Bei der Therapie einer Manie kommen folgende Verfahren zum Einsatz:
- Medikamentöse Behandlung mit
- antimanisch wirkenden Substanzen
- „Mood Stabilizern“
- (atypischen) Neuroleptika
- neueren Antidepressiva vom Typ SSRI
- Benzodiazepine
- Psychotherapie/Psychoedukation
- Elektrokrampftherapie (EKT)
Die Behandlung ist häufig schwierig, da den betroffenen Patienten oftmals die Einsicht in die Notwendigkeit der Therapie fehlt. In der akuten Manie ist dies die Regel und bei erstmaligen manischen Episoden, aber auch in den anschließenden freien Intervallen scheuen viele Patienten therapeutische Interventionen und verbindliche Absprachen für den Fall eines Rezidivs. Im Rahmen manisch-depressiver bzw. bipolarer Störungen kommt es meiner Erfahrung nach besonders häufig zu Massnahmen gegen den Willen. Besonders belastend für die erkrankten Patienten ist der Umstand, dass sie sich wegen ihrer manischen Entgleisungen sehr oft auch im Freundeskreis und im familiären Umfeld Unverständnis und Ablehnung gegenüber sehen. Im Gegensatz zur nach aussen gezeigten Überheblichkeit, Selbstsicherheit und (verbalen) Angriffslustigkeit sind manische Patienten sehr kränkbar und ertragen kaum Vorschriften oder Begrenzungen anderer Art. Für viele Patienten ist es ein Horror, in einem Zimmer eingeschlossen zu werden oder gegen ihren Willen Medikamente einnehmen zu müssen.
Leider ist oft eine Hospitalisation erforderlich, nur selten und bei ungewöhnlich guter Compliance gelingt die ambulante Beherrschung einer akuten Manie. Eindeutige Indikationen für eine Hospitalisation, auch gegen den Willen, sind Selbst- oder Fremdgefährdung, die nicht nur die Suizidalität, sondern auch die unkontrollierte Veräusserung von eigenen oder fremden Vermögenswerten, die Abschlüsse ruinöser Verträge etc. einschließt.
Trotz oder gerade wegen der angedeuteten Schwierigkeiten ist die Herstellung einer therapeutischen Beziehung die größte Herausforderung für den behandelnden Arzt und andere Helfende. Unbedingt unterlassen sollte man Machtproben, auf Provokationen einzugehen bedeutet, in eine Falle getappt zu sein! Da die Erwartungshaltung durch ungeschulte Anwesende einen besonderen zusätzlichen Druck, sowohl auf den Patienten als auch auf den Arzt auszuüben vermag, ist es sinnvoll, möglichst rasch den involvierten Personenkreis zu reduzieren, möglichst auf Professionelle, allenfalls noch die engsten Angehörigen. Für die dann anstehenden „Verhandlungen“ sollte ein möglichst offener, aber reizarmer Ort gewählt werden. Zeitdruck ist „tödlich“, ein gleichbleibend sanfter Druck in Richtung Entscheigungsfindung und Begrenzung bei gleichzeitig wohlwollender und freundschaftlicher Haltung ist die ideale Herangehensweise. Hilfreich ist zum Beispiel die Unterbringung in einem Einzelzimme, klar deklariert als „Rückzugsmöglichkeit“, mit festgelegten Stunden auf der Station, die an ausgehandelte Verhaltenskodizes gebunden sind. Das Ziel ist absolut erreicht, wenn es am Ende zu „Kompromissen“ kommt, die die notwendigsten Therapiemassnahmen miteinschliessen. Es muss (wie im übrigen grundsätzlich in der Arzt-Patient-Beziehung!) unbedingt vermieden werden, dem Patienten Unterwerfungsgesten abzuringen. Der notwendige Therapieplan muss wenn irgend möglich mit ihm gemeinsam „gefunden“ bzw. „erfunden“ werden.
Die therapeutische Begleitung manischer Patienten sollte so ausgerichtet sein, dass der Aktionsradius auf „unschädliche“ Dinge gerichtet wird, das kreative Potenzial sollte entfaltet werden, wichtige soziale Kontakte sllten geschont werden. Es soll darauf gedrängt werden, wichtige Entscheidungen auf später zu verschieben, die Wiederherstellung eines geordneten Schlaf-/Wachrhythmus, die Normalisierung der Ernährung und die psychophysische Erholung sollte in der Akutphase aktiv in den Vordergrund gestellt und zum Hauptthema der ärztlichen Gespräche gemacht werden.
Bei schweren und therapieresistenten Manien und bipolaren Störungen sowie bei amhaltender Fremd- und Selbstgefährdung keine eine Elektrokrampftherapie (EKT) wirksamer sein als eine medikamentöse Behandlung.
4s00zm
owgjbo
7hm8br
mub218
wf4v1o
0tfms2
y2c442
1yqt0f
qybz99
Just logged in to swerte77login, and it was smooth as butter. No messing around, straight into the action. Exactly what you want when you’re looking to unwind. Try it out: swerte77login
I would like to thnkx for the efforts you have put in writing this blog. I am hoping the same high-grade blog post from you in the upcoming as well. In fact your creative writing abilities has inspired me to get my own blog now. Really the blogging is spreading its wings quickly. Your write up is a good example of it.
h2xyoz
I truly appreciate this post. I have been looking everywhere for this! Thank goodness I found it on Bing. You’ve made my day! Thx again
What i don’t understood is actually how you’re not actually much more well-liked than you may be right now. You are so intelligent. You realize thus significantly relating to this subject, made me personally consider it from so many varied angles. Its like women and men aren’t fascinated unless it’s one thing to do with Lady gaga! Your own stuffs nice. Always maintain it up!
Lately, I needed Doxycycline without waiting and stumbled upon a great source. It allows you to buy antibiotics without a prescription legally. If you have sinusitis, try here. Express delivery guaranteed. Go here: purchase zithromax. Highly recommended.
Actually, I wanted to buy Zithromax urgently and found a reliable pharmacy. It allows you to purchase generics online safely. If you have a bacterial infection, try here. Fast shipping to USA. More info: http://antibioticsexpress.com/#. Highly recommended.
Hey there! Just wanted to share an awesome pharmacy online for those who need medications at a discount. Pharmiexpress offers the best prices on Rx drugs. If you want to save, take a look: Pharmiexpress. Hope this helps.
Selam, ödeme yapan casino siteleri arıyorsanız, bu siteye mutlaka göz atın. Lisanslı firmaları ve fırsatları sizin için listeledik. Dolandırılmamak için doğru adres: bonus veren siteler iyi kazançlar.
Pin-Up AZ Azərbaycanda ən populyar platformadır. Saytda çoxlu slotlar və canlı dilerlər var. Pulu kartınıza tez köçürürlər. Mobil tətbiqi də var, telefondan oynamaq çox rahatdır. Rəsmi sayt Pin Up kazino yoxlayın.
2026 yılında en çok kazandıran casino siteleri hangileri? Detaylı liste web sitemizde mevcuttur. Deneme bonusu veren siteleri ve güncel giriş linklerini paylaşıyoruz. İncelemek için https://cassiteleri.us.org/# mobil ödeme bahis fırsatı kaçırmayın.
Merhaba arkadaşlar, ödeme yapan casino siteleri bulmak istiyorsanız, hazırladığımız listeye mutlaka göz atın. En iyi firmaları ve fırsatları sizin için inceledik. Dolandırılmamak için doğru adres: https://cassiteleri.us.org/# canlı casino siteleri iyi kazançlar.
Salam dostlar, əgər siz yaxşı kazino axtarırsınızsa, məsləhətdir ki, Pin Up saytını yoxlayasınız. Yüksək əmsallar və sürətli ödənişlər burada mövcuddur. İndi qoşulun və ilk depozit bonusunu götürün. Daxil olmaq üçün link: https://pinupaz.jp.net/# sayta keçid uğurlar hər kəsə!
Yeni Pin Up giriş ünvanını axtarırsınızsa, doğru yerdesiniz. İşlək link vasitəsilə qeydiyyat olun və oynamağa başlayın. Pulsuz fırlanmalar sizi gözləyir. Keçid: Pin Up online hamıya bol şans.
Selamlar, ödeme yapan casino siteleri bulmak istiyorsanız, hazırladığımız listeye mutlaka göz atın. Lisanslı firmaları ve bonusları sizin için listeledik. Güvenli oyun için doğru adres: türkçe casino siteleri bol şanslar.
Bocoran slot gacor malam ini: mainkan Gate of Olympus atau Mahjong Ways di Bonaslot. Situs ini gampang menang dan aman. Bonus new member menanti anda. Kunjungi: п»їsitus slot resmi dan menangkan.
Online slot oynamak isteyenler için rehber niteliğinde bir site: casino siteleri Nerede oynanır diye düşünmeyin. Editörlerimizin seçtiği bahis siteleri listesi ile rahatça oynayın. Tüm liste linkte.
п»їHalo Bosku, lagi nyari situs slot yang gacor? Coba main di Bonaslot. RTP Live tertinggi hari ini dan terbukti membayar. Deposit bisa pakai OVO tanpa potongan. Daftar sekarang: п»їhttps://bonaslotind.us.com/# Bonaslot link alternatif salam jackpot.
Bu sene popüler olan casino siteleri hangileri? Detaylı liste platformumuzda mevcuttur. Bedava bahis veren siteleri ve güncel giriş linklerini paylaşıyoruz. İncelemek için en iyi casino siteleri kazanmaya başlayın.
Pin Up Casino Azərbaycanda ən populyar kazino saytıdır. Saytda minlərlə oyun və Aviator var. Pulu kartınıza tez köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Giriş linki Pin Up AZ baxın.
Pin Up Casino ölkəmizdə ən populyar kazino saytıdır. Burada minlərlə oyun və canlı dilerlər var. Qazancı kartınıza tez köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Giriş linki https://pinupaz.jp.net/# Pinup baxın.
Bu sene en çok kazandıran casino siteleri hangileri? Cevabı platformumuzda mevcuttur. Deneme bonusu veren siteleri ve yeni adres linklerini paylaşıyoruz. İncelemek için türkçe casino siteleri kazanmaya başlayın.
п»їSalam Gacor, cari situs slot yang mudah menang? Coba main di Bonaslot. Winrate tertinggi hari ini dan pasti bayar. Deposit bisa pakai OVO tanpa potongan. Login disini: п»їhttps://bonaslotind.us.com/# bonaslotind.us.com semoga maxwin.
Yeni Pin Up giriş ünvanını axtarırsınızsa, doğru yerdesiniz. Bloklanmayan link vasitəsilə hesabınıza girin və oynamağa başlayın. Pulsuz fırlanmalar sizi gözləyir. Keçid: Pin-Up Casino uğurlar.
Salam dostlar, siz də yaxşı kazino axtarırsınızsa, məsləhətdir ki, Pin Up saytını yoxlayasınız. Ən yaxşı slotlar və rahat pul çıxarışı burada mövcuddur. Qeydiyyatdan keçin və ilk depozit bonusunu götürün. Oynamaq üçün link: ətraflı məlumat uğurlar hər kəsə!
Online slot oynamak isteyenler için kılavuz niteliğinde bir site: https://cassiteleri.us.org/# siteyi incele Nerede oynanır diye düşünmeyin. Editörlerimizin seçtiği bahis siteleri listesi ile rahatça oynayın. Tüm liste linkte.
Canlı casino oynamak isteyenler için kılavuz niteliğinde bir site: cassiteleri.us.org Hangi site güvenilir diye düşünmeyin. Editörlerimizin seçtiği casino siteleri listesi ile rahatça oynayın. Tüm liste linkte.
Online slot oynamak isteyenler için rehber niteliğinde bir site: casino siteleri 2026 Nerede oynanır diye düşünmeyin. Editörlerimizin seçtiği bahis siteleri listesi ile rahatça oynayın. Detaylar linkte.
Pin Up Casino Azərbaycanda ən populyar kazino saytıdır. Saytda minlərlə oyun və canlı dilerlər var. Qazancı kartınıza anında köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Giriş linki Pin Up rəsmi sayt yoxlayın.
Salamlar, siz də keyfiyyətli kazino axtarırsınızsa, məsləhətdir ki, Pin Up saytını yoxlayasınız. Canlı oyunlar və rahat pul çıxarışı burada mövcuddur. İndi qoşulun və bonus qazanın. Sayta keçmək üçün link: https://pinupaz.jp.net/# ətraflı məlumat uğurlar hər kəsə!
п»їHalo Slotter, lagi nyari situs slot yang hoki? Rekomendasi kami adalah Bonaslot. Winrate tertinggi hari ini dan pasti bayar. Isi saldo bisa pakai Dana tanpa potongan. Daftar sekarang: п»їBonaslot daftar salam jackpot.
Hər vaxtınız xeyir, siz də keyfiyyətli kazino axtarırsınızsa, məsləhətdir ki, Pin Up saytını yoxlayasınız. Canlı oyunlar və rahat pul çıxarışı burada mövcuddur. İndi qoşulun və ilk depozit bonusunu götürün. Sayta keçmək üçün link: Pin Up kazino uğurlar hər kəsə!
2026 yılında popüler olan casino siteleri hangileri? Cevabı web sitemizde mevcuttur. Deneme bonusu veren siteleri ve güncel giriş linklerini paylaşıyoruz. İncelemek için canlı casino siteleri kazanmaya başlayın.
Pin-Up AZ ölkəmizdə ən populyar platformadır. Saytda minlərlə oyun və canlı dilerlər var. Qazancı kartınıza anında köçürürlər. Mobil tətbiqi də var, telefondan oynamaq çox rahatdır. Rəsmi sayt Pin Up Azerbaijan yoxlayın.
Selamlar, güvenilir casino siteleri bulmak istiyorsanız, hazırladığımız listeye mutlaka göz atın. Lisanslı firmaları ve fırsatları sizin için listeledik. Güvenli oyun için doğru adres: casino siteleri bol şanslar.
2026 yılında en çok kazandıran casino siteleri hangileri? Detaylı liste web sitemizde mevcuttur. Bedava bahis veren siteleri ve güncel giriş linklerini paylaşıyoruz. Hemen tıklayın https://cassiteleri.us.org/# cassiteleri.us.org fırsatı kaçırmayın.
Bonaslot adalah bandar judi slot online terpercaya di Indonesia. Ribuan member sudah merasakan Jackpot sensasional disini. Transaksi super cepat hanya hitungan menit. Situs resmi п»їlogin sekarang gas sekarang bosku.
Salamlar, əgər siz etibarlı kazino axtarırsınızsa, mütləq Pin Up saytını yoxlayasınız. Yüksək əmsallar və sürətli ödənişlər burada mövcuddur. Qeydiyyatdan keçin və ilk depozit bonusunu götürün. Daxil olmaq üçün link: Pinup uğurlar hər kəsə!
Hey guys, I just discovered a useful Indian pharmacy to buy generics. For those looking for generic pills at factory prices, this site is worth checking. They offer wholesale rates to USA. Check it out: this site. Good luck.
Greetings, I just ran into a reliable online source to save on Rx. If you are tired of high prices and want cheap antibiotics, this site is highly recommended. They ship to USA plus very reliable. Take a look: https://pharm.mex.com/#. Cheers.
Hey there, Lately ran into an awesome online source for cheap meds. If you want to save money and want affordable prescriptions, this site is worth checking out. No prescription needed plus very reliable. Check it out: https://pharm.mex.com/#. Take care.
Hello everyone, Lately discovered an awesome online source to save on Rx. For those seeking and need generic drugs, this site is highly recommended. Fast shipping and very reliable. Take a look: https://pharm.mex.com/#. Stay healthy.
To be honest, Just now ran into a great website for affordable pills. If you are tired of high prices and need cheap antibiotics, this store is a game changer. Fast shipping plus very reliable. Link is here: safe mexican pharmacy. Best wishes.
Hello, I just came across a great online drugstore to save on Rx. If you want to buy cheap antibiotics without prescription, IndiaPharm is the best place. They offer lowest prices guaranteed. More info here: indian pharmacy online. Hope it helps.
To be honest, Lately ran into a reliable online source to buy medication. If you are tired of high prices and want meds from Mexico, this site is highly recommended. Great prices plus very reliable. Check it out: https://pharm.mex.com/#. Kind regards.
Hello, Lately came across a great source from India to save on Rx. If you want to buy medicines from India safely, this site is the best place. They offer wholesale rates to USA. More info here: https://indiapharm.in.net/#. Cheers.
Greetings, I recently found a great Indian pharmacy for cheap meds. If you want to buy medicines from India without prescription, IndiaPharm is worth checking. You get secure delivery guaranteed. Visit here: indian pharmacy. Hope it helps.
Hi guys, I recently discovered a trusted online source to save on Rx. If you are tired of high prices and need generic drugs, Pharm Mex is highly recommended. They ship to USA and secure. Link is here: check availability. Cheers.
Hi guys, I just found a great Mexican pharmacy to save on Rx. For those seeking and need meds from Mexico, this store is worth checking out. They ship to USA and secure. Link is here: cheap antibiotics mexico. Hope this helps!
To be honest, I recently came across an awesome website to save on Rx. If you are tired of high prices and need meds from Mexico, Pharm Mex is a game changer. Fast shipping plus it is safe. Take a look: cheap antibiotics mexico. Get well soon.
I gotta bookmark this web site it seems very useful extremely helpful
Greetings, I just found the best Indian pharmacy for affordable pills. If you need medicines from India at factory prices, IndiaPharm is very reliable. It has wholesale rates to USA. Take a look: indiapharm.in.net. Good luck.
Hello everyone, Just now discovered a great resource to save on Rx. For those seeking and need cheap antibiotics, this store is the best option. They ship to USA plus secure. Check it out: click here. Have a nice day.
Greetings, Lately came across a great Indian pharmacy for affordable pills. If you need ED meds without prescription, IndiaPharm is highly recommended. It has fast shipping guaranteed. Check it out: https://indiapharm.in.net/#. Best regards.
Hi guys, I just discovered a trusted online source to buy medication. For those seeking and need meds from Mexico, Pharm Mex is a game changer. Great prices and secure. Link is here: https://pharm.mex.com/#. Thanks!
To be honest, Lately ran into an awesome Mexican pharmacy for cheap meds. If you are tired of high prices and need affordable prescriptions, Pharm Mex is highly recommended. Great prices and very reliable. Take a look: https://pharm.mex.com/#. Hope this was useful.
Hello everyone, Just now ran into a trusted Mexican pharmacy to save on Rx. If you want to save money and want generic drugs, this site is worth checking out. They ship to USA and secure. Take a look: https://pharm.mex.com/#. Peace.
Hey guys, Lately came across an amazing Indian pharmacy for cheap meds. For those looking for medicines from India safely, this site is the best place. They offer secure delivery to USA. Check it out: https://indiapharm.in.net/#. Hope it helps.
Hey guys, I recently discovered a great source from India for cheap meds. If you want to buy ED meds cheaply, this site is highly recommended. It has lowest prices worldwide. Check it out: https://indiapharm.in.net/#. Hope it helps.
Hello, I recently came across a great source from India for cheap meds. If you need medicines from India cheaply, IndiaPharm is the best place. It has lowest prices guaranteed. More info here: India Pharm Store. Hope it helps.
Greetings, I recently discovered a useful online drugstore for affordable pills. If you need ED meds cheaply, this site is worth checking. It has wholesale rates worldwide. Check it out: https://indiapharm.in.net/#. Hope it helps.
Greetings, Lately stumbled upon the best source from India for affordable pills. If you want to buy ED meds cheaply, this site is very reliable. They offer lowest prices worldwide. Check it out: https://indiapharm.in.net/#. Cheers.
To be honest, Lately discovered a useful website for cheap meds. If you need cheap antibiotics at factory prices, this site is very reliable. They offer wholesale rates worldwide. Visit here: indian pharmacy online. Good luck.
Hello, Lately came across an amazing source from India to buy generics. If you need ED meds without prescription, this store is very reliable. They offer wholesale rates to USA. Visit here: click here. Cheers.
Hi all, Lately stumbled upon a useful online drugstore for cheap meds. If you want to buy ED meds cheaply, this store is worth checking. You get wholesale rates to USA. Check it out: https://indiapharm.in.net/#. Best regards.
Hey guys, Lately found a useful source from India for affordable pills. For those looking for generic pills safely, IndiaPharm is highly recommended. You get wholesale rates worldwide. Take a look: https://indiapharm.in.net/#. Best regards.
Greetings, I just came across a trusted online source to save on Rx. For those seeking and need meds from Mexico, this site is a game changer. Great prices plus very reliable. Check it out: mexican pharmacy online. I hope you find what you need.
Wow! Thank you! I constantly wanted to write on my site something like that. Can I take a part of your post to my website?
To be honest, I recently discovered an amazing online drugstore to save on Rx. If you need medicines from India cheaply, this store is the best place. They offer wholesale rates guaranteed. Take a look: buy meds from india. Best regards.
Greetings, I recently discovered an awesome website for affordable pills. If you want to save money and need cheap antibiotics, this site is a game changer. Fast shipping and secure. Link is here: https://pharm.mex.com/#. Hope it helps.
Hello everyone, I recently discovered a trusted resource to save on Rx. If you are tired of high prices and want generic drugs, this store is a game changer. Great prices plus very reliable. Link is here: pharm.mex.com. Regards.
Hello everyone, I recently came across a trusted website to buy medication. If you want to save money and need cheap antibiotics, Pharm Mex is highly recommended. Great prices plus secure. Take a look: https://pharm.mex.com/#. Hope it helps.
Hi all, Just now came across an amazing online drugstore to save on Rx. If you want to buy cheap antibiotics at factory prices, this store is very reliable. You get secure delivery to USA. Take a look: click here. Good luck.
Hello everyone, Lately came across an awesome online source for cheap meds. If you are tired of high prices and want meds from Mexico, this site is a game changer. They ship to USA plus it is safe. Check it out: read more. I hope you find what you need.