Chronic neurosis symptoms treatment. Neurosis: causes, signs, therapy

Functional disorders higher nervous activity of 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).

Pathogenesis

The modern understanding of the pathogenesis of neurosis assigns the main role in its development to functional disorders of the 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 an acute or chronic stressful situation, integrative processes in the brain are disrupted 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. The positive effect of antidepressants that affect 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 of neurotic disorders: neurasthenia, hysterical neurosis (conversion disorder) and obsessive-compulsive disorder. All of them are discussed in detail in the corresponding reviews.

As independent nosological units also distinguished as depressive neurosis, hypochondriacal neurosis, phobic neurosis. 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 transient and appear during or immediately after tragic events, usually in the form of a 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 neurotic reaction- short-term neurotic disorder lasting no more than 1 month, resulting from acute psychotrauma. Typical for children. As isolated case 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 disease indicate the development 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 disorders of the genitourinary system cause cystalgia, pollakiuria, itching or pain in the genital area, enuresis, frigidity, decreased libido, and 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.

A typical symptom of many neuroses is asthenia - increased fatigue how in mental sphere, so physical nature. 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 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.

Required differential diagnosis 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, complex treatment is used, combining psychotherapeutic methods and pharmacotherapy. In mild cases, only psychotherapeutic treatment may be sufficient. It is aimed at reconsidering the attitude towards the situation and resolving internal conflict 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 the treatment of anxiety disorders and phobias, anxiolytic drugs are additionally used. 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. Long-term existence of neurosis is dangerous irreversible changes personality and 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. Adequate sleep, good work and an active lifestyle also contribute to strengthening the psyche. healthy eating, hardening.

Mental neurosis, the symptoms of which will be described below, occurs quite often. This disease is characterized by protracted and chronic disorders nervous system, in which psycho-emotional changes in mood occur.

In the moment acute stage neurosis, both the mental and physical state of a person decreases, hysteria, obsessive thoughts and asthenic syndrome. Neuroses can last for a long time. The disease must be treated correctly, and for this you need to know some of its features.

The disease overtakes those people who constantly lack sleep, worry about the slightest thing, get upset or are overtired. The disease neurosis was first described back in 1776 by the Scottish scientist and medical practitioner William Cullen. Later, academician I.P. studied neurosis in more detail. Pavlov.

Types of neuroses

Medicine has divided mental neuroses into 4 types, which to this day have not been fully studied and continue to be researched.

1. Depressive. With this type, a person experiences a constant decline in mood, and mental retardation appears.
2. . It manifests itself in the form of low self-esteem and feelings of being unloved. Often this type of neurosis manifests itself in childhood. Children's behavior becomes feigned, and there is a complete reassessment of personality.
3. Asthenic appearance or neurasthenia. A person gets tired quickly, his mood can change frequently, and he is in a state of complete depression.
4. Anxiety neurosis. The person is depressed, anxious, oppressed.
5. Bulimic type of neurosis. In this case, a mental disorder occurs, expressed in a constant craving for food. This type of disorder is most common among men.

Each type of neurosis has its own causes and clinical manifestations.

The main causes of neuroses:

1. Mental stress or due to various problems.
2. Mental experiences related to personal life, relationships in the family, at work, and so on.
3. Physical tendency to get tired easily.
4. Bad habits: alcohol, nicotine, drugs.
5. Some types of diseases that lead to depletion of the body.

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Mental symptoms of neurosis

Mental neurosis, the symptoms of which are characterized by rapid mood swings and impulsiveness, is a disease that can affect anyone. Changeability of mood is observed in almost everything: in family life, at work, in set goals, in sexual relationships, and so on. People with this diagnosis are very impulsive, sometimes they do not think about the consequences of their actions. It is dangerous when this impulsiveness causes harm to a person, for example, it can be expressed in unprotected sexual relations or in taking psychotropic drugs.

A person is unable to control his impulses. If he hears criticism directed at himself, then his actions can be threatening. He cannot plan his life for the future because he does not have self-control. Outbursts of anger lead to violent actions towards others and other types of extreme behavior.

In stressful situations, a sick person can completely lose self-control. With a calm course of life events, tension subsides and the person can behave as usual, that is, the symptoms of a nervous disorder disappear. This behavior is more common in women than in men.

Mood instability causes depression, which can lead to suicide attempts. Such states can constantly replace each other; moments of euphoria can alternate with prolonged anxiety.

There is also a manifestation of neurosis in the form of reckless impulsiveness. This leads to negative consequences. For example it could be overuse alcohol, uncontrolled sex, driving fast or overeating. Various factors can influence this behavior: parental education, social environment, genetic predisposition. Neuroses manifest themselves especially acutely at times of life difficulties and stressful situations. The next manifestation of neurosis is emotional imbalance, which serves main reason uncontrolled behavior of a sick person.

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Somatic symptoms of neuroses

1. A person cannot calculate the amount of work performed and the moment when fatigue sets in. Sometimes even a small load leads to rapid fatigue.
2. Regular dizziness appears, and vegetative-vascular dystonia develops.
3. Unreasonable pain in the head, around the heart or in the abdominal cavity.
4. Heavy sweating.
5. A person may experience a sharp decrease sexual attraction for no apparent reason.
6. Food addiction changes and appears a sharp decline or, conversely, increased appetite.
7. Nighttime sleep also changes. It can be very deep or, on the contrary, a person cannot sleep and nightmares arise.

Having similar symptoms, you need to remember that there are a number of diseases with similar symptoms. Therefore, treatment should be carried out by a competent psychiatrist. It provides both a medicinal and non-medicinal method. Also during the rehabilitation period, resort and sanatorium therapy is indicated. If you start treatment on time, you can preserve the patient’s opportunity to remain a full member of society and not lose good relationships with family, relatives, friends and colleagues.

Professional, child and adolescent neuroses. According to experts, the number of patients with neurosis in major cities will continue to increase in the coming years, this disease will take first place among other pathologies, even ahead of cardiovascular diseases and injuries.

Treatment of neurosis today is one of the most pressing problems in psychiatry, because the sooner specialized treatment for a nervous disorder is started, the greater the patient’s chances of quickly returning to normal life and avoiding the development of more severe ones. nervous disorders. Let's figure out how to treat neurosis.

Neurosis or neurotic disorder is a concept that unites a group of functional disorders of the nervous system, accompanied by changes in the psycho-emotional state, decreased performance, mood lability and deterioration of somatic health.

This group of diseases is, first of all, characterized by the absence of gross organic pathology of the nervous system - neuroses occur in completely mentally healthy people when the connection and interaction between the nervous system and other organs is disrupted in their body and at the same time a change in psycho-emotional and physical state develops.

The causes of neurosis, most often, are nervous and mental exhaustion caused by an overly busy work schedule, chronic stress (read more) or constant lack of sleep and lack of rest.

An acute condition usually occurs against the background of some traumatic event or prolonged nervous strain.

Neurosis manifests itself increased anxiety, fear, anxiety, irritability, decreased performance, deterioration of cognitive functions, forgetfulness, absent-mindedness. The patient constantly Bad mood, he cannot calm down, rest, relax, he worries all the time, worries, and negatively perceives any news and changes. Characterized by mood lability and a sharp increase in sensitivity. Literally everything disturbs and irritates – loud sounds, bright lights, smells, temperature changes and other factors.

In addition to psycho-emotional manifestations, the physical condition also worsens - weakness, dizziness, elevation or depression appear. blood pressure, increased sweating, sleep and appetite disturbances. Pain in the chest, abdomen, muscle and joint pain occurs less frequently in the absence of pathology of organs and systems. Therefore, it is important to treat neurosis in a timely manner. Let's figure out how to cure neurosis.

Treatment of a neurotic condition

With neuroses, the concentration of neurotransmitters responsible for the transmission of nerve impulses and psycho-emotional state person. This causes deterioration in mood, apathy and irritability.

In addition, the entire functioning of the nervous system “goes wrong”, resistance to stress, the ability to tolerate various stimuli and loads decreases, due to constant nervous overstrain, the synthesis of stress hormones increases: adrenaline and cortisol, which cause spasm of blood vessels and muscle tissue, tachycardia, increased sweating, as well as fears, anxiety or aggression. Antidepressants, tranquilizers, and drugs that have a sedative effect and stabilize mood help to cope with these unpleasant manifestations.

If drug therapy is designed to combat existing manifestations of neurosis, then non-drug treatment and psychotherapy help to understand the causes of neuroses and find ways to cope with stress without compromising health, behavior and well-being.

Drug treatment

The following groups of drugs are used in treatment:

Non-drug methods

Among non-drug methods for eliminating neurosis, phototherapy and hypnosis, color music therapy, breathing exercises, aromatherapy, art therapy, sand therapy and some other types are considered the most effective.

The choice of a specific technique in the treatment of neurosis depends on the cause of the disease and the character of the person.

Thus, phototherapy or light treatment helps with the development of seasonal depression in people living in temperate or northern zones and experiencing a deficiency sun rays, necessary for the synthesis of vitamin D. Hypnosis is indicated when the patient is unwilling to recognize the causes of internal conflict, the need to survive and “let go” of a long-standing trauma that may already be forgotten by the patient.

Continuing to deal with the question of how to get rid of neurosis, it should be noted that color and music therapy are aimed at stimulating pleasure zones in the patient’s brain. Breathing exercises, art therapy, sand therapy and other types of creativity help to get rid of internal tension, identify your feelings and “throw out” negative emotions.

Psychotherapy

Psychotherapy – the most important part therapy of neurosis. Unlike other methods of treatment, this one affects the cause, and not the consequences, of the disease, which means it helps not only to improve the patient’s condition, but also to permanently get rid of the danger of recurrence of neurosis.

To treat a neurotic condition, the following types of psychotherapy are used:

So we figured out how to get rid of neurosis.

It is not at all difficult to obtain a diagnosis of “neurosis” in our time - stress at work and the crazy pace of life have a detrimental effect on mental health modern man. Sometimes ordinary people diagnose themselves with a disease without turning to specialists. But only a doctor can determine what a person actually suffers from and how to cure him.

Neurosis is a protracted and chronic, reversible, not very severe disorder of the nervous system, which is characterized by frequent shifts emotional state of the patient. At the same time, a person experiences a decrease in mental and physical performance, hysterical manifestations, and fears.

Causes

Based on physiological theory, this disease is pathological condition the body, which occurs due to prolonged disruptions in the functioning of the higher nervous system. Excessive mental activity along with a huge number of current nervous processes, occurring in the cerebral cortex, can provoke this disease. That is, the physiological theory states that neurosis is nothing more than a consequence of overstrain of the nervous system, caused by long or short-term exposure to stimuli that are excessive for the psyche of a particular individual.

According to other hypotheses of scientists, the cause of neurosis combines two factors - the excessive effect of the stimulus and the characteristics of a person’s personality. In this case, the main role is played not by the intensity, but by the degree of threat of the stimulus. What is important is the person’s response to this stimulus. In other words, how seriously and deeply a person perceives this stimulus is of great importance.

An important role among the causes of neurosis is played by functional state the body, that is, its health. The risk group for this disease includes people who lead an unhealthy lifestyle - those who do not adhere to work and rest schedules, who experience enormous emotional and physical stress, and overwork. It is also very important how a person approaches his responsibilities. Among the causes of the disease are the realities of turbulent modernity, which is satiated with negative information and excessive demands on a person’s “success”.

It is important to note that neurosis is not a genetic disease and it is not inherited. In the overwhelming majority of cases, its occurrence depends on the environment in which a person grew up and was brought up. Among the main causes of neurosis in children is the period of growing up in a dysfunctional family. Living under the same roof with drinking relatives, frequent scolding of parents, and their overly expressive expression of emotions lay the foundation for future neurotic manifestations in the child.

Important! Neurosis occurs not only against the background of prolonged experiences of negative emotions, but also on the basis of bright, intense positive experiences. Therefore, education according to the “carrot and stick” scheme often entails the appearance of neurotic disorders.

Psychoanalytic theories say that neurosis is a consequence of an unresolved conflict that exists in the depths of human psyche. Often this conflict arises due to the inability to satisfy basic personal needs. In addition, neurosis arises on the basis of an existing real or imaginary threat to the future, which is considered by a person as insoluble.

Other causes of neuroses include:

• Striving for perfect performance
• Inability to fully rest, workaholism
• Total control of others
• Strong need for protection and recognition
• Unsatisfied desire for recognition and power
• Unfulfilled desire for personal freedom
• Contradiction between instincts and moral frameworks
• Inability to respond competently to stress

The biological reason lies in the insufficient production of certain neurotransmitters and the functional failure of neurotransmitter systems. These defects reward a person with excessive sensitivity, emotional instability and the inability to adequately resolve difficult situations.

The causes of the disease also include infectious and viral diseases, due to which the body cannot fully resist negative factors. A person’s bad habits play a special role in the development of neuroses. Psychoactive substances and alcohol primarily affect the nervous system, provoking the appearance of painful neurotic reactions in a person.

Symptoms

In order to begin treatment of neurosis, you must first clearly understand and distinguish between neurotic and psychotic disorders. The following key aspects of the development of neurosis are identified:

• Absence of any symptoms of personality change upon objective examination of the patient
• Maintaining the patient's criticism of his condition
• Reversibility of neurotic disorders
• A person’s awareness of the abnormality of his condition and efforts to eliminate debilitating symptoms
• Psychogenic factors as the cause of neurotic conditions
• The person is experiencing difficulties due to their symptoms
• The patient is ready to cooperate with the doctor, he makes efforts to achieve a positive effect from the treatment.

Symptoms of neuroses consist of two large groups – physical phenomena and psychological signs.

Physical signs

Among physical symptoms neuroses – neurological defects, autonomic disorders, somatic problems. The most common of them are the following manifestations:

• Chronic headaches of a squeezing or pressing nature, called “neurasthenic helmet”
• Painful sensations and discomfort in the area of ​​the heart, perceived by the patient as heart defects
• The occurrence of cardiac neurosis, which is characterized by increased arterial, rapid heartbeat, aching or stabbing pain in the area of ​​the heart, increased sweating, difficulty breathing; An indicative symptom of cardiac neurosis is heart pain, which is accompanied by dizziness and numbness of the limbs
• Feeling of heaviness in the stomach, presence pain syndrome in the epigastrium
• Availability dyspeptic disorders(digestive disorders)
• Excessive sweating
• Trembling and weakness in the limbs
• Unstable blood pressure
• Heart rhythm disturbances
• Unsteady gait, difficulty maintaining balance, dizziness
• Deterioration of visual acuity, appearance of “flying spots” before the eyes
• Frequent urge to urinate
• Decreased libido, inability to have sexual intercourse, menstrual irregularities in women.

Often, due to neurosis, men experience pain, and women cannot conceive and bear a child. Somatic problems in the form of, are also possible. The consequences of human neurotic conditions also include cardiac problems, hypertension. Therefore, timely treatment of neuroses is very important for the normal, healthy functioning of the body.

Psychological symptoms

Among psychological factors The following neuroses are noted:

• Severe irritability and nervousness
• Restlessness, agitation, fussiness
• Emotional instability
• Frequent mood changes without any objective reasons
• Intrusive uncontrollable fear
• Impressionability, vulnerability, suspiciousness
• Inadequate self-esteem – excessive overestimation or underestimation of one’s qualities and capabilities
• Lack of initiative and indecisiveness
• Aggression towards others, conflict
• Overreaction to the slightest changes in routine
• A cynical and critical attitude towards everything
• Pickiness to other people's words, touchiness
• Inconsistency in desires and own aspirations and beliefs
• Tearfulness without objective reasons

In a person suffering from neurosis, it is noticeable performance decreases. He can no longer perform the usual amount of work, the quality of labor indicators is noticeably deteriorating, it is observed extreme fatigue at standard loads.

Various sleep problems- one of the common symptoms of neurosis. Severe overexcitation of the nervous system prevents a person from falling asleep at the usual time. And when he finally manages to fall asleep, he is often tormented by nightmares, which can often cause him to wake up in the middle of the night in a cold sweat. In the morning, you feel exhausted because inadequate sleep cannot restore the body's energy resources. The first half of the day for a person passes in a drowsy, broken state, but after lunch it improves.

In a person suffering from neurosis, mnestic and cognitive functions worsen ( the ability to understand, study, comprehend, perceive and process information decreases). He cannot concentrate or recall necessary information. A person’s thinking becomes slow, making it difficult for him to answer the question.

Among the characteristic symptoms of neuroses are increased sensitivity to external stimuli. There is an intense reaction to loud sounds, and even barely audible noises do not go unnoticed. A person feels unwell in bright light and sunlight. Meteosensitivity – characteristic symptom. The patient has a hard time with his shift weather conditions, and when the climate zone changes, he feels an increase in painful symptoms.

Focusing on a traumatic event is one of the most common symptoms of the disease. A person constantly thinks about the drama that happened, analyzes it, tries to find confirmation of his guilt. He simply cannot switch to positive thoughts because he is fixated on the negative moments that have happened in his life.

Kinds

There are several types of neuroses, each of which manifests itself with its own specific symptoms. So, doctors call the most common types of disease:

• Neurasthenia
• Anxiety disorder
• Hysterical neurosis
• Obsessive-compulsive disorder

Neurasthenia

Neurasthenia is also often called astheno-neurotic syndrome. Another common name among ordinary people is syndrome chronic fatigue. For this state The following symptoms are typical:

• Increased fatigue
• Excessive excitability and irritability
• Inability to control and control oneself
• Touchiness and tearfulness
• Inability to concentrate, absent-mindedness
• Decrease in previous physical endurance
• Indifference and apathy to everything around
• Deterioration and loss of appetite
• Inability to engage in long mental work
• Sleep disorders

With this type of neurosis, the patient also suffers from a feeling of a sinking heart, and a feeling of heaviness in the epigastrium. Abilities in the intimate sphere deteriorate. In addition, neurasthenia is characterized by wave-like depressive moods.

Anxiety disorder

With this type of disease, a person experiences a feeling of anxiety - it is usually groundless and uncontrollable. A person may experience fear for his future, because of problems in his personal sphere, or for his health (hypochondriacal manifestations).

The condition has the following mental symptoms:

• feeling of fear, anxiety (most often without any objective reasons)
• sleep disorders
• hypochondria
• anxious thoughts, bad mood

Common physical symptoms include:

• headache
• feeling of a “squeezing helmet” on the head
• breathing disorder
• pressure surges
• feeling of dry mouth, thirst
• excessive sweating
• disruption of the digestive system - nausea,

The disease quickly becomes chronic and these sensations become integral companions of a person. Sometimes exacerbations occur, which can result in an attack of panic attack, irritability and tearfulness.

Important! If the disease lasts for a long time and there is no treatment, it can change into another form. mental disorder– for example, hypochondria or obsessive-compulsive disorder.

Hysterical neurosis

One of the forms of mental disorders, which is expressed in an excessive desire to attract attention to oneself in any way - the patient can “throw hysterics”, playing to the public, sobbing, screaming and almost convulsing. A person in this state is characterized by excessive demonstrativeness - bright appearances and sudden disappearances, as well as manipulative behavior in order to attract attention and subjugate.

The patient may deeply believe that he has an incurable disease and perfectly imitate its symptoms. In this case, the disease can be absolutely anything.

This condition occurs due to the fact that a person finds himself in an environment or situation that traumatizes his psyche - this could be a conflict at work, a family scene, or a life-threatening situation.

In the clinical picture of hysterical neurosis, three categories of symptoms are distinguished: autonomic disorders, sensory and motor impairments.

1. The symptoms of the first group are bright, changeable, migrating and varied pains and physical fantasies. A little stress can cause the patient to experience impaired consciousness and convulsions, which are signs of a seizure.
   

   Note! During a seizure, a person may hit the walls and floor, tear his clothes and hair, throw objects, laugh hysterically, and then sob for no reason.

2. Sensory symptoms include “glove” and “stocking” paresthesia (numbness, tingling, sensation of “pins and needles”) of the extremities. This is where sensory disturbances most often occur. A person may also experience loss of sensation. If a hysteric has set out to attract attention, then he can calmly literally walk on hot coals without feeling pain. The condition is also characterized by deafness, blindness, speech disorders, for example, stuttering.
3. Disorders in this group include complete or partial paralysis of the limbs, tremor, impaired coordination of movement, paralysis of the tongue, loss of voice, nervous tic, contraction of the orbicularis oculi muscle.

Treatment of this form of neurosis is a difficult, long and painstaking process, in which the correct selection of medications plays an important role. Incorrect treatment threatens the development of serious mental defects in the patient, which can completely change the personality portrait.

Obsessive-compulsive disorder

It is an obsessive-compulsive disorder (literally translated as “compulsion” and “obsession with an idea”). It can be either chronic or episodic. It is characterized by the appearance in a person of obsessive, disturbing and even frightening thoughts (obsessions). At the same time, the person constantly strives to get rid of the anxiety inspired by these thoughts with the help of tedious, obsessive actions (compulsions).

The disorder is characterized by the development of intrusive memories, thoughts, actions and movements, as well as the appearance of pathological fears (phobias).

Patients with this type of disorder are suspicious people who sometimes take extremely decisive actions, which is very noticeable against the background of their prevailing calm.

Obsessive thoughts and actions most often manifest themselves in:

• Severe fear of contamination or infection
• Fear of harming yourself or others
• Moral and religious ideas
• Sexually explicit or violent thoughts or images
• The desire for order and symmetry, the idea that everything around should be built “correctly”
• Fear of losing or not having some necessary things
• Superstitions, excessive attention to something that is regarded as good or bad luck

Treatment of such a disorder necessarily involves an integrated approach, which includes psychotherapy and drug treatment.

Treatment

Of course, every person suffering from this disorder thinks about how to treat neurosis. First of all, you should not be afraid that after a visit to the doctor you will be immediately sent to the neurosis department for compulsory treatment. As mentioned earlier, this disorder is not very dangerous and, with the right approach, responds well to treatment. It is important to understand that it is simply impossible to endure the symptoms and signs of neurosis for a long time - this can lead to more serious consequences and cause other mental diseases. If you repeatedly experience painful manifestations of neurosis, do not put off visiting a doctor. For starters it might be family doctor or a clinic therapist who will already refer you for a consultation with a psychotherapist. Or, by visiting the forums of your city and analyzing the recommendations and reviews of people, you can choose a private specialist yourself. The sooner you go to the doctor, the sooner treatment will be prescribed, which may consist of one of the modern methods.

Psychotherapy

The main task of psychotherapy for neuroses is to normalize the patient’s views on the world, identifying the causes that led to the disease, expanding the range of his interests.

Recovery occurs only when the patient, with the help of a doctor, comes to understand and realize the causes of his worries and fears. After this moment, everything that previously prevented the patient from living normally and calmly no longer seems to him of any significance or importance.

Modern psychologists and psychiatrists, when treating neuroses, resort to three main methods of influence: conversation, hypnosis, and cognitive psychotherapy.

Cognitive therapy is when they reproduce a situation that once caused anxiety in a person, but in a safe environment. At the same time, the patient sensibly assesses what is happening and draws the necessary conclusions. Sometimes this therapy is carried out during a hypnotic trance. When the patient is brought out of this state, the doctor talks with him about his future lifestyle, normalization of well-being, and the search for his place in the world around him. The doctor invites the patient to create his own “corner of freedom” - this can be any passion or hobby, and also advises him to find his own ways of distracting from the surrounding reality. This way can be listening to soothing music, meditation, relaxing in nature, yoga, etc.

Drug treatment

If psychotherapy does not have a positive effect, doctors resort to adjustments mental state patient with the help of medications, which consist of several groups of drugs:

• Neuroleptics
• Tranquilizers
• Psychostimulants

Neuroleptics (aka aminosines) are a group medicines antipsychotic action. They are characterized by an excellent calming and hypnotic effect, eliminating hallucinations. But long-term use can lead to depression.

The pharmacological effect of tranquilizers (diazepam) is similar to antipsychotics, but their mechanism of action differs by stimulating the production of gamma-aminobutyric acid. They have a pronounced relaxing and sedative effect. Prescribed in short courses for patients with obsessive-compulsive disorder.

Antidepressants are characterized by a pronounced sedative effect. Prescribed for neuroses that are accompanied by fear and anxiety. Prescribed in the form of tablets, injections, inhalations.

Psychostimulants and nootropics are characterized by an stimulating effect that increases mental performance and improves emotional state. They treat depressive forms of neurosis.

Prevention

Despite the fact that neurosis is treatable, it is still better to prevent than to treat. The best prevention in this case, you will normalize your emotional background as much as possible. Try to eliminate irritating factors or change your attitude towards them. Avoid overload at work, normalize your work and rest schedule. It is very important to give yourself proper rest, eat right, sleep at least 7-8 hours a day, do daily walks, exercise.

It is extremely important to release emotional ballast. You can give vent to your emotions by doing something creative, doing something you love like dancing or singing, or keeping your personal diary. And, of course, it is better to spend more time with people who contribute to a cheerful and pleasant feeling, support and inspire optimism.

Neurosis (psychoneurosis, neurotic disorder) is the general name for a group of neuro- mental illness, which are characterized by a combination of characteristics psychoemotional disorder and symptoms of somatic diseases.

Today, neurotic disorder is the most common disease among residents of large cities; according to WHO, the number of people suffering from one or another form of this pathology increases every year and can reach 20% of the total population of the Earth, and there is a pronounced uneven distribution of patients. Almost every second resident of a city with a population of more than 1 million faces various forms of disease, but residents of rural areas extremely rarely suffer from such pathologies.

Research by scientists convincingly proves that mainly residents of large cities suffer from nervous disorders; previously it was believed that this is due to a different rhythm of life, a large number of negative information and the intellectual overload that every city dweller feels.

But further study of this issue led to the conclusion that all of the above factors, of course, negatively affect the state of the nervous system and the health of the body as a whole, but cannot independently cause the development of a neurotic state and are just accompanying or aggravating factors.

A the real reason development of neuroses are psychogenic factors that cause a large number of negative emotions. The difference in the number of cases in urban and rural areas is explained by the difference in relationships between people and the level of aspirations for the standard of living and for oneself.

Equally often, all categories of patients, regardless of their place of residence, experience psychoneurosis due to such tragic events as:

• death or loss loved one;
• serious illness in loved ones or in the patient himself;
• divorce or separation from a loved one;
• dismissal from work, bankruptcy, business collapse, and so on.

But most often, neurotic disorder occurs due to a number of other reasons:

If you study the causes of neuroses from the second list, it becomes clear why today it is mainly residents of megalopolises who suffer from this disease. After all, it is in such places that people strive to achieve success or material well-being, not even paying attention to their own health or relationships with others.

Now it’s worth finding out what the signs of neurosis are.

Symptoms

Until now, it is quite difficult to accurately answer the question of what neurosis is and why this condition occurs.

Neuroses are classified as functional diseases nervous system, that is, they do not experience organic brain damage, trauma, infections and other similar factors.

Due to the influence of psychotraumatic factors, the coordination of the nervous system and some other organs and systems in the body is disrupted. Mental and somatic symptoms of neurosis arise, a mentally healthy person turns into a neurotic, a patient suffering from numerous “illnesses”, whose behavior and lifestyle change greatly.

Mental symptoms

Neuroses can manifest themselves as follows:

1. A reaction that is too acute or inadequate in terms of the strength of feelings to any irritants - with neuroses, the patient “receives with hostility” any joke, awkward remark, unpleasant situation, of those that occur in abundance in the life of every person. Such a person becomes seriously upset and may begin to cry or act out (depending on his character traits) in response to a fair remark from a manager, if his foot was accidentally stepped on in transport, was not immediately served at the bank, or was not answered. phone call. Patients are distinguished by increased sensitivity To loud sounds, bright light, smells and any other irritants.
2. Mood lability. Quick change mood depending on external circumstances also indicates problems with the nervous system.
3. Irritability, aggressiveness, moodiness, tearfulness. Behavior of a person suffering from nervous diseases, can change dramatically, it becomes difficult for him to cope with negative emotions, control himself and “not take it out” on others.
4. Indecisiveness, decreased or increased self-esteem, difficulties in communication, . Under the influence of the disease, a person’s character also changes; the patient has difficulty making decisions, ceases to adequately evaluate himself and his achievements, sees the future exclusively in “black” colors and has difficulty communicating with people around him.

Somatic symptoms

With neuroses the following are observed:

It is important to understand that a neurotic is a person who simultaneously suffers from a disorder of the nervous system and somatic manifestations. Most often, patients do not understand that they need the help of a specialist, believing that bad mood and changes in behavior are associated with lack of rest, hard work or health problems.

Patients, as a rule, begin to think about the need when their condition sharply deteriorates or when problems arise with others - in the family or at work. It is quite difficult to independently diagnose neuroses in yourself or others because there are many types of this disease - from professional to professional.

Types of neuroses

The following neurotic disorders are distinguished:

1. (nervous weakness or fatigue syndrome) is the most common form of neuroses. Occurs with prolonged nervous overstrain, chronic stress and other similar conditions that cause fatigue and “breakdown” of the protective mechanisms of the nervous system. With this type of neurosis, the patient feels constant weakness, cannot work normally, gets tired quickly, has headaches, stomach pain, sleep and appetite worsen. Sensitivity to external stimuli increases, tearfulness, irritability, and isolation appear.
2. – more common in women and in people with a demonstrative type of character. With this form of the disease, patients strive to attract as much attention as possible to themselves and the manifestations of their illness. Persons suffering from are characterized by inappropriate behavior, increased suggestibility, efficiency, impressionability and demonstrative behavior. The main goal of their behavior is to be the center of attention; all symptoms of the disease are experienced “for show” and are greatly exaggerated. Characterized by hysterics and seizures sharp deterioration conditions, hysterical convulsive seizures, even paralysis, if the patient is not paid attention to or he cannot get what he wants.
3. – patients devote most of their time and attention to problems of their own health. They, most often, are confident that they have a serious, incurable disease that no one can accurately diagnose and cure. Similar neurosis-like states can be observed in older people who are completely focused on their health. With true neurosis, patients ignore psychological problems, considering their cause to be physical health problems.
4. (obsessive-phobic) – one of the most severe forms neurosis. With this form of neurosis, a person performs certain actions without realizing it. Anything can become an obsession: mental arithmetic, the inability to get rid of thoughts or experiences on a certain topic, the habit of constantly adjusting hair or clothes, entire rituals in certain situations, and much more. In the absence of professional help for neuroses, the patient’s condition may worsen, even to the development of mental illness. Obsessive condition can be very different, from quite harmless (the habit of checking the iron or gas stove before leaving) to severe disorders that turn into phobias. A phobia is an unreasonable panic fear that occurs in certain situations, which, as a rule, do not pose any danger to a person. The most common phobias are: agoraphobia (fear of open spaces), claustrophobia (fear of enclosed spaces), social phobia (fear of being in unpleasant situation in front of other people, this could be the fear of blushing in society, burping, fear of speaking in front of a large number of people, fear of being the first to address a stranger, and so on).
5. Professional neuroses - there are many types of professional activities in which a person experiences severe stress, due to which a neurosis-like state or professional neurosis may develop. According to research by British scientists, the most high level stress (according to a 10-point system) among miners (8.3), civil airline pilots (7.5), machine workers, journalists, dentists, obstetricians, lawyers, and so on. Professional neurosis manifests itself first as excessive tension, fear of making a mistake, then difficulties arise in work, it becomes difficult to concentrate and complete tasks on time. necessary actions, and then the body tries to find a way to get rid of situations that provoke unnecessary stress - patients develop tremors, headaches, abdominal pain and other somatic symptoms that make it impossible to perform professional duties. These are the consequences of neuroses.
6. Teenage. IN puberty This type of mental neurosis is quite rare; in most cases, it affects those children who were registered with psychoneurologists in childhood or who have accompanying illnesses nervous system. In adolescents, neurasthenia, hysterical neurosis or obsessive-phobic neurosis are most often observed. There are no particular differences in clinical manifestations from the course of the disease in adults; only drug treatment and types of psychotherapy change.
7. - more common in children with neurotic disorders. However, logoneurosis.

Important: there are a number of diseases of the neurotic spectrum that are not directly related to neurosis, but are close to them in manifestation or type of lesion. This group of diseases includes such ailments as, (IBS), tics, (VSD), GAD () and a number of others.

Treatment

Since neurotic disorders are common, it is worth understanding how to deal with them. Neurosis is sometimes understood as a borderline state between normality and pathology in the functioning of the nervous system. Exist .

For neuroses, most experts advise starting therapy with lifestyle changes, using mild sedatives, and only if there is no effect, moving on to using antidepressants, tranquilizers or antipsychotics. An obligatory component of therapy is psychotherapy - the main type of treatment for neuroses.

In the absence of somatic pathologies, patients are necessarily recommended to change their lifestyle, normalize work and rest, sleep at least 7-8 hours a day, eat right, refuse bad habits, spend more time on fresh air and avoid nervous overload.

Drug treatment

How to deal with neuroses? To correct the condition the following are used:

1. Sedative herbal preparations. This is a tincture of motherwort, peony, valerian - for long-term use.
2. Tranquilizers - seduxen, relanium, elenium, neurol, tazepam. These drugs can be taken only in the dose indicated by the doctor and only for the recommended period of time, since the drugs are addictive and have a lot of side effects. In addition, when using these drugs, the reaction speed, concentration of attention decreases and cannot be controlled. vehicle and perform dangerous work.
3. Antidepressants - Cymbalta, fluoxetine. These drugs are rarely prescribed for neuroses, since the effect of their use occurs only after 2-3 weeks from the start of use.
4. Neuroleptics - sonapax, neuleptil, eglonil, rispolept and others. These drugs are used only in the most severe cases.

Psychotherapy

With the help of rational, psychoanalysis and other similar techniques, a psychotherapist helps the patient “work through” his problems, understand what thoughts, beliefs, actions caused the development of neuroses and how this situation can be changed.

Equally important is teaching the patient relaxation techniques and the ability to get rid of negative emotions, complexes, and stereotypes imposed by parents and others.