Mentism

An episodic disorder of the dynamics of thinking, manifested as an uncontrollable influx of many unrelated thoughts, subjectively felt as alien, appearing from outside and against the will of the individual, is called mentism, from the Latin mens, mentis - thought, mind. A person is unable to get rid of them, to distract himself, to switch to other thoughts at his own discretion. Under the influence of a violent flow of thoughts of any content, he temporarily loses the ability to adequately perceive what is happening and act according to the circumstances. At the same time, his consciousness remains clear, and after the attack the person feels the painfulness of what happened. Even short-term episodes of mentism are difficult for patients to experience and lead to mental exhaustion. [ 1 ]

The thinking process during an attack is not productive. Despite the accelerated flow of ideas or images, they lack specific content. In fact, there is a delay in the associative thought process, which prevents logical and purposeful activity.

Epidemiology

Statistics show that most often mentism is part of the symptom complex of mental automatism syndrome (Kandinsky-Clerambault) and is one of the signs of the onset of schizophrenia. It is in its initial stages that patients critically evaluate the pathological nature of the influx of thoughts. The disease is usually diagnosed for the first time at 15-24 years among the male population, 55-64 - among the female population. [ 2 ]

Causes mentism

A whirlwind of involuntary influx of various thoughts, some of which cannot be thought through to the end, can be felt by any person under the influence of stressful circumstances, emotional overload, sometimes for quite a long time, over the course of days and weeks, until the situation that worries him is resolved. However, the source of thoughts is usually perceived by a healthy person as belonging to his own “I” and the associations between thoughts, although superficial, often confused, are still more or less logical and understandable.

With mentism, thoughts do not just flow like a river, they come from the outside, are perceived as alien, imposed, it is impossible to get rid of them. Images, memories, ideas flash like in a kaleidoscope. The reasons for the periodic occurrence of their pathological influxes usually relate to psychiatric or neurological diseases.

Mentism is often a symptom of the onset of schizophrenia, especially if the disorder of the thought process continues for a long time or occurs very often and without apparent reason. It can also be a manifestation of an affective disorder, neurosis, psychopathy. Sometimes it is observed in epileptics. Based on this, an important factor increasing the likelihood of mentism is hereditary predisposition, the significance of which cannot be underestimated in the development of such diseases as schizophrenia and epilepsy. In addition, it causes a special sensitivity to the effects of various types of stressors, and the development of personality disorders and neuroses against their background.

Mentism may accompany exogenous psychoses and organic brain pathologies. In these cases, any risk factors that disrupt blood circulation and metabolism in the brain structures may act, capable of causing an imbalance in the course of neurobiological processes and triggering the pathogenesis of thinking disorders. These include craniocerebral trauma, tumors, hemorrhages, chronic alcoholism, drug addiction, acute poisoning, and cases of hypoxia.

Mentism as a symptom demonstrates the presence of a mismatch in the functioning of brain systems. What neurobiological processes are involved in its development mechanism is still not entirely clear.

Symptoms mentism

Patients usually complain of a sudden appearance of many thoughts, memories, images of absurd content, uncharacteristic for this person and current circumstances. They change quickly, preventing one from concentrating on any of them. At the same time, it is impossible to get rid of this stream. Mostly, such episodes are short-lived, the person does not have time to figure out anything, and the attack has already passed. Nevertheless, there remains a feeling of painfulness of what happened, patients evaluate mentism as the first signs of impending madness.

Usually, after an attack, people cannot describe coherently what they saw or what they thought about. Everyone agrees that images, ideas, and memories change very quickly, not allowing them to concentrate on anything. It is impossible to drive them away or switch to something else. During an attack, a person seems to drop out of the real world, losing the ability to think and act rationally, while remaining conscious and aware of what is happening.

In most cases, milder short-term episodes of mentism are observed, lasting several seconds or minutes. Patients note the sudden appearance of individual ideas, absolutely not corresponding to the current course of thinking, sometimes frightening in content, wild and not characteristic of this person. They come unexpectedly, as if from outside, and disappear almost immediately. Such thoughts disrupt the order of the thought process, drawing attention to themselves with their absurdity, exhausting the person's psyche.

Long-lasting, up to several days, episodes of mentism are even more exhausting. Patients complain that the flow does not stop either day or night. Sometimes they turn into dreams, just as chaotic, frightening and incomprehensible.

Hypnagogic mentism is a type of influx of images, successive frames, pictures, some fragments not connected with each other by a common theme. The images can be flat and three-dimensional, black and white and color. Patients see silhouettes, spots and swirls, circles, fragments of cities and streets, animals, flowers. The images can be clear and complete, blurred and fragmentary. They have one thing in common - they appear unexpectedly, violently and the patient cannot stop their flow. Figurative (hypnagogic) mentism most often occurs in the patient when he closes his eyes, in most cases this happens when falling asleep. Patients confidently differentiate mentism before sleep from the dreams themselves and note that sometimes the influx of images gradually turns into sleep. This type of mentism can be observed in a completely healthy person - before sleep after a day full of exciting events, a stream of uninvited and incoherent thoughts or images can intrude.

The content of thoughts can be different - simply strange, anxious, pessimistic, joyful, have an accusatory character. During long attacks of mentism, the person's mood, speech and behavior correspond to this content, and the thoughts themselves reflect the background of his mood and correspond to the patient's psychotype and his diagnosis.

In depressive disorders, streams of obsessive thoughts have a character of negativism, self-accusation, hopelessness. Patients often imagine misfortunes and illnesses (hypochondriac mentism) that await them and their loved ones. Scenes of death, disasters, funerals come to their minds. The patient is afraid of such a development of events in reality, however, these thoughts captivate his imagination.

Mentism in neurosis often occurs in individuals of the hysterical or asthenic type. Asthenics feel a rush of thoughts that reflect their lack of confidence in themselves and their own strengths. The content of ideas and images is often associated with irritants, attacks can be caused by loud sounds, bright light, and strong smells.

Accelerated thought flows and mentism belong to the same type of thinking disorders. Its pace is disturbed. In the case of mentism, it is greatly accelerated. However, tachyphrenia or accelerated pace of thinking, even its vortex form is still accompanied by the presence of associative links between successive thoughts. This condition is characterized by increased distractibility of the patient, not very coherent and not always finished choking speech, but still the meaning of the statements can be understood. It is also understandable to the patient, who, although incoherently, can convey it to the listener. The rush of ideas is usually accompanied by loud, rapid speech.

Poor speech or its absence is characteristic of mentism. It is also called "a silent race of ideas." The whirlwind of ideas, images, thoughts replacing each other are so absurd and incomparable that the patient can only watch their flow. He is unable to stop it or redirect it. Thoughts do not have time to acquire speech form, the patient often falls silent and falls into a stupor.

Experts classify mentism and sperrungs as manifestations of minor automatism. These opposite symptoms, the influx and blockade of thoughts, are observed mainly during the manifestation of schizophrenia and schizophrenia-like disorders, when the patient does not yet have a pronounced mental defect, and he is able to relate critically to attacks. Many psychiatrists see these symptoms as harbingers of the onset of alienation of thoughts. Later, when patients are overcome by delusional ideas of influence, criticism of attacks of mentism weakens and disappears completely.

Mentism in schizophrenia is characterized by prolonged attacks of ideational vortex flows that leave the patient for increasingly shorter periods of time.

Complications and consequences

The violent influx of uninvited thoughts is not dangerous in itself. Especially in short-term attacks of mentism, the ability to think, speak and act is usually restored quite quickly.

However, regularly recurring episodes indicate, at a minimum, the presence of a neurotic disorder. Especially if such conditions occur periodically on their own, and are not provoked by stressful situations. Patients usually have a hard time experiencing such attacks, they lead to nervous and mental exhaustion.

Long-term attacks of mentism are also an alarming sign. They may indicate the onset of schizophrenia, and this disease is seriously dangerous. Untreated schizophrenia has a progressive course. Patients lose the ability to adequately assess and react to current events, their behavioral control and self-organization of activities at home and at work are impaired. They become dependent on outside care, which provokes a depressive mood, contributes to the formation of antisocial behavior, and increases the likelihood of suicide.

Diagnostics mentism

If a patient complains of episodes of mentalism, a comprehensive examination is necessary, including a detailed interview with a psychiatrist, testing, consultation with a neurologist, narcologist, and sometimes an oncologist and traumatologist.

Laboratory tests are prescribed to assess the general state of health and instrumental diagnostics that provide an idea of the functioning of the brain: electroencephalography, echoencephalography, magnetic resonance imaging.

Differential diagnosis

Differential diagnostics, first of all, should confirm or exclude the presence of schizophrenia in the patient. This disease is characterized by a wide range of manifestations, and mentism, which disrupts associative thinking, is considered one of the main precursors to alienation of thoughts, the appearance of voices and delusions of influence.

Mentism is not a single symptom, it is present in different pathological processes. In epileptics, violent influxes of thoughts can develop in the prodromal period before seizures and between them.

Whirling influxes of thoughts can be a consequence of craniocerebral trauma and tumors. When delimiting organic damage to brain structures, they rely on the results of hardware studies.

Affective disorders and neuroses are distinguished from mental illnesses by the absence of personality changes in the patient. [ 3 ]

Differentiating psychopathological conditions is usually possible by observing clinical symptoms over time, taking into account the patient’s somatic state.

Treatment mentism

Therapy for mentism is determined by the nature of the underlying disease. Basically, therapy is drug-based.

The main drugs for treating schizophrenia are neuroleptics. Patients usually take them throughout their lives, which allows them to maintain their quality of life at a practically normal level.

The antipsychotic effect of this group of drugs is realized by blocking central neurotransmitter receptors. Drugs of this group have the ability to influence the frequency and intensity of the generation of nerve impulses in different parts of the central nervous system and their transmission to the periphery. They are able to influence metabolic processes in the cerebral cortex and regulate higher nervous activity, which includes associative thinking.

Neuroleptics are used to accelerate the rate of thinking in cases of affective, alcoholic, post-traumatic psychoses, severe neuroses. Preference is given to drugs with an inhibitory effect. They can be prescribed in small doses - below the so-called antipsychotic level, that is, used for sedation, as sleeping pills or to achieve an anxiolytic effect.

Depending on the observed symptoms, drugs of different generations are used, all of them have a wide range of side effects. Therefore, the drugs are dosed individually; it is not recommended to deviate from the treatment regimen proposed by the doctor. When the course is interrupted, a withdrawal syndrome occurs, so the drug should be discontinued gradually and under the supervision of a doctor. You cannot change the dosage on your own.

The main neuroplegic side effects caused by neuroleptics are associated with their direct action - muscle numbness, constant muscle spasms, tremors in the limbs and other extrapyramidal reactions. However, when using small doses, side effects are usually not realized.

Absolute contraindications to the use of antipsychotics are severe systemic pathologies of the brain and spinal cord, inflammatory and degenerative diseases of the liver and kidneys, decompensated heart disease, hematopoiesis disorders, myxedema, and vascular thrombosis.

Patients with depressive disorders and negative thought content may be prescribed antidepressants, as well as lighter sedatives of plant origin. In case of cerebral circulation disorders, hypoxia, consequences of intoxication and trauma, drugs with nootropic activity are used.

In the presence of concomitant diseases, appropriate therapy is prescribed based on known drug interactions.

In combination with drug therapy, psychocorrection is used – training courses with a psychologist are conducted in the form of group sessions or according to an individual program. They are aimed at restoring impaired thinking functions. [ 4 ]

Prevention

It is possible to prevent the emergence of mentism within the framework of neuroses and personality disorders in practically healthy people by increasing their stress resistance, positivism and trying to avoid psychotraumatic situations.

Leading a healthy lifestyle, people are insured against alcohol and drug psychosis. Even the probability of injuries, severe infections and tumors, as well as neuroses in fans of proper nutrition and regimen, an active lifestyle, who have given up bad habits, is much lower.

For mentally ill people, the main preventive measure is timely diagnosis and conscientious treatment of the underlying disease with compliance with all medical recommendations.

Forecast

Neuroses and affective disorders are more favorable in terms of prognosis. In the presence of mental illnesses, drug-compensated states of long-term remission occur in the overwhelming majority of cases.