Dependence distorts workaholics ...

Dependence of workaholics distorts perception of the world and relationships with others. They are beginning to recognize only its own interests, become more callous and selfish. You can describe a kind of personal degradation workaholics. Workaholics are very similar to alcoholics. The next wave "of labor enthusiasm" is a bit like an alcoholic binge. Workaholics, just as alcoholics do not recognize the destructive power of their addiction, as well as alcoholics in their dependence, they find a way to escape from real life. Alcoholic suppresses their unmet needs for alcohol, a workaholic suppresses their work. Hiding behind a mask of workaholism lot of psychological problems: fears and complexes. At the head of a company engaged in trade of tobacco products, I discovered the following: It is low self-esteem and loss of self-esteem, frustration loved one. Fear of losing recognition and acceptance by the relevant people. Fear of constant stress in his personal life, but workaholism intensified this tension even more. Fear of misunderstanding in a relationship with the children. Workaholism further alienate and isolate the addict from their relatives. Endless work becomes a psychological screen, reflecting the negative emotions. As well as alcoholism and drug addiction, workaholism has the same destructive force, and on this, people suffering from this addiction, in need of psychological assistance and social rehabilitation. Wait, when the workaholic will agree to return to normal life is meaningless. This agreement should be actively forming. First step: to help realize that workaholism - a devastating, destructive behavior, no less dangerous, like other forms of addiction, such as alcoholism, gambling or drug addiction. Appealed to me about the problems people workaholism. When I received the consent of the addict deal with the psychological program, we immediately set about training, under the terms of the proposed program, we always achieved results. The program was carried out individually or in groups. If previously it was only possible during the classroom sessions, the program now being implemented and remotely. Workaholism - the disease is indisputable. It must be recognized officially. Otherwise, head - a workaholic finds that the subordinates, leaving from work at exactly 18.00 - lazy and irresponsible people. And, because he - the chief, he may apply to you the proper measure. I believe that if a worker (head) remains after 18.00 on the job, he or workaholic (ie, patient), or lazy, who does not keep pace with the normal working hours. Life is so short, and the work - this is only a means of livelihood. " Natalie. Workaholism - a form of addictive behavior. At first glance, it might seem that this is not quite adverse condition. However, workaholism is detrimental to the individual and not less than, say chemical dependency. Diagnosis of workaholism hampered by the fact that the commitment to work at present is currently one of the priority areas of human activity.

Workaholics who kill themselves physically ...

Workaholics who kill themselves in physical labor, not only because it is they are very good at it. Energy costs have their limits and eventually the possibility to fill them - are exhaustible. All ends extreme fatigue. Fatigue - is a natural defense against this infinite limit. Workaholics who kill themselves in mental work more times in five, six, so as to kill themselves this way - it is necessary to try! By itself, the brain does not get tired, if it does the job easily and creatively. But the brain mental workaholic working very hard and inefficient, causing strain in the literal sense - physically. These people are constantly strained muscle upper back and shoulders. In addition, on a subconscious level workaholics constantly play the game: "Try me on anything to reproach," they only want to work not just on the "five" and the "five plus", but this is achieved through tremendous stress, and therefore no work has been productive, too much cost. In workaholic managers have certain difficulties with trust, their subordinates, they disparage micromanagement and regulation of each step. Such control is also not effective. Among the professions workaholism is most striking geek programmers. Do workaholics this profession there is a clear binary logic used in programming, which inadvertently imposes certain difficulties to communicate in the real world. They laid out their lives on the shelves and make your life a program with branches for a particular case. Next come the businessmen and entrepreneurs, and the third place is occupied by lawyers, economists, accountants, doctors retain fourth place. In the structures of the brain (the so-called "pleasure center"), mostly in the cingulate gyrus irritated nerve cell receptors can be operated, causing them to synthesize and release active agents - neurotransmitters, including endorphins (hormones, health and mood), but rather quickly exhausts them, that the duration of the work is no longer able to "get" the necessary amount of endorphins, there is a need to further increase the duration of work and so on increasing ... Like the horse that beat the whip, but the forces of this it is not added. And so, the desire to enjoy the process of work creates insatiable hunger of pleasure. The quest for happiness intermediate results generates an insatiable thirst to get this joy, instead get a sense of annoyance and frustration. The original purpose is lost. "How would not have accelerated running ass to get a bagel is not possible if the bagel is tied to a stick, a rod attached to the shafts. Workaholism geek into a computer addiction or variety: Internet addiction. They literally stick to the screens of monitors, from which it is impossible to tear. Emotional dependence workaholics deform their inner world, it pervades thinking, emotions, intellect, memory, actions, deeds, character personality permeates the bodily, physically.

And the symptoms of deprivation (similar to "drug ...

And the symptoms of deprivation (similar to "drug-breaking") pronounced: emotional instability dominated by dysphoria, in other words, workaholics find no place, no causes are evil and dark, when they are deprived of the opportunity to work. Like alcoholics, they are "abut" to the last, denying the existing problem of addiction. Hardworking person has a goal, it is important result of his work for him professional work only a part of life, self-expression and a means of self-sufficiency and wealth creation. For the workaholic is the opposite: the result of the work does not make sense, the work - a way to fill time, he focused on the manufacturing process. family relationships, the family itself workaholic perceived as obstacles that distract from work and it causes irritation and annoyance. "Tyranny of duty," a workaholic instead of "duty" hard-working person. The distinctive feature of workaholics: "colorblindness necessary." This prevents them from blindness to distinguish values ??of life, normal human needs, their implementation and satisfaction, as does a healthy person. For this reason, the normal full life passes by. The value of health and the need for healthy recreation, they recognize only in words, really doing nothing for it. a direct question: why are they so disregard of their health, why refuse to rest? "These questions are answered ridiculous explanations about the "operational need", the need for earnings, the specifics of the business. In fact, it's an excuse and a way to get away from the really necessary and urgent matters: seriously improve your on the move collapsing health or exercise the care and attention to his wife and children. The wives of workaholics - alone Children living with his father - an orphan. These problems are not seen at close range. It often happens that the interests and communication limited the scope of this work. That is life replacing his "profession." There's an expression: "workaholics live to work, hardworking people work to live. "workaholism can be regarded as a form of psihostenii (obsessive-compulsive disorder). The process works only creates the impression of" solutions "of some internal mental problems, but in fact neither of which does not resolve. In a psychological portrait of the workaholic predominant type of conscientious, and he characterized the following features: thoroughness in work, love of cleanliness, order, more effort, patience and diligence, but eventually achieving average results - striving for perfection in all things: as in the moral and ethical standards, a requirement this from other people - the difficulties in choosing: as a careful weighing of the pros and cons "in deeds, in thoughts and in the strategies, striving to be" right "- stuck in the details, the details of the moment, too much circumstantial - perseverance, growing into stubbornness, determination straightness in achieving the goal - consistency in thought, organization, excessive Captures the value of secondary importance - caution, fear of making mistakes - the accumulation of stress, tension, resentment (inability to relax, rest, to forgive, to openly express their emotions) Who is more trapped in a net workaholism: Men or women? "Well, of course, men!" Social stereotypes dictate the men to be miners, by definition, and is born, but workaholics perceive this as a valid excuse their addiction.

If there is no possibility of them ...

If there is no possibility of their acquisition is used with sufficient effect of haloperidol in the drops (5-10 drops), peritsiazin in drops (3-5 drops), thioridazine 25-50 mg at bedtime. However, these appointments are only temporary supplement to the main neurotransmitter and vasoactive therapy. Published with permission from Russian Medical Journal.

Workaholism: work - the drug and the tyranny of debt

Vladimir Kukk psychiatrist, psychologist, social activist web: http://www.DrKukk.com http://www.dr.kukk.wrk.ru e- mail: vladimirkukk2000@mail.ru A letter from Serpukhov from Vadim, he asked: "And when you tell from the most common emotional dependence," workaholism "? According to the number of victims of this dependence is not inferior to alcoholism or smoking. I am from my former classmates do not counted about a dozen, five of my peers died of a heart attack, another paralyzed, and the third died on the job, put a strange diagnosis: the syndrome of sudden death, four died from cancer. But I do know that behind this: workaholism. I only 38 years old and I go to a funeral almost every month either. Even in the nineties I started to ask for help regarding this relationship. The work as a drug. In this case, very strong, samorazrushayushy and ruthless. People with this form of dependence of I offered assistance, which was similar to the program "a conscious sobriety", gaining experience and enriching their program, I put together a program that focuses on problem solving workaholism. Served with information on television, on radio, after such transfer, in January 2001 on my program there was a small article on the Internet: http://news.battery.ru/theme/health/?id=40557 workaholism in my classification is the second group and belongs to the dependent classes. The second group. Dependent classes, workaholism (In Japan, where many worried by the growing mortality from exhaustion at work, scientists are serious about the search for an objective test of fatigue. They hope to find a biomarker of fatigue - a special substance in the blood, which allows to quantify the fatigue monitor its changes over time and monitor the results of treatment) to the same group includes sports fanatics, fanatics health systems (According to the study, daily work is in the gym can lead to dependence on exercise. As written by The Daily Telegraph, scientists have discovered that parts of the brain responsible for addiction to drugs, alcohol and gambling games, can become a high activity, fitness fanatics, when deprived of exercise. These findings may put an end to a long-standing disputes about whether the relationship of exercise to physical or psychological phenomenon.). workaholism workaholism has all the criteria for dependence (see topic: the criteria for dependencies) working non-stop, do not know of any weekend or holiday, arriving early and leaving all the latest - freaks of labor.

However, if there are signs of cognitive ...

However, if there is evidence of cognitive decline with disorders of concentration and impaired mnemonic destination of tranquilizers even if only in order to establish a dream shall be strictly limited in both time and dose used, the more so that the elderly and elderly with diseases and dementiruyuschimi sleep disorders it does not bring the desired effect. Quite often, the practice of appointing amitriptyline elderly patients complaining of insomnia, taking into account side-effect of this drug in the form of sleepiness, as well as its protivotrevozhnyh properties. However, as practice shows, in this case are rarely taken into account contraindications to amitriptyline (glaucoma, benign prostatic hyperplasia, cardiac pathology with arrhythmia) and do not take into account cholinolytic effect with prolonged use the risk of worsening of cognitive decline in older and elderly people with impaired memory. Sleep disorders in patients with dementia special therapeutic approaches require sleep disorders in patients with late-life dementia (Alzheimer's type, vascular, combined sosudistoatroficheskoy), as well as sleep disorders clinic delirious disorders, most commonly of vascular origin. In these cases, the dementia patients almost never do not complain of insomnia. Patients with cerebral-vascular disease often report unusually vivid dreams, painful or fantastic content. It should be borne in mind that these manifestations may be prodrome of vascular delirium, and timely correction of drug therapy can prevent confusion. In dementia patients with sleep disorders are caused by violation of the circadian rhythm in the form of an inversion of sleep with wakefulness during the night and sleepiness during the day. As a rule, these states are accompanied by disorientation, restless behavior, fussiness, "charges in the road," knotting of bedding, removing items from cabinets, etc. that is, the manifestations of behavioral disorders, typical for late-life dementias. When delirious states of vascular origin mental disorders is increasing in the evening, at night occur or increasing confusion, patients do not sleep, motor nervous, often suffer delusions of perception (illusions, hallucinations). These states with severe sleep disorders is very difficult to maintain patients in a hospital (as well as care at home) and are often the cause of stress disorders among relatives of dementia patients and staff care offices. The use of tranquilizers, hypnotics and third-generation hypnotics are usually ineffective in patients with dementia or confusion. Moreover, well-known paradoxical effect of increasing the excitation of their use. In these cases, the most justified treatment with low doses neyoleptikov. The best effect and safety is ensured by the appointment of current medications from the group of atypical antipsychotics (risperidone 0,5-1 mg, quetiapine 25-100 mg, olanzapine 2,5-5 mg).

Risk of dependence increases with ...

The risk of dependence increases in the presence of addiction to alcohol in the past or continuing into old age. Usually we are talking about the fears associated with prolonged or permanent taking the same dose of a single dose at bedtime. Clinical observations show that, in respect of these cases is not quite correct to use the concept of substance abuse. Guided by the principles of a course of treatment of limited duration, in some cases can be considered reasonably safe and prolonged use of drugs in order to improve the quality of life of late life. Hypnotics new generation in recent years the possibility of safe and effective treatment of sleep disorders in elderly patients and the elderly have increased significantly due to the development and introduction of third-generation hypnotics, which belong to the derivatives tsiklopirrolona (zopiclone, zolpidem). These drugs exhibit substantial advantages in both forms of soporific effect and an almost complete absence of adverse effects of therapy, as well as the peculiarities of the application. Due to the higher selectivity effects on benzodiazepine receptors drugs in this group are sleeping, most approaching physiological. Soporific effect is soon due to the rapid absorption of drugs in connection with what is recommended medication at bedtime already in bed. Short half-life hypnotics in this series makes them seem primarily for violations of falling asleep. On the other hand, these pharmacokinetic features prevent accumulation of the acting agent and its metabolites in the body of elderly patients had a positive impact on the tolerability and the absence of aftereffects of sleeping pills the next day. Only infrequently observed adverse effect is found in the complaints of the bitterness in the mouth, necessitating a dose reduction to 1 tablet (7.5 mg) to 1 / 2 tablets. A special study of the dynamics of cognitive function showed no signs of deterioration (on a scale MMSE) for a monthly course of treatment. Upon reaching the therapeutic effect is not observed significant problems with the termination of therapy. Currently, this group of drugs (zopiclone, zolpidem) are considered as drugs of first choice for treatment of sleep disorders of various origins in a geriatric patient population. Effect of tranquilizers on cognitive function in older people in geriatric practice raises another question, namely the impact of taking drugs, including with the soporific effect on cognitive function in aging patients. It is known that these drugs can reduce the concentration of attention, and according to some sources, and influence mnestic abilities, weakening them. The risk of developing cognitive decline more relevant long-term use of repeated throughout the day taking tranquilizers and, as experience shows, is unlikely to seriously justified when taking minimal doses of these drugs before bedtime.

Tactically, medical devices include ...

Tactically, medical devices also include a change of medication, intermittent reception, reducing the dose. Drug interaction benzodiazepines Given the forced polypharmacy in elderly patients with multiple somatic pathology inevitably arises the problem of drug interactions, in particular, the interaction of benzodiazepine drugs with other drugs in the combined appointing them seniors and the elderly: increased hypotensive effect of clonidine, ACE inhibitors, the risk of high blood pressure during simultaneous introduction teofillinovyh drugs; depressing effect on the CNS in the combined use of b-blockers, increase the concentration of sedative (midazolam) in serum at sochetnnom application with calcium channel blockers, increase the concentration of cardiac glycosides in serum, when combined with cimetidine, omeprazole increases the concentration of benzodiazepines in serum, when taking anticoagulants (warfarin), there is some increase in prothrombin time, increased hypoglycemic effect, while the application of antidiabetic drugs, macrolides, slow metabolism alprazolam, in contrast, rifampicin, according to some, has the ability to accelerate the metabolism of diazepam. Isoniazid inhibits the metabolism of diazepam. Side effects of benzodiazepines, the issue of side effects of treatment of sleep disorders benzodiazepine derivatives, such of them as muscle relaxation and trace drowsiness, well known to doctors (usually skipped and the main contraindication - diagnosed with myasthenia gravis or myasthenic syndrome). As experience shows, the emergence of adverse effects makes the patients themselves with intact criticism to stop taking drugs to lower the dose, slowed to receive or to resort to alternative methods of treating sleep disorders. Less awareness of general practitioners typically have the modest inhibitory action on the respiratory center, especially in chronic obstructive pulmonary disease, may cause constipation while taking clonazepam, a benzodiazepine bromdigidrohlorfenil. One should also bear in mind the possibility of reducing myocardial contractile function, diffuse arterial hypotension. Adverse effects of tranquilizers, hypnotics in patients with middle and old age: excessive sedation, muscle relaxation, imbalance, falls, disturbances of concentration; worsening dismnesticheskih disorders. In general, the use of benzodiazepines for sleep disorders in the elderly and the elderly is safe enough, and it is well known to practitioners. Drug dependent natural concern both doctors and patients themselves are causing the problem of drug addiction. Is not ignoring this problem, we should recognize that, in its pronounced clinical manifestations, that is, with the development of psychic and physical dependence, signs of increasing tolerance, the need for increasing doses and severe manifestations of withdrawal syndrome is observed in the elderly and the elderly are rare.

If earlier the treatment of depressive ...

Earlier in the treatment of depressive disorders have traditionally used a combination therapy with antidepressants and tranquilizers, including hypnotics, it is currently in practice by implementing the newest antidepressants (mirtazapine, Mianserin), with properties to improve sleep and do not require additional destination of tranquilizers, hypnotics . In cases of iatrogenic dissomnii, of course, need to review the dose of the drugs, potentially responsible for the violation of sleep mode useful for maneuvering the medication during the day, etc., that is, it is desirable to do everything possible to do without the extra assignments of psychotropic drugs. In appointing the older drugs, including with the soporific effect, doses should be reduced by half in comparison with those used in young and middle age, and courses of therapy should not exceed the required duration, interrupted time when the effect or be replaced by medication in the unsteady mode. The choice of drug for the treatment of sleep disorders for medical treatment of sleep disorders in elderly patients and the elderly are now avoided the first-generation hypnotics (ie, barbiturates) because of the high risk of respiratory depression during sleep. The most widely used in treating secondary sleep disorders are derivatives of benzodiazepine hypnotics, or second generation. At their appointment should be based on the prevailing characteristics of sleep disorders and information on the pharmacokinetic properties of drugs, especially when they were half-life of the organism. Depending on this, drugs are divided into three groups: short-acting drugs (up to 6 hours); drugs mean duration of action (up to 12 hours), long-acting drugs (more than 12 hours). Short-acting drugs (midazolam, triazolam, flurazepam) are appointed at the expressed difficulty falling asleep. Often, to facilitate the use of tranquilizers, sleep without sleeping pills (oksazepam, tofisopam, Temazepam, diazepam), which remove the feeling of inner tension and mild anxiety, thus facilitating sleep through sedation. Leaving no drowsiness, they can still be a cause of daily muscular relaxation. Benzodiazepine hypnotics mean duration of action (bromdigidrohlorfenil benzodiazepine, Temazepam) are shown to improve sleep, achieve greater depth of sleep, frequent nocturnal awakenings elimination. Traces of reaction after their admission often in the form of morning sleepiness miorelaxation. Benzodiazepine drugs with long half-life used in patients with impaired sleep, superficial sleep and early awakening. These drugs significantly improve the performance of sleep, but most leave behind a trace of sleepiness during the day, thereby increasing the risk of adverse effects with prolonged use. In geriatric practice in the appointment of benzodiazepine drugs in patients with sleep disorders have to maneuver between the efficacy of a long-acting with the risk of their accumulation in the senile body and safer in this regard, drugs with short half-life, but with a significantly greater incidence of sleep disorders in their cancellation.

Sleep disorders can cause eye ...

Sleep disorders can cause eye drops containing b-blockers, and nasal drops having in its composition sympathomimetics. Due to the indirect pharmacological mechanism may occur while taking sleep diuretics (including as a result of fear of incontinence), antidiabetics (polyuria, hypoglycemia, and others). Identify the main causes of insomnia, as well as clarifying the features of sleep disorders on the basic parameters (time to sleep, sleep duration, night awakening, presence and nature of dreams, the assessment of sleep quality and quality of awakening) is necessary not only for diagnostic purposes, but also important for the choice of methods and therapies. Basic principles of elderly patients with insomnia: Identifying causes of insomnia with a possible correction, patient education, recommendations for optimizing the process of falling asleep; drug therapy. The first task is the physician's differential diagnosis of sleep disorders in patients with middle and old age, clarifying the main manifestations dissomnii and only after this action of therapeutic intervention. Education of patients suffering from insomnia, reduced to the following recommendations: the need to go to bed only when the offensive needs to sleep, and the transition from the bedroom to another room to read if you can not fall asleep after 15-20 minutes of being in bed and returning to the bedroom in the newly emerged need for sleep . The purpose of this maneuver is to assotsirovalas bedroom is sleep, not with insomnia, getting up from bed in the morning at the same time, regardless of the duration of sleep last night, avoiding sleeping in the daytime or its reduction to a minimum (no more than 30 minutes while the need for sleep); limit of stay in bed only during sleep, going to bed at the same time avoiding undue impressions in the evening, eating, soft drinks, etc. Basic principles of drug treatment of insomnia: The presence of the indications for drug therapy for insomnia; appointment lowest effective dose, drug selection with optimal pharmacokinetic properties; intermittent therapy (2-3 times per week), short-term use of drugs (3-4 weeks), the phasing out of hypnotics ; monitoring of patients during treatment and after discontinuation of hypnotic. Medication should only be a state with long-existing sleep disorders. Transient episodes dissomnii not require medical appointments, as well as physiological changes in the nature of sleep in the elderly and the elderly. Primary sleep disorders require a differentiated approach to treatment. If, myoclonus may be useful tranquilizers, then sleep apnea, these drugs are not shown because they can aggravate breathing disorders. Some effect is achieved in the appointment tsiklopirolonov (zopiclone, zolpidem). Basic principles of therapeutic correction of secondary sleep disorders can be reduced to an active and adequate treatment of underlying disease (physical, mental neurological) symptoms are sleep disorders, adjustment of drug therapy for iatrogenic dissomniyah.

Preceding falling asleep, painful ...

Preceding falling asleep, painful sensations in the legs and feet forcing patients to make movements down or walk, will resume when laying in bed and pass only enough deep sleep. For sleep disorders associated with somatic pathology, the most characteristic of shallow sleep and frequent waking, and no difficulty sleeping. In these situations, the paramount importance is the adequate therapy of the underlying disease and the use of drugs with hypnotic action is justified only when the failure of the measures taken and to meet strict contraindications for prescribing psychotropic drugs. In neurological practice, sleep disturbances were studied in detail in the organic CNS lesions involving structures for initiating and maintaining sleep, disorders of the peripheral nervous system (for vertebral diseases, neuropathies, etc.), as well as neurogenic asthenic conditions. Among all secondary sleep disorders in older age two thirds are mental disorders and diseases. The most frequently sleep disorders are a symptom of depressive states of various origins, both endogenous and neurotic, vascular. Moreover, even in shallow depression (mild to moderate severity) is usually accompanied by dissomniey. Observed depression in which the sleep disorder is the leading and determines the clinical picture of the state, while the actual depressive symptoms are revealed only through careful questioning. Shallow depression particularly frequent in somatic practice, but not always diagnosed, often because of masking depression somatic complaints and symptoms or other manifestations of atypia. Depressed patients with sleep disorders often complain of insomnia. On questioning revealed as difficulty falling asleep, and the characteristic early awakening with inability to fall asleep again, anxious restlessness in the night awakening, a painful state of mind in the early morning hours. It is characteristic of depressed patients lack a sense of sleep, often forming an obsessive fear of nightfall, and insomnia. Among the psychiatric cases with sleep disorders may be the point where patients do not complain, but there are pronounced sleep disturbance (excitation states in psychosis, manic or hypomanic states, delirious disorders, toxic and vascular origin) and in dementia of late life. In the latter case, the frequently observed inversion of sleep the night fussy waking and daytime sleepiness. Such a clinical situation is particularly difficult in the hospital and home care for dementia patients. In the geriatric practice is particularly important to consider the possibility of iatrogenic insomnia. By direct pharmacological mechanism of sleep disorders can be caused by the following medications: psychotropic drugs (antidepressants, psychostimulants, nootropics), antihypertensive drugs (clonidine, b-blockers), antiarrhythmics, bronchodilators drugs (ipratropium bromide and terbutaline, salbutamol, teofillinovye drugs); hormonal medications (glucocorticoids, thyroid hormones, progesterone), certain antibiotics (quinolones), lipid-lowering agents (statins, fibrates, cholestyramine), antiparkinsonian drugs (levodopa, selegiline), cardiac glycosides (if an overdose), anticancer drugs, antitussives.