it is not possible to bring them to us; we have to help on the spot, find a balance between the dosage and combination of medications.

And it also happens: a person arrives in an adequate state, but by the evening he ceases to understand who he is, where he is, what kind of people are around him, fragmentary hallucinations and delirium appear. He shouts that there are enemies all around and they want to kill him.

Patients tear off their oxygen masks, tear out catheters, and try to escape. One grandfather got ready to go home on foot straight from the intensive care unit, and he arrived from Opochka - 125 kilometers from Pskov.

Some refuse treatment for no apparent reason, suspecting everyone around them of sabotage. One patient did not take the pills with the words: “Why take treatment? I'll still die. Don't waste your time." While her general condition was improving, she was suddenly overcome by depression. How can you force a person to undergo treatment if he spits out medicine and doesn’t let anyone in? There are many such cases.

Of course, such behavior creates additional difficulties for doctors. From time to time, the psychiatric team has to be called directly to the infectious disease wards.

It’s very difficult there now, the workload is crazy. Colleagues in the infectious disease ward do not sit, do not even walk, they run, rushing from one patient to another.

If the body still manages to cope with the virus, then the head gradually falls into place. There are such stories among both men and women. However, there are exceptions when an elderly patient survives, but the virus becomes a trigger and starts a process that could have begun much later or more gradually. In this case, cognitive impairment, including dementia, remains with the person until the end.

As the condition worsens, delirium is followed by confusion and complete chaos in the perception of reality ensues. This happens, for example, with cerebral edema due to coronavirus. I also had to see such patients in the infectious diseases hospital.

There is a third scenario: the person seems to be on the mend, all physiological indicators have returned to normal, he is being prepared for discharge, and he suddenly develops schizophrenia-like psychosis, moreover, at the age of 40-50 years, which is generally not typical for the first episodes of schizophrenia . So, one woman convinced herself that she was able to treat anyone, was going to save the world from diseases, talked out loud to heaven, did not sleep at night, called everyone, raised the dead from their graves. In my head, of course.

In addition, in the treatment of coronavirus, hormone therapy is used, which in itself can provoke psychopathic-like manifestations - irritability, short temper, aggression, up to the development of psychosis with hallucinations and delusions. This is a side effect.

“A pandemic is a tragedy extended over time”

Alina, 24

Depression

I was diagnosed with depression as a child. I don’t take pills, I try to cope without them. In mid-April this year, I suffered from coronavirus; I sat at home for two weeks, worked from bed, had a temperature of 37.5 and all the signs of a cold, lack of smells and tastes. I really wanted to sleep, I fell asleep while working every few hours.

Shortly after I received a negative PCR test, my anxiety increased. This period coincided with the fact that my friend was detained and put in a pre-trial detention center, and I helped organize a support campaign. I felt sick for days, couldn’t sleep from excitement, and was under a lot of stress. This was the first time, although I have been working in politics for two and a half years now and such work is routine for me. So I associate my anxiety specifically with the consequences of Covid.

Over the next months, sometimes I couldn’t even get out into the city center: I felt so sick and weak that I could only lie down. The anxiety continued for a few more months and went away, but it became difficult for me to concentrate on work matters and do many things at once, although I used to be a master at this. The usual task of drawing up a report or writing a text was many times more difficult than before Covid. The boss thought I was being lazy and “not working,” and I felt depressed and vulnerable like never before. I received my first vaccine injection on February 18th. All winter I cried every day for two or three hours.

AlinaPhoto: Alena Agadzhikova

By the beginning of March, the severity of the condition reached its peak; I could no longer sit quietly at my workplace and constantly cried because I couldn’t do anything. On March 10, I was given the second component of the vaccine. Since the end of March, I also went on vacation for this period, they began to let me go, plus I started taking a nootropic and an anxiolytic.

I was “lucky”: my job means that it can be done remotely, so I was able to maintain my financial situation. And thanks to chats and regular calls with friends during the period of self-isolation, we managed to maintain and even strengthen our connections, although, of course, when the quarantine was lifted, it became easier.

The pandemic has greatly affected the entire world. This is a tragedy stretched over time. People began to feel fear and uncertainty, and coronavirus restrictions became one of the new methods of pressure on civil society. This includes a ban on single pickets when a concert is being held at the same time in Luzhniki, and all that. I feel general anxiety and depression, but I try to cope and do what I can.