Neuroses are reversible (functional) neuropsychic disorders, characterized by specific emotional-affective and neurovegetative-somatic disorders, intact criticism and the absence of psychotic phenomena. Essentially, this is a pathological, most often selective, reaction of the individual to disturbances in micro-social and psychological relationships with other people. The term “neurosis” was first used by the Scottish physician Gullen at the end of the 18th century (1776) to refer to disorders that “are not accompanied by fever...
Classification. Lots of suggestions various classifications neuroses. According to the International Statistical Classification of Diseases, Injuries and Causes of Death, Ninth Revision (1975), the following forms of neuroses are distinguished: neurasthenia, hysterical neurosis, obsessional neurosis, neurotic phobias, anxiety neurosis, hypochondriacal neurosis, neurotic depression etc. The most convenient for clinical practice seems to be the division of neuroses into general ones, which include neurasthenia, hysteria and obsessive neurosis...
A person deprived of any neurotic traits under the influence of excessive neuropsychic overload may experience neurasthenic disorders or a reactive state, but without certain constitutional (premorbid) personality characteristics, such types of neuroses as hysteria, neurosis usually do not develop obsessive states, motor and autonomic neuroses. Risk factors for neuroses include: physical overexertion, somatic illnesses, injuries, family troubles,...
Neurasthenia (Greek neuron-nerve, asthenia - weakness, impotence) - nervous exhaustion, overwork. It manifests itself as a combination of increased excitability and fatigue. Characterized by inadequate reactions to minor troubles and the inability to suppress them, that is, disorders relate primarily to the sphere of emotions. Anything can be annoying: bright light, loud conversation, radio on, etc., and this often serves as a reason for another conflict...
Increased emotionality influences all judgments and assessments - they are extremely unstable and changeable (affective logic). Common symptom hysteria is a pseudo-organic sensorimotor disorder: anesthesia of the hemitic or amputation type (not corresponding to the anatomical laws of distribution of sensitivity), paralysis or paresis (without symptoms of central or flaccid paralysis), astasia-abasia - the inability to stand and walk (without paresis...
Motor neurosis is manifested by local motor disorders - tics, stuttering, professional cramps such as writer's cramp, etc. They usually occur against the background of other neurasthenic disorders - increased irritability, fatigue, headache, bad sleep etc. Autonomic neurosis ( autonomic dystonia) - more or less selective dysfunction internal organs. The most common dysfunction is the cardiovascular, respiratory…
Functional psychosomatic disorders developed as a consequence of constitutional characteristics and systematic neuropsychic overstrain. The effectiveness of lifestyle improvement has been shown. Neurosis-like conditions (neurosis syndrome) include transient, mainly neurasthenic, disorders caused by organic lesions of the brain (initial manifestations of insufficient blood supply to the brain, dyscirculatory encephalopathy, stroke, encephalitis, meningitis, etc.), general somatic diseases, infections, intoxications and injuries. All neuropsychic and vegetative...
The main methods of treating neuroses and neurosis-like conditions are psychotherapy (individual and group), rest, exclusion from the environment that provoked the disease, as well as restorative and psychotropic drugs. Depending on the form and severity of the neurosis, they are used in various combinations. For patients with relatively moderate hypersthenic and vegetative-vascular manifestations, milder sedatives- valerian, motherwort, passionflower, bromides or...
It is always important, during a conversation with a patient, to reveal the cause that is traumatic to the patient’s neuropsychic sphere and try to eliminate it, or, using various methods of psychotherapy, reduce its significance. In cases of neurasthenia, obsessional neurosis, vegetoneurosis and neurosis-like conditions, the method of rational psychotherapy (or persuasion psychotherapy) is used primarily; in those suffering from hysteria and motor neuroses, the method of suggestion is used both in the waking state,...
Possible complications from the use of tranquilizers - drowsiness, decreased psycho-emotional tone and memory (short-term), decreased speed of motor reactions, arterial hypotension, ataxia, impaired potency and sphincter function, nystagmus, double vision, dysarthria; from the use of neuroleptics - early and late extrapyramidal disorders (lingual-buccal -facial dyskinesias, choreoathetoid hyperkinesis, parkinsonism) and vegetative-endocrine disorders (weight gain, amenorrhea, arterial hypotension, hyperglycemia, hypothermia or hyperthermia, ...
The prognosis depends on the form of neurosis and the age of the patients. It is more favorable for neurasthenia, vegetative neurosis and neurosis-like conditions (if the latter are not caused by a severe and prolonged somatic illness). Hysteria, obsessive-compulsive neurosis and motor neuroses are more difficult to treat. However, with age, many emotional, affective and phobic disorders usually smooth out. Most patients with neurosis can be treated on an outpatient basis with follow-up...
Neuroses and neurosis-like conditions
Neurologist Yu.M. Amdur
A nervous disorder or neurosis is a consequence of psychological trauma resulting from severe fright, fear or a protracted traumatic situation. Neurotic disorders can manifest themselves in different ways, e.g.obsessive actions (finger sucking, nail biting, etc.), tics, stuttering, enuresis. With neurosis, there are usually three characteristic symptoms: low mood,sleep disorder And appetite disorders.
Nervous disorders can be divided into three degrees:
Short-term neurotic reaction (lasts from several minutes to several days);
Neurotic state (lasts several months);
Neurotic personality development (temporary neurosis develops into chronic and distorts personality development).
Prerequisites and causes of neuroses in children
The first thing I want to pay attention to is , it is that there are certain age periods characterized by increased vulnerability nervous system, this is 2 - 3 years (a crisis of 3 years, in which the child enters into a “struggle” with his parents) and 5 - 7 years, when the child takes traumatic situations especially close to his heart, but does not yet know how to influence them and does not have psychological protection.
In addition, different children are susceptible to neuroses in varying degrees. Children who have the following characteristics of character, nervous system and health are most prone to nervous disorders:
diffidence;
Elevated: vulnerability, shyness, impressionability, dependence, suggestibility, irritability, excitability,anxiety, hyperactivity;
Increased striving for primacy , the desire to always be better than others.
Social and psychological factors:
Excessive demands on the part of parents for the child, formal relations in the family, suppression of the child’s initiative, excessive guardianship, authoritarian upbringing;
- inconsistency in education; lack of a unified parenting style, inconsistency of views on education between parents;
- “intimidating” parenting, in which the child is constantly frightened (“If you don’t sleep, Baba Yaga will fly in and take you away”) or “anxious” parenting, in which parents are constantly worried about the child (“Don’t pick up a knife, you’ll cut yourself” ).
Also important for the occurrence of neurosis are:
Biological factors (features of the child’s psyche and physiology):heredity, temperament (strong or easily excitable type of nervous system), previous diseases, generalphysical health, maternal pregnancy and childbirth , gender and age, body type, etc.
Generally depleting factors:
chronic lack of sleep, physical and mental overload (all kinds of clubs and sections) , acute and chronic diseases.
There are three main forms of neurosis:
1. Neurasthenia (asthenic neurosis)
If a child is suspicious, timid, irritable, does not tolerate any mental stress well, and is often ill, then he has a predisposition to developing neurasthenia.
Asthenic neurosis occurs against the background of general weakness of the child ( increased fatigue, dizziness, headaches, gastrointestinal disorders), sleep disorders, autonomic disorders(pain in the heart area, cold hands and feet, sweating, feeling that “something is shrinking inside”). When excited or physical activity these disorders are getting worse. Often occur after infectious diseases, prolonged stress or a traumatic situation, lack of sleep, overwork, excessive mental or physical overload.
A child with neurasthenia comes into conflict with himself: “I want,” but “I cannot.” He becomes irritable, gets upset easily and cries. His behavior is often unpredictable: sometimes he is cowardly, sometimes desperately determined, sometimes he takes on an impossible task, sometimes he gives in to a simple task.
Often neurasthenia occurs against the background of excessive demands from parents, their inability to accept the child for who he really is. At the same time, the child, constantly feeling these high expectations (must be the smartest in the class, speak English like a native, etc.), begins to feel “inferior” and experiences chronic nervous tension, as a result of which neurasthenia develops.
Another cause of neurasthenia may be the parents' attention switching to another child who has appeared in the family. The older child, having lost parental attention, experiencing jealousy and acquiring new responsibilities (helping to care for the baby), begins to suffer from nervous breakdowns.
2. Hysterical neurosis
If the child is selfish, capricious, “demonstrative”, loves attention, childish, dependent, easily suggestible, capricious and often dissatisfied with everything,throws tantrums (rolling on the floor, stomping his feet, throwing things), there is a high probability that he will be susceptible to hysterical depression or hysterical seizures.
The internal conflict of such a child lies in the infringement of his egoistic position “I want/I don’t want”, in which resentment and dissatisfaction arise. The child does not yet know how to defend his interests, so he achieves his goals in ways accessible to him.
For example, in the first two years after birth the child was allowed everything, and after two years the parents introduced strict restrictions. Another option: parents adhere to one position in education (strictness and all kinds of restrictions), and grandparents adhere to the opposite (permissiveness).
Hysterical neurosis can also develop due to a lack of basic attention to the child. And as the attention deficit accumulates, the child makes demonstrations - falls into hysterics, hits his head or, as we have already said, gets sick (fever, vomiting, etc.). By doing this, he attracts attention to himself, showing his experiences and suffering.
3. Obsessive-compulsive disorder
If a child is unsure of himself, fearful, overly cautious, anxious and suspicious, and, at the same time, pedantic, principled, meticulous and reasonable, then there is a possibility that, due to chronic traumatization of the psyche (when every now and then needs and desires) children are in conflictwith a “must” attitude ) obsessive-compulsive neurosis will develop.
This neurosis is characterized by involuntary, obsessiveworries and fears. How accompanying symptom can appear nervous tics- monotonous movements (blinking, wrinkling of the forehead, shrugging, coughing) - or monotonous actions ( frequent washing hands, pinching a pillow), which have a protective and soothing function, relieve nervous tension.
The roots of this neurosis are disturbances family relations(increased demands and integrity of parents, excessive strictness and authoritarianism).
How to deal with childhood neurosis
Neurosis is easier to prevent than to treat.
Neuroses are psychogenic diseases; they are not generated organic disorders, but disharmony in interpersonal relationships, so the leading role in this situation belongs to the psychologist.
And the main way to treat neurosis is to identify, eliminate or mitigate the causes of stress. Sedative (calming therapy) is only an assistant.
Need to changeparenting style , strengthen the child's character , develop his emotional sphere . A psychologist or psychotherapist will help calm the child,give him confidence , help re-experience the trauma (if it is not too painful for the child) in order to clarify and work through it.
Neurosis-like conditions
Neurosis-like conditions in children most often occur between the ages of 2 and 7 years. Unlike neuroses, there is no psychotraumatic factor in the origin of such disorders. Pathology has organic nature and is often associated with disorders of the brain. Some diseases of the internal organs can contribute to the onset of a neurosis-like state.
The occurrence of pathological conditions in children can be caused by a disruption of the process intrauterine development, congenital childhood nervousness (neuropathy), allergic diseases etc. The disorder can occur against the background of previous diseases, head injuries, toxic factors. Congenital factors, heredity, parental alcoholism, etc. play a big role.
Clinical picture
Neurosis-like conditions in children are often manifested by hyperactivity with motor disinhibition syndrome, the presence of fears and nightmares, depression, tearfulness, dissatisfaction, aggressiveness, etc.
Children are in a state of anxiety, restlessness, become fearful, and complain of fatigue. Frequent accompaniments of the disease are nervous vomiting with refusal to eat (anorexia), bedwetting, stuttering, tics, fears, etc. The pathology is characterized by a slow or increased heart rate, nausea and vomiting, dry skin or increased sweating, stool retention or diarrhea and other painful manifestations.
Diagnosis and treatment
The main diagnostic signs on the basis of which a neurosis-like state can be distinguished from neurosis are the lack of connection between the disease and psychotraumatic situations, as well as the lower effectiveness of psychotherapy. When the cause of NS is identified and eliminated, the patient’s health is gradually restored. Drug treatment in combination with psychological help, physical therapy and creating a calm home environment with a friendly attitude towards the child guarantees a favorable outcome.
Functional disorders of higher nervous activity psychogenic origin. The clinical picture of neuroses is very diverse and may include somatic neurotic disorders, autonomic disorders, various phobias, dysthymia, obsessions, compulsions, and emotional and mental problems. A diagnosis of “neurosis” can be made only after excluding clinically similar psychiatric, neurological and somatic diseases. Treatment has 2 main components: psychotherapeutic (psychocorrection, training, art therapy) and medication (antidepressants, tranquilizers, antipsychotics, restoratives).
General information
Neurosis as a term was introduced in 1776 in Scotland by a doctor named Couplen. This was done in contrast to the previously stated statement by G. Morgagni that the basis of each disease is a morphological substrate. The author of the term “neurosis” meant by it functional health disorders that have no basis organic damage any organ. Subsequently, the famous Russian physiologist I.P. made a great contribution to the doctrine of neuroses. Pavlov.
In ICD-10, instead of the term “neurosis”, the term “neurotic disorder” is used. However, today the concept of “neurosis” is widely used in relation to psychogenic disorders higher nervous activity, i.e., caused by the action of chronic or acute stress. If the same violations are associated with the influence of others etiological factors(eg, toxic exposure, trauma, past illness), then they are classified as so-called neurosis-like syndromes.
IN modern world neurosis is a fairly common disorder. IN developed countries various forms neurotic disorders affect 10% to 20% of the population, including children. In the structure of mental disorders, neuroses account for about 20-25%. Since the symptoms of neurosis are often not only psychological, but also somatic in nature, this issue is relevant both for clinical psychology and neurology, as well as for a number of other disciplines.
Causes of neurosis
Despite extensive research in this area, the real reason neurosis and the pathogenesis of its development are not known for certain. For a long time neurosis was considered an information disease associated with intellectual overload and a fast pace of life. In this regard, a lower incidence of neuroses among residents rural areas explained by their more relaxed lifestyle. However, studies conducted among air traffic controllers refuted these assumptions. It turned out that, despite the intense work that requires constant attention, quick analysis and response, dispatchers suffer from neuroses no more often than people in other professions. Among the reasons for their illness were mainly family troubles and conflicts with superiors, rather than overwork during work.
Other studies, as well as the results of psychological testing of patients with neuroses, have shown that it is not the quantitative parameters of the traumatic factor (multiplicity, strength) that are of decisive importance, but its subjective significance for a particular individual. Thus, external trigger situations that provoke neurosis are very individual and depend on the patient’s value system. At certain conditions any, even everyday, situation can form the basis for the development of neurosis. At the same time, many experts come to the conclusion that it is not the stressful situation itself that matters, but the incorrect attitude towards it, as destroying a personal prosperous present or threatening the personal future.
A certain role in the development of neurosis belongs to the psychophysiological characteristics of a person. It has been noted that people with increased suspiciousness, demonstrativeness, emotionality, rigidity, and subdepression are more likely to suffer from this disorder. Perhaps the greater emotional lability of women is one of the factors leading to the fact that the development of neurosis in them is observed 2 times more often than in men. Hereditary predisposition to neurosis is realized precisely through the inheritance of certain personal characteristics. Besides, increased risk The development of neurosis occurs during periods of hormonal changes (puberty, menopause) and in individuals who had neurotic reactions in childhood (enuresis, logoneurosis, etc.).
Pathogenesis
The modern understanding of the pathogenesis of neurosis assigns a major role in its development functional disorders limbic-reticular complex, primarily the hypothalamic part of the diencephalon. These brain structures are responsible for ensuring internal connections and interaction between the autonomic, emotional, endocrine and visceral spheres. Under the influence of acute or chronic stressful situation there is a disruption of integrative processes in the brain with the development of maladaptation. However, no morphological changes were noted in the brain tissue. Since disintegration processes cover the visceral sphere and the autonomic nervous system, in the clinic of neurosis, along with mental manifestations somatic symptoms and signs of vegetative-vascular dystonia are observed.
Disruption of the limbic-reticular complex in neuroses is combined with neurotransmitter dysfunction. Thus, a study of the mechanism of anxiety revealed a deficiency of noradrenergic systems of the brain. There is an assumption that pathological anxiety is associated with an abnormality of benzodiazepine and GABAergic receptors or a decrease in the amount of neurotransmitters acting on them. The effectiveness of treating anxiety with benzodiazepine tranquilizers confirms this hypothesis. Positive effect antidepressants affecting the functioning of the serotonergic system of the brain indicates a pathogenetic connection between neurosis and disorders of serotonin metabolism in cerebral structures.
Classification
Personal characteristics, the psychophysiological state of the body and the specific dysfunction of various neurotransmitter systems determine the diversity clinical forms neuroses. In domestic neurology, there are three main types: neurotic disorders: neurasthenia, hysterical neurosis (conversion disorder) and obsessive-compulsive disorder. All of them are discussed in detail in the corresponding reviews.
Depressive neurosis, hypochondriacal neurosis, and phobic neurosis are also distinguished as independent nosological units. The latter is partly included in the structure of obsessive-compulsive disorder, since obsessions are rarely isolated and are usually accompanied by obsessive phobias. On the other hand, in ICD-10, anxiety-phobic neurosis is included as a separate item called “anxiety disorders”. By features clinical manifestations it is classified as panic attacks (paroxysmal autonomic crises), generalized anxiety disorder, social phobias, agoraphobia, nosophobia, claustrophobia, logophobia, aichmophobia, etc.
Neuroses also include somatoform (psychosomatic) and post-stress disorders. With somatoform neurosis, the patient’s complaints fully correspond to the clinical picture of a somatic disease (for example, angina pectoris, pancreatitis, peptic ulcer, gastritis, colitis), however, with a detailed examination with laboratory tests, ECG, gastroscopy, ultrasound, irrigoscopy, colonoscopy, etc. this pathology is not detected. There is a history of a traumatic situation. Post-stress neuroses are observed in people who have survived natural disasters, man-made accidents, fighting, terrorist attacks and other mass tragedies. They are divided into acute and chronic. The first are transitory and appear during or immediately after tragic events, usually in the form hysterical attack. The latter gradually lead to personality changes and social maladaptation (for example, Afghan neurosis).
Stages of development of neurosis
In their development, neurotic disorders go through 3 stages. In the first two stages, due to external circumstances, internal reasons or under the influence of treatment, neurosis may cease to exist without a trace. In cases of prolonged exposure to a traumatic trigger (chronic stress), in the absence of professional psychotherapeutic and/or medicinal support for the patient, the 3rd stage occurs - the disease passes into the stage of chronic neurosis. Persistent changes occur in the structure of the personality, which remain in it even with effectively carried out therapy.
The first stage in the dynamics of neurosis is considered to be a neurotic reaction - a short-term neurotic disorder lasting no more than 1 month, resulting from acute psychological trauma. Typical for children. As an isolated case, it can occur in completely mentally healthy people.
A longer course of a neurotic disorder, changes in behavioral reactions and the emergence of an assessment of one’s illness indicate the development of a neurotic state, i.e., neurosis itself. An uncontrollable neurotic state for 6 months - 2 years leads to the formation of neurotic personality development. The patient’s relatives and the patient himself talk about a significant change in his character and behavior, often reflecting the situation with the phrase “he/she was replaced.”
General symptoms of neuroses
Autonomic disorders are multisystem in nature and can be either permanent or paroxysmal (panic attacks). Disorders of the nervous system function are manifested by tension headaches, hyperesthesia, dizziness and a feeling of unsteadiness when walking, tremors, shudders, paresthesias, muscle twitchings. Sleep disturbances are observed in 40% of patients with neuroses. They are usually represented by insomnia and daytime hypersomnia.
Neurotic dysfunction of cardio-vascular system includes: discomfort in the cardiac region, arterial hypertension or hypotension, rhythm disturbances (extrasystole, tachycardia), cardialgia, pseudocoronary insufficiency syndrome, Raynaud's syndrome. Respiratory disorders observed in neurosis are characterized by a feeling of lack of air, a lump in the throat or suffocation, neurotic hiccups and yawning, fear of suffocation, and an imaginary loss of respiratory automaticity.
On the part of the digestive system, dry mouth, nausea, loss of appetite, vomiting, heartburn, flatulence, vague abdominal pain, diarrhea, and constipation may occur. Neurotic work disorders genitourinary system cause cystalgia, pollakiuria, itching or pain in the genital area, enuresis, frigidity, decreased libido, premature ejaculation in men. A disorder of thermoregulation leads to periodic chills, hyperhidrosis, and low-grade fever. With neurosis, dermatological problems may arise - rashes such as urticaria, psoriasis, atopic dermatitis.
Typical symptom Many neuroses include asthenia - increased fatigue, both mental and physical. Anxiety syndrome is often present - a constant expectation of upcoming unpleasant events or danger. Phobias are possible - obsessive-type fears. With neurosis, they are usually specific, related to a specific object or event. In some cases, neurosis is accompanied by compulsions - stereotypical obsessive motor acts, which can be rituals corresponding to certain obsessions. Obsessions are painful intrusive memories, thoughts, images, desires. As a rule, they are combined with compulsions and phobias. In some patients, neurosis is accompanied by dysthymia - low mood with feelings of grief, melancholy, loss, despondency, sadness.
Mnestic disorders that often accompany neurosis include forgetfulness, impaired memory, greater distractibility, inattention, inability to concentrate, an affective type of thinking and some narrowing of consciousness.
Diagnostics
The leading role in the diagnosis of neurosis is played by identifying a traumatic trigger in the anamnesis, data from psychological testing of the patient, studies of personality structure and pathopsychological examination.
The neurological status of patients with neurosis does not reveal any focal symptoms. There may be a general revival of reflexes, hyperhidrosis of the palms, tremor of the fingertips when stretching the arms forward. The exclusion of cerebral pathology of organic or vascular origin is carried out by a neurologist using EEG, MRI of the brain, REG, and ultrasound scanning of the vessels of the head. At pronounced violations sleep consultation with a somnologist and polysomnography is possible.
A differential diagnosis of neurosis with clinically similar psychiatric (schizophrenia, psychopathy, bipolar disorder) and somatic (angina,
Treatment of neurosis
The basis of neurosis therapy is the elimination of the impact of a traumatic trigger. This is possible either by resolving a traumatic situation (which is extremely rare), or by changing the patient’s attitude towards the current situation in such a way that it ceases to be a traumatic factor for him. In this regard, psychotherapy is leading in treatment.
Traditionally, in relation to neuroses it is mainly used complex treatment, combining psychotherapeutic methods and pharmacotherapy. In mild cases, only psychotherapeutic treatment may be sufficient. It is aimed at revising the attitude towards the situation and resolving the internal conflict of a patient with neurosis. Among the methods of psychotherapy, it is possible to use psychocorrection, cognitive training, art therapy, psychoanalytic and cognitive behavioral psychotherapy. Additionally, training in relaxation techniques is provided; in some cases - hypnotherapy. Therapy is carried out by a psychotherapist or medical psychologist.
Drug treatment of neurosis is based on the neurotransmitter aspects of its pathogenesis. It has a supporting role: it facilitates work on oneself during psychotherapeutic treatment and consolidates its results. For asthenia, depression, phobias, anxiety, panic attacks The leading antidepressants are: imipramine, clomipramine, amitriptyline, St. John's wort extract; more modern ones - sertraline, fluoxetine, fluvoxamine, citalopram, paroxetine. In therapy anxiety disorders and phobias additionally use anxiolytic drugs. For neuroses with mild manifestations, herbal sedatives and short courses of mild tranquilizers (mebikar) are indicated. In case of advanced disorders, preference is given to benzodiazepine tranquilizers (alprazolam, clonazepam). For hysterical and hypochondriacal manifestations, it is possible to prescribe small doses of antipsychotics (tiapride, sulpiride, thioridazine).
Multivitamins, adaptogens, glycine, reflexology and physiotherapy (electrosleep, darsonvalization, massage, hydrotherapy) are used as supportive and restorative therapy for neurosis.
Prognosis and prevention
The prognosis of neurosis depends on its type, stage of development and duration of course, timeliness and adequacy of the psychological and medication assistance. In most cases, timely initiation of therapy leads, if not to cure, then to a significant improvement in the patient’s condition. The long-term existence of neurosis is dangerous due to irreversible personality changes and the risk of suicide.
A good prevention of neuroses is to prevent the occurrence of traumatic situations, especially in childhood. But the best way It may be cultivating in oneself the right attitude towards upcoming events and people, developing an adequate system of life priorities, getting rid of misconceptions. Strengthening the psyche is also facilitated by adequate sleep, good work and an active lifestyle, healthy eating, and hardening.
Neuroses are a collective name for reversible psychogenic disorders. Although this group Pathologies of the nervous system have been studied for a long time; a clear definition for them still does not exist.
Neuroses in adults are characterized by reversible and not very severe course, which distinguishes them, in particular, from psychoses. According to statistics, up to 20% of the adult population suffers from various neurotic disorders. The percentage may vary among different social groups.
Signs of neuroses in adults are various kinds of asthenic or hysterical manifestations. In most cases, they are accompanied by a decrease in performance (both physical and mental). Patients with neurotic conditions fully retain a critical attitude and control over the situation, i.e., they are aware that their current condition is not normal.
Causes of the development of neuroses in adults
The most common cause of the development of neuroses is sufficiently prolonged physical and (or) physical activity. Their intensity can be quite moderate, but a person has practically no opportunity to rest. Such stress factors can be, for example, family problems, conflicts with co-workers, or an irrational work schedule.
Important:neuroses are more often observed in those people whose nervous system is not capable long time function normally under conditions increased load. In particular, the pathologies of this group are characteristic of the so-called. “workaholics” who are constantly busy with work and don’t know how to relax at all. For this category of patients, nervous breakdowns are almost inevitable.
What are the types of neuroses in adults?
According to one of the common classifications, neuroses in adults are divided into:
- phobias that arise under certain conditions;
- phobias not related to specific circumstances;
- neuroses of obsessive states (or movements);
- reactive neuroses;
- neurasthenia (psychosomatic disorders);
- hysterical neuroses (conversion disorders).
Fear can arise in situations that do not actually pose a threat. However, a person with a phobia may fear dying or going crazy.
With neuroses, some people try to avoid traveling certain types transport or do not leave the house at all. This group of disorders also includes social phobias, in which a person may fear increased attention from others or fear of “losing face.” Some fears are caused only by strictly defined situations. The patient may have a panicky fear of the sight of blood, the dark, or some animals. Phobias are often accompanied by somatic manifestations; symptoms of such neuroses in adults are hyperhidrosis ( increased sweating), hyperemia (redness) of the facial skin, urge to urinate and nausea.
Phobias are not always associated with specific circumstances. In some cases, with neuroses in adults, vague fear for loved ones or oneself appears. Such phobias in most cases manifest themselves less acutely, but the patient develops a depressed state.
Obsessive-compulsive disorder is characterized by stereotypical and constantly recurring thoughts or urges to do something. A common manifestation of this kind of neuroses is an obsessive need to turn off the water or electrical appliances and once again check the locks when leaving the premises.
Neurosis obsessive movements in adults, it often represents a kind of ritual in which a person, for example, bypasses obstacles only from a certain side. Individual movements and actions are irrational; They do not make life easier, but complicate it. A patient with such a neurotic state is well aware that certain stereotypical actions are devoid of any meaning and tries to get rid of the habit, but, as a rule, attempts are unsuccessful and lead to the development of a depressed state.
Important:It is important to distinguish neurosis of obsessive movements in adults from motor anxiety, which is manifested by restlessness and twitching of the legs. The patient needs constant physical activity to somewhat dampen the feeling of anxiety.
Reactive neuroses arise as a response to severe stress or significant situational disturbances. The severity of the manifestations of such neurosis depends on the lability of the patient’s nervous system, as well as on the nature, strength and duration of exposure external factor. A person may be haunted by intrusive memories of an unpleasant event for a long time. Some, on the contrary, have partial amnesia, due to the fact that the consciousness tries to “erase” traumatic events from memory. Patients often withdraw into themselves, minimize contact even with very close people and show virtually no emotions. Situational disorders are caused by problems with adaptation to certain new conditions after a change of job, the loss of a loved one, or vice versa - the birth of a child. This disorder is characterized by depression, unmotivated feelings of anxiety and severe dissatisfaction with oneself. In many cases, reactive neuroses in adults gradually disappear after some time on their own.
Hysterical neurosis is a conversion mental disorder in which there are disturbances in perception, memory, or even self-identification. Disorders of the nervous system may manifest as loss of hearing or vision, which are in no way related to diseases of the sensory organs. Short-term loss of consciousness, convulsions and retrograde amnesia are possible. Some patients with hysterical neuroses develop an inexplicable urge to wander.
Psychosomatic disorders mean various pathologies, conditioned . Patients with neurasthenia may experience heart or organ problems gastrointestinal tract. Often appear itchy skin, cough, hiccups and frequent urge to urinate. One of the manifestations of neurasthenia is hypochondria, that is, a panicky fear of getting sick or an unfounded belief that the disease has already developed.
Symptoms of neuroses in adults
Clinical manifestations of the nervous system
People suffering from neuroses often experience:
- mood instability;
- a feeling of self-doubt and the correctness of the actions taken;
- overly expressed emotional reaction to minor stress (aggression, despair, etc.);
- increased sensitivity and vulnerability;
- tearfulness and irritability;
- suspiciousness and exaggerated self-criticism;
- frequent manifestation of unreasonable anxiety and fear;
- inconsistency of desires and changes in the value system;
- excessive fixation on the problem;
- increased mental fatigue;
- decreased ability to remember and concentrate;
- high degree of sensitivity to sound and light stimuli, reaction to minor temperature changes;
- disorders .
Note:Sleep disturbances are very characteristic of a number of neurotic conditions. A person's sleep becomes superficial and does not allow the nervous system to recover at night. During the day, on the contrary, drowsiness and lethargy are noted.
How does neurosis physically manifest in adults?
Autonomic disorders that are often found in neuroses include::
- cardiac dysfunction (palpitations, tachycardia);
- digestive disorders;
- increased sweating;
- hyperemia or pallor skin faces;
- dry mouth or hypersalivation (increased salivation);
- tremor of the limbs (shaking in the hands);
- increase or decrease in blood pressure;
- dizziness and headaches;
- chest pain;
- chills or feeling of heat;
- frequent urge to urinate;
- disorders of the vestibular apparatus;
- decreased sex drive;
- Erectile dysfunction in men.
Important:many somatic manifestations are characteristic of short-term episodes of severe discomfort, which are called “panic attacks.” Their regular repetition in some cases leads to the development of panic disorder.
Treatment of neuroses in adults
General principles of treatment
The choice of treatment tactics directly depends on the nature of the disorder and the severity of clinical manifestations, as well as on factors such as the gender and age of the patient. Relatively mild disorders of the nervous system often end in spontaneous recovery, that is, the patient’s condition returns to normal without any medical assistance. As a rule, this happens when the irritating factor disappears, or the lifestyle changes.
How to treat neuroses in adults if the nervous system cannot cope with them on its own can only be determined by an experienced psychologist (psychotherapist) after talking with the patient and collecting a detailed history. In such cases, an individual approach is very important, and complex therapy is required.
The main method of treatment is psychotherapy. The results of treatment are better visible if the neurotic state is not disguised as somatic diseases, and mental changes did not become personality traits.
To strengthen the nervous system, the use of physiotherapeutic methods and Spa treatment. It is important to normalize the work and rest regime. A patient with neurosis should, if possible, avoid both physical and psycho-emotional stress.
How to cope with neurosis with the help of medications?
Patients with neuroses are prescribed general strengthening medications that help the body cope with physical and mental overload. These, in particular, include complexes including vitamins A, B, C and PP. To reduce feelings of anxiety and normalize sleep, sedatives are recommended, preferably of natural origin (in particular extracts of valerian and motherwort). From synthetic drugs Glycine is often prescribed. To strengthen the psyche, it is recommended to take antidepressants, for example, Amitriptyline. For neuroses that develop due to overwork, it is advisable to take medications that improve metabolism and blood supply to the brain. One of the most effective tranquilizers for neuroses is Afobazole.
Note:psychotropic medications for neuroses in adults can be prescribed only for severe disorders!
To regulate autonomic functions, if indicated, the use of drugs from the groups of anticholinergics, cholinomimetics, adrenergic agonists and ganglion blockers is justified.
Important: any medications must be prescribed by the attending physician; self-medication can lead to worsening of the condition.
Prevention of neuroses in adults
Like most diseases, neuroses are easier to prevent than to cure. Prevention of these nervous disorders involves minimizing occupational hazards and creating the most comfortable living conditions. Elimination of a psychotraumatic factor is one of the most important conditions. In many cases, at the first manifestations characteristic symptoms the patient has enough good rest. A good effect can be achieved by a temporary change of scenery.
Loading...