RU2203015C2 - Method for antidepressive impact upon human emotion-affective sphere and rehabilitation method in patients with addiction syndrome of psychoactive substances and patients with emotion- affective disorders - Google Patents

Abstract

FIELD: medicine, rehabilitation. SUBSTANCE: it is suggested to perform complex of physical exercises including both dynamic and static ones. Each dynamic exercise is based upon rhythmically repeating movements performed synchronously with respiration. Each static exercise is based upon posture maintenance. Each physical exercise should be performed till overcoming discomfort feelings. Rehabilitation method in patients with addiction syndrome of psychoactive substances and patients with emotion- affective disorders consists of three stages. The first stage should be carried out for 15-40 d under hospital conditions by performing daily exercises including complex of physical ones, 2-5 times daily and carrying out either individual and/or group psychotherapy. The second stage is conducted for 30-60 d under dispensary conditions by performing exercises 3-5 times weekly, and the third stage is carried out for, at least, one and a half year by performing mentioned exercises 1-3 times weekly. EFFECT: higher efficiency of therapy. 10 cl

Description

 The invention relates to medicine and can be used for the rehabilitation of patients with a syndrome of dependence on psychoactive substances and with emotional and affective disorders.

 It is known that drugs and alcohol affect all body systems and significantly reduce the life expectancy of people at the most active ages. Changing the patient’s personality, they affect social relations, destroying them. Therefore, the problem of rehabilitation of such patients is relevant.

 The closest analogue is a method of rehabilitation of patients with a syndrome of dependence on psychoactive substances and emotionally-affective disorders, including performing physical exercises and conducting individual and group psychotherapy, developing new behavioral stereotypes, and conducting a diet (see RU 2134594 C1, 08.20.99).

 The objective of the present invention is to develop complexes of therapeutic measures aimed at the patient's refusal of psychological attraction, and the restoration of the normal satisfaction system inherent in a healthy person.

 For this, in the method of antidepressant effects on the emotional and affective sphere of a person, including the implementation of a set of physical exercises, the complex includes dynamic and static physical exercises, each dynamic exercise based on rhythmic repetitive movements performed synchronously with breathing, each static exercise based on holding a pose, in addition, each dynamic and static exercise is performed to overcome uncomfortable sensations.

 Dynamic exercises are performed with a load on the muscles, on the joint-ligamentous apparatus, on the musculoskeletal system, simultaneously on the muscle and joint-ligamentous apparatus and grimaces and shaking exercises, while the dynamic exercises are performed in a sitting, lying, standing position.

 Static exercises are performed while sitting, lying, standing.

 In addition, after each exercise or group of exercises, a short relaxation is performed, and at the end of the complex of exercises, a deep long relaxation is performed.

 Also, to solve this problem in a method of rehabilitation of patients with a syndrome of dependence on psychoactive drugs and patients with emotionally-affective disorders, containing three stages, the first stage is carried out for 15-40 days in a hospital with daily classes, including exposure to antidepressant drugs on the emotional and affective sphere of a person 2-5 times a day and conducting individual and / or group psychotherapy, the second stage is carried out on an outpatient basis for 30-60 days with those indicated classes 3-5 times a week, and the third step is carried out for at least eighteen months with holding of said classes 1-3 times a week. In this case, concentration of attention is carried out on breathing and / or on various parts of the body.

 In addition, psychotherapy is carried out on the basis of the 12-step program.

 The method further includes the use of food additives having an antidepressant effect.

 In addition, nutritional supplements are taken 3 times a day for 0.5-2 hours before meals and 3 times a day with meals.

 The method is as follows.

 The rehabilitation program begins after stopping drug use and relieving withdrawal symptoms. The program is carried out in three stages, which last about two years.

 Stage 1.

 The first stage is carried out for three weeks in a hospital. At this stage, intensive daily classes are held with the patient during the day from 8 hours 30 minutes in the morning to 23 hours 00 minutes in the evening. The first stage is the time for the adoption of new thinking and worldview for mastering the skills of daily self-care, which allow you to evoke and maintain a high level of stimulatory component of satisfaction. The program offered in the hospital is a training program, so the patient should be prepared for cooperation. The psychotherapeutic program is carried out in the form of three to four lessons per day in group and individual form. The patient creates motivation aimed at recovery and refusal to use drugs. If necessary, in case of sleep disturbance, the patient can receive psychotherapeutic help at night.

 Patients in the hospital are trained to conduct sets of exercises. Physical exercises formed in complexes, in combination with various types of breathing, have a positive effect on the emotional and affective sphere of a person. The action of the complexes is based on normal human physiology. Regular daily exercise complexes can completely eliminate the depressive state in 2-3 weeks. On average, each complex consists of 8-12 exercises. Exercise is associated with physical exertion, which can create discomfort for the patient (muscle fatigue, feeling of physical fatigue) and emotional resistance - “I can’t”, “I don’t want,” “why is this necessary”). Regardless of the presence of discomfort, each exercise, the patient must perform a strictly defined time. He must overcome the developing discomfort.

 Dynamic exercises contain a complex aimed at the load of muscles, the load on the articular-ligamentous apparatus - “stretch marks”, the load on the spine, on the entire spine or its departments (cervical, thoracic, lumbar), contain a complex combining muscle and joint-ligamentous types loads, contain specific exercises, when the patient shakes his head, performs various grimaces, stretches his lips with a tube, puffs his cheeks, etc. Dynamic exercises, depending on their type, the patient performs in a sitting, lying and standing position. Dynamic exercises are based on stereotyped repetitive and rhythmic movements. The rhythm of the movements coincides with the patient's respiratory rate. As fatigue develops as a result of the exercise, the patient’s breathing rate increases, and the pace of the exercise should also increase in sync with his breathing rate. The main thing is the synchronization of breathing and patient movement.

 The patient performs static exercises in the form of holding certain postures. The patient takes a simple (sitting with crossed legs) or uncomfortable pose with a feeling of tension on certain muscle groups for each pose, and overcomes the discomfort that develops due to muscle tension in the process of performing this exercise. Depending on their type, the patient can hold poses in a sitting position, in a supine position, in a supine position, in a position with support on his arms and legs - a "bridge", in a standing position. The patient can combine posture with holding his arms or legs in different positions.

 The patient combines dynamic and static exercises with certain types of breathing, for example, breathing through the nose or through the mouth. The patient breathes through the nose, depending on the type of exercise, through one or two nostrils. When performing breathing exercises, the patient can perform slow deep breathing with filling the entire volume of the lungs or intensive deep breathing: a combination of abdominal and chest breathing, or frequent shallow breathing using the abdominal muscles and pelvic muscles with active exhalation and passive inhalation, breath holding by inhalation or on exhalation, fractional breathing with dividing the inhalation or exhalation into several phases, or inhale through the mouth, and exhale through the nose, and vice versa, can carry out specific types of breathing I, for example, breathing through a folded tongue, etc.

 The same breathing exercises can be performed independently, in addition to physical ones.

 Each complex contains a set of static and dynamic exercises performed in a specific order. Each exercise is performed with concentration on the breath or on different parts of the body.

 At the end of the exercise or group of exercises, depending on the degree of physical activity, the patient performs a short relaxation. After performing a full range of exercises, the patient conducts a deep, long relaxation. The patient spends relaxation while lying on his back, his arms are placed along the body, his legs are extended parallel to each other, his eyes are closed, his breathing is deep and slow through his nose, he relaxes his muscles as much as possible. During the relaxation period, the patient should strive not to fix attention on thoughts or physical sensations.

 The patient performs sets of exercises three times a day, each session for 1-1.5 hours. With the help of a set of exercises, the patient eliminates depressive disorders and thereby can facilitate pathological cravings. Knowing the positive effect of performing the exercises actively directs the patient to use them to maintain good health, which allows us to solve the problem of eliminating depressive states.

 The following are examples of exercise complexes used in this invention.

Complex 1
1. Lie on your back, hands along the body with palms down. With a powerful breath, raise the straight right leg as high as it turns out, with a powerful breath, lower it back to the floor. Repeat the same with the left foot. Continue to raise and lower legs alternately for 2 minutes.

 2. Without a break, extend your arms perpendicular to the floor and connect your palms. Start raising both legs connected together, inhale upward, lower the legs with exhalation. Continue for 1 minute.

 3. Tighten the knees to the chest and clasp their hands. The head lies freely on the floor. Relax in this position for 3-5 minutes.

 4. Starting position as in exercise 3. With a powerful breath, spread your arms to the sides, while stretching your legs forward and upward at an angle of 60 degrees to the floor. With a powerful exhale - return to the starting position. Continue for 3 minutes.

 Relax lying on your back.

5. Lying on your back, pull the left knee to your chest and grab it with both hands. With a breath, raise the straight right leg under 90 ^o to the horizontal, with an exhale lower it to the floor. Continue at a fast pace for 1 minute. Change legs and do 1 minute. Change legs again and continue doing 1 minute. And the last time to change legs and do 1 minute.

 Relax, lying on your back, 2 minutes.

 6. To stand and raise straight arms above the head so that the shoulders touch the ears, palms looking up. With an exhalation, lean forward, trying to bend in the lower back (shoulders remain near the ears). With a breath, rise back. Do it very slowly with deep breathing. Continue for 2 minutes. Then increase the pace and do another 1 minute.

 7. Complete relaxation for 10-15 minutes.

 In each exercise, the lead time is enough to overcome the discomfort.

Complex 2 (sedative)
1. Sit cross-legged, put your right hand on your right knee, pads of the index finger and thumb together; raise at an angle of 60 ^o to the horizontal. The palm looks up, fingers - together. Bend your palm towards the floor as far as possible. Remain in this position for 2 minutes, then change hands and repeat. Rest a bit (30 seconds), sitting in a simple pose, hands lie on your knees, pads of the index finger and thumb together. Then raise both hands at 60 ^o to the horizontal. Remain in this position for 2 minutes. The arms should remain straight throughout the exercise.

 Relax, lying on your back, 2 minutes.

2. Raise both hands at an angle of 60 ^o to the horizontal, squeeze the fingers into fists, the thumbs inside the fists press on the pads under the little fingers, the rest cover them from the outside. Start fisting, continue for 1.5 minutes. Hands should remain straight at the elbow joints. Then (without stopping) bend your elbows slightly, add to the rotation with your fists the rotation of the forearms in the same direction in the elbow joints. Continue for 1.5 minutes.

 Relax, lying on your back, 2 minutes.

 3. Extend straight arms to the side parallel to the floor, slightly above shoulder level, palms down, fingers together. Stay in that position with deep slow breathing for 3-10 minutes.

 Relax, lying on your back, 2 minutes.

 4. Stretch your arms up above your head. The shoulders touch the ears. Fist with thumbs inside. Straighten the index fingers of both hands, bend them back, then repeat the same with the middle, ring, little fingers. Continue to bend and extend your fingers alternately for 2 minutes.

 Relax, lying on your back, 2 minutes.

 5. Lie on your stomach, put your palms under your shoulders. Start slowly and carefully stretching the vertebra behind the vertebra forward and upward, raising the body and arching in the back. Stick your tongue out. Deep and slow breathing through the mouth. Continue for 2 minutes.

 6. Sit in a simple pose with crossed legs, stick out your tongue and roll it into a tube. Inhale through the tongue rolled up into the tube, exhale through the nose. Concentration on the feeling of coolness on the surface of the tongue. The time is 3 minutes.

 7. Sitting cross-legged, grab your knees with your hands. Helping yourself with your hands, rotate the middle part of the body, aging, so that the head and tailbone remain motionless on the same axis. Continue spinning for 1.5 minutes in each direction.

 8. Stay in a simple pose. Hands are bent at the elbows, hands are completely free to hang down. Start spinning shoulders forward. Continue for 2 minutes.

 9. Straighten your legs. Leaning on your hands behind your back, begin to alternately raise and lower your straight legs. The movement is done with a minimum amplitude. Raise legs with a breath, lower - with an exhale for 2 minutes.

 10. Sit on your knees and heels. Clasp your hands into the lock behind your back. Lean forward, lowering your forehead to the floor and raising your arms up as high as possible. Stay in this position for 1 minute. In the end, inhale and pull your arms even higher up, then exhale lower your hands.

 11. Complete relaxation for 10 minutes.

 In each exercise, the lead time is sufficient to overcome the patient's discomfort.

Complex 3 (activating)
1. A simple posture (sitting cross-legged). The position of the fingers 1: the thumb is pressed to the tubercle under the little finger; the nameless and little fingers close the big one from above; forefinger and middle finger straight. Bend your elbows, forearms parallel to the floor. Hands - at the level of the heart center, palms down. The index and middle fingers of both hands point to each other. Inhale through the mouth, exhale through the nose (powerful exhalation so that the nose wrinkles). During exhalation, sharply raise the forearms to parallel to each other. With a breath (through the mouth), return the hands to their original position. Concentration on the tip of the nose. Continue for 3 minutes.

 At the end: take a deep breath, hold your breath for 10 seconds, straining all the muscles (back, face, arms, etc.) to a shiver. Exhale through the mouth is sharp and powerful ("like a gun"). Repeat two more times.

 2. A simple pose. The position of the fingers 2 & 3: the index and middle fingers are straight, the thumb captures the bent ring fingers and little fingers from above. Bend your elbows so that your forearms are pointing upward (hands at shoulder level). Mouth letter "O". Quick breathing through the stomach through the mouth, so that the sound is "hu, hu, hu." Rotate the brushes in a circle at maximum speed and a small amplitude from yourself. The speed of breathing and rotation is the same. Concentration on the tip of the nose. Continue for 3 minutes.

 At the end: take a deep breath, hold your breath for 10 seconds, straining all the muscles (back, face, arms, etc.) to a shiver. Exhale through the mouth is sharp and powerful ("like a gun"). Repeat two more times.

 3. The position of the fingers is the same as in exercise 2. Simple pose, stretch straight arms to the sides, palms up. Turn brushes back as far as possible. Elbow bends up. The patient will feel healing pain in his hands. If the elbows are deployed correctly, the chest will automatically bend forward and the chest will rise. Stay in this position with calm breathing. Concentration on the tip of the nose. Continue for 3 minutes.

 At the end, take a deep breath, hold your breath for 10 seconds, tensing all the muscles (back, face, arms, etc.) to tremble. Exhale through the mouth is sharp and powerful ("like a gun"). Repeat two more times.

 In each of the exercises for the specified execution time, uncomfortable sensations are overcome.

 Examples of antidepressant effects using the proposed method.

 Example 1

 Patient M. 36 years. Born and raised in an intelligent family. In the army, the patient became acquainted with drugs (wild hemp and opium poppy). For two years of continuous use of various drugs, I tried several methods of treatment for drug addiction. He was in a state of deep depression. I turned for help to the Kundala MC. A rehabilitation program was developed using complexes of physical exercises.

 1. Complexes of dynamic and static exercises 1, 3, causing an activating effect (feeling of euphoria).

 2. Nutritional supplements: tyrosine 1 capsule 3 times a day, taurine 500 mg 3 times a day, dimethylaminoethanol DMAE 500 mg 3 times a day, lecithin 1 teaspoon once a day and B vitamins.

 After the rehabilitation course, depression and craving for drugs disappeared, and hopes for recovery and a normal, happy life appeared.

 Example 2

 Patient P., 25 years old. At 16, he first tried drugs; first marijuana, and soon began to use heroin. 3 years was constantly on drugs (heroin). In an extremely serious depressive state, he turned to the center. A rehabilitation program has been developed.

 1. Complexes of dynamic and static exercises of a sedative type (complex 2).

3 Nutritional supplements: taurine 1000 mg in combination with 5-hydroxytryptophan (50 mg) and hypericin (extract from St. John's wort) and vitamin B ₆ (pyridoxine), D, L-phenylalanine 2 capsules 3 times a day 1 hour before meals .

 The depressive state has disappeared. He doesn’t use drugs for about 5 years, he got an education, works, has a family.

 Conducting exercise complexes alternate with group psychotherapy. Instructors direct conversation topics, talk about treatment methods.

 Former instructors, former alcoholics, and those with special education work as some instructors. Experience shows that this approach allows the patient to see the possibility of recovery.

 Psychotherapeutic classes based on the 12-step program using modern types of psychotherapy: art therapy, gestalt therapy, elements of psychodrama and others - bring up a world of sobriety, that is, they allow you to choose sober decisions and avoid a behavioral strategy that leads to a breakdown. The goal of psychotherapy programs is to bring the ideas of recovery to the patient, to help him learn effective methods of maintaining steady sobriety. The patient is given the opportunity to consciously choose and maintain a sober lifestyle without any chemicals that change consciousness.

 The program helps the patient to identify himself in objective reality, to realize the nature of the pathological dependence itself and to learn how to solve personal problems without chemicals. Each component of the program is an introductory part, which contains a course of lectures. Another component is the practical part of the program. This part contains meetings and conversations with people who have real experience of recovery, discussion of lectures. The patient performs practical work in the form of solving problems that impede recovery, conducts special psychological trainings that help get rid of negative character traits and teach how to build new relationships. In the hospital, they monitor internal experiences in order to teach the patient self-control and prevention of breakdowns. Patient nutrition is based on serving to stabilize mood (the prevention of mood swings associated with fluctuations in blood sugar) and is a low glycemic diet. This diet contains foods that do not contain easily digestible carbohydrates and substances that limit their absorption. While the patient is in the hospital, classes are held once a week with his relatives to solve the problems of dependence on psychoactive substances. Emotionally affective problems affect all family members. Classes are held in the form of lectures and seminars that guide how to build relationships in a family in a new way, where there is a recovering person, and thereby help him recover.

 2 stage.

 The rehabilitation program in the second stage is carried out within 35 days. After the hospital, the patient returns home to normal conditions. The second stage is the stage of implementing the acquired skills, their development, and consolidation, and active application in ordinary life. Classes are held 4 times a week in the evening, after each lesson, patients receive homework. This allows the patient to maintain daytime employment (study, work), and once a week the patient visits an individual psychologist. Evening classes consist of classes in a small psychological group, exercises and classes in a self-help group. The duration of each lesson is 1-1.5 hours.

 The duration of all classes is 4.5 hours. An outpatient program helps reinforce and make the best use of skills in real life. At the second stage, they continue to work with the patient's relatives.

 3 stage.

 The third stage lasts for two years. This biennial extensive ambulatory program. In the third stage, the patient attends evening classes twice a week and an individual psychologist if necessary. At this stage, the patient performs a set of exercises, uses group and individual psychotherapy and diet with the use of special nutritional supplements. Nutritional supplements are based on the effect of restoring mental, physiological functions in the body, normalizing the central nervous system. They contain a set of essential amino acids and substances that have an antidepressant effect. The duration of the third stage is due to international statistical studies, which showed that the likelihood of a breakdown in patients remains for exactly two years from the moment of the last use of psychoactive substances.

 The method has no contraindications. The high effectiveness of non-drug therapy is determined by its pathogenetic orientation and the fact that the patient actively joins the rehabilitation process, and this is effectively combined with psychotherapeutic methods.

Claims (10)

 1. A method of antidepressant effects on the emotional and affective sphere of a person, comprising performing a set of physical exercises, characterized in that the complex of exercises includes dynamic and static physical exercises, each dynamic exercise based on rhythmic repetitive movements performed synchronously with breathing, each static exercise based on holding the posture, while each dynamic and static exercise is performed until overcoming uncomfortable sensations.  2. The method according to claim 1, characterized in that the dynamic exercises are performed with a load on the muscles, on the joint-ligamentous apparatus, on the musculoskeletal system, simultaneously on the muscle and joint-ligamentous apparatus and grimaces and shaking exercises, with dynamic exercises are performed in a sitting, lying, standing position.  3. The method according to any one of claims 1 and 2, characterized in that the static exercises are performed in a sitting, lying, standing position.  4. The method according to any one of claims 1 to 3, characterized in that the complex of exercises further includes breathing exercises.  5. The method according to any one of claims 1 to 4, characterized in that after each exercise or group of exercises, a short relaxation is performed, and at the end of the set of exercises, a deep, long relaxation.  6. The method according to any one of claims 1 to 5, characterized in that they focus on respiration and / or on various parts of the body.  7. A method of rehabilitation of patients with a syndrome of dependence on psychoactive substances and patients with emotionally-affective disorders, comprising three stages, the first of which is carried out within 15-40 days in a hospital with daily classes, including exposure according to claim 1 2-5 once a day and with individual and / or group psychotherapy, the second stage is carried out for 30-60 days on an outpatient basis with these classes 3-5 times a week, and the third stage is carried out for at least a year and a half after iem these sessions 1-3 times a week.  8. The method according to claim 7, characterized in that the psychotherapy is carried out on the basis of the "12 steps" program.  9. The method according to claim 7 or 8, characterized in that it further includes the use of food additives having an antidepressant effect.  10. The method according to claim 9, characterized in that the food additives are taken 3 times a day for 0.5 hours before meals and 3 times a day with meals.