Neuroses and neurotic conditions. Types of neuroses

Neurosis– a psychogenic, functional, personality disorder, which is manifested mainly by emotional disorders, behavioral disorders and disorders of the neurovegetative regulation of internal organs.

Neurosis– this is a consequence of an insoluble intrapersonal motivational conflict with insufficient effectiveness of mechanisms psychological protection.

Neurosis– acquired functional disease nervous system, in which a “breakdown” of brain activity occurs without any signs of it anatomical damage. Neurosis is a consequence of failures, frustrations and interpersonal clashes and at the same time often serves as their cause. So it turns out vicious circle: conflicts lead to neuroticism, and this, in turn, provokes new conflicts. Short-term neurotic states that go away on their own over time, without treatment, are observed at one time or another in almost any person’s life.

The causes of neuroses lie in a wide variety of traumatic situations, in acute or chronic emotional stress. And depending on the predisposing background, the disease may manifest itself various symptoms. The main manifestations of neurosis:

High sensitivity to stress – people react to a minor stressful event with despair or aggression
tearfulness
touchiness, vulnerability
anxiety
fixation on a traumatic situation
when trying to work, they quickly get tired - memory, attention, and thinking abilities decrease
sensitivity to loud sounds, bright light, temperature changes
sleep disorders: it is often difficult for a person to fall asleep due to overexcitation; superficial, disturbing sleep that does not bring relief; I often feel drowsy in the morning
autonomic disorders: sweating, palpitations, fluctuations in blood pressure (usually downward), disruption of the stomach
sometimes – decreased libido and potency

Neuroses are often caused by:

Prolonged psycho-emotional and physical stress of moderate intensity without the opportunity to relax and recuperate, that is, chronic stress - this can be work that takes all the strength, and difficulties in personal life, and a conflict, because of which a person is very worried, and most often - combination of these factors

Sometimes exhaustion of the nervous system occurs due to the inability to complete a task or get out of a deadlock situation.

Often, the origin of neurosis is based on the same genes as those that cause depression.

The emergence of neurosis is facilitated by the inability to relax and workaholism

Some people are naturally bad at long-term loads and therefore prone to overwork

An additional factor in the development of neuroses are diseases that debilitate the body (for example, influenza)

Types of neuroses:

1. Neurasthenia(Lat. – “nervous weakness”). Reason: long lasting emotional stress, leading to exhaustion of the nervous system. Conflicts at work, family troubles, unsettled personal life. Psychological defense mechanisms such as “denial”, “rationalization”, “repression”. A patient with neurasthenia is bothered by irritability for the most significant reasons. It is difficult for them to concentrate their attention, they quickly get tired, they develop headaches, heart pain, stomach functions are disrupted, insomnia appears, sexual function is upset, and the acuity decreases. sexual relations. Sleep disturbance.

2.Hysteria– observed more often in women. They sometimes imagine themselves as seriously ill, unhappy, “misunderstood people” and become deeply accustomed to the image they have created. Sometimes an occasional unpleasant minor family quarrel or minor work conflict is enough for the Patient to begin to sob bitterly, curse everything and everyone, and threaten to commit suicide. A hysterical reaction usually begins when the Patient needs to achieve something from others, or, conversely, to get rid of their allegedly unfair or simply unwanted demands. These reactions can manifest themselves as uncontrollable tears, fainting, complaints of dizziness and nausea, vomiting, convulsive curling of the fingers, and in general - symptoms of almost any disease known to a given person; imaginary paralysis, deafness, and loss of voice may occur. But with all this, a hysterical attack cannot be considered a simulation; it most often occurs against a person’s desire and causes him to suffer greatly physically and mentally.

3.Neurosis obsessive states (psychasthenia) - persistent anxious thoughts and fears appear, for example, “contracting a disease,” losing a loved one, blushing during a conversation, being left alone in a room, etc. At the same time, the person understands well the illogicality of his fears, but cannot get rid of them.

Each of them occurs in people with a certain type of GNI, with specific mistakes in their upbringing and typical unfavorable life situations.

Problems and approaches to study

IN Pavlov's teachings the essence of neurosis comes down to a chronic deviation of the GNI from the norm, which occurred as a result of overexertion nervous processes and changes in their mobility. According to Pavlov and his students, neuroses depend on the initial type of nervous system. Thus, people of the “artistic type”, who perceive reality very emotionally, are more prone to hysteria; “mental type” - to obsessive-compulsive neurosis, and the mean between them - to neurasthenia.

The first definition of the concept “neurosis” belongs to Gullen. Neuroses are “disorders of sensations and movements that are not accompanied by fever and do not depend on local damage to any organ, but are caused by general suffering, on which movements and thought specifically depend.” In the second half of the twentieth century. have emerged 2 main directions in the doctrine of the origin of neuroses: anatomical and psychological.

It should be noted that the search for the pathoanatomical substrate of neuroses has not yet brought significant results, although supporters anatomical direction It is believed that advances in the field of molecular biology and genetics make it possible to confidently deny the existence of functional diseases and find morphological substrates that are adequate to any dysfunction.

Supporters of the psychological direction are the most numerous. Already in the second half of the 19th century. The basis for the emergence of neuroses in humans, in particular hysteria, was considered to be increased suggestibility and self-hypnosis. Therefore, hypnosis was proposed as the main method of treating neurotic conditions.

According to Z. Freud, who headed the psychoanalytic school, neuroses are explained by the action of “infringed” affects, repressed into the unconscious of various drives. Freud shared everything psychogenic disorder, having somatic correlates, into 2 main groups: conversion neuroses (hysteria) and actual neuroses. The latter included anxiety neurosis, hypochondria and neurasthenia. From the standpoint of various psychological trends associated with Freudianism, the essence of the conflict in neuroses is the contradiction between instincts in the sphere of the unconscious and social norms.

All representatives of the psychological movement recognize that psychological factors are leading in the etiopathogenesis of neuroses.

Obsessive thoughts - one of the types of obsessive states (obsessions). The term "obsessions" is sometimes misused to refer only to intrusive thoughts, but its meaning is much broader.

Obsessive states are conventionally divided into obsessions in the intellectual-affective (phobia) and motor (compulsions) spheres. The conventionality of this division is evidenced by the fact that most often several types of obsessions are combined in the structure of obsessions.

Obsessive thoughts are characterized by the same basic properties that, according to the definition of V.P. Osipov (1923), are inherent in all obsessive phenomena in general. The main distinctive features of obsessive thoughts were highlighted by S. A. Sukhanov (1912) and V. P. Osipov (1923).

1. Obsessive thoughts arise involuntarily and even against the will in a person’s mind. At the same time, consciousness remains unclouded and clear.

2. Obsessive thoughts are not in visible connection with the content of thinking; they have the character of something alien, extraneous to the patient’s thinking.

3. Intrusive thoughts cannot be eliminated by force of will sick. The patient is unable to get rid of them.

4. Obsessive thoughts arise in close connection with the emotional sphere and are accompanied by depressive emotions and feelings of anxiety.

6. The painful nature of obsessive thoughts is recognized by the patient, and there is a critical attitude towards them.

V.P. Osipov admitted that with a sharp expression of obsessive thoughts, a loss of reasonable attitude towards them is possible, and then obsessive thoughts and ideas can develop into delirium. D. S. Ozeretskovsky (1961) writes that the development of obsessions into delirium is observed in isolated cases, so it cannot be considered a typical phenomenon.

The main difference between an obsession and a delusional idea is the patient’s critical attitude towards obsessive thoughts that remain alien to his thinking and his personal position. Obsessive thoughts involuntarily invade the patient’s psyche, he experiences them hard, understands their absurdity, but

Painful ideas, impulses and actions bring significant suffering to a person, but he cannot do anything with himself except to replace, use another instead of one stupid idea, move from one prohibition to another. A person suffering from neurotic obsessive actions has all kinds of doubts, indecision increases, and there is a restriction of freedom. Psychoanalysis takes into account the symptoms of the disease, perceives a hidden meaning in them, based on the identification of this meaning, gives a historical (rooted in childhood) interpretation of them and thereby provides the opportunity to translate the unconscious into consciousness with the aim of subsequently eliminating neurotic symptoms.

Among mental pathologies, neuroses are one of the most common diseases. Their treatment is complicated by the fact that there is no single generally accepted system by which the types of manifestations of the disorder can be effectively structured. Most often, medical specialists use the classification of neuroses according to ICD-10.

General description of neuroses

Systematization of neuroses is impossible without determining the main parameters of the disease, including the concept, symptoms, causes, etc.

Concept

Neurosis is a group of functional mental disorders that arise as a result of strong experiences and stress, which are reversible and tend to be protracted.

The concept was first introduced into scientific circulation at the end of the 18th century by the Scottish physician William Cullen. Since the beginning of the study, the content of the term has been revised several times. In modern science there is no generally accepted interpretation of the concept of neurosis. With the advent of new works and research, the content of the phenomenon is adjusted and changed. In biology and medicine, neuroses can be understood as radically different disorders of higher nervous activity.

Symptoms

The key parameter for characterizing the pathology in question is the clinical picture. It can be asthenic, obsessive or hysterical in nature. An additional aspect of the course of the disorder is a temporary decrease in mental and physical activity.

The nature of the development of the disease is influenced by age (children suffer from the disease differently than adults), gender, and other personal characteristics.

Differences between neuroses and other nervous pathologies:

• the primary role of experiences, stress (psychogenic nature);
• painful manifestations are secondary, additive in nature to psychogenic manifestations;
• reversibility;
• absence of signs of dementia, progressive personality changes;
• a person realizes the presence of certain psychological characteristics in himself, and experiences this with difficulty.

Symptomatic manifestations are expressed in the psychological and physical spheres.

What are the psychological forms of the disorder?

1. Emotional depression, mood swings.
2. Behavioral defects manifested in indecisiveness.
3. Communication problems.
4. Self-esteem problems.
5. The presence of anxiety, fears, phobias, panic attacks. High sensitivity to stress.
6. Vagueness, inconsistency and variability of the system of values, desires, aspirations, expectations from life, attitudes towards oneself and others.
7. Irritability, touchiness, tearfulness, anxiety, sensitivity to external stimuli (noise, light).
8. Obsession with the situation that led to psychological trauma.
9. High level of fatigue, problems sleeping.

Which ones are highlighted? physical forms illness:

1. Pain in the head, stomach, heart area.
2. Decreased physical and mental capabilities of the body.
3. Dizziness and darkening of the eyes.
4. Panic attacks.
5. Disruption of the digestive system.
6. Sleep disorders.
7. Increased psychological sensitivity to physical pain, excessive concern for health.
8. Sweating, frequent urination, changes in blood pressure, cough.

Reasons for development

Factors that encourage the emergence and development of neurotic disorders:

1. External conflicts.
2. Internal (deep psychological) conflicts.
3. Circumstances that influenced the occurrence of traumatic factors.
4. Nervous and mental tension.
5. Excessive emotional and intellectual stress.
6. Personal characteristics of a person, the conditions for their formation and maturation.
7. The nature of a person’s social role, its relationship with internal aspirations.
8. Disturbances in the functioning of nervous system systems.

Preventive and therapeutic measures

The disease is reversible, so it can be completely cured and the condition of the patient’s body can be restored.

Competent preventive measures also play an important role. They are able to prevent the occurrence and development of pathology. Used as a means of prevention and elimination various methods and means:

• drug treatment;
• various types of psychotherapy (cognitive-behavioral, psychodynamic, etc.);
• hypnosis;
• muscle relaxation, self-hypnosis;
• light therapy, walks in the fresh air;
• breathing exercises techniques.

Classifications and typologies

There is no generally accepted classification of psychoneuroses. The most authoritative typologies are the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the system adopted in clinical psychology.

Classification according to ICD-10

ICD-10 is a document used throughout the world as a statistical and classification framework for healthcare. The document is periodically updated and adjusted in accordance with the latest discoveries in the field of disease research. The number "10" indicates that this document was created as a result of the tenth revision.

Classification and brief characteristics of neuroses according to ICD-10:

1. Neurosis of obsessive states (thoughts) is a disorder, the causes of which are conflicts of needs and morality.
2. Anxiety-phobic disorder is a disease caused by fears and phobias.
3. Hysterical neurosis is a disorder of an unstable emotional state caused by a defensive reaction to an “unsolvable” situation.
4. Neurasthenia is a disorder, the causes of which lie in the internal conflict of demands on oneself and the inability to meet them.

Clinical classification

As a result scientific research And practical treatment A clinical classification of patients has been created.

What types of neuroses are there?:

1. Neurasthenia is irritable weakness.
2. Obsessiveness.
3. Neurotic depression.
4. Phobias and fears.
5. Obsessive behavior and thoughts.
6. Refusal of food.
7. Pathological feeling of hunger.
8. Exhaustion.
9. Defective manifestations in the activity of the stomach are various forms of disturbances in the activity of the digestive system.
10. Panic attacks.
11. Nervous pathologies of cardiac activity.
12. Self-forming neuroses - unreasonable pain, disturbances in the functioning of organs.
13. Laryngo- and pharyngospasms.
14. Disorders of success or guilt.
15. Neurosis of sexual activity.

Differences in classifications in domestic science and abroad

The classification of the disease in question does not have generally accepted world standards. Domestic psychologists prefer to divide the phenomenon into three types: neurasthenia, obsessive-compulsive neurosis and hysteria.

In foreign scientific circles the situation is radically different. Thus, in the USA, neurosis as a concept has been completely phased out since 1980. Disorders of this type are divided into the following types:

1. Dysthymic disorder (the term replaced the concept of depressive neurosis).
2. Obsessive-compulsive disorder (instead of obsessive-compulsive neurosis).
3. Hypochondria (instead of hypochondriacal neurosis).

The lack of a unified classification of the pathology in question is due to the lack of common opinion regarding the definition and characteristics of the disease. The division into types is determined by the criteria that are the basis of the created structure. Further study of the disorder will make it possible to clarify the formulation of the characteristics, types and types of neurosis.

Functional disorders of 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 variety of clinical forms of 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, and 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 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 enters the 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 the cardiovascular 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, as 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 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. In case of severe sleep disturbances, it is possible to consult a somnologist and conduct polysomnography.

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 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 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. 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. Strengthening the psyche is also facilitated by adequate sleep, good work and an active lifestyle, healthy eating, and hardening.

Neurosis is a reversible neuropsychic disorder that occurs due to a violation of significant life relationships, manifested by specific clinical phenomena in the absence of psychotic phenomena. Neurosis occupies a borderline position between neurological and psychiatric diseases.

Prevalence of neuroses

Neurosis is one of the most common diseases, according to statistics from developed countries, detected in 10-20% of the population. The prevalence of neuroses is constantly increasing. According to WHO, the number of patients with neuroses over the last 65 years of the twentieth century. increased 24 times, while the number of patients mental illness over the same time it increased only 1.6 times. Women get sick 2 times more often than men.

Classification of neuroses

In ICD-10, neuroses are included in the section on neurotic and somatoform disorders (F-4). This section presents data on neuroses from a phenomenological point of view. According to the predominant phenomenological manifestations, six main types of neuroses are distinguished:

1. anxious-phobic;
2. depressive;
3. obsessive-compulsive;
4. asthenic;
5. hysterical;
6. somatoform.

In our country, where nosological diagnosis has long been preferred, it is customary to distinguish three forms of neuroses:

• obsessive-phobic neurosis;
• hysterical neurosis.

The form of neurosis depends mainly not on the nature and severity of the psychogenic effect, but on the personal characteristics of a particular person.

Taking into account the duration and characteristics of the course, the following types of neuroses are distinguished:

• neurotic reaction that usually occurs to acute emotional stress(for example, the death of a loved one) and lasts up to 2 months;
• neurotic state (neurosis itself), the duration of which varies from 2 months to a year;
• neurotic personality development, usually manifested by chronic exposure to a psychotraumatic factor on a person who is unable to adapt to it.

Causes of neuroses and pathogenesis

The main cause of the development of neurosis is considered to be acute or chronic psychogenic effects, which have high degree personal significance, disrupting the ability to fulfill important needs for the patient and causing strong negative emotions, resulting in vegetative and somatic manifestations.

Risk factors for neurosis:

• congenital emotional instability, anxiety, vulnerability, suspiciousness, suspicion;
• tendency to develop depression and the appearance of hysterical reactions;
• difficulty in social adaptation;
• constitutional features;
• chronic fatigue;
• starvation;
• long;
• somatic diseases;
• previous injuries;
• hypoxic conditions;
• conditions;
• endocrine disorders, including physiological hormonal changes ( puberty, pregnancy, );
• exogenous intoxications.

The primary pathophysiological basis of neurosis is functional changes deep structures of the brain, usually arising under the influence of severe stress. Neurosis develops as a result of a dysfunction of the predominantly limbic-reticular complex (LRC), which ensures the integration of the emotional, vegetative, endocrine spheres and secondarily affects the tone of the cerebral cortex, which in neuroses can affect the productivity of cortical processes, in particular cognitive activity.

In the development of neurosis, the premorbid state of LRC (inherited characteristics and manifestations) has a certain significance congenital pathology, as well as previous traumatic, toxic, infectious and other brain lesions). When there is a congenital or acquired mismatch in the functions of the LRC structures, a metabolic imbalance occurs in it, leading to an increased response of the brain to emotiogenic influences, a decrease in its adaptive capabilities and an increasing predisposition to neurosis.

According to the results of experimental studies, in neurosis, changes in the LRC occur primarily at the subcellular level and include:

• reduction in the number of ribosomes in nerve cells;
• destruction of cell membranes;
• lipid peroxidation disorder;
• expansion of endoplasmic reticulum cisterns;
• increasing the concentration of vesicles containing mediators in synaptic nerve endings.

In addition, in patients with neuroses in LRC, the following are possible:

• degeneration of nerve endings;
• reduction in quantity nerve cells in the hippocampus;
• formation of additional synaptic connections (hypersynapsia). It has also been established that a decrease in the number of nerve cells in the LRC is accompanied by the accumulation in the remaining neurons of a larger number than normal nucleic acids and enzymes. Such cells are called highly charged.

All of these changes are accompanied by disintegration of functions emotional sphere, autonomic, endocrine systems, secondary intellectual disorders and memory impairment. This memory impairment is not related to dementia, since it is dynamic in nature, but it negatively affects the ability to work during the period of illness.

Symptoms of neurosis

Along with emotional disorders, the main manifestations of neurosis are various signs of vegetative and endocrine imbalance. In this case, psychotic disorders (for example, hallucinations, delusions) are absent, and the patient’s critical attitude towards his condition remains.

The picture of neurosis is determined not so much by the nature and severity of emotiogenic stress as by its meaning for the patient exposed to stress. The characteristics of his personality are essential. Since the personality of each person is formed under the influence of inherited characteristics, as well as upbringing, training, the influence of the environment and the somatic state of a person, it is practically unique. As a result, there are many clinical options neurosis, i.e. Each patient suffers from neurosis in his own way. However, from a practical point of view, it is advisable to distinguish the main clinical forms of neurosis, or neurotic syndromes.

Neurasthenia

Neurasthenia develops against the background of nervous exhaustion, more often in people with suspicious character traits. The condition manifests itself as a neurasthenic syndrome, the signs of which are usually observed in neurosis-like conditions. This syndrome is based on “irritable weakness” - increased emotional excitability and rapid onset of exhaustion. Characteristic signs this state:

• increased sensitivity, emotionality, temper;
• fixation on a stressful situation and, as a result, decreased attention, difficulty concentrating and assimilating current information, complaints of memory impairment;
• decreased mood, sleep disturbances, appetite;
• tendency to senestopathies;
• neurocirculatory dystonia, the consequence of which can be, in particular, persistent;
• hormonal disorders, which are manifested primarily by decreased libido, sexual potency, frigidity, and sometimes menstrual irregularities.

The clinical picture of neurasthenia is quite diverse. It is customary to distinguish hypersthenic and hyposthenic forms of neurasthenia.

The hypersthenic form is characterized by:

• lack of restraint, impatience, irritability, inattention;
• muscle tension and the inability of voluntary muscle relaxation;
• a persistent feeling of decreased productivity soon after starting mental work.

The hyposthenic form of neurasthenia is characterized by apathy, persistent fatigue and general weakness after slight mental and especially physical exertion, fatigue, exhaustion after applying minimal effort. Often the manifestations of these forms of neurasthenia are combined or transformed into each other during the course of the disease. With variants of neurasthenia, dizziness and headache are possible. Neurosthenic disorders are usually included in the picture of other forms of neuroses, as well as neurosis-like conditions, but with neurasthenia they are the leading signs of the disease.

All forms of neurosis, in particular neurasthenia, are characterized by constant vegetative-vascular lability, but sometimes against this background vegetative paroxysms develop, with a predominance of sympathetic-adrenal or parasympathetic manifestations. In ICD-10 they are known as panic disorder- attacks of intense anxiety that suddenly occur without a clear connection with specific situations, sometimes strong fear, reaching a maximum in minutes. During an attack, pronounced autonomic reactions are typical: tachycardia, hyperhidrosis, tremor, dry mouth, shortness of breath, feeling of suffocation, discomfort, sometimes pain in chest, nausea, feeling of gastrointestinal discomfort, dizziness, in in rare cases derealization and depersonalization. The attacks are repeated with different frequencies. The duration of the attack usually does not exceed 20-40 minutes. As a rule, between attacks, patients are worried about the unpredictable possibility of their recurrence.

Obsessive-compulsive disorder

Since the patient strives to repeat certain actions, associating them with preventing trouble or good luck, over time these actions become obsessive. The patient gradually develops increasingly complex rituals. At the initial stage of formation, rituals have the character of so-called direct protection. It is expressed in the desire to avoid traumatic situations, diverting attention from them and leads to a gradual complication of defensive actions, which sometimes acquire an illogical, ridiculous form of ritual action, qualified as a manifestation of “indirect defense.”

In addition to rituals, the main obsessive neuroses include:

• obsessive fears (phobias), characterized by irrational fear;
• obsessive thoughts (including “mental chewing gum”), ideas, doubts;
• intrusive memories;
• obsessive images (including ideas);
• obsessive drives (obsessions, manias);
• obsessive actions (compulsions).

Obsessive phenomena can be abstract (obsessive counting, recalling names, definitions, dates, and other “mental chewing gum”) and sensory (figurative) with an affective, often extremely painful, feeling of discomfort.

Manifestations of obsession make the patient indecisive, reduce the productivity of his thinking, and worsen the results of physical and mental work. They arise against the will of the patient, as if by force. A patient with obsessive neurosis usually treats them quite critically, but is not able to overcome them. Only during the culmination of fear does the patient sometimes completely lose his critical attitude towards it. If a patient with cardiophobia is overcome by a corresponding feeling of fear, he may experience sensations that, in his opinion, are characteristic of cardiac pathology. Fear is accompanied by pronounced general vegetative, sometimes violent emotional reactions (for example, the horror of impending death), accompanied by calls for help.

For obsessive neurosis, a gradual expansion of the range of situations causing anxiety is typical, which can acquire a generalized, sometimes unmotivated character and usually lead to hyperventilation and other autonomic disorders. The number of variants of obsessive mania, phobias and other similar phenomena amounts to many dozens. Manias and phobias, as a rule, are combined with feelings of anxiety, are independent of the will and may be accompanied by elements of depression.

Contrasting obsessive states are possible: a pronounced desire to commit some specific tactless or dangerous act and awareness of its uselessness and fear of the urge to do something that should not be done. Abstaining from such an act is usually accompanied by a pronounced feeling of discomfort, while committing this act leads to a feeling of comfort.

Obsessive neurotic phobias include:

1. agoraphobia - fear of spaces;
2. algophobia - fear of pain;
3. acriophobia - fear of misunderstanding what you hear or read;
4. acrophobia - fear of heights;
5. acousticophobia - fear of sharp sounds;
6. anthropophobia - fear of people;
7. autophobia, isolophobia, monophobia - fear of loneliness;
8. automysophobia - fear of stinking;
9. aerophobia - fear of drafts;
10. hamartophobia - fear of committing a sin;
11. haptophobia - fear of touch;
12. iophobia - fear of poisoning;
13. claustrophobia - fear of enclosed spaces;
14. copophobia - fear of overwork;
15. mesophobia - fear of pollution;
16. oxyophobia - fear of sharp things;
17. peiraphobia - fear of performing;
18. peniaphobia - fear of poverty;
19. scopophobia - fear of being funny;
20. thanatophobia - fear of death;
21. erythrophobia - fear of blushing, fear of the color red.

Also distinguished following forms phobias with neuroses.

Social phobias usually occur in adolescents and are centered around fear increased attention those around you. At the same time, there may be manifestations of anxiety, shame and confusion, as well as the fear that its manifestations will be recognized by others and become objects of ridicule. Such phobias, as a rule, are combined with low self-esteem and fear of criticism. In severe cases, patients often strive for social isolation.

Specific phobias- fears caused by a specific isolated triggering situation (fear of heights, darkness, thunderstorms, eating certain foods, sharp objects and HIV infection, cancerophobia). They usually appear in childhood or youth and do not show a tendency to random fluctuations in intensity.

Generalized anxiety - pronounced constant anxiety of a persistent, usually unmotivated nature. Complaints of constant nervousness dominate, increased sweating, trembling, palpitations, dizziness, abdominal discomfort. There is often a fear that he or his relatives will get sick, and there may be other premonitions of approaching trouble. These concerns are usually combined with motor restlessness, signs of depression and autonomic dysfunction, in particular cardiorespiratory disorders. A generalized anxiety state is typical for women and is associated with chronic emotional stress, revealed by a careful history taking.

Mixed anxiety-depressive disorder- combination chronic manifestations anxiety and depression without specific motivation. Their severity is often moderate. The neurological status of patients usually shows signs of autonomic lability.

The reaction to stress in neurosis, adaptation disorders develop with acute intense emotional or chronic psychosocial stress, i.e. significant shocks or important changes in life, leading to long-term negative manifestations, in particular fear, accompanied by a disorder of general and social adaptation. This is characterized by:

• dulling of feelings (emotional “anaesthesia”);
• a feeling of distance, detachment from other people;
• loss of interest in previous activities, dulling of adequate emotional reactions;
• changes in behavior, up to stupor;
• feelings of humiliation, guilt, shame, anger;
• attacks of anxiety, fear;
• transient decreases in attention and memory;
• possible amnesia of the experienced stressful situation, rudimentary illusions and hallucinations, impaired control of one’s own impulses;
• often a tendency towards alcohol abuse, drug use, and suicide.

The described neurotic syndrome develops in 50% of people who have experienced severe stress. Moreover, the severity of pathological manifestations is often disproportionate to the intensity of this stress, and they are often regarded as manifestations of reactive psychosis.

In addition, ICD-10 distinguishes organ neuroses (somatoform disorders) and hypochondriacal neurosis.

Somatoform disorders- repeated, often changing symptoms of somatic diseases of functional origin, which are usually present for several years. Most of the patients had previously been treated by non-psychiatric specialties, in particular by, went through a long journey and many different examinations, and sometimes underwent useless surgical interventions. Most often the patient's attention is focused on the possibility of illness digestive tract and skin; There may be complaints of menstrual irregularities and impotence, which are often accompanied by anxiety and depression. The patient's somatic complaints are usually combined with emotional instability.

Hypochondriacal disorders characterized by the fact that patients are burdened by somatic discomfort, experience fear, being confident that they have an as yet unidentified disfiguring or life-threatening disease. As a rule, they suggest a cardiovascular or gastroenterological disease. Patients are characterized by:

• limited empathic potential (inability to understand and empathize with the state of mind of another person);
• self-centeredness;
• verbosity at a doctor's appointment, a tendency to provide detailed descriptions, presenting numerous materials from previous consultations and examinations;
• frequent affective reactions of protest when trying to dissuade them in the presence of dangerous somatic diseases;
• a feeling of resentment at the lack of attention to them and the sympathy of others. Sometimes patients’ increased concern about their health becomes a defense against low self-esteem. Sometimes an imaginary somatic illness turns into a symbolic means of atonement for a felt sense of guilt and is regarded as a punishment for previously committed unseemly acts.

Hysterical neurosis

People with hysterical traits are prone to hysteria (demonstrativeness, thirst for recognition by others, tendency to make pseudological judgments). Various manifestations of hysterical neurosis include:

• emotional "storms";
• disorders various types functional sensitivity (such as hysterical blindness and deafness);
• motor disorders (functional paresis or paralysis, hyperkinesis, convulsive seizures);
• rapid mood changes;
• demonstrative behavior;
• increased suggestibility;
• often the absurdity of complaints and behavioral reactions;

development of painful manifestations according to the mechanism of “flight into illness”. The disturbances of movement and sensitivity demonstrated by patients correspond to their idea of ​​a realistically possible organic pathology. Others may perceive them as patients with focal neurological symptoms, but movement and sensitivity disorders contradict the anatomical and physiological principles, and when examining patients objective signs organic neurological pathology is not detected.

The manifestations of motor and sensory disorders depend on their emotional state, which is usually influenced by the presence of people, their composition and number. As with other manifestations of hysteria, it is characterized by psychogenic conditioning, the obligatory visibility of emerging symptoms, and demonstrativeness. Paralysis, convulsions, and sensory disturbances may be accompanied by pronounced emotional accompaniment or may be tolerated with “beautiful indifference.” Such disorders are more common in young women.

Since neurosis is always associated with a traumatic influence and its development is determined by the personal attitude to this stimulus, in the process of examining the patient it is necessary, by carefully analyzing complaints and anamnesis, to obtain maximum information about the characteristics of his personality and social status, his living and working conditions. At the same time, one should strive to identify and understand the nature of the acute and chronic psychotraumatic influences affecting the patient, adequately assessing the significance of these influences for him personally. As for the initial personality traits of the patient, the same personal characteristics predispose to the development of neurosis, a neurosis-like state. In the process of diagnosing neurosis, a complete somatic and neurological examination is indicated.

Differential diagnosis of neurosis

Dysfunction of the LRC can cause the development of neurosis, neurosis-like syndrome - a condition similar to neurosis in clinical manifestations. Like neurosis, neurosis-like syndrome is characterized by signs of disintegration of the emotional, autonomic, and endocrine systems. It can be caused by intoxication, head injury, infection, damage to tissues and organs. For somatic and infectious diseases neurosis-like syndrome can manifest itself not only in acute period illness, and during the period of convalescence, and in cases, for example, chronic hepatic or renal failure it usually takes on a protracted, often progressive course.

The main difference between neurosis and a neurosis-like state lies in the etiological factor, the cause of the disease. In neuroses, this cause is acute or chronic emotional stress, while the development of a neurosis-like state is usually provoked by other exogenous or endogenous factors. Therefore, a carefully collected anamnesis is important in differential diagnosis. In addition, the diagnosis of somatogenic neurosis-like conditions is aided by the results of a detailed and careful physical examination, including laboratory data and the results of imaging studies (for example, ultrasound, x-ray, computed tomography, magnetic resonance imaging).

Having established a diagnosis of “neurosis,” one should analyze the nature of the dominant clinical manifestations, which usually directly depend on the characteristics of the patient. As a result of such an analysis, it is possible to determine the form of neurosis of the patient being examined.

Treatment of neurosis

When starting treatment, it is necessary to consider the possibility of removing a patient with neurosis from a traumatic situation. Unfortunately, this is rarely possible. Much more often, the doctor has the opportunity to assist the patient in reconsidering his attitude to the traumatic factor.

Psychotherapy can be useful, in particular rational psychotherapy, which every doctor should master: based on evidence, in particular, on the results medical examination, as well as on the patient’s ability to think logically, the doctor can often reduce the relevance of the patient’s anxiety and fear of existing or imaginary circumstances.

If the patient does not accept logical evidence, then it is possible to use suggestion both during the patient’s normal waking state, and after the administration of psychotropic drugs (narcopsychotherapy) or against the background of hypnosis (hypnotherapy). Self-hypnosis also has a certain importance in the treatment and prevention of neuroses, in particular, autogenic training; this method of self-medication should be taught (if appropriate indications).

Effective physical methods treatments, primarily hydrotherapy and balneotherapy. It has been noted that drug therapy and physiotherapy are more effective if accompanied by therapeutic suggestion, i.e. instilling in the patient ideas about the appropriateness and effectiveness of drugs and medical procedures. The condition of patients with neuroses is favorably influenced by reflexology, herbal medicine and acupuncture; All these treatment methods must be accompanied by suggestions aimed at improving the patient's condition. People close to him can also contribute to the treatment of a patient with neurosis, creating a favorable psychological climate for him in the family.

Evaluation of treatment effectiveness

For neurotic disorders it is necessary long-term treatment; its effectiveness can be assessed no earlier than several weeks. Signs of treatment effectiveness include the disappearance of neurotic symptoms, improvement in mental, physical condition patient, reducing the severity of experiences associated with past or current psychotraumatic effects.

Complications and side effects of treatment

Excessively long-term use benzodiazepines and hypnotics are inappropriate, as they can lead to the development of tolerance and drug addiction. Side effects of highly active benzodiazepines (alprazolam, clonazepam) with panic attacks include their insufficient effectiveness with a high frequency of attacks, the possibility of excessive sedation and ideational inhibition, especially in the initial stages of drug therapy for neurosis.

Treatment with tri- and tetracyclic antidepressants may be accompanied by the development of severe side effects, including tachycardia, extrasystole, changes in blood pressure and dry mucous membranes.

Taking SSRIs occasionally (and in overdose) leads to the development of serotonin syndrome (tremor, akathisia, myoclonic manifestations, dysarthria, and in severe cases, confusion and cardiovascular disorders).

Errors and unreasonable assignments

For chronic somatoform disorders accompanied by pain, the use of benzodiazepines is ineffective; Trying to relieve pain with analgesics and novocaine blockades is also ineffective.

At hysterical neurosis drug therapy is not always effective; psychotherapy (psychoanalysis, hypnosuggestion) is necessary.

MAO inhibitors cannot be combined with antidepressants of other groups, since, by suppressing the metabolism of the latter, they can provoke psychomotor agitation, delirium, convulsions, tachycardia, fever, tremor and coma.

Prognosis for neurosis

In case of correct treatment tactics and resolution of the traumatic situation, the prognosis for neuroses is usually favorable. As a rule, a good prognosis for the development of a stress response is observed when it develops quickly clinical picture, initially good ability to adapt, expressed social support, as well as in the absence of concomitant mental and other serious illnesses in the patient.

With chronic exposure to a psychotraumatic factor that has great personal significance for the patient, and in the absence of adaptation to it, “neurotic personality development” is possible, i.e. the acquisition of persistent pathological characterological properties, for example, hysterical, hypochondriacal, litigious or affective.

If we draw parallels with forms of neurosis, then we can in simple words label them as a spoiled mood. All people are familiar with the various signs and symptoms of a bad mood. Someone screams, someone becomes depressed, someone is aggressive, etc. Neurosis can be called the totality of all manifestations of a bad mood, but which lasts for a very long time. for a long time. That is why specialized treatment for all its causes is required here.

Of course, talking about neurosis as bad mood is a simplified form of conveying the essence of a mental disorder. In fact, a person in a state of neurosis is simply not in balance with his psyche, emotions and sense of self.

What is neurosis?

What is, in the psychological understanding of this word, neurosis? These are functional and psychogenic reversible disorders that last a long time. Neurosis manifests itself in the form of asthenic, hysterical and obsessive states. Mental and physical performance is also noted. In other words, neurosis is referred to as a neurotic disorder or psychoneurosis.

The causes of this disorder are classified as psychological:

• Long-term stress.
• Emotional stress.
• Psychotraumatic situations.
• External or internal.
• Circumstances that cause emotional imbalance.
• Tension in the intellectual sphere.

I. P. Pavlov defined neurosis as a chronic, prolonged tension of the nervous system, provoked by inadequate and strong external stimuli that overstrain nervous processes.

Psychoanalysis views neurosis as a psychological hidden conflict in a person.

There is still debate about what neurosis is and what causes it. However, one thing remains obvious: the majority of people suffer from various forms of neurosis, which today are considered the norm, as long as they do not cause real harm to the person and others.

Forms of neurosis

What are the most common forms of neurosis today?

1. Neurasthenia, manifested in headaches, increased fatigue and vulnerability, lack of concentration. There are 3 stages of this form:

• The first is accompanied by irritability with preservation of mental and physical abilities and the absence of somatic symptoms.
• The second stage is marked by a decrease in performance, which is realized by the person.
• The third stage is expressed in lethargy, apathy, weakness, and asthenic syndrome.

1. Hysterical neurosis, which manifests itself in inappropriate behavior, unpredictability, nervousness and irritability. Symptoms such as hypotension, obsessive behavior, seizures, paralysis, hysterical arthralgia, paresis, body pain, vomiting, hyperkinesis, “lump” in the throat, etc. develop. During a hysterical attack, the patient screams, rolls on the floor, physically affects people , trying to hurt himself.
2. Depressive neurosis, which manifests itself in sleep disturbances, bad mood, painful sensations, loss of the ability to rejoice, irregular heartbeat, dizziness, increased sensitivity, tearfulness, gastrointestinal dysfunction, lethargy, sexual dysfunction, hypotension. A person complains of despondency, melancholy, a feeling of abandonment and uselessness, and an inferiority complex arises.
3. Obsessive-compulsive neurosis, when a person does not control his actions and thoughts that seem alien to him.
4. Hypochondriacal neurosis is a fear of a situation from which a person cannot escape, or of contracting a serious illness. The disorder can occur in the form of obsessive states or hysteria with corresponding symptoms.

Causes of neurosis

The causes of neurosis include psychological and physiological factors:

• Long-term mental overload or emotional distress: dissatisfaction with life, dismissal, workload, divorce, etc.
• Inability to solve personal problem situations, for example, the inability to repay a loan to the bank.
• The confusion that led to Negative consequences. For example, leaving a kettle on the stove to boil and leaving the house, which led to a fire. This often leads to the development of obsessive states.
• Diseases and intoxication that deplete the body. People who use tobacco or alcohol are also prone to neuroses.
• Pathology of the development of the central nervous system ( congenital asthenia), when a person is unable to endure prolonged physical and mental stress.
• Self-hypnosis and morbidity of the inner world, which leads to neuroses. Occurs in individuals with a hysterical personality type.

Symptoms of neurosis

All forms of neurotic disorder exhibit somatic and psychopathic symptoms. They differ in each case, which is how the form of neurosis can be determined.

Psychopathic symptoms of neurosis include:

• Chronic anxiety, fatigue, self-doubt, indecisiveness. A person does not strive for anything, because he is sure in advance that nothing will work out. Here an inferiority complex is formed due to one’s own appearance and lack of communication with others.
• A constant feeling of fatigue, which leads to a decrease in academic performance or performance, and sleep disturbance (insomnia or drowsiness occurs).
• Inadequate self-esteem – low or high.

Somatic symptoms of neurosis include:

1. Episodic heart pain that occurs during exercise or at rest.
2. Severe anxiety, sweating, symptoms of vegetative-vascular dystonia, tremor of the limbs, hypotension.
3. A decrease in blood pressure may occur, leading to loss of consciousness or fainting.
4. Psychalgia is pain in the body for no apparent reason.

Signs of neurosis

To determine the presence of neurosis, the following signs should be identified:

• Communication problems.
• Irritability.
• Tearfulness.
• Unreasonable emotional distress.
• Phobias, panic attacks and disorders.
• Constant experience of anxiety, fear, anxious anticipation.
• Inadequate self-esteem, which can be either overestimated or underestimated.
• High sensitivity to stressful situations in the form of aggression or despair.
• Indecisiveness.
• Attempts to work quickly result in fatigue, decreased thinking ability and attention.
• Unstable mood that changes abruptly and frequently.
• Touchiness, vulnerability, anxiety.
• Inconsistency of values, desires, positions, cynicism.
• Obsession with a situation that is traumatic.
• Pain in the head, stomach, heart.
• Increased sensitivity to bright light, loud sounds, and temperature changes.
• Fear of physical pain, excessive concern for one's health.
• : superficial, does not allow rest, anxious, drowsiness in the morning, nightmares, early awakening, inability to fall asleep, night awakenings.
• Constant fatigue, decreased performance.
• Dizziness, darkening of the eyes due to pressure changes.
• Loss of balance, vestibular disorders.
• Decreased libido and potency.
• Appetite disturbances: overeating, undereating, early satiety, feeling of hunger.
• Autonomic disorders: disturbance of the stomach, frequent urge to urinate, increased heart rate and sweating, blood pressure fluctuations, loose stools, cough.

Treatment of neurosis

Treatment of neurosis has two main directions: psychotherapeutic and pharmacological. Medication is prescribed in severe cases. Usually the emphasis is on psychotherapeutic work.

Psychotherapy is aimed at changing a person’s view of the world around him, solving his psychological problems, expanding the range of interests, as well as eliminating the causes that caused emotional imbalance. When a person learns to cope with his own problems, then neuroses go away.

A person may be drawn into a situation where his neurosis manifests itself. Then there is a discussion of his actions, finding other ways of behavior. The client is also encouraged to engage himself in a new hobby or relax more, to distract himself from problems.

If psychotherapy does not help, then medications are prescribed:

• Antidepressants.
• Neuroleptics.
• Tranquilizers.
• Psychostimulants.
• Nootropics.

The first 3 groups of drugs are aimed at a sedative effect. Only the last 2 groups have a stimulating effect. Which medications and in what dosage should be prescribed by a doctor, who takes into account the patient’s condition, as well as his individual body reactions to certain medications.

How to treat neurosis?

A person can resort to, as well as techniques such as treating neurosis - music therapy and auto-training.

If hypnosis requires the help of a specialist who will direct all his efforts to changing attitudes and beliefs that provoke neuroses, then a person can engage in music therapy and auto-training himself. A person’s desire to personally recover is a huge step towards their goal.

Music therapy suggests listening to melodies that have a positive effect. These include compositions that encourage a person or calm them down. It should be noted that this can be your favorite music and pop compositions. The most important thing is that they do not depress emotionally.

Auto-training involves setting a person up in a positive way. When a person sets himself up to be active, cheerful, etc., this has a greater impact than medications.

Prevention of neuroses

Treating neurosis is much more difficult and costly than preventing it. It is recommended to take care in advance not to fall into a neurotic disorder. This will help:

1. Normalization of work and rest.
2. Having hobbies that interest and captivate you.
3. Walking and moderate physical activity.
4. Communication with nice people.
5. Keeping a diary where the person’s condition is noted.
6. Sun walks and light therapy to prevent seasonal depression.
7. Resolving family conflicts.
8. Eliminate stress at work and at home.
9. Eating well, avoiding alcohol and coffee.
10. Changing your attitude towards a situation that is traumatic.
11. Adding brightness to the room.
12. Elimination of alcoholism, drug addiction, substance abuse.
13. Preventing relapses.
14. Taking vitamins.
15. Full sleep.

Bottom line

Neurosis is a common condition modern society. It appears in various forms, which depends on the structural features of the nervous system and human psyche. The result, in any case, depends only on whether the person takes action to heal himself or not.

Forecasts are only favorable if a person accepts and seeks help from specialists, if he himself cannot cope with his own condition. Events turn out completely differently if a person ignores all attempts to get rid of neurosis. In the latter case, there is only a deepening of the negative state, which often leads to isolation, loneliness, mental disorders and even suicide.