What symptoms can be used to identify neuroses and neurotic conditions? Neurotic disorders: causes, symptoms, treatment
– a large heterogeneous group of transient functional disorders caused by acute or chronic psychological trauma. Clinical symptoms are extremely diverse, with maladjustment, restrictive behavior, mood disorders, and neurotic symptoms(anxiety, asthenia, phobias, obsessions) and somatovegetative disorders. Self-awareness and criticism of one’s own condition are completely preserved. The diagnosis is made based on complaints, medical history and life history of the patient. Treatment – psychotherapy, drug therapy.
Another obligate sign of neuroses is asthenia. Patients do not tolerate stress well and quickly become exhausted. Neurotic disorders are accompanied by mood instability, irritability and decreased performance varying degrees expressiveness. The sexual side of the patients’ lives also suffers - sexual desire disappears or decreases, the duration of sexual intercourse decreases, sexual contacts do not bring the same satisfaction, various disorders arise (potency disorders, premature ejaculation).
In neurotic disorders, affective disorders are observed. The general background of mood decreases, patients feel sadness, melancholy and hopelessness. Habitual pleasures (delicious food, hobbies, communication with friends and family), which previously brought joy, become indifferent. The range of interests narrows, patients become less sociable and begin to avoid contact with other people. Depression or subdepression often develops. The level of anxiety increases. Patients see the future as unfavorable and unfavorable. They live in anticipation of an uncertain catastrophe and tend to overly concentrate on negative scenarios.
In contrast to the above manifestations of neurosis, obsessions and phobias do not occur in all patients. These two signs are closely related, but in the clinical picture, as a rule, one of the two symptoms predominates. Obsessions are involuntary, intrusive thoughts, urges, fears, or memories. To get rid of obsessions, patients perform compulsive actions, often taking the form of complex rituals.
Phobias are obsessive fears of objects or situations that currently do not pose a real danger to the patient. There are three types of phobias: simple phobias (isolated fears of spiders, flying, birds, clowns, etc.), agoraphobia (fear of open spaces, places that cannot be left unnoticed, and situations in which you can be left without help) and social phobia (fear of situations , in which the patient is the center of attention of others).
Diagnosis and treatment of neurotic disorders
The diagnosis of neuroses is complicated by the small number of objective symptoms that make it possible to unambiguously judge the presence or absence of a disorder. The patient's complaints and medical history are of primary importance in making a diagnosis. In addition, the doctor conducts psychological testing using special standardized questionnaires (BVNK-300 in Bakirova’s adaptation, Cattell’s 16-factor questionnaire, etc.). During the diagnostic process, organic pathology is excluded that could provoke the appearance of psychological and somatovegetative disorders. If necessary, the patient is referred for consultation to drug support. Depending on the symptoms, tranquilizers, antidepressants and antipsychotics are used.
General restorative treatment is prescribed, which includes physical therapy, massage, taking vitamins and microelements. Great importance has a change in lifestyle: adherence to a work-rest regime, moderate physical activity, staying on fresh air, balanced diet, rejection of bad habits. Sometimes a change of activity is required. With timely initiation of treatment, the prognosis is favorable. Symptoms disappear, patients return to normal life, but relapses are possible under severe stress. With late treatment and non-compliance with doctor’s recommendations, there is a tendency for a protracted course.
Brief historical background. More than 200 years ago in 1776-1784. Representative of the Edinburgh Medical School, Scottish physician W. Cullen, first introduced the term “neurosis” into medicine, including in this concept all mental illnesses, regardless of their genesis. Intensive study of this group of diseases began a century later, at the end of the 19th century. Significant contributions to the development of the problem were made by G. Beard (1868,1880), P. Janet (1903) and others, who substantiated the psychogenic origin of this painful disorder. G. Beard, linking neurasthenia with the rapid development of civilization, as well as with the fact that the nervous system is unable to withstand the ever-increasing demands imposed by the intense pace of life of contemporary society. Thus, he emphasized, first of all, the importance of the exogenous factor in the etiology of neuroses.
In Russian psychiatry, major studies by S.N. are devoted to this problem. Davidenkova, E.P. Popova, O.V. Kerbikova, A.M. Svyadoscha, B.D. Karvasarsky and others. It is impossible not to note the contribution of the staff of the Department of Psychiatry of the Military Medical Academy in the modern understanding of the causes, clinical manifestations and treatment of psychogenic disorders, primarily because they studied these painful disorders in combat and other extreme situations. The priority works in this area are the works of V.M. Bekhtereva, V.P. Osipova, F.I. Ivanova, V.I. Barabasha, V.I. Kurpatova, E.V. Snedkova and others.
Prevalence. The study and identification of psychogenic disorders is one of the most pressing problems modern medicine. According to B.D. Petrakova (1989), for the period from 1900 to 1983. in 15 economically developed countries of the world, the average annual prevalence of neuroses increased 40.6 times. The prevalence of neuroses among the population of countries such as Germany, Finland, and Spain ranges from 100 to 300 per 1000 population. Within the totality of mental illnesses, neuroses, according to various authors, range from 15 to 30%.
Neurotic state(neurosis - from the Greek neuron - nerve, osis - suffix denoting disease) - a psychogenically caused disease that occurs under the influence of traumatic factors, as a result of a violation of particularly significant personality relationships, manifested in the form of general neurotic clinical phenomena, insomnia, headaches, various vegetative -visceral symptoms of a functional nature in the absence of psychotic phenomena.
Neurosis is characterized by Firstly, reversibility of pathological disorders; Secondly, the psychogenic nature of the disease, which is determined by the existence of a connection between the clinical picture of neurosis, the characteristics of the system of personality relationships and the pathogenic conflict situation; Thirdly, the specificity of clinical manifestations, consisting in the dominance of emotional-affective and somato-vegetative disorders. Neurosis differs from psychosis, including psychogenic (reactive) nature, by the absence of psychotic symptoms: perception disorders, delusions, disturbances of consciousness, etc. In Russian psychiatry, three main neuroses are traditionally distinguished: neurasthenia, hysterical neurosis, neurosis obsessive states.
As a rule, when studying neuroses in military personnel, complex syndromic structures are revealed. The so-called “undifferentiated” mixed forms of neurosis predominate. In connection with this predominance of undifferentiated forms, the term “ neurotic state” indicating its severity and main clinical syndromes.
Etiology and pathogenesis. The emergence of neuroses has a multifactorial etiology; biological, psychological and social mechanisms interact dialectically in their formation. The works of domestic scientists V.N. Myasishcheva, G.K. Ushakova, A.M. Svyadoscha, N.D. Lakosina, B.D. Karvasarsky and others overcame the mechanical “linear” understanding of the etiology of neuroses, and carried out extensive socio-psychological and genetic studies of them.
The main reason for the development of psychogenic disorders is the effect of traumatic experiences ( defining factor). At the same time, the damaging effect of mental trauma is determined by its informational and personal significance. The higher the significance of the stimulus for the individual, the greater its intensity, the development is more likely painful disorders. The pathogenicity of an experience largely depends on the duration of its impact. However, the presence of a traumatic experience is not always sufficient for the occurrence of a psychogenically caused disease. Typically required predisposing conditions for this: individual characterological characteristics, asthenization, prolonged emotional stress, somatic diseases, organic inferiority of the nervous system due to previously suffered traumatic brain injuries, neuroinfections, etc. TO launcher factors that are like “the last straw that overflows the cup” include additional stress, situational conflicts and other pathogenic influences.
The combination of these pathogenic factors (determining, predisposing and triggering) leads to the emergence of a painful condition, manifested in mental and somatovegetative disorders. In most cases, despite the adverse effects of these pathogenic factors, the body of a practically healthy person is able to compensate for the effect of harmful stimuli for a long time. However, as adaptive capabilities are exhausted, pre-morbid changes, on the basis of which developed painful disorders are formed.
The pre-morbid (pre-neurotic) state reduces the body’s resistance and depletes the adaptive and compensatory capabilities of the individual. Against this background of neuropsychic ill-being, in the case of persistence of traumatic experiences or exposure to additional harms, which in such situations play the role of triggering factors, neurotic or psychosomatic painful conditions are easily formed. The emergence of neurosis is often caused not by a direct and immediate reaction of the individual to an unfavorable situation, but by a more or less prolonged processing by the individual of the current situation, its consequences and the inability to adapt to new conditions. The concept of “predisposition to neurosis” consists of factors of heredity, characteristics of personality formation and asthenizing factors that precede the onset of neurosis. Some personality traits can be inherited, such as isolation, timidity, anxiety, pedantry, etc.; these same traits can arise under the influence of constant contacts with parents who have pronounced personality traits. The presence of character accentuations in conditions of psychotraumatization can become fertile ground for the emergence of neuroses. Not only the features of the clinical picture of neurosis, but also selective sensitivity to a certain kind of psychogenic factors - “the place of least resistance” - depend on the type of accentuation.
Exist three main types of neurotic conflicts - neurasthenic, hysterical, obsessive-psychasthenic. The first of them ( neurasthenic) represents a contradiction between the capabilities of an individual, on the one hand, and her aspirations and inflated demands on herself, on the other. Second (hysterical) the type of conflict is determined, first of all, by excessively inflated claims of the individual, always combined with underestimation or complete ignorance of objective real conditions. It should be emphasized that he is distinguished by exceeding demands on others over demands on himself and the lack of a critical attitude towards his behavior. Conflict ( obsessive-psychasthenic) of the third type - is caused, first of all, by contradictory internal tendencies, expressed in the struggle between desire and duty, between moral principles and personal attachments. In this case, the personality fluctuates in the struggle of two opposing tendencies; even if one of them becomes dominant, but continues to encounter opposition from the other, opportunities are created for a sharp increase in emotional stress and the emergence of obsessive-compulsive neurosis. To summarize, the essence of the above conflicts could be formulated as follows: neurasthenic - “I don’t have enough strength, but I want to”; hysterical - “I don’t have the right, but I want”; obsessive-psychasthenic - “I can’t make up my mind, but I want to.” The above types of neurotic conflicts usually correspond to certain types of neuroses, namely: neurasthenia, obsessive-compulsive neurosis, hysteria.
Among neurotic conditions traditionally distinguished neurasthenia, hysterical and obsessive neurosis.
Neurasthenia. This neurosis is manifested by increased excitability and irritability, combined with rapid fatigue and exhaustion. The clinical picture of neurasthenia is very characteristic general neurotic disorders, insomnia and headache, as well as various vegetative-visceral symptoms.
Of the general neurotic disorders with neurasthenia, increased fatigue, some deterioration of the main mental functions, especially memory and attention, increased irritability and unstable mood. Emotional and affective disorders can acquire a depressive overtones and, as the disease develops, sometimes reach the level of neurotic depression syndrome.
The most typical for neurasthenia is asthenic syndrome. Observed increased excitability and at the same time weakness, exhaustion, as well as easy transitions from hypersthenia to hyposthenia, from excessive activity to apathy. Frequent manifestations of the clinical picture of neurasthenia include symptoms of a hypochondriacal nature, which manifest themselves in the form of asthenic-hypochondriacal and depressive-hypochondriacal syndromes. Of significant importance among the clinical manifestations of neurasthenia are sexual disorders, for men it is premature ejaculation and weakening of erection, as well as a slight decrease in libido. In women - decreased libido, incomplete feeling of orgasm, sometimes anorgasmia. Numerous disorders of visceral functions are characteristic - psychogenic disorders cardiac activity, gastrointestinal tract and respiration.
Almost obligate symptoms of neurasthenia should be considered autonomic disorders, manifested in the form of chilliness of the extremities, general and distal hyperhidrosis, pulse lability, often with a tendency to tachycardia. Frequent symptoms are a uniform increase tendon reflexes, trembling of the eyelids and fingers of outstretched arms, muscle pain, hyperesthesia of certain areas skin etc. More pronounced disturbances in the form of vegetative crises are also noted.
Clinical example. Private S., after prolonged increased workload, began to complain of headaches, insomnia, irritability, discomfort in the heart area, sweating, decreased performance, mood swings. During the examination by a psychiatrist, he looked tired, easily affected, and was fixated on his incompetence. In the conversation he talked about the difficulties of the service, he was quickly exhausted. After hospitalization in a specialized hospital and adequate treatment, the condition improved.
Hysterical neurosis(from Greek hystera - uterus). The diagnosis of hysteria is based on three main criteria: the clinical picture, personality characteristics and the uniqueness of the pathogenic conflict situation. The complex and varied symptoms of hysteria can be schematically reduced to several groups of painful manifestations, which include mental disorders, motor, sensory and autonomic-visceral disorders.
Mental disorders such as psychogenic amnesia, twilight states, hysterical hallucinations, pseudodementia, puerilism, etc., with hysteria have recently become less common, at the same time they are typical for situations of acute mental stress associated with danger to life (combat ). Emotional and affective disorders, phobias, asthenia and hypochondriacal manifestations have now acquired greater practical importance. Hysterical symptoms of an emotional-affective nature most often appear in the form of decreased mood and fears. General Features These violations, as a rule, are of small depth, demonstrativeness, deliberateness of experiences and their completely definite situational conditioning.
Sick hysterical neurosis They are distinguished by increased sensitivity and impressionability, suggestibility and self-hypnosis, and mood instability. They tend to attract the attention of others, which is a manifestation of one of the main tendencies of the hysterical personality - the demand for recognition.
Motor disorders in hysteria include convulsive seizures, paralysis and paresis, astasia-abasia, hyperkinesis, contractures, blepharospasm, aphonia and mutism. Sensory and sensitivity disorders include hysterical blindness, deafness, loss of smell, taste and sensory disturbances in the form of hypoesthesia, hyperesthesia and paresthesia. Autonomic-somatic manifestations include disorders of the heart, breathing, gastrointestinal tract, autonomic and sexual disorders.
Clinical example. Private Zh. Against the backdrop of a long-standing conflict situation in the unit, I received news of a breakup with my beloved girl. After receiving the letter, I could not speak, communicated with gestures, and cried. On examination: tries to attract the attention of others, gesticulates animatedly, reveals pronounced facial reactions. He is not burdened by his defect and treats treatment formally. After the therapeutic measures, speech function was restored, mental disorders were leveled out.
Obsessive-compulsive disorder. Dominant in the clinical picture of neurosis are various obsessive states: obsessive fears (phobias), obsessive thoughts, ideas, memories, doubts (obsessions), obsessive movements and actions (impulses, rituals). Obsessive-phobic manifestations occur in various combinations, arise involuntarily in the minds of patients, and are characterized by awareness of their painfulness and a critical attitude towards them. The most represented group of obsessive fears is: cardiophobia, thanatophobia (fear of death), claustrophobia (fear of closed spaces), etc.
In addition, the clinical picture of obsessive-compulsive neurosis always includes general neurotic symptoms: increased irritability, fatigue, difficulty concentrating, sleep disturbances, etc. These symptoms can reach a significant degree of intensity and appear in obsessive-compulsive neurosis as a concomitant asthenic syndrome.
Patients with obsessive-compulsive disorder often show signs of increased excitability of the nervous system: revitalization of tendon reflexes, trembling of the fingers of outstretched arms, increased muscle excitability. In the presence of pronounced phobias, as a rule, vegetative and vegetative-vascular disorders are observed, the nature of which is generally determined by the content of the phobic syndrome: various functional cardiovascular disorders in patients with cardiophobia; gastrointestinal tract - in patients with cancerophobia; severe sweating of the hands - in patients with obsessive sweating of the hands, etc.
Clinical example. Sergeant R. was distinguished by pedantry, excessive accuracy, and anxiety. During preparations for the inspection of the property entrusted to him, he was worried about the state of affairs. I worked a lot and didn't sleep at night. Not long before the commission’s arrival, thoughts about a shortage appeared. I realized the foreignness and absurdity of my thoughts, double-checked my object, and got even more tired. He turned to the commander with a request to exclude him from inspection. On examination: anxious, fixated on thoughts of shortages. Proves to the doctor that “everything is in order” in his warehouse. Asks for treatment. After the treatment measures, the condition improved.
Dynamics of formation of neurotic states. In the overwhelming majority of cases, in peacetime conditions, neurotic states in military personnel develop gradually with a distinct change in development stages. Only in rare observations, when the mental trauma is prohibitively great (an accident with the death of people, the death of loved ones, a series of serious mental traumas), is it possible acute occurrence neurosis with passing initial stages. Clinical observations carried out from the standpoint of “course psychiatry” allow us to highlight stages and stages in the formation of neuroses in military personnel (according to V.I. Kurpatov):
· Preneurotic(pre-morbid) stage - a state of prolonged mental stress, leading to an inadequately changed system of personality relationships with exaggeration of individually significant psychological difficulties and scattered, short-term, mildly painful syndromic manifestations. Against this background (“soil”), if traumatic circumstances persist or when exposed to additional harmful factors (triggers of neurosis), a neurotic state is formed.
· Neurotic(painful) stage includes three main stages: short-term neurotic reactions, persistent neurotic symptoms and a protracted neurotic state.
· Final stage, including the transition of the disease either into neurotic personality development, or recovery with residual (residual) phenomena.
In typical cases, as the disease progresses, these stages replace each other, reflecting the severity of the condition. With a favorable course (timely and adequate treatment and preventive measures are taken), painful symptoms can be reduced at any of the listed stages, until recovery occurs.
Diagnosis and differential diagnosis. This problem can be successfully solved by using the actual clinical method and additional research data, among which, along with laboratory methods, psychological research plays a significant role. A convincing diagnosis of neuroses, distinguishing them from similar pathologies, and studying the dynamics of the disease should always include three main criteria: the severity and originality of clinical manifestations, the structure and characteristics of the patient’s personality, and the type of pathogenic conflict situation. It must be emphasized that when studying the anamnesis of patients with neuroses, it is not the statement of the nature of their main life situations (work, family, everyday life, etc.) that is important, but the patient’s degree of satisfaction with them.
For the purpose of diagnosing neuroses using clinical and laboratory research Diseases of the internal organs and nervous system of an organic nature must be excluded, or in the presence of psychogenicity, their role in the overall structure of the disease must be taken into account. In this case, great diagnostic difficulties arise, because It is often not possible to identify a clear connection between the clinical picture of neurosis and mental traumatization. Neuroses have to be differentiated from a wide range of diseases - with psychopathy, neurosis-like conditions of exogenous and endogenous origin.
Neurosis-like states in organic diseases of the central nervous system differ from neuroses in the presence in their psychopathological structure of memory impairment, decreased intelligence and characteristic emotional disturbances. Cyclothymic depression differs from neurosis in the greater depth of affective disorders, slowing of thinking, motor retardation, and a periodic type of course. Neurosis-like states observed at the very beginning of schizophrenia are distinguished by the fact that in these patients it is possible to identify pronounced emotional and volitional disorders in the form of a weakening of feelings for family and friends, i.e. emotional coldness, weakening interest in the environment, loss of initiative and decreased activity, as well as mental disturbances characteristic of schizophrenia.
Neurotic disorders related to stress, it is customary to identify it as a separate class of diseases in psychiatry. Such conditions in children and adults differ in that in most cases the patients are fully able to work. Consequently, adequate treatment is not provided, since such people rarely turn to specialists for help or do not turn to them at all. Sometimes the symptoms of diseases indicate completely different ailments, as a result of which treatment and prevention are carried out gastrointestinal diseases , arterial hypertension , and other ailments.
Therefore, it is important that at the first suspicion that a patient is developing a neurotic disorder, he seeks advice from a psychotherapist or psychiatrist.
There are several groups of neurotic conditions, which are characterized by certain manifestations and characteristic symptoms.
Phobias
The main feature phobias As neurotic disorders are a manifestation of strong fears and anxiety states. In some cases, the patient exhibits a constant state of anxiety, which is either vague or has a clear direction. A phobia is usually called a strong and at the same time unconscious feeling of fear in relation to an object or a certain situation. A person susceptible to a phobia is constantly in an anxious state and feels a threat or danger emanating from the phenomenon or object that frightens him.
A patient in this condition may experience a panicky feeling of fear, strong heartbeat, nausea,. Such signs are characteristic of all types of phobias that a person suffers from. If a patient with such a disease ends up in difficult situation, then he manifests himself, turning into panic. In order to prevent such manifestations, the patient tries to protect himself from contact with the object of fear and, accordingly, is to a certain extent isolated from society. As a result, he often has difficulties in his daily life.
At the same time, a person prone to phobias visits a doctor relatively rarely. Mostly, patients who come to specialists are afraid of serious illness or imminent death. Women are more likely to face irrational fears. At the same time, a person often clearly realizes that his fear has no rational explanation, and tries to cope with it.
Doctors today identify an extensive list of phobias, but they are usually divided into three large types. At social phobias a person exhibits a fear of society, as well as a variety of situations that happen every day in society. Experts today define social phobia as one that can seriously ruin a person’s quality of life.
At agoraphobia the patient suffers from manifestations irrational fear be trapped.
Another type of fear is specific phobias , in which the patient develops fear of certain objects and situations. Fear can be caused by bacteria, spiders, snakes, medicine, etc. There are a lot of such fears, and their number is constantly growing.
Treatment for phobias depends on individual characteristics the disease and the patient himself, in particular on his willpower and character. One of the methods used in the treatment of phobias is the use of exposure to the patient of the object of his fear. A certain situation is simulated, and the person is left alone with his fear. Thanks to this approach, the patient comes to the realization that this object does not cause him real harm.
The contrasting technique is also used in the therapy process, which consists of teaching a person relaxation methods that allow them to relax and cope with fear.
Specialists distinguish separately, in which the patient develops a sudden strong feeling of anxiety, which turns into panic. There are no objective reasons for this condition. At anxiety states signs are often observed depression .
Obsessions
Obsession syndrome It is customary to call a condition, the clinical picture of which is characterized by the presence of constant fears, thoughts, and feelings in a person that arise against his will. At the same time, the patient realizes that they are painful and treats them critically. But he is not able to overcome this condition on his own.
Experts divide the state of obsession into several groups. If the patient has sensual (figurative) obsessions , then he is bothered by obsessive doubts about the correctness of actions, memories of unpleasant events for a person, obsessive ideas of unpleasant situations, actions, fears, and a feeling of antipathy.
When the patient develops obsessive fears very often there are certain rituals that, in the opinion of the patient, protect him from fear. For example, to prevent misfortune, a person must invariably knock on wood ten times.
At obsessions of affectively neutral content The patient exhibits obsessive philosophizing, remembering words or terms, and counting.
States of obsession can be varied, and at the same time, all of them are characterized by an awareness of the incorrectness and uselessness of thoughts and actions, but at the same time they are irresistible.
Treatment of obsessive disorders is carried out with drug therapy. The patient is prescribed antidepressants and tranquilizers. In addition, the method of cognitive behavioral therapy is practiced, which consists of gradually teaching the patient the correct forms of behavior and thinking with the help of psychotherapeutic procedures. In especially severe cases, the two methods are combined.
Conditions caused by severe stress
This group includes any neurotic condition that causes a very strong impact. Such a stressful situation can be the death of a loved one, an attack by an intruder, a sudden loss of property, etc. This condition can occur in both adults and children. It manifests itself as acute symptoms, in which the patient experiences inadequacy, severe excitability, and confusion. Such signs occur immediately after exposure to stress. If delayed manifestations develop, which occur some time after difficult events, then the person may experience an astheno-neurotic, anxiety-neurotic state, sleep disorders, depression and other manifestations. Treatment methods should be selected in such cases only by a specialist.
Dissociative disorders
Dissociative disorders
It is customary to call those disorders in which a person partially or completely loses the relationship between memories of the past, awareness of his own “I” and current sensations, control over body movements.
At its core, dissociation is a certain psychological defense. A person who behaves this way when severe stress, can describe his behavior with the words “it seemed like it wasn’t me doing all this.” In some cases this can be defined as normal psychological mechanism. But sometimes a person loses control for a long time, is poorly aware of surrounding events, and does not remember many things. In this case we are talking about illness.
Most often, dissociative disorders are sudden, so it is difficult to determine them from the outside. Very often the patient denies problems, even if they seem obvious to others.
Depending on the type of dissociative disorder, its symptoms may manifest differently. If a person has it, he may lose memory due to recent serious stressful situations. If hypnosis is used in treatment, the patient remembers all the lost moments. As a rule, the patient is in a calm state, although sometimes he may experience a certain degree of absent-mindedness. Sometimes a person behaves as if he is a tramp. For example, for several days he may not wash at all. Dissociative amnesia, as a rule, is recorded in people of working age. Often this disorder is observed in men who participated in military operations.
At dissociative fugue The same symptoms are observed as with dissociative amnesia. However, a person may completely lose memory of events that occurred before the illness. The patient may then go on a trip to some place associated with his emotions, or completely unexpected. Outwardly, the person looks relatively normal: he behaves adequately in society and follows the rules of hygiene. However, sometimes the patient may consider himself a completely different person. A person completely forgets the fugue period.
Able dissociative stupor the patient's reactions to external stimuli, as well as voluntary movements, practically disappear. He can sit silently in one position for a very long time, while speech completely or partially disappears. Sometimes a person's consciousness is impaired, but he is not asleep or unconscious.
Able trance and obsession the patient loses awareness of the surrounding world and his own “I” for some time. In some cases, another person may control his actions. In this state, a person can focus attention only on a certain aspect, while he will often repeat a certain set of phrases and movements.
At dissociative disorders of sensation and movement the patient cannot move at all, or his movements are difficult. The sensitivity of the skin is lost. Sometimes the symptoms that appear indicate the patient’s idea of a certain disease.
Diagnosis of this condition is carried out based on the presence of the described symptoms and the absence of physical or neurological disorders with which they could be associated. Dissociative disorders are associated with stress and insoluble problems. In the process of treating the disorder, the main method is psychotherapy. Techniques that are mainly used include hypnosis. As a rule, such disorders arise and go away suddenly, but relapses occur very often.
Somatoform disorders
are called somatic symptoms that doctors cannot explain as organic diseases. However, they are not a consequence of other mental illnesses.
There are three groups of such disorders: somatization disorders , autonomic somatoform dysfunction , hypochondriacal disorders . However, all these groups of disorders can manifest themselves in different combinations, so they are mainly used general definition- somatoform disorders
The main manifestation of such disorders is the regular presence of complaints about one’s own health. Moreover, such complaints appear even if examinations and the absence of symptoms indicate normal health.
Experts closely associate somatoform disorders with conditions anxiety , depression , hysteria , hypochondria . One of distinctive features Such diseases are precisely numerous complaints about the work of certain groups of organs and an urgent requirement for their treatment. The patient does not even want to talk about the psychological reasons for such complaints: he is clearly sure that he is sick with a somatic illness.
Treatment of such disorders is carried out comprehensively, with a combination of psychotherapeutic methods and medications. Psychotherapy methods are selected individually, taking into account the person’s condition. Pharmacotherapy involves prescribing a course of treatment with tranquilizers, tricyclic antidepressants, selective inhibitors serotonin reuptake, antipsychotics in various combinations. Patients are also recommended to take nootropic drugs and physiotherapy. Treatment lasts about a month and a half, since if it is abruptly discontinued, a relapse is inevitable.
State of depersonalization
State of depersonalization (derealization ) is manifested by a disorder of self-perception: a person perceives himself and his own actions as if from the outside, he gets the impression that he cannot control them. At certain moments in life, every person can be in this state. Depersonalization manifests itself as a consequence of a serious stressful situation and goes away after the consequences of such stress become less acute.
But sometimes these symptoms do not disappear. A person in such a state seems to feel outside his body and becomes fixated on this state, which, in turn, causes him anxiety. As a result, the patient develops a certain stereotype of thinking. This condition is typical for people who suffer. A person cannot explain his condition, but it is painful for him.
In the treatment of this condition, the use of psychopharmacological therapy is practiced. Psychotropic drugs are selected strictly individually. Tranquilizers, antidepressants, and antipsychotics are used. Methods of rational psychotherapy, hypnosis, and auto-training are practiced.
State neurasthenia
also called a state of irritable weakness, nervous exhaustion. The disorder belongs to the group. With the development of such a disorder, a person becomes hot-tempered, tearful, and crying appears immediately after an attack of anger. In addition to mood swings, this condition is characterized by disturbances in appetite, sleep, and irritability. The patient's performance decreases and memory is impaired.
In a state of neurasthenia, the patient simultaneously experiences nervous excitability and severe fatigue. Often a person complains of attacks, a feeling of lack of air, stabbing pain in the area of the heart. Sometimes it seems to him that the heart is beating very slowly, but at the same time the cardiogram does not show pathological changes. A person feels bad in transport - he feels sick and motion sick. Headaches and dizziness may occur in the morning. Characteristic of the state of neurasthenia and manifestations of various phobias, panic attacks, causeless fear upon sudden awakening or in the process of falling asleep.
It is customary to distinguish three stages of neurasthenia. On first stage a person is characterized by increased irritability and excitability. People, as a rule, do not want to consider this condition a disease.
On second stage illness, in addition to irritability, the patient notes constant severe fatigue. Third, hyposthenic stage Neurasthenia is manifested, among other things, by depression.
Doctors identify many reasons for the manifestation of this disease. In general, the modern lifestyle of people often contributes to the development of neurasthenia. It can develop as a consequence of chronic sleep deficiency, too much work, or lack of normal rest. In addition, factors provoking the development of astheno-neurotic syndrome are smoking, alcohol, chronic infections, poor nutrition, heredity, traumatic brain injury, birth and intrauterine hypoxia, endocrine disorders.
Neurasthenia cannot be cured without consulting a specialist. But in addition to undergoing the course of treatment prescribed by a neurologist, a person needs to completely change their lifestyle, taking care of normal rest and the absence of constant stress. It is important to look for sources of positive emotions, so yoga, meditation, and art therapy are often practiced during the treatment process. It is equally important to ensure daily normal physical activity, give up coffee, alcohol, cigarettes, and energy drinks. Each person should take into account that if the symptoms described above continue for two weeks or more, then they should definitely consult a doctor without delaying it.
), which are based on the pathological development of personality. Clinical picture This pathology is very diverse and is characterized by mental and physical ( bodily) symptoms.
Statistics on neuroses are very diverse and contradictory. The incidence of this disease depends on the socio-economic and cultural level of development of the country. Thus, 40 percent are registered in the UK, 30 in Italy, 25 in Spain. These numbers change every year. According to the World Health Organization, over the past 70 years the number of patients with neuroses has increased 25 times. At the same time, the number of mental illnesses has doubled. However, these statistics only include those who applied for medical care. According to unofficial data, this figure is much higher. Experts in the field say that since the beginning of the twentieth century, the number of neuroses has increased 30-fold. This increase in numbers is also explained by more frequent requests for help. One way or another, neurosis remains the most common mental illness.
Among the adult population, middle-aged individuals are most susceptible to neuroses. As for children, their neuroses predominate at a young age and in older preschool years. According to the American Psychiatric Association, the incidence of neuroses in men ranges from 5 to 80 cases per 1000 population, while in women it ranges from 4 to 160.
As a rule, neuroses are found in the structure of any disease. In the structure of borderline pathologies, neuroses occur in more than 50 percent. As an independent disease, neuroses are less common.
Interesting Facts
The term neurosis was coined by the Scottish physician William Cullen in the twentieth century. From that time to the present day, the term has undergone various interpretations and has not yet received an unambiguous interpretation.
And today the concept of neurosis by different authors various contents are included. Some believe that neurosis is the result of chronic overstrain of nervous activity. Most experts generally believe that neurosis is a psychogenic pathology based on interpersonal contradiction. Neurosis reflects problems in human relationships, primarily problems of communication and the search for one’s “I.” This so-called psychoanalytic theory of neurosis was presented by Freud. He believed that neuroses are the result of contradictions between instinctual desires and the laws of morality and ethics.
According to international classification diseases synonymous with neurosis is the term “neurotic disorders”, which covers a wide range of diseases, such as obsessive-compulsive disorder, conversion disorder ( the old name of which is hysteria) and neurasthenia.
Causes of neurosis
The cause of neuroses is the action of a psychotraumatic factor or a psychotraumatic situation. In the first case we are talking about a short-term but strong negative impact on a person, for example, the death of a loved one. In the second case, we talk about the long-term, chronic impact of a negative factor, for example, a family conflict situation. Speaking about the causes of neurosis, it is psychotraumatic situations and, above all, family conflicts that are of great importance.However, both factors and situations will cause painful and painful experiences. The inability to find a productive way out of a conflict situation leads to mental and physiological disorganization of the individual, which is manifested by mental and physical symptoms.
Psychotraumatic factors and situations are:
- family and household factors and situations;
- interpersonal conflicts;
- intrapersonal ( interpersonal) conflicts;
- derived factors;
- death of loved ones;
Family factors and situations
According to various studies, seminal problems are the main source of neuroses. In women, these problems are the source of neurotic disorders in 95 percent of cases, in men - in 35 percent. Also, an unhealthy family climate is a leading factor in the development of neuroses in children.Family and household factors are:
- separation, divorce or betrayal;
- pathological jealousy;
- constant conflicts, quarrels and unhealthy relationships in the family ( for example, leadership of one family member and suppression of another);
- one-sided disharmonious upbringing of a child;
- excessive severity or self-indulgence;
- symbiotic relationship with one of the parents;
- excessive ambitions of parents.
Interpersonal conflicts
Interpersonal conflicts affect as an aspect family life, and non-family. Conflicts can be between distant and close relatives, between subordinates and superiors, between parents and children. These conflicts in both men and women lead to the development of neurosis in 32–35 percent of cases.Interpersonal conflict is the most common type of conflict. In it, the needs of one person conflict with the needs of another.
Many experts argue that neurosis is an integral part of life, because it characterizes real life and helps solve problems. It is the inability to resolve conflict or resist it that gives rise to neurotic disorder. If the conflict is not resolved, but is repeated again and again, it disorganizes mental activity, causing constant tension. Thus, conflict either increases stress resistance and strengthens a person, or has a destructive effect on the individual.
Intrapersonal ( interpersonal) conflicts
With intrapersonal conflict, one’s own desires, emotions and needs come into conflict. This is the most common reason ( 45 percent) development of neuroses in men. Freud and other psychoanalysts believed that this type of conflict was the main cause of neuroses. Thus, the conflict between “It” ( unconscious part of the psyche) and “super-ego” ( moral attitudes of a person) gives rise to the emotional distress that underlies neurosis.Maslow's concept of intrapersonal conflict is also very popular. According to this concept, the need for self-realization is the pinnacle of human needs. However, not all people realize this need. Therefore, a gap arises between the need for self-actualization and the real result, which is the cause of neurosis.
One type of conflict is the conflict between the individual and the environment. To protect yourself from the adverse effects of society, a person develops defense mechanisms.
Derived factors
Various unfavorable factors and situations at work are also a source of the development of neurosis. The extent to which a person is attached to work and how much time he spends on it is directly proportional to the significance of this problem. That is why the predominance of this factor in the structure of the causes of neurosis was identified in men. It also occurs in women and ranges from 20 to 30 percent, but they have a significant predominance of intra-family problems.Production factors include an unfavorable work environment, lack of career growth, and low wages.
Death of loved ones
The loss of a loved one is the most powerful psychotraumatic factor. However, this factor in itself cannot lead to a neurotic state. It is only a trigger, under the influence of which previously dormant problems become aggravated.The mechanism of neurosis
The main mechanism for the development of neurosis is a disorder of brain activity, which normally ensures human adaptation. As a result, both somatic and mental disorders arise. According to studies, patients with neurosis sometimes experience changes in the bioelectrical activity of the brain, which is recorded using an electroencephalogram. These changes may be in the form of slow waves or paroxysmal discharges.
Since the nervous and humoral mechanisms are closely related to each other, any change in the psyche is accompanied by a deviation in the functioning of the internal organs. Thus, tension and anger will be accompanied by an increase in adrenaline, which, in turn, will cause those bodily symptoms that are characteristic of neuroses. Together with adrenaline, the secretion of adrenocorticotropic hormone from the pituitary gland and insulin from the pancreas increases. This, in turn, activates the adrenal cortex, and further enhances the release of catecholamines. The release of these hormones is the main cause of panic attacks in neurotic disorders.
However, all the changes that are observed during neurosis are only temporary and functional in nature. No stable changes in the metabolism of a person with this pathology have been identified, which gives reason to lean more toward psychoanalytic theories.
Freud's psychoanalytic theory of neurosis
According to this theory, in early childhood, every person develops drives. These attractions are of a sexual nature - sexual attraction to family members, autoerotic attraction. To a small child they do not seem taboo, while they go against social norms of behavior. During upbringing, the child learns about their prohibitions and weans them. The thought of these drives becomes unacceptable and is repressed into the “unconscious”. What has been squeezed into the unconscious is called a “complex.” If in the future these complexes intensify, then neurosis develops. The repressed complex can move on to some kind of bodily symptom, and then a “conversion” develops. Hence the name conversion disorder ( hysteria).As a method of treatment, Freud proposed a method of psychoanalysis based on the restoration of these complexes in memory.
Not all followers of Freudianism adhered to this mechanism of the emergence of neuroses. Freud's student Adler believed that the source of neurosis was the conflict between the desire to rule and one's own inferiority.
Horney's theory
Horney, a representative of neo-Freudianism, paid great attention to the influence of environment. In her opinion, neurosis arises as a defense against negative social factors ( humiliation, isolation, aggressive behavior of parents towards the child). In this case, methods of protection are formed in childhood.The types of main methods of protection according to Horney are:
- “movement towards people” - the need for submission, love, protection;
- “against people” - the need for triumph over people, for success, for glory.
- “from people” - the need for independence, for freedom.
Symptoms of neurosis
Conventionally, there are three forms of neurosis, each of which is characterized by its own symptoms. The forms of neurosis are:
- neurasthenia;
- conversion disorder;
- obsessive-compulsive disorder.
Neurasthenia
Neurasthenia or nervous weakness is the most common form of neurosis. The main manifestation of this neurosis is increased excitability and easy exhaustion.Mental symptoms of neurasthenia are:
- increased excitability;
- fatigue;
- hot temper;
- irritability;
- rapid change of emotions ( sadness and joy);
- anxiety;
- cognitive disorders in the form of decreased memory and attention.
Physical symptoms of neurasthenia are:
- heartbeat;
- increased sweating;
- hand trembling;
- headache;
As the nervous system becomes exhausted, the ability to adapt and exercise is reduced. Patients begin to get tired quickly and complain of constant physical and mental weakness. A decrease in adaptive abilities leads to increased irritability. Irritability occurs in response to light, slight noise, and the slightest obstacle.
Increased excitability and fatigue also affect emotions ( joy quickly gives way to sadness), appetite ( rapid appearance and satisfaction of hunger), dream ( constant drowsiness and quick awakening). Under the influence of even minor stimuli, patients wake up. However, even if they sleep, their dreams are restless and, as a rule, accompanied by violent dreams. As a result of this, neurasthenics almost always wake up in a bad mood, without sleep, and with a feeling of weakness. By the middle of the day, their emotional background may improve slightly, they are even capable of certain types of activities. However, by the evening their mood decreases and headaches appear.
Symptoms of neurasthenia can be very variable, but during the course of various studies the most common of them were identified.
Common symptoms of neurasthenia are:
- 95 percent – asthenia or weakness;
- 80 percent – emotional instability;
- 65 percent – increased irritability;
- 60 percent – sleep disorders;
- 50 percent – headaches;
- 48 percent – other bodily symptoms such as palpitations, shortness of breath, sweating.
Neurasthenia is characterized by low electrical activity of the brain and irregularity of the alpha rhythm, which is recorded on the EEG ( electroencephalogram).
The neurasthenic complex can be observed in long-term infectious diseases, endocrine pathologies, tumors and brain injuries. However, in this case, neurasthenia has its own specific features.
Conversion disorder
Of all forms of neurosis, conversion disorder or hysteria has extremely diverse symptoms. Patients ( As a rule, these are women, but there are also men) with hysteria are highly suggestible ( self-hypnosis), and therefore their symptoms can change and vary from day to day.Common symptoms of conversion disorder include:
- seizures;
- motor activity disorders;
- sensitivity disorders;
- autonomic disorders;
- disorders of the senses and speech.
In hysteria, the seizures are very varied and are often similar to epileptic ones. The difference between seizures during hysteria is that they always unfold in the presence of people ( "spectators"). The attack may begin with hysterical crying or laughter, and sometimes patients begin to tear out their hair. The crying or laughter that is observed is always violent.
Next begins the phase of convulsions, which can also be very diverse. Patients tremble, squirm, and make large sweeping movements ( clown phase). Seizures in conversion disorder are protracted and can last for hours. Also, the difference between hysterical seizures and seizures of other etiologies is that when falling, patients never injure themselves. They fall carefully, sometimes bending in the form of an arc ( hysterical arc).
At the same time, during a seizure, a number of autonomic disorders are observed ( redness or paleness, increased blood pressure), which may mislead the doctor.
Movement disorders
With hysteria, paresis, paralysis, and contractures can be observed. In this case, there is a decrease or complete absence of movements in the limbs. Tone during hysterical paresis and paralysis is preserved. Also very often there is a condition such as astasia-abasia, in which the patient can neither sit down nor stand up.
Hysterical contractures often affect the neck muscles ( hysterical torticollis) or limbs. Hysterical paralysis and paresis are selective in nature and in certain situations they can disappear and appear. If a neurological examination is performed, it does not reveal any abnormalities. Tendon and skin reflexes do not change, muscle tone remains normal. Sometimes, when a doctor examines a patient, he deliberately shudders, but at the same time he shudders with his whole body.
Sensitivity disorders
Sensory disturbances in conversion disorder are manifested in anesthesia ( decreased sensitivity), hyperesthesia ( increased sensitivity), and hysterical pain. The difference between sensitivity disorders in hysteria is that it does not correspond to the areas of innervation.
Hysterical pains have a very unusual localization. They can be localized in a certain area of the head ( where there may have once been an injury), in the nails, in the stomach. Sometimes the patient has pain in the place where there was a previous injury or which was previously operated on. Moreover, injuries may date back to early childhood and may not be recognized by the patient.
Patients with hysteria may react differently to painkillers. Sometimes even the administration of narcotic drugs does not “ease” the patient’s condition.
Autonomic disorders
Autonomic disorders observed during hysteria include changes in the color of the patient’s skin ( paleness or redness), fluctuations in blood pressure, vomiting. Hysterical vomiting occurs once and, like all symptoms of hysteria, is observed in the presence of spectators.
From the outside respiratory system Forced inhalations and exhalations, increased breathing, like a “hound dog,” and shortness of breath may be observed. Sometimes patients can imitate attacks of bronchial asthma or hiccups. Hysterical constipation, diarrhea, and hysterical urinary retention may also occur.
Sensory and speech disorders
With hysterical visual disorders, a narrowing of the visual fields or hysterical blindness is often observed ( hysterical amaurosis). In parallel with visual impairment, color vision disturbances are noted. Hysterical amaurosis can occur in one eye or in both. At the same time, patients claim that they do not see anything, while an ophthalmological examination does not reveal any abnormalities. This is confirmed by the fact that patients with hysterical blindness never find themselves in dangerous situations.
Hysterical deafness is very often observed with hysterical muteness ( mutism). If you ask a patient: “Can you hear me?”, he will shake his head negatively, as if he does not hear ( which, at the same time, will prove that the question was heard by the patient). Hysterical muteness is very often combined with a sensation of a lump or hedgehog in the throat. Patients hold their necks, indicating that something is bothering them there. The difference between hysterical muteness and real muteness is that the cough in patients remains loud.
Obsessive-compulsive disorder
Obsessive-compulsive disorder is also called obsessive-compulsive disorder (obsessive-compulsive disorder). obsessive) states. This form of neurosis is the most difficult to cure. At the same time, images, thoughts and feelings arise in a person’s mind that he cannot get rid of. These images arise forcibly, that is, against his will. There are also obsessive fears ( phobias) and actions ( compulsions).Obsessive thoughts and ideas
This could be a melody, individual phrases or some images. Often they are in the nature of memories and bring a certain atmosphere. They can also acquire a tactile character and be expressed in certain sensations. Obsessive thoughts are expressed as obsessive fears and doubts. These may be doubts about the correctness of the work performed or its completion. Thus, thoughts about whether the gas is turned off or not can force a person to check the stove dozens of times. Even after performing the ritual ( for example, check the switches on the stove seven times) after a certain time, painful doubt about what was done returns to the patient.
With intrusive memories, patients constantly try to remember something - works, first and last names, geographical names. With obsessive philosophizing, people constantly think about some things that “supposedly could happen.” For example, they think about what will happen if a person grows a tail or wings, if there is weightlessness on Earth, and so on. This type of obsessive thoughts is also called “mental chewing gum.” These thoughts constantly swirl in the patient’s head, forcing him to think. In addition to obsessive philosophies, obsessive comparisons may arise. The patient is overcome by doubts about which is better - summer or winter, a pencil or a pen, a book or a table, etc.
Obsessive fears ( phobias)
Obsessive fears are those fears that involuntarily arise in people’s minds and, as a rule, subsequently lead to their social maladjustment. The most common phobias are associated with the fear of dying, contracting some kind of disease, as well as the fear of open and enclosed spaces.
The following obsessive fears are clearly defined:
- fear of heart disease – cardiophobia;
- fear of getting cancer - cancerophobia;
- fear of developing a mental illness – lissophobia;
- fear of enclosed spaces – claustrophobia;
- fear of open spaces – agoraphobia;
- fear of germs – mysophobia.
Obsessive actions (compulsions)
Obsessive actions or compulsions most often have the nature of a ritual. For example, a patient must wash his hands 7 times or touch an object 3 times before eating. In this way, patients try to overcome their obsessive thoughts and fears. After completing these actions, they experience some relief.
Obsessive actions also occur in other diseases, such as schizophrenia. However, in this case they are extremely absurd.
Sexual dysfunction in neuroses
With neuroses observed different kinds sexual dysfunction.Types of sexual dysfunction in neurosis are:
- alibidemia – decreased libido;
- erectile disfunction– lack of erection;
- dyserection syndrome – loss of erection during sexual intercourse;
- disinhibition of sexual desire ( frequent erections);
- anorgasmia – lack of orgasm;
- psychogenic vaginismus is an involuntary contraction of the pelvic and vaginal muscles.
In 40 percent of women with neuroses, anorgasmia is observed. Psychogenic vaginismus, which occurs due to fear of sexual intercourse, is observed in one in ten women.
Treatment of neurosis
How can you help a person in a state of neurosis?
A person experiencing neurosis needs help from loved ones. The patient needs support both during exacerbation of the disease and during remission.First aid for an attack of neurosis
One of the most effective methods helping a patient during neurosis is verbal support. To alleviate suffering, a number of rules should be followed when talking with a sick person.
- You should not try to start a conversation first. It is necessary to be close to the sick person and let him know that he is not alone. The desire to speak out may arise spontaneously in a patient with neurosis, and it is important not to miss this moment. Don’t ask cliched questions or say phrases like “Do you want to talk about this?” or “Trust me.” Sometimes help involves turning off the light, bringing a glass of water, or attending to other needs of the patient.
- If the patient allows, you should stroke his arms and back. This will help establish closer contact with the person.
- If neurotic ( person with a neurotic disorder) began to talk about his experiences, it is necessary to give him words of encouragement. You should try to make the patient talk more about his internal sensations, feelings and emotions that bother him.
- Regardless of what the patient says, it is worth letting him know that his experiences are normal. Encouraging a neurotic person to not be ashamed of his tears and sincere emotions is the main task that his loved ones should set for themselves.
- You should not clarify details or ask leading questions. But if a person with neurosis begins to talk about what worries him, you should listen to him carefully and show your participation in the conversation. A good way of support is a personal story in which a relative of the patient can talk about similar moments he experienced. You should avoid standard phrases like “I understand how hard it is for you now” or “the same thing happened to me.” All suffering and experiences are individual, and even the closest people cannot be aware of what a neurotic person is experiencing. The best option would be the phrase: “It’s not easy for you now, but I’ll be there and help you get through it.”
Relieving muscle tension during neurosis
During stress, various muscle groups tense, which provokes discomfort and increases the level of anxiety. Being close to the patient, a loved one can offer him help in carrying out exercises that will promote relaxation.
Muscle relaxation techniques include:
- normalization of breathing;
- massage;
- exercise to calm down;
- water procedures.
In stressful situations, the patient involuntarily begins to hold exhalation, which increases the amount of oxygen in the blood. The result of such actions is an increased feeling of anxiety and a deterioration in physical well-being. To alleviate the condition of a neurotic person, during an attack you should help him normalize respiratory process.
Ways to regulate breathing are:
- cross breathing;
- belly breathing;
- breathing into a paper bag.
Cross breathing
The stages of the cross-breathing procedure are:
- close your right nostril with your fingers and take a deep breath with your left;
- close your left nostril with your fingers and exhale air with your right;
- repeat the exercise 3 times;
- Next, you should close your left nostril and draw in air with your right;
- close your right nostril and exhale with your left;
- repeat the exercise 3 times.
To carry out this exercise, a person with a neurotic disorder should be asked to fold his arms so that one hand is on top and the other is on the bottom of the abdomen. Next, at counts 1,2,3, the patient needs to draw in air and inflate his stomach. On the count of 4.5 you need to hold your breath, and then exhale on the count of 6,7,8,9,10. The exhalation should be long and more extended than the inhalation. The person next to the neurotic person should recite the count out loud, making sure that the patient inhales through the nose and exhales through the mouth.
Breathing into a paper bag
Breathing with a paper bag will help reduce the amount of oxygen that enters the lungs and increase the amount of carbon dioxide. This will allow the patient to normalize the respiratory process and return to normal. To start breathing, you need to put the bag to your face and press it tightly with your hands so that air does not enter inside. After this, you should ask the patient to start inhaling and exhaling into the bag until breathing returns to normal. An alternative to a paper bag can be cupped palms placed over the neurotic’s mouth and nose.
Massage for neurosis
Massaging specific muscle groups helps relieve physical and emotional stress. The muscles of the neck, shoulders, and head are the most vulnerable to stress. It is in these areas that patients feel tightness at the time of anxiety most strongly.
Before starting the massage, you should ask the patient to wash his face with cold water and take a comfortable position in a chair or armchair. A person helping a neurotic person should begin the massage with the shoulders and neck. To do this, you can use gentle tapping and kneading movements. After the tension in your shoulders and neck has subsided, you need to start massaging your temples with light circular movements. All actions during the massage should be coordinated with the patient’s sensations. If he experiences discomfort, the session should be stopped. After the temporal zone, you need to proceed to the points that are located on the inner corners of the eyebrows. You need to massage with the tip of the index or middle finger of your right hand. In this case, it is necessary to support the patient’s head from behind with your left hand. When performing a massage, it should be taken into account that the duration of pressure on one point should not exceed 45 seconds. After the eyes, you should proceed to the scalp. You need to massage in a circular motion, moving from the hair growth area to the crown, then to the neck and back.
Muscle relaxation
One of the effective methods to get rid of muscle tightness during stress is progressive muscle relaxation. This method includes two stages - tension and subsequent relaxation of various muscle groups. The help of a loved one consists of sequentially indicating the parts of the body that need to be tensed and relaxed. The assistant can also turn on relaxing music, dim the lights, or fulfill the patient’s request, which will help him better concentrate on performing the exercises.
The parts of the body that need to be consistently tensed and relaxed are:
- right foot ( if the patient is left-handed, he should start with the left foot);
- left foot;
- right shin;
- left shin;
- right thigh;
- left thigh;
- thighs, buttocks;
- rib cage;
- back;
- right hand, including brush;
- left arm with hand;
- shoulders;
- facial muscles.
Water procedures
Water has a relaxing effect on the nervous system. You can increase the effectiveness of water procedures using essential oils of those plants that have a sedative or tonic effect.
Types of water procedures for neurosis are:
- inhalation;
- wraps;
- baths.
To carry out this procedure, pour half a liter of hot water into a deep bowl made of glass, ceramic or steel and add 10 drops of essential oil. Cover the patient's head with a terry towel and ask him to inhale the steam for 5 to 7 minutes. After completing the procedure, the face of a person with neurosis should be wiped dry. After inhalation, you should lie down and refrain from going outside for an hour.
Wraps
This procedure has a gentle effect on the body and is widely practiced for neuroses. In a container with warm water In an amount of 2 liters, add 10 drops of essential oil. Soak a sheet made of natural fibers in the liquid, wring it out and wrap it around the patient’s body. The duration of stay in the sheet is no more than 15 – 20 minutes.
Baths
A bath with essential oil will help relieve muscle pain. Also, such procedures have a calming and relaxing effect on the nervous system. In order for the essential oil to be better distributed in the water, you should mix it with table or sea salt, honey, and cream. The duration of the first bath should not exceed 10 minutes. Subsequently, the session can be increased to 15 minutes. The water temperature should be selected according to the patient's condition. At 30 degrees the bath has a tonic and invigorating effect, at 37 degrees it has a calming effect. To prevent the bath from causing a worsening of the condition, these procedures should not be performed after meals or at a body temperature above 37 degrees. Contraindications for baths with essential oils are skin lesions, epilepsy, diabetes, and cancer.
Essential oils for neurosis
Before carrying out any procedures using essential oils, you should conduct a test to identify the patient’s allergy to this product. To do this, apply a drop of oil to the crook of your elbow. Signs of intolerance to essential oils are shortness of breath, increased heart rate, redness of the skin, and headache.
Essential oils that can be used for water procedures for neurosis are :
- anise oil – eliminates tearfulness, fights stress and reduces nervous system excitement;
- orange oil – promotes healthy sleep, improves mood;
- basil oil – normalizes the overall tone of the body;
- clove oil – eliminates headaches, helps restore strength after physical and mental fatigue;
- jasmine oil – promotes sound and healthy sleep;
- lavender oil – fights depression, reduces nervous system excitement;
- Rose oil – increases performance and causes a feeling of vigor.
A patient with a neurotic disorder tends to focus his attention on internal sensations, which aggravates his condition. A close environment can help the patient switch attention to other factors, which will make the fight against neurosis more effective.
Factors that can distract the patient during an attack are:
- Concentration of attention on surrounding objects– The patient should be asked to take a verbal inventory of everything in the room. It is necessary to ask the patient to describe in detail the furniture, accessories, textiles, and toys. You can remember the stories associated with the purchase or use of each item.
- Carrying out daily duties– if the patient’s physical condition allows, you should try to involve him in cleaning, washing dishes or preparing food.
- Hobby– Doing what you love will allow you to take your mind off internal tension.
- Music– calm music will help you relax and take your mind off negative thoughts. Listening to music can be combined with doing household chores or other activities.
- Check– Recounting the days remaining until a vacation or other event will allow you to take your mind off stress. The patient can also be asked to draw up an estimate for the planned repairs and other topics of interest to him that require concentration and a rational approach.
- Games– board, logic and other types of games will help a neurotic person reduce their anxiety level.
The participation of family members and loved ones in the prevention of neurotic disorders will help prevent relapses ( repeated exacerbations) of this disease.
Actions that relatives of a neurotic person can take for preventive purposes are:
- a joint visit to a psychotherapist;
- reception control medicines;
- assistance in changing lifestyle.
In most cases, neuroses arise against the background of a large number of factors, which only a doctor can understand. The specialist will determine the causes of the disease and prescribe treatment. The difficulty is that many people are resistant and do not want to see a therapist. Close people should act without pressure, gently explaining to the patient that they are worried about his health. An impressive argument in favor of visiting a doctor will be the fact that the specialist works anonymously. If this is possible, relatives of the neurotic person can arrange the first meeting with the doctor on neutral territory or in a place where the patient will not feel constrained.
Taking medications
If a doctor prescribes medications, relatives should ensure that the medications are available at home and monitor their use by the patient. When prescribing serious psychotropic drugs, loved ones should study contraindications and side effects to prevent trouble.
Lifestyle for neurotic disorders
An unhealthy lifestyle is a factor that aggravates neurosis. Therefore, the patient’s environment should help him change his habits and lifestyle.
The rules of life with neurosis are:
- Balanced diet– the patient’s menu should include a sufficient amount of carbohydrates, proteins and fats so that the body is provided with energy. The condition of a neurotic person can be aggravated by alcoholic drinks, tobacco products, and caffeine. Also, you should not abuse fatty, salty, spicy and fried foods.
- Physical activity– People suffering from neurosis benefit from physical activity. The effectiveness of classes increases if they are carried out in the fresh air. This could be roller skating, jogging or walking in the park, or cycling. The presence of a loved one nearby is an effective motivation to systematically play sports.
- Timely and healthy rest– sleep has a great influence on the restoration of the nervous system, preventing overstrain and emotional breakdowns. The benefits of a good night's sleep cannot be offset by other means. Therefore, family members of a neurotic person should assist in normalizing his sleep. Ways to help ensure an effective night's rest include a relaxing bath before bed, a regularly ventilated bedroom, and no caffeine or tobacco products at least 6 hours before bedtime.
- Having a hobby– doing something you love helps you take your mind off problems at work or others unpleasant factors. The close environment may interest the patient by inviting him to do some things together ( embroidery, fishing, cooking) or visiting a gym, dance studio, or weapons range.
- Limiting the influence of external negative factors – in a family where a person with neurosis lives, watching horror films and listening to heavy music should be minimized.
Patients with neurosis often feel lonely and abandoned. Such people rarely seek help because they experience self-doubt and confusion. Neurotics often get offended over trifles and make scandals for no reason. Being around such people can be very difficult. Relatives must understand that their relative is going through a difficult period and needs support and care. At critical moments, those around the neurotic should stock up on endurance and patience. There is no need to provoke conflicts and focus attention on the mistakes made by the neurotic.
Psychotherapy for neurosis
Psychotherapy is the main method of treating neuroses, in which the patient is influenced not by medications, but by information. With this method of treatment, the main effect is on the patient’s psyche.There are many methods of psychotherapy, which differ in the number of participants in it ( group and individual), by task ( search and corrective) and so on. For various forms of neurosis, the psychotherapist chooses the technique that, in his opinion, is most effective in this case.
The most commonly used methods of psychotherapy for neuroses are:
- group therapy;
- art therapy;
- autogenic training;
- psychodrama;
- psychoanalysis.
With this type of therapy, classes take place in groups of 6–8 people, which are held 1–2 times a week. During the sessions, the features of various situations and conflicts that patients tell are analyzed, and ways to overcome neurosis are considered. Each participant talks about how he copes with the disease. The main focus is on the fact that neurosis is a completely curable disease.
One of the options for group therapy is intrafamily therapy, in which the conversation is carried out among members of the entire family. The effectiveness of family psychotherapy is very high, since it establishes the source of mental trauma. Knowing the traumatic factor, it becomes easier to improve the climate in the family. It is not only the therapist who influences, but also all members of the discussion.
Art therapy
Treatment with various methods of art ( visual, theatrical, musical) in order to reduce voltage. This achievement in art therapy is called sublimation. This means that the energy of internal tension, which the patient relieves from himself, is redirected to achieving certain goals in art. At the same time, the abilities of self-expression and self-knowledge develop.
Autogenic training
This is a method of self-hypnosis in which relaxation is initially achieved, and then suggestions are made on various functions of the body.
Sessions are carried out lying or sitting, the arm muscles relax. Then follows a series of exercises aimed at reducing tension. For example, the patient lies down on the couch and repeats the phrase “The body is heavy” a certain number of times, then “I am completely calm.” When the patient is completely relaxed, self-hypnosis rhythms such as “calmness,” “heaviness,” and “warmth” are set. In order to master this technique, the patient sometimes needs several months. The advantage of this method is that it can be done at home using an audio recording.
Using this method, you can learn to control not only your mental processes, but also physiological ones ( for example, breathing). This therapy is very effective for neurasthenia.
Psychodrama
This method uses dramatic improvisation to explore the patient's inner world in more detail. Psychodrama is used both in group therapy and in individual therapy ( monodrama).
The session initially begins with a warm-up, to achieve which various games and exercises are performed. Then there is a choice of a participant who will work on his problem in a psychodramatic action. This participant can choose a partner from the group to play out his situation. The drama lasts 30 minutes – 2 hours. In psychodrama, both real actions and actions from the past can be played out.
Psychoanalysis
There are more than 20 concepts of modern psychoanalysis. Classical psychoanalysis is based on the verbalization of thoughts through various associations, narration of dreams and fantasies. At this time, the psychotherapist is trying to analyze the unconscious conflicts that are the cause of neurosis. Thus, an analysis of complexes, desires and experiences repressed into the unconscious takes place.
The stages of psychoanalysis are:
- Stage 1 – accumulation of material by interpreting dreams and making associations;
- Stage 2 – interpretation, by interpreting conflict situations;
- Stage 3 – resistance analysis;
- Stage 4 – development and restructuring of the psyche.
Freud's symbols are:
- ring road - hopelessness of the situation;
- wall is an obstacle;
- snake, canes, skyscrapers ( straight, hard objects) – phallic symbols ( penis symbols);
- hats, caves are symbols of female genital organs;
- ladder - career path.
Drug treatment of neurosis
Drug treatment is only an auxiliary remedy for neuroses. With the help of psychotropic drugs, tension, tremors, and insomnia are eliminated. Their appointment is permissible only for a short period of time.For neuroses, the following groups of drugs are usually used:
- tranquilizers – alprazolam, phenazepam.
- antidepressants – fluoxetine, sertraline.
- sleeping pills – zopiclone, zolpidem.
Medicines used for neuroses
| Drug name | Mechanism of action | How to use |
| Alprazolam | Eliminates anxious mood, provides sedative effect and also relieves muscle tension. | 0.25 mg three times a day; the dose can then be increased to 0.5 mg three times a day. Maximum dose 3 mg. |
| Phenazepam | Has a sedative-hypnotic effect. It also reduces emotional stress and relaxes muscles. | For the treatment of neurotic disorders, the dose is 1 mg per day ( two tablets of 0.5 mg). After a week it is increased to 2–4 mg. |
| Diazepam (trade names – Relanium, Sibazon) | Eliminates fear, anxiety and tension. Has a mild hypnotic effect. | The initial dose is one to two tablets ( 5 – 10 mg). The effective therapeutic dose is 10–20 mg, divided into 3–4 doses. |
| Fluoxetine (trade names: Prozac, Magrilan) | Has an antidepressant effect. Effective for obsessive disorders. | Used in the first half of the day during meals. The initial dose is 20 mg. In extreme cases, the dose can be increased to 60–80 mg per day. In this case, the dose is divided into 2 doses. |
| Sertraline (trade name – Zoloft, Stimuloton) | Blocks the reuptake of mediators, thereby increasing their concentration in the nervous tissue. Used for anxiety and obsessive-compulsive disorders. | Treatment begins with 50 mg per day. The tablet is used once a day, in the morning. If there is no result, the dose is increased to 200 mg. |
| Zopiclone (trade name – somnol, relaxon) | Used for insomnia, which manifests itself as difficulty falling asleep and frequent awakenings. | One tablet each ( 7.5 mg) half an hour before bedtime. People over 65 years old take half a tablet ( 3.75 mg). The course of treatment is 4 weeks. |
| Zolpidem | It is used for chronic and transient disorders, with difficulty falling asleep. | Immediately before going to bed, take one tablet ( 10 mg). People over 65 years old take half a tablet ( 5 mg). |
| Zaleplon (trade name – andante) | It has both a hypnotic and sedative effect. It is used for insomnia, which manifests itself as difficulty falling asleep. | 15 minutes before bedtime, two hours after eating, one tablet ( 10 mg). Duration of treatment is 2 weeks. |
Prevention of recurrences of neurosis
Prevention of neuroses includes a set of measures to create favorable living and working conditions, normalize sleep and eliminate factors that can provoke emotional stress. Proper nutrition and maintenance therapy, including self-hypnosis and relaxation classes, will help prevent neurotic disorder. Measures that will help prevent neurosis are:
- balanced diet enriched with vitamins;
- eliminating factors that can provoke the disease;
- developing a tolerant attitude towards stress.
Nutrition for neuroses
The diet of a person prone to neuroses should include foods rich in vitamins and microelements that will provide sufficient energy to fight the disease. It is necessary to follow a number of rules regarding the schedule, quantity and manner of eating. You should also avoid a number of foods that can trigger anxiety.Substances that products should contain in a healthy diet are:
- carbohydrates;
- proteins;
- fats;
- vitamins.
Carbohydrates are substances that provide the body with energy, so carbohydrate foods should make up half of the food consumed per day. Such products contain a large number of fiber and water, which provides a feeling of fullness and helps avoid overeating. Foods rich in carbohydrates have a beneficial effect on the gastrointestinal tract and help avoid a wide range of diseases of the digestive system.
High carbohydrate foods are:
- legumes ( peas, beans, lentils);
- vegetables ( broccoli, Brussels sprouts, potatoes, corn, bell peppers);
- fruits ( apricot, banana, pear, plum, melon);
- nuts ( peanuts, almonds, cashews);
- bran ( wheat, oat);
- pasta from durum wheat;
- bread ( rye, grain).
Protein foods for the prevention of neurosis
Protein is a source of amino acids that support the body's immune system. Protein products should be about 20 percent of the daily food intake.
High protein foods include:
- eggs;
- cottage cheese, cheese;
- liver;
- meat ( chicken, beef);
- fish ( tuna, sardine, salmon, mackerel);
- soy products ( milk, cheese).
A lack of fat in food leads to a person’s reduced resistance to various diseases and disruption of the nervous system. Therefore, for preventive purposes, a person with neurosis should include in their diet foods containing fats of both animal and plant origin. According to the mechanism of action and composition, fats are divided into beneficial and harmful.
Harmful fats and products containing them include:
- saturated fats– fatty meats, dairy products, rendered fat, lard, egg yolk, butter;
- transported ( artificial) fats – confectionery, meat and fish frozen semi-finished products, spread, margarine, chips;
- cholesterol– margarine, egg yolk, canned fish and meat, liver.
For products that contain healthy fats, relate:
- salmon and other types of fatty fish;
- oil ( olive, nut, sesame, corn, rapeseed);
- nuts ( cashews, almonds);
- seeds ( flax, sunflower, pumpkin, sesame).
When under stress, the body produces large quantities of free radicals ( particles that have harmful effects on the nervous system). Vitamins actively fight free radicals and contribute to the development of resistance to adverse internal and external factors.
Foods that cause nervous tension
There are a number of foods, excessive consumption of which can provoke the development or return of neurosis. In addition, some foods and drinks reduce the absorption of vitamins and other nutrients.
Products that should be avoided when preventing neurotic disorders are:
- Alcohol– alcoholic drinks stimulate the production of adrenaline, which causes insomnia, irritability and tension.
- Caffeine– coffee, cola, strong tea disrupt the natural process of rest and wakefulness, which causes exhaustion of the nervous system.
- Sugar– an excess of this product in the body can provoke anxiety and depression.
- Fatty food- A study was conducted at Ohio State University that proved the fact that stress reduces metabolic rate. Eating high-calorie foods can cause excess weight, which will cause stress to return.
- White bread and other flour products– such foods are poor in vitamins, and the body spends a large amount of energy to absorb them.
- Flavor enhancers, food additives, dyes, preservatives, spices– have a stimulating effect on the nervous system.
Meals should correspond to human biological rhythms. The most active interval is between 10 and 14 hours, so at this time the feeling of hunger is most intense. For the proper functioning of all body systems during this period, it is recommended to take several meals.
Breakfast should not contain meat and coarse fiber, since such products can cause drowsiness, laziness, and a feeling of heaviness in the stomach. Also, in the early and late hours it is necessary to avoid fatty and heavy foods. Preference should be given to dairy and fermented milk products, fruits and vegetables. In order for foods to have time to digest, the pause between meals should be at least two hours. You need to have dinner 2-3 hours before going to bed. This will avoid the accumulation of toxins in the body and ensure sound and healthy sleep.
During neuroses, many people experience false feeling hunger, as a result of which they begin to overeat and acquire overweight. Excess weight can be a reason that slows down the healing process. You should not use strict diets or severely limit the amount of food you eat, as this can cause neurosis. People prone to this disease should divide the amount of food consumed per day into 4 to 6 meals. This will avoid overeating, and will also provide the required amount of nutrients and beneficial elements with minimal energy expenditure. An adult should eat about 2 kilograms of food per day.
The rules for distributing the daily allowance of products are:
- breakfast – 30 percent;
- second breakfast – 5 percent;
- lunch – 40 percent;
- afternoon snack – 5 percent;
- dinner – 20 percent.
Situations that provoke anxiety and working with them
In order to prevent neurosis, a person should, if possible, correct or eliminate the causes that contribute to the emergence of emotional imbalance.Factors that often cause nervous exhaustion include:
- life goals;
- Job;
- relationships with loved ones.
Life planning for many people is a factor that provokes dissatisfaction with oneself, which can serve as a prerequisite for the development of neurosis.
Situations in which feelings of dissatisfaction arise when setting goals are:
- the goal is set, but the person experiences a feeling of anxiety at the thought that he should begin to take action to achieve it;
- stress can arise in cases where a person makes efforts, but the goal remains unattainable;
- A common situation is when a goal is achieved, but this fact does not bring satisfaction to a person.
The rules for setting goals are:
- The implementation of the plan should not depend on the environment or circumstances. A properly set goal should be effortlessly formulated in one simple sentence without additional phrases.
- When defining a task, you need to focus not only on the end result, but also on the process of achieving it, which should bring pleasure.
- When setting goals, you should use specific language. So, the phrase “I want to earn more money” should be replaced with the expression “I want an increase in wages by 10 percent” or “I want to find a source of additional income in the amount of $100 per month.” This will allow a person to later more easily determine at what stage of goal realization he is.
- When setting goals, a person must know exactly why he needs their implementation. Otherwise, there is a high probability of disappointment in achieving this goal.
According to Japanese statistics, in 2006 there were 355 serious cases of nervous disorders (137 cases were fatal), the cause of which was overload in the workplace. In order to prevent neuroses, you should control the level of stress and take measures to reduce its effect on the body.
- timely identification of symptoms of excessive stress;
- maintaining a healthy lifestyle;
- correct definition priorities at work;
- getting rid of factors that slow down the work process.
The causes of overstrain may be factors such as fear of dismissal, a large amount of extracurricular work, pressure from management, and lack of interest in the duties performed. Ignoring the symptoms of work stress can lead to the development of neurosis.
Signs of burnout in the workplace include:
- poor concentration;
- sleep problems;
- disruptions in the digestive system;
- muscle tension and headaches;
- loss of sexual desire;
- excessive craving for alcohol.
Timely measures taken to combat work stress will help prevent neurotic disorder.
Self-care in the workplace
The rules that must be followed at work are:
- Physical activity– To reduce stress levels, you should spend 30 minutes doing aerobic exercise. If classes are difficult to fit into your work schedule, you need to divide the training into several short sessions.
- Meal schedule– hunger at work can cause irritability, and an excessive feeling of fullness provokes lethargy. Therefore, during the day it is necessary to eat small portions, doing this in a calm environment.
- Bad habits– Nicotine abuse in the workplace contributes to increased anxiety. You should also control the desire to reduce stress with alcohol, as this can cause alcohol addiction.
- Rest– lack of sleep makes a person vulnerable to stress. To maintain emotional calm, you need to sleep at least 7 to 8 hours a day.
Correct prioritization will help you maintain composure even in critical situations.
The rules for organizing the work process are:
- Balanced schedule– proper planning of work tasks will help avoid overwork.
- Arriving at work on time– being late represents an additional source of stress.
- Regular breaks– during the working day it is necessary to take breaks in order to restore strength. When completing a large project, you need to break it down into several small parts. This will allow you to control the process and save strength.
- Determining importance– when planning your workday, high-priority tasks should be put first. Also, those tasks whose implementation is difficult or unpleasant for the employee should be placed at the top of the list.
- Delegation of Responsibility– you should not try to do everything yourself and control every step of your work colleagues.
- Willingness to compromise– working in a team, it is necessary to take into account and agree with the opinions of other team members.
Very often the reason nervous tension at work are not external, but internal factors. Following certain rules and habits increase the level of stress, so in order to prevent neurosis, they should be abandoned.
Factors that make it difficult to manage stress at work include:
- Perfectionism– the belief that an imperfect result is not acceptable and the desire to achieve the impossible provoke a feeling of dissatisfaction with oneself.
- Mess– chaos in the workplace makes it difficult to concentrate, which causes tension.
- Negative thoughts– negative judgments are a source of stress. In addition, searching for and discussing the shortcomings of his work, a person wastes time, which prevents him from coping with his responsibilities and entails emotional problems.
The cause of disagreements in the family may be factors such as different perceptions of the world around them, conflicting interests, and lack of desire to compromise. To prevent neurosis, you should develop skills that will help resolve conflicts with loved ones with minimal negative consequences.
- The problem should be driven by the desire to correct the situation, and not to prove that one is right.
- Arguments and arguments should relate only to the conflict that has arisen. There is no need to remember past grievances.
- In some cases, a dispute may end before it even begins. To do this, you need to decide that the problem is not worth spending time and energy on.
- When discussing a conflict, you should try to accept the position of the opposite side and see the situation through the eyes of another person.
- You should respond to arguments calmly and respectfully. It is worth making it clear to the interlocutor that the purpose of the conversation is the desire to resolve the issue constructively.
- Punishing the culprit rarely helps compensate for the emotional losses. Sincere forgiveness of the offender will quickly bring a feeling of satisfaction.
- There are situations when you should take your opponent's side in a dispute, even if there are arguments against his opinion.
Developing resistance to stress
There are negative situations in a person’s life that cannot be prevented or avoided. In such cases, you should try to reduce the effects of stress on the body by calming down and changing your attitude towards what is happening.Ways to cope with stressful situations are:
- physical exercise;
- stress analysis;
- relaxation;
- looking at the situation from a different angle.
Plays an important role in the prevention of neurosis exercise stress. Muscle work eliminates stress hormones that maintain emotional tension. As a result of active physical activity, blood pressure is normalized and nervous excitement is reduced. Also, playing sports helps fight stress factors such as apathy, lethargy, and lack of interest.
Groups of physical exercises aimed at preventing neurotic disorders are:
- dynamic loads (squats, race walking, running, jumping, aerobic exercise) – contribute to increased excitability of the nervous system and are recommended for decreased general tone body;
- muscle relaxation, breathing exercises– reduce tension in case of excessive emotional excitability;
- exercises for neck and head muscles, deep breathing– normalize cerebral and peripheral blood circulation. Performed at the time of alarm in order to prevent the situation from worsening.
Stress is the body's reaction to current events. Analysis of stressful situations will help you learn to control and reduce their impact on a person.
One of the effective ways to analyze personal stress is a diary, which does not provide any difficulties, but requires time and patience. The principle of this method is to compile notes containing information about where and under what circumstances anxiety, worry and other symptoms of stress were identified. It is better to record observations in the evening after the end of the working day. Both external circumstances and internal sensations. After some time, you need to return to the notes. In most cases, such actions lead to the conclusion that the initial reaction was excessive and did not correspond to the level of the event that occurred. This allows you to control your stress level if similar circumstances arise.
Relaxation
Timely rest, physical and mental relaxation are an effective way to prevent neurosis. One of the effective ways to get rid of anxiety and normalize the emotional background is baths with the addition of medicinal plants. Such procedures will help reduce the negative impact of events that happened during the day, relieve fatigue and normalize sleep. In order for baths to bring maximum benefits, a number of rules should be followed.
- You should take baths before going to bed;
- the water temperature should be 36 - 37 degrees;
- Procedures should be carried out every other day for a duration of no more than 20 minutes;
- the water in the bath should not exceed the area of the heart;
- aromatic candles, dim lighting, meditation - all this will allow you to relax faster and enhance the effect of the bath.
Plants that have a sedative effect are:
- chamomile;
- lavender;
- Linden ( flowers);
- sage;
- valerian;
- spruce ( needles).
When stressed, a person loses the ability to think rationally and control the situation. Subjective perception of the events that occurred makes it difficult to cope with negative emotions and increases the duration of anxiety. In order to prevent neurosis, one should develop skills in objectively assessing the circumstances that provoke stress. One of the ways that allows you to look at a negative event from the outside and change your attitude towards it is the “photography” exercise.
The stages of performing the photography technique are:
- First, you need to quickly scroll through all the moments of the event in your thoughts.
- Next, you need to select a frame that most fully reflects the essence of the situation and present it in the form of a photograph.
- You should look closely at the image for a few seconds, paying attention to small details. If there are people in an imaginary photo, you need to look intently at their facial expressions and body postures.
- Then the photograph must be framed and hung on the wall. To do this, you should mentally select a photo frame ( choose material, shape, size) and find a place on the wall. After placing the image, you need to imagine that spotlights and other lighting elements are shining on the picture.
- The next step is to imagine that several years have passed. It is necessary to look at the photo through the eyes of a person for whom this event is far in the past.
- Returning to the present, you need to rethink the event and compare sensations. If the difference between the reactions is small, you should continue to work mentally with the picture. You can imagine how a children's artist, caricaturist or impressionist would depict this frame.
What can contribute to the occurrence of neurosis?
Both internal and external factors can contribute to the occurrence of a neurotic disorder.The reasons that contribute to the development of neurosis are:
- Job:
- improper planning of the working day;
- no breaks in work;
- the desire to always be on top and live up to your idols;
- unwillingness to share responsibility or lack of such opportunity;
- painful perception of criticism;
- moral dissatisfaction from the duties performed.
- Family:
- unresolved conflicts;
- feeling of resentment towards loved ones;
- lack of people with whom you can share your own experiences;
- desire to control all family members;
- inability to assess a situation through the eyes of another person;
- dependence on spouse spouses), parents;
- unrealized feeling of love, care;
- unwillingness to compromise.
- Habits and lifestyle:
- lack of a favorite activity or hobby;
- setting wrong life goals;
- lack of physical activity;
- prolonged lack of sleep;
- pessimistic outlook on life;
- inability to cope with negative emotions;
- inability to express and realize your true needs;
- smoking, alcoholism and other bad habits;
- overindulgence sweet, fatty foods;
- inability to look at a situation with humor.
- a group of unique disorders that psychiatry deals with, with predominant disturbances in the emotional and vegetative spheres, but with full responsibility and control over behavior, and not leaving behind any negative health consequences.
In other words, neurosis in no way destroys the body, but it invades the inner world, shackling with fears, debilitating fears, situations of which there is no trace, never was and never will be, but which for the patient himself are sometimes more significant, more real than the events of the surrounding world .
Tormented by guesswork in search of the cause, patients with neurosis are sent to the offices of various doctors, doing examination after examination, analysis after analysis, sparing no time and money. But every time they hear that no pathology was found, physical health is in order. For a while, the medical report brings relief, but only a couple of days pass and again a wave of anxiety drives you to the same doors.
Emotional disorders consist of almost constant tension, the inability to relax, various fears related mainly to health, and anxious anticipation of the realization of one’s worst fears. Fear is unusual, not the kind that many have had to face in life, it does not give room for active opposition, paralyzes, turns even strong-willed women and brave men into sad, helpless creatures.
Autonomic nervous system - part of the nervous system that controls internal organs blood vessels, metabolism, etc., which does not obey our will, works in automatic mode. With neurosis, a malfunction occurs in its functioning, which can manifest itself in the form of severe weakness, persistent insomnia, unreasonable palpitations, attacks of inspiratory shortness of breath, i.e., with the inability to breathe deeply, a lump in the throat (due to a slight spasm of the esophageal muscles), trembling in the hands, painful sensations in the upper abdomen, “in the pit of the stomach,” nausea, vomiting, dizziness, moving pain, burning, temperature rise to 37.5, etc. All this is with healthy organs - the violation concerns only the leadership. An example would be a military unit with well-trained personnel, where they send an incapable commander and confusion begins, shaking all units, some orders contradicting others. As soon as the management changes, everything calms down and rhythmic and efficient work begins.
The prevalence of neurotic disorders (they are also called functional) is very impressive: up to 25% of the population of developed countries have experienced a short-term or long-term condition at some time in their lives.
The most common forms of neuroses are panic states, obsessive fears (phobias), somatoform manifestations, naturally not counting the neuroses of childhood: bedwetting, stuttering, sleep-talking and sleepwalking, which have completely different characteristics than in adults.
Obsessive fears and phobias.
There are more than 200 scientific terms denoting the variety of phobias. The name depends on the cause of the fear.
Among them, obsessive fear of cancer - cancerophobia, open spaces - agoraphobia, fear of disease or sudden stop hearts - cardiophobia, fear of closed spaces - claustrophobia.
Obsessions occur in a normal healthy state as mild, fleeting phenomena. Sometimes a familiar song gets stuck in your head, a melody from which it is difficult to free yourself, a persistent memory of an unpleasant scene that we unwittingly witnessed. Or, for example, you are in a hurry, got dressed, got out and left, but on the way it suddenly struck you: is the gas or iron turned off? Is the door slammed? Or if there are kids, is the window closed? Thoughts relentlessly pursue, instill fear. Some manage to suppress their fears, while others turn the car around...
All these things pass quickly by switching to other things. It’s not so easy to escape a painful obsession. She holds you in her tenacious embrace, attracting all your attention, exhausting your soul.
The cause of a phobia, as a rule, is a specific incident. For example, she died from cancerous tumor women. After some time, her friend discovers similar symptoms, and the more she looks, the more convinced she is that she has nothing more than cancer. Every day I am overcome by sad thoughts, sleep and appetite disappear, and body weight is lost. With a sad discovery, she rushes to the oncology clinic, is thoroughly examined, but nothing of the kind is revealed. There is a brief moment of calm, but the fears do not disappear; they attack again and again, prompting you to go through the same offices again, circle after circle.
While riding in a crowded minibus, the passenger became ill and fainted. Later, when getting into city transport, he begins to experience an obsessive fear of losing consciousness, struggles intensely with it while driving, stands next to the door to jump out, if necessary, at any stop, and avoids getting into a filled minibus. Fear can increase and force you to avoid riding in public transport, on the subway, and sometimes leads to a fear of being in a closed space, in a room, or in an office.
A man has suffered a myocardial infarction. The treatment was successful, I need to get up and walk. But that was not the case, the fear of a second heart attack or cardiac arrest paralyzes the will of some, binds them with shackles, does not allow them to take the first steps, and can leave them in a stroller for a long time. Some stroke patients also have similar problems when it’s time to get back on their feet. If such phenomena occur, they are often short-term in nature; they are overcome with the help of relatives and friends; in protracted cases, they resort to the help of a psychotherapist.
Somatoform disorders (i.e. similar to bodily diseases).
From this group we will describe two common conditions that can be combined with other neurotic symptoms.
Lump in throat. A disorder characterized by a feeling of tightness in the front of the neck, perceived as a foreign body. Constantly attracts attention to itself; when nervous tension increases, it intensifies; when calmed down or distracted by other things, it decreases and disappears for a while. Sometimes getting worse, it leads to difficulty swallowing solid food, so-called dysphagia, causing a lot of trouble. Taking into account the high self-hypnosis, a number of patients assume that in this way a tumor of the thyroid gland makes itself known, although this is a serious misconception - the tumor does not give such symptoms, so there is no need to rush to the operating table, it is better to see a psychiatrist.
Nausea and vomiting. At first it occurs periodically, then gradually spreads throughout the day. For this reason, eating food becomes very difficult, appetite disappears, day after day the person melts, weakness, dizziness sets in, and heavy thoughts fill the head. Quite naturally, many are referred to therapists and gastroenterologists in search of causes and only then to a psychiatrist. This path is justified because nausea, and especially vomiting, can be signs of serious disorders, which should first be excluded and only then resort to psychiatry methods.
The duration of neurotic manifestations encountered by a psychiatrist can vary, from several months to several years. The effectiveness of treatment is quite high.
