Lena asks:
Hello. My daughter a few days will be forty years. She lives alone, but near me. I go to her every day and she went, but over the last two months of her psychological condition is terrible. Wants nothing, does nothing, doesn't go anywhere. Says that she forgot everything. She wants to die. Trying to talk to her about the situation, to determine what is happening. But the contact is not quite. I propose to go to a psychiatrist, but the only answer is no. For completeness, I want to write that twenty years ago she had a panic attack and she was on the verge of anorexia. But then I was able to take her to the doctor and somehow managed it. And now I don't know what can be done in this situation. Thank you in advance for answer.

Responsible psychotherapist, psychiatrist Poltava Anastasia:
Good day, Lena! Looks like Your daughter now, and she's going through a crisis. This condition may be due to several reasons, perhaps the external circumstances that affected her mental health, or is it an inner conflict is expressed so, and life alone is not all may rejoice. Whatever the reason, now Your daughter will need help and support. Try to keep calm when dealing with her, not persuade, treat with understanding, try to show her that You are near, in spite of this her condition. What You describe, it's like a mental disorder, but without personal contact is not just to judge. The descriptions, there is a possibility that Your daughter is in a state of depression, her mood and the activity is reduced, energy is reduced, lost interest in the world around them, in such States can also occur refusal of food or Vice versa overeating, sleep disturbance. From the psychoanalytic perspective, depression is unexpressed anger, a sense of dissatisfaction and irritation, which she is not able to Express to the outside world, so directs negative emotions on myself. In her life had this kind of problem – a tendency to anorexia nervosa can be the manifestation of depressive symptoms, a panic attack is also often combined with other mental disorders. And if such difficulties exist for a long time, Your daughter will be shown psychotherapy, but at the moment need to take more decisive action, because the condition can worsen and prescribe medication. Particularly alarming is the desire to die, which, unfortunately, leads some people to attempt suicide. Suicidal thoughts is a direct indication for hospitalization in a psychiatric hospital, where she would be able to effectively help, to observe, to choose therapy, to protect from things that in the future she would regret it. Guided by the Law of the Russian Federation dated 02.07.1992 N 3185-1 "On psychiatric care and guarantees of citizens 'rights in its provision", namely article 29 - involuntary hospitalization is possible in the following cases: -immediate danger to themselves or others, or helplessness, i.e. inability independently to satisfy the basic vital needs, or essential harm to its health owing to deterioration of mental condition if the person is left without psychiatric care. Thus, in the presence of the above, we can safely call phone number of ambulance and to call a psychiatric team for hospitalization. If we exclude the possibility of involuntary hospitalization to assist Your daughter, for diagnosis and prescriptions will still require inspection and monitoring of a psychiatrist. Perhaps it will call a house, visits the local doctor from mental hospital or treatment in private clinics, depending on the severity of the condition and desires of Your daughter. Being with the person who is in depression requires its own vitality, so in order to help a friend, first and foremost, you need to be in a resourceful state. If You will take care of their own health and continue to perform all of the usual things, going to first think about yourself, and the person next to You will become more comfortable. Listen to yourself, to your feelings, desires, needs, possibly, You too will need help and support. Strength to You, and to help your daughter You will be able being in harmony with yourself and your inner world! Sincerely, psychotherapist, psychiatrist Poltava Anastasia.

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