Traditional medicine

How to get rid of inhibition. Causes of speech retardation in adults

Depressive disorders are quite diverse, and inhibited depression is those in which there is psychomotor retardation. However, there is no evidence to suggest that this condition is a distinct syndrome. In this regard, it is most correct to use the term only in descriptions. It is known that the most severe form of inhibited depression is characterized by a gradual transition to a state of depressive stupor. It has been established that the basis of every depression, including inhibited depression, is mainly due to mood swings and periodic changes in emotions, which is considered a normal phenomenon in everyone’s life.

But it often happens that emotions become painful when, in a state of depression, a person suffers from a feeling of hopelessness, expressed in a variety of combinations. First of all, anxiety, depression manifests itself, persistent pessimism and emptiness arise. Such a condition does not pass without leaving a mark on a person’s psyche; his normal rhythm of life is disrupted, and his general well-being worsens. If we consider the cause of inhibited depression at the biochemical level, then neurons are primarily involved in this disorder. If they are damaged, they lose the ability to produce the required amount of neurotransmitters such as dopamine, as well as serotonin and norepinephrine.

The release of these neurotransmitters is produced by one neuron into the synapse - a special space located between neurons. Thus, the second neuron of the electrical circuit is excited, and an electric current is directed through it. In this case, there is a lack of these neurotransmitters, therefore, in a state of depression, the transmission of nerve impulses from neuron to another neuron does not occur, which leads to general brain dysfunction. This is the cause of the symptoms of inhibited depression. Any depression interferes with a full life. If the condition is severe, then a symptom occurs in which hospitalization of the patient is inevitable. These are the patient's attempts to commit suicide. Sometimes suicide attempts are not expressed explicitly. For example, a person may begin to limit himself in food, so that exhaustion occurs.

Inhibited depression is also called passive melancholia. It is understood that the basis of inhibited depression is always a painful state of mind, based on a depressed mood and various experiences. Basically, the disease is characteristic of people who have suffered a significant amount of severe suffering of a moral nature. Inhibited depression is observed more often in young people, in the first half of life. Often, among the causes of the disease, the first place is occupied by somatic diseases, leading to subsequent exhaustion, difficult childbirth, or surgical operations with large blood losses. Factors such as hard physical labor, poverty, failure, addiction to alcohol, and much more influence the development of the disease.

It has been established that women are more susceptible to inhibited depression, although there are cases of inhibited depression in childhood, and it is also observed in old age. Such depression is always caused by long-term causes that affect the psyche over a certain period of time. In addition, there are problems that have an additional negative impact, for example, it could be an insult, an unexpected insult, or financial loss. As for pathological heredity, in this case, its role is not significant and does not affect the development of the disease.

Basically, people who, by nature, have an intact heredity, are susceptible to inhibited depression. Experts believe that this type of depression may well be detected in those who are endowed with a family history, however, this is only an occasional complication and cannot be considered as the main point. To imagine what the clinical picture of inhibited depression is, we should remember the state that everyone knows in sad moments of life, when a person is sad. When receiving difficult news that is painful due to its content, most people seem to withdraw from the world and become immersed in their own thoughts and feelings. At the same time, pressure in the heart area and heaviness may be felt.

In the presence of inhibited depression, specialists prescribe symptomatic treatment. To alleviate symptoms as much as possible, psychiatrists use, they are supplemented with psychotropic drugs included in other groups, in particular, this and. But, many drugs only affect symptoms, and they do not eliminate the cause of the disease itself, and can cause side effects, including dependence on the drug and addiction. Side effects include cardiotoxicity, which means the drug is toxic to the heart muscle. Including hematotoxicity and nephrotoxicity. At the same time, body weight may increase, the functions of endocrine organs may be disrupted, and so on.

S.N. Mosolov points out that such depressions with a predominance of apatoanergic symptoms in recent years are found among other depressions very often and often turn out to be torpid to pharmacotherapy. It is assumed that their increase is associated with the drug-induced pathomorphism of depression.
The author identifies two variants of apathetic depression: 1) anergic depression, which is characterized by a decrease in emotional response to ongoing events, vitality, and indifference; 2) abulic depression, in which mental inertia dominates (patients complain of laziness, “life by inertia”).
In parallel with apatoanergic symptoms, depression and anxiety are always present in the clinic. Suicidal tendencies are rare. Feelings of self-pity and indifference towards the child predominate. Somatovegetative symptoms are mild.
As with melancholic depression, inhibition of motor skills and thinking, monosyllabic, laconic answers may be observed. Patients lie in bed for a long time, take little care of themselves, and become sloppy. After getting out of a depressive state, they note that it was difficult for them mentally, they suffered. Undoubtedly, such a state is not true emotional emptiness, inherent in patients with schizophrenia with an increase in the apatoabulic defect. The reversibility and curability of such depressions indicates that both in structure and prognosis these are different conditions.

Depersonalization (anesthetic) depression. Extensive literature is devoted to the clinic, analysis and assessment of this variant of depression. Yu.A. Nuller and colleagues, as well as H.JI. Ilyin raise the question of isolating this syndrome into a special clinical form in the group of affective psychoses.
The condition is characterized by a feeling of one’s own change, unrecognizability of the surrounding world, a painful feeling of absence of emotions of alienation.
There is a kind of inversion of depression into suffering from the lack of sensory coloring of the perception of the external and internal world.
Depersonalization should probably be considered primary in such depression. Patients with a neurotic level of depression understand that the world around them remains the same - their perception of the world and themselves changes, and this causes suffering.
Therefore, it is correct to call such depression depersonalization. Psychomotor retardation in this form of depression, if expressed at all, is insignificant. A depressed mood may be accompanied by anxiety, suicidal thoughts and attempts.
Patients experience a disruption in communication with others. The world fades, colors, sounds, smells become less bright. Everything seems gray, lifeless, often unreal, seen as if through a transparent partition.
Sometimes patients complain about a “film before their eyes,” but immediately emphasize that they see all the details well. The passage of time slows down, at times it feels as if time has stopped.
At the same time, a feeling of one’s own change, emotional inferiority, and lack of empathy with the people around him appears (“The heart is petrified”; “I can’t love as before” - what in literature is called mournful, or painful, insensibility (anaesthesia dolorosa psychica).
The ability not only to love and to empathize is lost - patients experience painful anhedonia (inability to enjoy life), indifference to food (food becomes “like grass”), they have no feeling of hunger, sleep, physical pain, or sexual satisfaction.
The ratio of the components of such depression varies, and all of its listed components are not always fully represented.
It should be emphasized that the phenomenon of depersonalization in the form of mournful insensibility is present in an undeveloped form in the structure of almost all forms of postpartum depression, both psychotic and non-psychotic.
First of all, this refers to the feeling that mothers have for their newborns. With mild depression, women say that instead of love for their child they feel only pity or curiosity (“I love with my mind, I understand that he is mine”).

Inhibition of thinking is scientifically called “ bradypsychia" Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Reasons

The pathophysiology of the process is extremely complex and not fully understood. Thinking, behavior, emotional background and many other achievements of the human mind are associated with the work of the limbic system - one of the sections of the nervous system. And the limbicus cannot be properly deciphered. Therefore, in everyday practice, we can only name conditions - diseases in which bradypsychia is noted, but cannot answer the question of why it appears.

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.

Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.

Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, inhibition occurs, as do many other signs of a change in thinking.

Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.

Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.

Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.

Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still most clearly describes the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Treatment

General preventive measures. The more the brain is loaded, the better it works. Nerve cells that are not used during life happily die off as unnecessary in the literal sense. Accordingly, the mental reserve decreases. Learning new things is possible at any age, but after thirty years it is significantly complicated by the slowdown in the development of new interneuronal connections. You can load your brain with anything, as long as it is not familiar to it. Learning a new language, solving mathematical problems, mastering new sciences, studying historical archives and understanding them. But! Solving crossword puzzles, scanword puzzles, and the like is like memorizing a large Soviet encyclopedia. Dry information only occupies cells responsible for memory, but not for thinking. Physical activity also helps keep the brain in working order. It’s difficult to say what this is connected with.

Vascular therapy. It is impossible to bring the vessels to a state corresponding to twenty years of age, however, partial restoration is possible, which is what doctors use by prescribing appropriate medications.

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Before visiting a doctor, the patient can only engage in prevention - all drug treatment has a significant number of contraindications, which the specialist takes into account when choosing one or another drug. In case of bradypsychia, it is imperative to consult a doctor - there is not a single “easy” reason for such a mental state.

Such mental disorders must first be very carefully studied and correctly assessed by a psychotherapist, who should become a leading specialist in treatment of loss of energy and feelings of lethargy .

Types of inhibition, symptoms and treatment

What is retardation?

In serious cases, a person completely stops reacting to the surrounding atmosphere and remains in apathy or stupor for a long time. There are several types of inhibition:

comprehensive;

Retardation can be verbal and mental, that is, it has psychological causes. Sluggish and untimely motor reactions are caused by motor retardation. Problems with memorization and memory lapses may occur. In most cases, such conditions are caused either by illness, chronic fatigue, or psychological pathologies.

Motor and emotional retardation is a pathology, the causes of which only doctors can identify. They also prescribe adequate treatment.

Causes and symptoms of slow thinking

A person’s behavior, thinking, and psychological state can be disrupted due to pathologies of the nervous system and brain. Ideation inhibition is also caused by:

Parkinson's disease. In case of complex brain pathology, an additional symptom is also revealed - slowness of thinking. The patient himself does not notice any changes. As the disease progresses, his mental activity not only slows down. The patient becomes annoying, meticulous, and clingy. His speech becomes confused and incoherent.

All of these diseases, the symptom of which is inhibition of thinking, must be diagnosed and treated. Temporary inhibition of movements and thinking appears after severe stress, fatigue, and prolonged lack of sleep.

Suppression of motor and mental processes typically manifests itself after drinking alcohol, even once. The same symptoms are sometimes caused by psychotropic drugs, as well as strong sedatives. When they are cancelled, the inhibition goes away.

Causes and symptoms of motor retardation

Motor, as well as mental retardation, manifests itself as a result of psychological disorders, as well as various diseases. Lethargy is sometimes or always felt in the patient's facial expressions and movements. The posture is usually relaxed; there is often a desire to sit down, lie down in bed, or lean on something.

Lethargy in a child

This symptom is also typical for children. It can be chronic in some neurovegetative disorders, for example, cerebral palsy, or appear spontaneously at high temperatures, after severe stress or impression. Lethargy in children often results from:

vascular pathologies of the brain;

Diagnosis of lethargy

In case of psychological disorders, as well as physiological pathologies caused by inhibition of mental, motor or speech reactions, a thorough diagnosis is necessary, that is, a medical and psychological examination.

Diagnosis of written and oral speech is also carried out. Perhaps the person suffers from stuttering, defects in sound pronunciation, which lead to speech inhibition. The patient’s intellectual development, the state of sensory functions, general motor skills, and the condition of joints and muscles are also studied.

Treatment of lethargy

Activation of thought processes. To do this, they read new books, master languages, engage in creativity or solve mathematical problems. Such actions train the brain and activate mental activity.

If the lethargy is temporary and caused by high fever, then you should take tablets or syrups that reduce the temperature. Temporary inhibition caused by medications and strong sedatives can be stopped by abandoning such drugs. Usually it passes without a trace, the body’s reactions are completely restored.

Inhibition of emotions and movements (video)

What is inhibition of emotions and movements? How to correctly identify and treat pathology, we will learn the doctor’s recommendations from the video.

Prevention of lethargy

The pathology usually goes away without a trace if treatment is started in the early stages, when the underlying disease is identified. After competent psychological assistance and correct medication support, a person’s reactions improve, both emotional and physical.

Lethargy

Inhibition of a person’s mental processes and behavioral reactions can be caused by various reasons: fatigue, illness, exposure to tranquilizers that slow down organic processes, negative emotional states such as stress, depression, sadness, apathy.

Retardation is a decrease in an individual’s reaction speed, a slower flow of thought processes, and the appearance of protracted speech with long pauses. In extreme cases, a person may completely stop reacting to others and remain in a daze for a long time. Inhibition may not be complex, but relate only to thinking or speech. In the first case it is called ideational, and in the second - motor.

Suppression of thinking is scientifically called “bradypsychia”. Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Causes of slow thinking

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.
Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, inhibition occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still most clearly describes the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Of course, with such a large number of diseases, the number of types of treatment should also be large. Unfortunately, until scientists have finally figured out how the brain works, there are not as many of these species as we would like. The temporary effect of inhibition in speech and thinking occurs due to lack of sleep, when the body is already exhausted, or due to the use of drugs and alcohol, which inhibit mental and motor processes. That is, the reasons can be divided into those that block activities and those that reduce the possibilities for its implementation.

Symptoms of lethargy

The image of the patient fits into the classic description of a melancholic person: lethargy, slowness, protracted speech, every word seems to be squeezed out with effort. It feels like thinking takes a lot of strength and energy from this person. He may not have time to react to what is said or may completely plunge into a stupor.

In addition to a decrease in the rate of speech and thinking, there is a muffledness of what is said - an extremely quiet and calm voice that occasionally breaks the silence. Lethargy is noticeable in movements and facial expressions, and posture is most often too relaxed. An individual may have a desire to constantly lean on something or lie down. It is not necessary that all manifestations of inhibition be observed. Just one is enough to say that a person needs medical attention.

Diagnosis of bradyllalia

Persons with speech tempo disorders, including bradyllalia, need a comprehensive medical and psychological-pedagogical examination, which is carried out by a neurologist, speech therapist, psychologist, and psychiatrist. When examining a patient with bradyllalia, a detailed examination of the anamnesis regarding past diseases and brain injuries is necessary; presence of speech tempo disorders in close relatives. In some cases, to clarify the organic basis of bradyllalia, instrumental studies are required: EEG, REG, MRI of the brain, PET of the brain, lumbar puncture, etc.

Diagnosis of oral speech in bradyllalia includes assessment of the structure of the organs of articulation and the state of speech motor skills, expressive speech (sound pronunciation, syllabic structure of the word, tempo-rhythmic aspect of speech, voice characteristics, etc.). Diagnostics of written speech involves completing tasks for copying text and independent writing from dictation, reading syllables, phrases, and texts. Along with a diagnostic examination of speech, for bradyllalia, the state of general, manual and facial motor skills, sensory functions, and intellectual development is studied.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

General preventive measures. The more the brain is loaded, the better it works. Nerve cells that are not used during life happily die off as unnecessary in the literal sense. Accordingly, the mental reserve decreases. Learning new things is possible at any age, but after thirty years it is significantly complicated by the slowdown in the development of new interneuronal connections. You can load your brain with anything, as long as it is not familiar to it. Learning a new language, solving mathematical problems, mastering new sciences, studying historical archives and understanding them. But! Solving crossword puzzles, scanword puzzles, and the like is like memorizing a large Soviet encyclopedia. Dry information only occupies cells responsible for memory, but not for thinking. Physical activity also helps keep the brain in working order. It’s difficult to say what this is connected with.

Vascular therapy. It is impossible to bring the vessels to a state corresponding to twenty years of age, however, partial restoration is possible, which is what doctors use by prescribing appropriate medications.

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Psychotherapy is carried out only as a secondary addition to drug therapy. Modern psychotherapeutic techniques help to identify and eliminate the true cause of the disorder, form a new model of response to stressful situations, and correct personal assessment.

Before visiting a psychotherapist, the patient can only engage in prevention - all drug treatment has a significant number of contraindications, which the specialist takes into account when choosing one or another remedy. In case of bradypsychia, it is imperative to consult a doctor - there is not a single “easy” reason for such a mental state.

Forecast and prevention of bradyllalia

The prognosis for overcoming bradyllalia is most favorable with an early start of correctional work and psychological reasons for the violation of speech tempo. But even after developing normal speech skills, long-term observation by specialists and constant self-monitoring of the rate of speech are necessary.

To prevent bradyllia, it is important to prevent perinatal lesions of the central nervous system, head injuries, neuroinfections, and asthenic syndrome. It is necessary to take care of the child’s normal speech development and surround him with the right role models.

Lethargy

Lethargy is a symptom of certain diseases, usually of the central nervous system and brain, or a consequence of severe psycho-emotional shock. This state of a person is characterized by the fact that he has a decrease in the speed of reaction to actions addressed to him or performed by himself, a deterioration in concentration, more extended, with long pauses in speech. In more complex cases, there may be a complete lack of reaction to surrounding events.

This human condition should not be confused with apathy or a chronic depressive state, since the latter is more of a psychological factor than a physiological one.

The true causes of lethargy can only be determined by a qualified doctor. It is strongly not recommended to carry out treatment at your own discretion or ignore such a symptom, as this can lead to serious complications, including irreversible pathological processes.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

under alcohol or drug intoxication;
with chronic fatigue and constant lack of sleep;
with frequent nervous tension, stress, chronic depression;
under circumstances that cause a person to feel fear, anxiety and panic;
with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

Depending on the underlying factor, this condition in a child can be temporary or chronic. It goes without saying that if such a symptom appears in children, you should immediately consult a doctor, since the cause of the pathology can be dangerous to the baby’s health.

Classification

The following types of retardation are distinguished according to the clinical picture:

bradypsychia – inhibition of thinking;
mental or ideational inhibition;
motor or movement retardation;
emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are damaged, the following clinical picture may be present:

drowsiness (hypersomnia), lethargy;
headaches, which will intensify as the pathological process worsens. In more complex cases, pain relief is impossible even with painkillers;
memory impairment;
decreased quality of cognitive abilities;
the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
illogical perception of speech or actions addressed to him;
speech becomes slow, the patient may have difficulty finding words;
nausea and vomiting, which is most often observed in the morning;
impaired coordination of movements;
unstable blood pressure;
rapid pulse;
dizziness.

In a child, the general clinical picture with this kind of pathology may be complemented by moodiness, constant crying or, on the contrary, constant drowsiness and apathy towards usual favorite activities.

It should be noted that the above-described symptoms are also observed after a stroke. If you suspect that a person is having a seizure, you should call emergency medical help and rush them to hospital. It is the urgency and coherence of primary medical measures after a stroke that largely determine whether a person will survive or not.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

insomnia or drowsiness, which is replaced by an apathetic state;
unreasonable attacks of aggression;
sudden change in mood;
causeless attacks of fear, panic;
suicidal mood, in some cases, actions in this direction;
state of chronic depression;
visual or auditory hallucinations;
nonsense, illogical judgments;
neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
excessive suspicion, the feeling that he is being watched;
deterioration or complete loss of memory;
incoherent speech, inability to express one’s point of view or specifically answer the simplest questions;
loss of temporal and spatial orientation;
feeling of constant fatigue.

You need to understand that this human condition can progress quickly. Even with a temporary improvement in the patient’s condition, we cannot say that the disease has been completely eliminated. In addition, such a person’s condition is extremely dangerous both for him and for the people around him. Therefore, treatment under the guidance of a specialized doctor and in an appropriate institution is, in some cases, mandatory.

Diagnostics

First of all, a physical examination of the patient is carried out. In most cases, this should be done with a person close to the patient, since due to his condition he is unlikely to be able to answer the doctor’s questions correctly.

In this case, you may need to consult the following specialists:

Diagnostic measures include:

general clinical laboratory tests (blood and urine tests);
study of the level of pituitary hormones;
CT and MRI of the brain;
EEG and Echo-EG;
cerebral angiography;
psychiatric tests.

Depending on the diagnosis, the issue of hospitalization of the patient and further treatment tactics will be decided.

Treatment

In this case, the treatment program can be based on both conservative and radical treatment methods.

If the cause of such a person’s condition is a tumor of the brain or central nervous system, then an operation is performed to excise it, followed by drug treatment and rehabilitation. The patient will also need rehabilitation after a stroke.

Drug therapy may include the following drugs:

painkillers;
sedatives;
antibiotics if the disease is of an infectious nature;
nootropic;
antidepressants;
tranquilizers;
drugs that restore glucose levels;
vitamin and mineral complex, which is selected individually.

In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

Provided that therapeutic measures are started in a timely and correct manner and are fully implemented, almost complete recovery is possible even after serious illnesses - oncology, stroke, psychiatric illnesses.

Prevention

Unfortunately, there are no specific prevention methods. You should follow a rest and work schedule, protect yourself from nervous experiences and stress, and begin treatment for all diseases in a timely manner.

“Retardation” is observed in diseases:

Alalia is a speech function disorder in which the child cannot speak partially (with a poor vocabulary and problems in constructing phrases) or completely. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Apathy is a mental disorder in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This condition very often comes into a person’s life unnoticed, since it does not manifest itself with pain symptoms - a person may simply not notice deviations in mood, since the causes of apathy can be absolutely any life process, and most often a combination of them.

Status asthmaticus is a prolonged attack of bronchial asthma, the progression of which causes severe respiratory failure. This pathological condition develops as a result of swelling of the bronchial mucosa, as well as spasms of their muscles. In this case, it is not possible to relieve an attack by taking an increased dose of bronchodilators, which, as a rule, are already taken by a patient with asthma. Status asthmaticus is a very dangerous condition that can lead to the death of the patient, so it requires emergency medical attention.

Affective disorders (syn. mood swings) are not a separate disease, but a group of pathological conditions that are associated with a violation of the internal experiences and external expression of a person’s mood. Such changes can lead to maladjustment.

Bacterial endocarditis is an inflammatory process in the inner lining of the heart caused by the influence of pathological microorganisms, the main one of which is streptococcus. Often, endocarditis is a secondary manifestation that develops against the background of other diseases, but it is bacterial damage to the membrane that is an independent disorder. It affects people of any age group, which is why endocarditis is often diagnosed in children. A distinctive feature is that men suffer from this disease several times more often than women.

All over the world, many people suffer from a disorder called bipolar disorder. The disease is characterized by frequent mood swings, and a person’s mood changes not from bad to good, but from extremely depressed and sad, to a feeling of euphoria and the ability to perform feats. In a word, mood swings in patients with bipolar disorder are enormous, which is always noticeable to others, especially if such fluctuations are frequent.

Legionnaires' disease, or legionellosis, is a bacterial infection that most often manifests as a severe form of pneumonia. A characteristic expression of the disease is intoxication and dysfunction of the central nervous system and kidneys. Sometimes, during illness, damage to the respiratory and urinary systems occurs.

Acute intestinal infection caused by a bacterial environment and characterized by the duration of fever and general intoxication of the body is called typhoid fever. This disease is a severe ailment, as a result of which the main area of damage is the gastrointestinal tract, and when it worsens, the spleen, liver and blood vessels are affected.

Hypernatremia is a disease characterized by an increase in serum sodium levels to 145 mmol/L or higher. In addition, a reduced fluid content in the body is detected. The pathology has a fairly high mortality rate.

Hypersomnia is a sleep disorder characterized by increased rest periods and daytime sleepiness. In this case, the duration of sleep is more than ten hours. It rarely occurs as an independent disorder - it is often a complication of certain diseases. After a long sleep, there is no improvement in the general condition; there is constant drowsiness and problems with waking up.

Hypertensive crisis is a syndrome in which there is a significant increase in blood pressure. In this case, symptoms of damage to the main organs develop - the heart, lungs, brain, etc. This condition is very serious and requires emergency care, as otherwise serious complications may develop.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is a rather dangerous type of disease, caused by a person’s passivity and depression.

Diabetic coma is an extremely dangerous condition that develops against the background of diabetes mellitus. If it progresses, metabolic processes in the human body are disrupted. This condition threatens not only the health, but also the life of the patient.

Cardiogenic shock is a pathological process when the contractile function of the left ventricle fails, the blood supply to tissues and internal organs deteriorates, which often ends in human death.

Ketoacidosis is a dangerous complication of diabetes mellitus, which without adequate and timely treatment can lead to diabetic coma or even death. The condition begins to progress when the human body cannot fully use glucose as an energy source because it lacks the hormone insulin. In this case, the compensatory mechanism is activated, and the body begins to use incoming fats as an energy source.

Tick-borne encephalitis is a severe infectious disease that is transmitted to humans from encephalitis ticks. The virus makes its way into the brain and spinal cord of an adult or child, causing severe intoxication and affecting the central nervous system. Severe encephalitic forms without timely treatment can lead to paralysis, mental disorders and even death. How to recognize the symptoms of a dangerous pathology, what to do if you suspect a tick-borne infection, and what is the importance of vaccination in the prevention and treatment of a deadly disease?

False croup is a pathology of an infectious-allergic nature, causing the development of laryngeal edema with subsequent stenosis. Narrowing of the airways, including the larynx, leads to insufficient air supply to the lungs and poses a threat to the patient’s life, so help in this condition should be provided immediately - within minutes after the attack.

Waldenström's macroglobulinemia (syn. primary macroglobulinemia, macroglobulinemic reticulosis) is an extremely rare disease in which a tumor consisting of lymphocytic and plasmacytic cells forms in the bone marrow.

Metabolic acidosis is a pathological condition characterized by an imbalance in the acid-base balance in the blood. The disease develops against the background of poor oxidation of organic acids or their insufficient removal from the human body.

Myxedema is the most severe form of hypothyroidism, which is characterized by the development of edema of the skin and subcutaneous tissue. The pathology begins to progress in the human body as a result of insufficient secretion of thyroid hormones. Women are most often susceptible to this disease during the period of hormonal changes, that is, during menopause.

Cerebral edema is a dangerous condition characterized by excessive accumulation of exudate in the tissues of the organ. As a result, its volume gradually increases and intracranial pressure increases. All this leads to disruption of blood circulation in the organ and to the death of its cells.

Quincke's edema is usually defined as an allergic condition, expressed in its rather acute manifestations. It is characterized by the occurrence of severe swelling of the skin and mucous membranes. Somewhat less frequently, this condition manifests itself in the joints, internal organs and meninges. As a rule, Quincke's edema, the symptoms of which can appear in almost any person, occurs in patients suffering from allergies.

A disease that is characterized by the formation of pulmonary insufficiency, presented in the form of a massive release of transudate from the capillaries into the pulmonary cavity and ultimately promoting infiltration of the alveoli, is called pulmonary edema. In simple terms, pulmonary edema is a situation where fluid stagnates in the lungs and has leaked through the blood vessels. The disease is characterized as an independent symptom and can develop on the basis of other serious ailments of the body.

Pancreatic necrosis of the pancreas is a dangerous and severe pathology in which the organ itself begins to actively digest its own cells. This, in turn, leads to certain areas of the gland becoming necrotic. This pathological process can provoke the progression of a purulent abscess. Pancreatic necrosis also negatively affects the functioning of other vital organs. If timely and complete treatment is not carried out, this disease often leads to the death of the patient.

Overwork is a condition that not only adults, but also children often face today. It is characterized by decreased activity, drowsiness, impaired attention and irritability. Moreover, many people believe that overwork is not a serious problem, and that it is enough to get a good night’s sleep for it to go away. In fact, it is impossible to get rid of such a disorder by sleeping for a long time. It's the other way around - a constant desire to sleep and the inability to regain strength after sleep are the main symptoms of overwork.

Hepatic encephalopathy is a disease characterized by a pathological process that occurs in the liver and affects the central nervous system. The result of this disease is neuropsychiatric disorders. This disease is characterized by personality changes, depression and intellectual impairment. You won’t be able to cope with hepatic encephalopathy on your own; you can’t do it without medical intervention.

Multiple organ failure is a severe pathological process that occurs as a result of severe injury, severe blood loss or any other condition. In this case, we are talking about disruption or complete cessation of the functioning of several systems of the human body at the same time. In 80% of cases, death occurs if the necessary medical measures are not taken in a timely manner to normalize the functioning of the organs. This high mortality rate is due to the fact that damage to systems or organs occurs at such a level that the ability to maintain the life of the body is lost.

A disease characterized by inflammation of the joints due to infectious diseases of various organs and systems is called reactive arthritis. Often, inflammation of the joints occurs due to infection of the genital organs, urinary system, or even the gastrointestinal tract. After the body is infected with infections, the development of reactive arthritis may be observed in the second to fourth week.

Rh conflict during pregnancy is a pathological process that manifests itself in a situation where the mother has a negative Rh factor and the father is positive, and the child acquires the positive Rh factor of the father. If both parents are Rh positive or Rh negative, Rh conflict is not detected.

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With the help of exercise and abstinence, most people can do without medicine.

Retardation of thinking, movements and the mental sphere: causes, symptoms

From time to time, every person may notice that the brain is not functioning fully. Such a disorder is expressed in difficulty performing movements (bradykinesia) and in remembering information, inhibition of reactions and thinking disorders (bradypsychia).

It should be said that in most situations these disruptions are temporary and can be explained by natural factors: fatigue or nervous exhaustion. However, there are cases when the awkwardness of movements, inhibition of thinking and the mental sphere is a pathological process, the causes of which must be promptly identified and appropriate therapy selected.

Features of bradypsychia

Pathological inhibition of thinking is called bradypsychia. This phenomenon has no parallels with apathy or inertia of thinking, but suggests mental and pathophysiological disorders.

Bradypsychia is considered as a kind of neurological symptomatology, which in most cases develops in people in old age. But sometimes people at a young age, as well as children, experience inhibition in their thinking processes.

Poverty and insufficiency of mental processes is a symptom of many psychological or physiological pathological processes, manifested as a decrease in reaction speed, slow speech, slow thinking and motor activity. In difficult situations, the individual is not able to react to what is happening and remains for a long time in an apathetic state or stupor. The following types of inhibition are distinguished:

Thought processing can be disrupted at any age

Retardation also occurs in speech and thought, which has psychological factors. Weak and involuntary movements can cause motor retardation. Memory problems and failures appear. In many cases, such conditions are provoked by a neurological disease, constant fatigue, or psychological pathological processes.

Slowness of movements and emotional inhibition is a pathological process, the causes of which only specialists can detect. They also recommend proper therapy.

Associated disorders

Bradypsychia is the result of damage to the central nervous system, which is responsible for brain activity. Depending on the element of the lesion, different types of disorders develop. These include:

bradybasia - slow walking;

Bradykinesia is characteristic of parkinsonism

When bradypsychia is a consequence of Parkinson's disease, it is necessary to focus on the symptoms of the underlying pathological process. These include feelings of fatigue, anxiety, sleep disorders, etc.

Provoking factors and diseases

The pathophysiology is very complex and not fully understood. It is only known that thinking, behavior, emotional component and other functions of the human brain are associated with the activity of the limbic system. In everyday practice, only conditions are identified - diseases, during which bradypsychia and accompanying deviations are observed:

Vascular diseases of the brain. Acute, often chronic disorders of blood flow in the brain, which arise due to progressive atherosclerosis, hypertension, embolism and vascular thrombosis, are a factor in the destruction of substances in the brain. The structures that are responsible for quick thinking are also susceptible to disruption.
Parkinson's disease. A common cause, the characteristic manifestation of which is slow thinking. In addition to such depressing symptoms (patients at a late stage of development of this pathological process do not tend to notice any changes), there are a large number of other unpleasant manifestations. For example, thoughts will become not only slow, but also viscous; the patient will be characterized by importunity and slow, confused speech.
Epilepsy. At a late stage in the development of the disease, when experts observe the destruction of personality as a result of a progressive disease, inhibition may be noted, as well as other symptoms of altered thinking.
Schizophrenia. As with epilepsy in schizophrenia, bradypsychia is not considered an initial symptom of pathological processes, but develops gradually over time.
Depression. A mental illness that is characterized by a large number of symptoms, often disguised as somatic difficulties - including toothache or ischemia. These also include sluggish thinking.
Hypothyroidism. Improper functioning of the thyroid gland. With this disease, the symptoms are extremely pronounced and are one of the first to occur.
Toxic lesions. Such a subgroup of diseases does not exist in the international classification. However, the term best describes the causes of painful symptoms - intoxication of the body.

The short-term effect of lethargy appears after lack of sleep, due to exhaustion of the body, or as a result of the use of drugs and alcohol, which inhibit thinking and movement. The reasons can be divided into those that block brain activity and those that reduce the possibilities for its implementation.

Naturally, with such an abundance of provoking diseases, treatment can also be different.

What does it look like?

The image of a “inhibited” patient falls under the typical characteristics of a melancholic person: weakness, slowness, drawn-out speech, every word is pronounced with effort.

There may be a feeling that the thought process takes a large amount of strength and energy from a person who does not have time to react to information or is completely plunged into a stupor.

In addition to a decrease in the speed of speech and thought processes, muffled words are observed - a very quiet and calm voice, sometimes breaking the silence. Weakness is visible in movement and facial expressions; posture is often too relaxed.

A person has a desire to constantly find support or lie down.

Not all symptoms are always observed. Just one thing is enough to recommend a person to seek medical help from specialists.

Diagnostic criteria and methods

People with speech rate disorders, including bradyllalia, need comprehensive medical, psychological and pedagogical diagnostics carried out by a specialized specialist. During the examination, the patient’s medical history should be studied in detail, which concerns previously suffered diseases and brain lesions, as well as the presence of disturbances in the rate of speech in relatives.

In certain situations, in order to find out the organic basis of the disease, it is necessary to conduct instrumental studies, including:

The study of oral speech involves assessing the structure of the organs of articulation and the state of motor skills, expressive speech (pronunciation of sounds, syllables, words, tempo-rhythmic side, voice characteristics, etc.). Diagnostics of written speech involves performing tasks such as copying text, writing from dictation, and reading. In addition to a diagnostic examination of speech function, a study of general condition, manual motor skills, sensory functions, and intelligence is carried out.

When making a diagnosis, it is necessary to differentiate this disease from dysarthria and stuttering.

What does modern medicine offer?

To carry out proper treatment of the disease, you must first consult with a specialist. He will recommend effective treatment, and will also warn about the presence of contraindications to the use of certain therapy methods or any medication.

The following methods of therapeutic and preventive action are used more often than others:

Activation of thinking processes. For these purposes, you need to read new books, study foreign languages, engage in the creative process, or solve various puzzles. This technique helps train the brain and activate thinking.
Neuroprotectors and nootropics are prescribed. Drug therapy that is aimed at restoring and strengthening nerve cells and tissues.
Treatment of vascular pathologies. Products are used that make it possible to cleanse the vascular walls, which is necessary for proper brain function. As a result, mental and physical activity is activated.
Psychotherapy. It acts as an auxiliary drug therapy. Modern therapeutic techniques help counteract the effects of stress, adjust personality assessment, and form the necessary models of response to specific situations.
Sports activities and walks in the fresh air. Moderate physical stress and walks give the brain the opportunity to rest and the nerve cells to recover thanks to the influx of oxygen.

If emotional and mental retardation is caused by tranquilizers, then discontinuation of any drugs is required. In most cases, reactions recover over time.

Summing up

The prognosis is relatively favorable with an early start of correction and the presence of psychological causes of disorders of motor activity and speech motor skills. However, after regaining your skills, you should be observed by doctors for a long time and constantly independently monitor your movements and train of thoughts.

As preventive measures, damage to the central nervous system should be prevented, head injuries should be avoided, and asthenic syndrome should be detected in time.

Pathological inhibition of thinking involves various mental and pathophysiological disorders. This phenomenon should be qualified as a symptom that in most situations occurs in older people. But in certain cases, a similar problem can manifest itself in childhood and young people.

If you notice that your thinking processes are slow, you should immediately seek advice from a doctor. It is likely that this condition is the result of dangerous disruptions in the functioning of the central nervous system and requires special correction.

Apathy

A state of apathy overcomes every person from time to time. If apathy towards life lasts for a relatively short time, then this condition is not dangerous. But if a state of apathy is observed in a patient over a long period, then it is necessary to consult a specialist.

How does apathy manifest itself?

Translated from Greek, the word “apathy” means “insensitivity.” If a person shows signs of apathy, then among other people he can be easily recognized by his indifferent attitude towards what is constantly happening around him. He does not show emotions, does not express any life aspirations. Those things or problems that until recently were of decisive importance for him, in a state of apathy, no longer interest him. The state of apathy is also manifested in the patient by a sharp limitation of communication. His professional activity may be slowed down, since a constant state of despondency affects the ability to work fruitfully. Most often, the patient spends time motionless. At the same time, he is not interested in the question of how to get out of the state of apathy.

In everyday life, apathy develops in most people at a certain period of life. But not everyone considers apathy a disease or a symptom of some kind of illness.

A person's emotions are the main driving force of his life activity. Emotions determine both pleasant and not so good feelings, while filling a person’s life with more pronounced meaning. However, the human psyche can periodically become exhausted, resulting in a certain dullness of emotions. The opposite development of events is also possible - if there are no positive emotions in a person’s life for a long time, then the result may be a noticeable loss of strength. Apathy often manifests itself at a time when a person needs to replenish an energy deficit.

Of course, a person may periodically experience complete apathy. Moreover, such a state can even be somewhat useful, as it allows you to reassess values and carry out certain psychological work on yourself. Sometimes a person’s state of apathy occurs during a period followed by a certain important event in life, and in such a situation, apathy even allows one to accumulate a little internal strength.

But if temporary apathy is a completely normal stage in life, then apathy, which a person perceives as depression, can lead to worsening mental health in the future.

If a person is constantly in a depressed state, and the reasons for this state are completely incomprehensible to the people around him, then we can talk about apathy as an alarming symptom.

This term appeared in psychiatry, having entered medicine from philosophical science. Psychiatry defines apathy as complete indifference to what is happening around, an indifferent attitude towards other people, and even signs of disgust for everyday life.

Symptoms of apathy in humans are manifested by a number of characteristic signs that clearly indicate this disorder. But it is worth noting that very often apathy and drowsiness indicate the development of a serious disease in the human body. Therefore, if there are a number of signs of apathy in a loved one, you need to encourage him to undergo a comprehensive medical examination. Only after making a diagnosis will the doctor be able to clearly say how to deal with apathy and prescribe adequate therapy. A person who has developed apathy often experiences weakness and drowsiness. From the outside it may seem that he is simply too lazy to do anything, that he is simply overcome by extreme fatigue. By the way, chronic fatigue often leads to manifestations of apathy, and sometimes depression can be a consequence of this condition.

Vivid symptoms of apathy are lethargy, indifference to everything and everyone, isolation and the desire to constantly be alone. Such a person usually speaks inexpressively; he can be openly sad for no reason. The patient, prone to apathy, does not show initiative. All these symptoms are worth knowing in order to promptly notice the development of apathy both in yourself and in the people around you.

Why does apathy appear?

In the modern world, apathy develops in people very often, and it can be observed in successful and even happy people who have taken place in life. Sometimes from the outside it seems that the reasons for apathy are completely incomprehensible. Even the patient himself very rarely can understand what lies behind his illness and what provoked it. In addition, it should be taken into account that the patient, imbued with indifference to everything that happens around him, is still indifferent to his own illness, which leads to its aggravation.

However, apathy in a person can develop both due to internal and external reasons. So, sometimes those events that at first glance seem completely insignificant can leave a serious mark on the soul, which leads to changes in the psyche.

Psychologists identify several reasons that very often lead to the development of apathy. This condition sometimes develops in people whose profession is associated with strong emotional stress. A decline in energy can also be associated with a serious illness, lack of sunlight, or vitamin deficiency. Any manifestations of prolonged stress, both physical and moral, can also ultimately cause apathy in a person. Also, as the reasons due to which this condition develops, experts identify both negative stress and a very bright positive event, after which a person experiences emotional emptiness.

Apathy is quite common among women during pregnancy. If the expectant mother does not show interest in novelty, is constantly bored and even has very little interest in changes in her own condition, then these may be signs of apathy. The cause of this condition is serious hormonal changes during pregnancy. Doctors advise not to allow the condition to worsen: just walk a lot, do exercises in the fresh air, and the state of apathy will become a thing of the past.

But apathy and a lethargic state are not always an exclusively psychological phenomenon. Sometimes these signs indicate the development of serious illnesses. Apathy can be a sign of serious depression, schizophrenia, organic brain damage in the head and other diseases. Apathy is also sometimes a sign of endocrine dysfunction, a number of chronic illnesses, alcoholism, drug addiction, and premenstrual syndrome.

A visit to a psychotherapist or other specialists is necessary if the causes of inhibition are difficult to determine, and the apathy lasts more than one month. The mental component should also be of concern - the presence of disruptions in thinking, memory lapses, and a very weak reaction to external stimuli. Speech inhibition and inhibition of thinking should also be considered alarming symptoms. In addition, the state of inhibition is manifested by motor retardation. Sometimes with apathy, it is the retardation of movements that is one of the most alarming symptoms. If such signs are present, immediate diagnosis and proper treatment of the disease is required.

How to deal with apathy?

Treatment of apathy must be practiced after a doctor has confirmed that a person has this symptom. However, the most effective fight against apathy will be if the person himself realizes that a depressed state needs to be dealt with somehow. That is, before determining how to treat apathy, the patient himself must agree that he has such a problem and clearly understand it. If apathy is a consequence of psychological reasons, then experts advise paying close attention to introspection. Analyzing everything that happens and thinking about his condition in detail, the patient himself must try to determine the reason that prevents him from living a full life. Psychologists say that this process can be very difficult, but its result is often relief from signs of apathy.

In addition, in the process of treating apathy, doctors advise be sure to adhere to a nutritious healthy diet, practice physical activity, and travel. Sometimes it’s worth trying to change your job or social circle. Taking vitamin complexes and massage sessions are also recommended.

But still, even when practicing treatment for apathy prescribed by a doctor, it should be taken into account that the way out of this state directly depends on the correct behavior of the patient himself. You cannot be too demanding of yourself and demonstrate strong-willed behavior, as this can ultimately lead to complications - a depressive state and a state of passion.

Experts advise to perceive the state of apathy as a kind of respite from life and spend this period calmly. It’s worth going on vacation and limiting all contacts. There is absolutely no need to take medications without a doctor’s permission. Alcohol is also not a help in this case. But doctors advise drinking green tea and eating dark chocolate, since these products contain substances that increase the tone of the body.

However, if there is the slightest suspicion that the state of apathy was the result of a serious illness, then self-medication is out of the question. In this case, it is important to conduct a comprehensive examination by specialists in various fields and subsequently prescribe adequate therapy.

There are several types of inhibition:

comprehensive;

Motor and emotional retardation is a pathology, the causes of which only doctors can identify. They also prescribe adequate treatment.

Causes and symptoms of slow thinking

A person’s behavior, thinking, and psychological state can be disrupted due to pathologies of the nervous system and brain. Ideation inhibition is also caused by:

Parkinson's disease. In case of complex brain pathology, an additional symptom is also revealed - slowness of thinking. The patient himself does not notice any changes. As the disease progresses, his mental activity not only slows down. The patient becomes annoying, meticulous, and clingy. His speech becomes confused and incoherent.

Causes and symptoms of motor retardation

Lethargy in a child

vascular pathologies of the brain;

Diagnosis of lethargy

Treatment of lethargy

Activation of thought processes. To do this, they read new books, master languages, engage in creativity or solve mathematical problems. Such actions train the brain and activate mental activity.

Inhibition of emotions and movements (video)

What is inhibition of emotions and movements? How to correctly identify and treat pathology, we will learn the doctor’s recommendations from the video.

Prevention of lethargy

Lethargy

This human condition should not be confused with apathy or a chronic depressive state, since the latter is more of a psychological factor than a physiological one.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

under alcohol or drug intoxication;
with chronic fatigue and constant lack of sleep;
with frequent nervous tension, stress, chronic depression;
under circumstances that cause a person to feel fear, anxiety and panic;
with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

Classification

The following types of retardation are distinguished according to the clinical picture:

bradypsychia – inhibition of thinking;
mental or ideational inhibition;
motor or movement retardation;
emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are damaged, the following clinical picture may be present:

drowsiness (hypersomnia), lethargy;
headaches, which will intensify as the pathological process worsens. In more complex cases, pain relief is impossible even with painkillers;
memory impairment;
decreased quality of cognitive abilities;
the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
illogical perception of speech or actions addressed to him;
speech becomes slow, the patient may have difficulty finding words;
nausea and vomiting, which is most often observed in the morning;
impaired coordination of movements;
unstable blood pressure;
rapid pulse;
dizziness.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

insomnia or drowsiness, which is replaced by an apathetic state;
unreasonable attacks of aggression;
sudden change in mood;
causeless attacks of fear, panic;
suicidal mood, in some cases, actions in this direction;
state of chronic depression;
visual or auditory hallucinations;
nonsense, illogical judgments;
neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
excessive suspicion, the feeling that he is being watched;
deterioration or complete loss of memory;
incoherent speech, inability to express one’s point of view or specifically answer the simplest questions;
loss of temporal and spatial orientation;
feeling of constant fatigue.

Diagnostics

First of all, a physical examination of the patient is carried out. In most cases, this should be done with a person close to the patient, since due to his condition he is unlikely to be able to answer the doctor’s questions correctly.

In this case, you may need to consult the following specialists:

Diagnostic measures include:

Depending on the diagnosis, the issue of hospitalization of the patient and further treatment tactics will be decided.

Treatment

In this case, the treatment program can be based on both conservative and radical treatment methods.

Drug therapy may include the following drugs:

painkillers;
sedatives;
antibiotics if the disease is of an infectious nature;
nootropic;
antidepressants;
tranquilizers;
drugs that restore glucose levels;
vitamin and mineral complex, which is selected individually.

In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

Prevention

“Retardation” is observed in diseases:

Hypernatremia is a disease characterized by an increase in serum sodium levels to 145 mmol/L or higher. In addition, a reduced fluid content in the body is detected. The pathology has a fairly high mortality rate.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is a rather dangerous type of disease, caused by a person’s passivity and depression.

Cardiogenic shock is a pathological process when the contractile function of the left ventricle fails, the blood supply to tissues and internal organs deteriorates, which often ends in human death.

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With the help of exercise and abstinence, most people can do without medicine.

Lethargy

Causes of slow thinking

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.
Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, inhibition occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still most clearly describes the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Symptoms of lethargy

Diagnosis of bradyllalia

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Forecast and prevention of bradyllalia

Difficulty speaking

Speech difficulty is a speech disorder that interferes with a person's normal verbal communication and social interaction with others. We can talk about the presence of disorders when there are deviations in the functioning of the psychophysiological mechanisms of speech, if the level of speech development does not correspond to the age norm, or with speech deficiencies that negatively affect mental development and cannot be overcome independently. Speech therapists, as well as neurophysiologists, neurologists, otolaryngologists and other specialists study and treat speech difficulties in adults and children.

Symptoms and manifestations

This pathology can be expressed either in a complete absence of speech, or in a violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

speech is unclear and slow, it is unintelligible;
the patient has difficulty choosing words and naming things correctly;
speech is possible quickly and without hesitation, but completely meaningless;
there is haste and incoherence of thinking;
a person strongly separates syllables and places stress on each of them.

Causes in adults

Speech impairment may develop suddenly or gradually. There are the following main reasons that can lead to this pathological process:

improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movements of the body muscles and speech);
brain injuries caused by stroke or thrombosis;
head injuries;
the presence of tumors in the brain;
the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
Lyme disease;
excessive consumption of alcoholic beverages;
weakness of the facial muscles, for example, Bell's palsy;
too weak or tight fastening of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

Phonation (external) design of the utterance - this includes speech pronunciation disorders;
Structural-semantic (internal) design of a statement is a systemic or polymorphic speech disorder.

Disturbances in the speech process of phonation design of utterances can be either individual or combined. Based on this, speech therapy distinguishes the following types of disorders:

Aphonia and dysaphonia are a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, pitch and timbre of the voice or a complete absence of phonation. Aphonia and dysaphonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of child development.
Bradylalia is a pathological slowing of speech rate. A characteristic feature is the slow implementation of the articular speech program.
Tachylalia is a pathological acceleration of speech rate. Characterized by accelerated implementation of the articulatory speech program.
Stuttering is a disorder of speech organization in which the muscles of the speech apparatus are in a convulsive state. The pathology is centrally determined and appears, as a rule, in the process of the child’s speech development.
Dyslalia - pathology is a disorder of sound pronunciation, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifests itself in the form of distorted sound design of speech, with incorrect pronunciation of sounds or their replacement and confusion.
Rhinolalia is a violation of the pronunciation of sounds and voice timbre, caused by anatomical and physiological disorders of the speech apparatus. A pathological change in voice timbre is characteristic, accompanied by the passage of a vocal stream of air during exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of resonance in the latter.
Dysarthria is a pronunciation disorder, the distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy that appears at an early age in the child.

Speech difficulties of structural and semantic design are divided into two types: alalia and aphasia.

Alalia is the absence or insufficient development of speech, provoked by damage to the areas responsible for speech located in the cerebral cortex during fetal development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the selection and analysis operation at all stages of birth, as well as the reception of speech utterances, as a result of which the child’s speech activity is not fully formed.

Aphasia is a complete or partial loss of speech, which is caused by local brain lesions. The ability to speak normally may be lost due to traumatic brain injury, neuroinfection, or brain tumors after speech is formed.

Diagnostics

First of all, it is necessary to analyze the complaints presented by the patient, as well as the medical history. It is important to take into account how long ago complaints of quiet, slow speech and difficulties in pronouncing words and phrases arose, and whether the patient’s immediate relatives have similar manifestations.

Then it is necessary to undergo an examination by a neurologist, which consists of checking the mandibular and pharyngeal reflexes, examining the pharynx, and the presence of thinning (atrophy) of the tongue muscles. In addition, it is important to check the reflexes of the lower and upper extremities.

You need to undergo an examination by a speech therapist; the doctor will be able to evaluate speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronouncing specific sounds.

An examination by an otolaryngologist helps to exclude various space-occupying processes (ulcers and tumors) in the nasal cavity, as they can also affect the voice.

Using computed tomography and magnetic resonance imaging of the head, it is possible to conduct a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these could be tumors, areas of impaired blood circulation, ulcers, areas of myelin decay - the main protein of nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy for speech disorders consists of treating the main disease that provoked dysarthria:

the tumor must be removed surgically;
resection of a hematoma (hemorrhage) is possible if it is located on the surface;
surgically remove ulcers from the cranial cavity, and then prescribe antibacterial drugs to stop the infectious process as soon as possible;
normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any kind of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

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Causes of slow speech in adults

Slow speech in adults may appear abruptly or develop gradually. The causes of this condition are different: disorders of the functional state of the nervous system, brain injuries that appeared after a stroke or thrombosis, or malignant neoplasms. In order to find out what to do and why your speech has slowed down, you need to consult a doctor. Only a specialist can recommend further examination and treatment for a patient with such a complaint.

Speech difficulties associated with slow speech

Speech difficulties come in many forms, including stuttering, dysarthria, voice problems and articulation difficulties. Accidents can damage the brain centers or vocal muscles. Sometimes these pathologies correct themselves naturally, but often have long-lasting consequences. Some diseases can cause difficulty speaking due to degeneration of muscle and nerve cells.

Some adults have had speech problems since childhood, and speech difficulties become a problem when the person becomes elderly. Patients describe this as a “speech impediment,” “speech problem,” or “pronunciation problem.” Sometimes it can be difficult to change some speech difficulties that have been present since childhood, they are so built-in. The problem of slow speech often occurs due to problems and diseases of older people.

Brain injury that causes slow speech can be caused by a brain tumor, stroke, cerebral palsy, long-term use of certain medications, or degenerative diseases such as Parkinson's disease.

Why does slow speech occur in adults?

Speech impairment is a focal symptom. Speech impairment can occur either as aphasia or in a milder form - slow speech. Most often, a person has lesions in the cortex of the dominant hemisphere (in left-handed people - right). A person loses the ability to partially or completely use speech to express his own thoughts and feelings. Another reason for the disorder of expressive speech while maintaining its understanding (dysarthria). This is a lesion of the cerebellum, basal ganglia. As a result of disruption of these anatomical structures, flaccid or spastic paralysis of the speech apparatus may occur: tongue, pharynx, larynx, soft palate, muscles that lift the mandible, and respiratory muscles. The articulation of consonants especially suffers, speech is slow and sometimes intermittent. At the same time, the voice is often weak and muffled.

Diseases that cause slow speech

The causes of speech impairment in adults are varied in their etiology and pathogenesis, with symptoms of a large number of diseases. Slow speech may develop gradually, but can suddenly deteriorate the quality of speech and make people feel uncomfortable.

Alzheimer's disease.
Brain tumors.
Dementia.
Traumatic brain injury.
Suffered a stroke.
Transient ischemic attack (TIA).
Alcohol intoxication.
Diseases affecting neuromuscular structures, such as amyotrophic lateral sclerosis, cerebral palsy, multiple sclerosis.
Head and neck surgery for cancer.
Neurological disorders of the brain, such as Parkinson's disease in old people or Huntington's disease.
Poorly adapted prostheses.
Side effects of drugs acting on the central nervous system, such as narcotic analgesics and anticonvulsants.

The brain is an extremely complex machine and consists of many different working areas. When one or more components stop working effectively, language and speech can often be affected. The severity of speech slowdown depends on the location of the process and the severity of the damage. Producing speech sounds can be very difficult, causing speech to slow down.

Doctor's advice. For any changes in speech, you need to contact a specialist to eliminate the cause, which may further threaten a person’s life

Stroke is the most common cause of slow speech

Hemorrhagic and ischemic changes in blood vessels occur quickly, so symptoms often appear suddenly and without warning.

The main symptoms of a stroke are:

Speech disorders. If the lower parts of the left frontal lobe and the lower parts of the parietal lobe are damaged, motor aphasia may occur in right-handed people. The patient is deprived of the ability to speak due to a violation of speech motor commands. These older people are quiet. They are reluctant to engage in conversation and answer in monosyllables.
Headache - possibly with altered consciousness or vomiting.
Numbness or inability to move parts of the face, arms, or legs—especially on one side of the body.
Problems with walking - including dizziness and lack of coordination.
The effects of a stroke are accompanied by permanent changes such as bladder or bowel problems, pain in the arms and legs, paralysis or weakness on one or both sides of the body.

Parkinson's disease is accompanied by speech disorders

In Parkinson's disease, in addition to motor disorders, there are often pathological changes in the processes of phonation and articulation. The extent of speech changes depends on the clinical prevalence of rigidity, hypokinesia or tremors, and also depends on the ratio and severity of the latter. Pathological changes in speech are often manifested by slower speech, decreased sonority of the voice, and aphonia (disappearance of the voice) may occur. A silent whisper (virtually inaudible) makes a person’s speech unintelligible, which is aggravated by monotony and the disappearance of intonations that are characteristic of spoken language. In patients with hypokinesia, spontaneous speech activity decreases, their answers are laconic, and their speech is slow. With severe akinesia, speech becomes quiet, slurred, unexpressed and slow, so it becomes impossible to understand the patient. Only under the influence of great willpower can a person pronounce a word more loudly and clearly. Pathological changes involve the articulatory muscles, which leads to dysarthria, which becomes the main cause of slow speech.

There are many ways you can use in everyday life to make your speech clearer and easier to understand.

Speech impairment: classification of pathology, symptoms and treatment methods

For every person, speech is an integral part of normal interaction with others, and any deviation in speech function can lead to psychological problems associated with the impossibility of personal self-realization.

Dysfunction of the speech apparatus has a direct impact on the life activity of any person, and therefore it is very important to promptly diagnose the pathology at the slightest deviation in order to avoid serious complications in the future.

Speech impairment is a violation of speech function, which can be caused by completely different reasons. This term includes various types of deviations in human speech development, which can lead to either complete or partial loss of reproduction of words and sounds.

Conventionally, speech disorders in medical practice are divided into two main groups:

Organic reason for the development of deviations. The causes of speech dysfunction in this case are internal anatomical pathologies affecting the structure of the speech apparatus. For example, birth or mechanical damage to areas of the brain responsible for speech functions, abnormal structure of the speech apparatus, hereditary disposition, etc.;
Functional reason for the development of deviations. In this case, the normal functioning of the speech apparatus is disrupted due to certain external factors. For example, prolonged stress, abnormalities in the functioning of the nervous system, infectious diseases, head injuries, mental disorders, etc.

Deviations can manifest themselves in the form of expressive speech, slowness in pronunciation, nasality or stuttering. To identify the causes of disorders, consultation with a neurologist, speech therapist and diagnostics are required.

Classification of speech deviations

There are several main forms of speech disorders in adults encountered in medical practice. Depending on the type of speech defect, specific work is always required to eliminate deviations, since the lack of proper treatment at any time can lead to a complete loss of speech function or psychological deviations.

The main classification of speech disorders includes several forms of deviations in speech development:

Stuttering is considered one of the main types of speech deviations. The reasons for the development of this pathology are factors such as stress, fear, neurological abnormalities, genetic disposition, and severe emotional shock.

Speech dysfunction is characterized by such signs as constant disruptions in the rhythm of speech caused by spasms or convulsions of some parts of the speech apparatus. When a person stutters, there is difficulty pronouncing words and sounds, as a result of which he is forced to constantly take long pauses and repeat the same sound or syllable several times.

Due to a disturbance in voice timbre, nasal sound may develop. The main reason for the development of the deviation is pathology in the area of the nasal septum.

Impaired oral speech, which occurs as a result of malocclusion or damage to certain areas of the brain responsible for the speech apparatus, provokes the development of dyslalia. The main symptom of this deviation is that the patient experiences disturbances during the pronunciation of certain sounds or words. Incorrect perception and distortion of individual sounds, slurred speech or “swallowing” of sounds is also popularly called tongue-tied. This pathology is not associated with hearing impairment or damage to the patient’s central nervous system.

Slowness of speech as a result of difficulty in pronunciation and deviation in the rate of pronunciation is called bradyllia. It may be a consequence of congenital disposition, diseases of the central nervous system or psychological abnormalities of the patient.

Aphasia is a speech disorder that represents systematic disruptions in the rhythm of already formed speech, which is caused by lesions in the speech areas of the brain. Characteristic signs of deviation are the patient’s inability to understand the speech of other people and express his thoughts through his voice. This speech disorder is not a consequence of any mental illness. The main causes of this disease are pathologies such as head injuries, cerebral hemorrhage, abscess or thrombosis of cerebral vessels.

Bradyphrasia is slow speech, which is caused by the patient’s weak and inhibited thinking caused by mental disorders during the course of brain pathologies. A characteristic feature is the prolongation of words and sounds, unclear articulation, long and imprecise formulations of thoughts. This form of speech disorder is most often found in people suffering from mental illness or mental retardation.

With partial or complete absence of speech urges, alalia develops. Pathology occurs due to the mental underdevelopment of the patient or damage to the areas of the brain responsible for speech function. These are extremely severe forms of pathology, during the development of which the patient may not perceive the speech of other people at all, and is not able to master the language, since there are problems with the assimilation and understanding of sounds and syllables.

A very fast and rapid rate of speech flow is called tachylalia. The main signs of the disease are such manifestations as a fast pace of speech, constant hesitation during pronunciation, “swallowing” of individual letters and sounds, and their distortion. The main reasons for the development of the disease are: hereditary disposition, hyperreactivity, brain pathologies, mental disorders.

Dysarthria can cause problems with oral speech. It is a disorder of the pronunciation function of speech, which is associated with pathologies of areas of the speech motor and muscular articulatory apparatus (for example, damage to the vocal cords, dysfunction of the facial or respiratory muscles, limited mobility of the tongue, lips or palate). Pathology develops during damage to parts of the brain (retrofrontal and subcortical). Dysfunction is expressed in difficult pronunciation, distortion of some sounds and syllables.

Many abnormalities are associated with expressive language disorders. Most often, the pathology develops in children. Moreover, this speech disorder can occur against the background of successful mental and psychological development of the patient.

The pathology of expressive speech is characterized by such signs as: a small vocabulary of the patient, which is in no way the norm for this age; problems with verbal communication; weak ability to express one’s thoughts using words; incorrect use of prepositions and word endings; active use of gestures. The main causes of expressive speech have not been fully identified in medicine, however, the process of development of deviations may be influenced by the participation of genetic factors; psychological disorders; untimely formation of the relationship between the speech areas of the cerebral cortex and neurons.

When areas of the central nervous system are damaged, mutism can develop - a complete absence of speech reflexes. This can be caused by diseases such as epilepsy, damage to parts of the brain, and certain types of mental illness (schizophrenia, depression, hysteria).

In order to identify the form of the disease, it is necessary to understand what reasons serve as the impetus for the development of speech abnormalities.

Causes of development of abnormalities in adults

There are many internal and external factors that provoke deviations in speech pronunciation. Moreover, depending on the cause of the speech disorder, the process of development of deviations can be both rapid and gradual. The most common reasons for dysfunction are:

severe pathologies affecting the brain: with intracranial high pressure, a stroke may occur, the main consequence of which may be a violation of speech functions;
in the course of impaired coordination of movements caused by damage to the cerebellum of the brain (for example, a heart attack or cerebral ischemia), an organism reaction such as complete or partial loss of speech may occur;
mechanical damage and trauma to the head and face, in particular in children during childbirth;
brain pathologies caused by thrombosis;
dysfunction of the parts of the brain responsible for speech and movement;
various types of degenerative pathologies of the nervous system and brain (Alzheimer’s, dementia, tumors, etc.);
genetic disposition;
disruptions in the functioning of the central nervous system;
birth injuries, during which speech functions are damaged;
alcoholism can cause problems with speech;
facial paralysis;
atherosclerosis;
pathologies of the muscular articulatory and motor speech apparatus (low mobility of the lips, tongue, facial muscles);
improper fastening of the denture;
decreased tone of the soft palate;
stress, fear, prolonged depression;
some infectious diseases;
developmental delay, dementia;
disruption of blood circulation;
cerebral palsy;
oligophrenia;
deafness;
frequent neuroses;
Down syndrome;
Lyme disease;
long-term use of certain medications (antidepressants, antibiotics).

It should be remembered that the causes of speech disorders can be of a physiological, social and psychological nature.

Signs of abnormalities

It should be noted that more severe cases of speech impairment that occur with dementia and certain psychological abnormalities in the body, regardless of the patient’s age, can provoke muteness. Therefore, it is very important to recognize the primary signs in a timely manner in order to prevent the disease from progressing.

Inconsistency of the language norm with the age of the speaker.
Spastic dystrophy is manifested by involuntary vibrations of the patient’s vocal cords. In this case, abnormalities in speech may be accompanied by initial signs such as hoarseness, a muffled voice, or a breathy sound of speech.
With aphasia, a person is completely unable to express his thoughts competently and quickly. The patient has problems perceiving the speech of people around him. A person suffering from speech disorders takes a very long time to formulate his thoughts and express them in words. The words and sounds he pronounces are incorrect and indistinct.
A speech rate that is too fast, or, conversely, too slow, can be evidence of dysfunction in the patient’s speech apparatus. This may be the result of a complex mental illness; TNR caused by brain pathologies; infectious diseases or degenerative conditions.
Another syndrome of the disease is a violation of the timbre of the voice. Any change in the function or shape of the vocal cords can provoke changes in the articulation and pronunciation of individual sounds, as well as lead to ease of speech during pronunciation.
Due to the weakness of the speech apparatus and vocal muscles, signs such as speech inhibition and “swallowing” of sounds appear.
Problems can manifest themselves in the form of expressive speech - rapid and frequent repetition of the same words, increased speech activity that is unusual for a normal person, disruption of the syntactic structure of phrases and fluency of pronunciation.
Nasality, stuttering, inability to pronounce a word or phrase, repeated pronunciation of sounds are the main signs of speech abnormalities.

It should be noted that intellectual-mnestic functions, which represent various forms of mental disorder, are degrading in nature. Often, with this form of the disorder, brain cells are affected, which negatively affects the patient’s speech function. As a result of such complex pathologies as a cerebral infarction or stroke, an adult patient may, over time, develop severe impairment of speech functions, up to complete numbness. Therefore, it is so important to promptly consult a specialist at the slightest manifestation of symptoms.

Treatment

As soon as the cause of the pathology is identified and a diagnosis is made, the doctor will prescribe appropriate treatment, the main principle of which is to eliminate the causes that caused speech dysfunction.

As for children, a speech therapist can help correct speech defects at an early age. But only if the deviations are not associated with mental disorders and mechanical damage to the head. It is important to understand here that the older the patient and the more complex the cause of speech abnormalities, the longer the process of treatment and correction of speech abnormalities will be.

Treatment methods are as follows:

Conservative treatment. This includes classes with a speech therapist, the use of special exercises to restore speech and articulation exercises, as well as physiotherapeutic procedures.
Drug treatment. It comes down to improving cerebral blood flow, normalizing blood pressure and enhancing metabolic processes in the central nervous system. Drugs that influence the process of improving memory, attention and perception of the patient are also used.
The last resort is surgery. Which involves the removal of tumors and ulcers in the cranial cavity, resection of hematomas and elimination of other growths that provoked deviations of the speech apparatus as a result of dangerous diseases. Surgery is used only when all other treatment methods have failed to produce the expected results.

The choice of a specific treatment method, medications and the appropriateness of the operation is determined by the doctor, depending on the form of the pathology and the stage of concomitant diseases.

There is a separate branch of psychology that studies people suffering from speech dysfunctions - logopsychology. The psychology of people who have speech disorders requires a systematic and thorough study of the symptoms, signs and mechanisms of development of this disorder. Thanks to this, it is possible to achieve positive results through the development of special methods of psychological assistance and suitable treatment regimens in each specific case.

It should be understood that any defects and speech disorders, as well as damage to areas of the speech apparatus, if untimely or incorrectly treated, can lead to underdevelopment of speech, decreased communication and attentiveness, as well as limiting the patient’s logical and mental conclusions.