NEUROSIS OR MENTAL ILLNESS HELP UNDERSTAND

Not every person benefits from the frantic pace of modern life. Psychological stress at work, household responsibilities, traffic jams in big cities, all these factors can provoke neurosis. A neurotic disorder can be recognized by certain symptoms characteristic of this disease. Many people don’t even think about how dangerous neurosis is and what consequences may arise if the disease is ignored.

Definition of neurosis

Neurosis is based on the mechanical processes of a disorder of the nervous system, which is responsible for the body’s adaptation in stressful situations. Psychological and physical pathologies are formed when neurotransmitter connections are broken. Neurosis provokes disruption of the functionality of the central nervous system, but does not destroy brain cells, so the disease process is reversible.

Often the nervous state is protracted. This is determined by a person’s personal qualities and the degree of his suggestibility. With a weak level of adaptation to stress, a chronic form of the disease may occur.

There are 3 stages of neurosis.

1. Initial. It implies a slight increase in the effect of stress on the central nervous system, accompanied by irritation and a feeling of fatigue.
2. Hypersthenic stage. The supply of impulses to neurons increases.
3. Hypostenia is a stage characterized by symptoms of inhibition of brain processes.

There are 4 forms of neurosis.

1. Neurasthenia is the most common form of neurosis that occurs against the background of prolonged exposure to a stressful situation, leading to moral and physical exhaustion. Characterized by symptoms: fatigue, lack of attention.
2. The hysterical form is accompanied by tearfulness, aggression, irritability, and convulsions and trembling in the hands may occur.
3. Neurosis of obsessive thoughts - the occurrence of this form is due to deep psychological trauma, due to which obsessive disorders develop.
4. Depressive neurosis is accompanied by an apathetic state, thoughts of suicide, and low food intake.

Prognosis and prevention

In most cases, specialists help patients effectively get rid of the disease and return the nervous system to a normal state. Incurable forms of neurosis, the consequences of which pose a direct threat to human life, are very rare.

In order to fully restore the body after an illness, it is necessary to carry out all diagnostic measures in a timely manner, after which the doctor selects the method of treatment that will be suitable for a particular person. The fastest recovery occurs in patients who can afford long periods of rest after completing therapy.

In order to prevent the occurrence of this disease, there are certain preventive rules, following which you can significantly reduce the risk of developing the disease. First of all, it is necessary from childhood to cultivate the correct attitude towards all events that occur. Another important factor that helps strengthen the nervous system is proper rest and regular physical activity.

Many people ignore neuroses without thinking about the consequences of the disease. It should be remembered that when you detect the first signs of any disorder of the nervous system, you must definitely seek help from a specialist. He will assess the situation and decide what therapeutic measures are necessary in this case. This will help avoid a large number of health problems.

The danger of neuroses

The danger lies in the irreversible effects of stress on the central nervous system. An increasing number of people over 20 years of age are experiencing nervous disorders. Neurasthenia leads to deterioration of health and also affects the quality of a person’s social life. If you do not pay attention to the problem in time, neurosis can lead to negative consequences.

1. Sharp exacerbation of chronic diseases. Deterioration in the performance of the cardiovascular system, the occurrence of gastrointestinal tract disorders: VSD, gastritis, ulcers.
2. Deterioration of memory and physical performance. There is a feeling of apathy, uselessness, fatigue even during simple activities, anxiety and insomnia.
3. Manifestations of neurosis are dangerous, such as causeless tears, aggression, irritability, which prevent a person from leading a normal way of life. Relationships with loved ones and colleagues suffer.
4. Against the background of neurosis, an impulsive-compulsive disorder may develop, in which the patient repeats meaningless rituals.
5. The emergence of obsessive states in which a person mentally injures himself or others is dangerous.

ICD 10 code

Stress-related and somatoform neurotic disorders in ICD 10 are classified in categories F40-F48. Neurosis is a disease with reversible mental disorders. The disease is caused by exposure to traumatic factors. Neurotic disorder is characterized by the presence of the following symptoms:

• disturbances of well-being, somato-vegetative, emotional functions;
• mental exhaustion;
• the patient’s awareness of the fact of his illness;
• absence of disruption of the reflection of the real world.

Psychiatrists distinguish the following clinical forms of neurotic conditions: asthenic neurosis (astheno-neurotic disorder or neurasthenia), obsessive-compulsive neurosis, hysterical neurosis, neurotic depression (depressive neurosis).

Symptoms

In order to recognize a nervous disorder in time and seek qualified help from a medical institution, you need to see the symptoms of the disease. The disease can manifest itself in mental and physical health. If a person experiences the following symptoms for a long time, it is necessary to see a doctor.

From the emotional state:

• causeless anxiety;
• feelings of irritation, aggressive behavior;
• panic attacks;
• long-term depression;
• unwillingness to live;
• slowness;
• tearfulness;
• poor sleep, nightmares;
• low self-esteem.

Physical signs of neurosis:

• trembling hands, rapid heartbeat;
• pain in the diaphragm, feeling of tightness;
• exacerbation of chronic gastrointestinal diseases, frequent urination;
• disruption of the menstrual cycle in women;
• shortness of breath, chronic fatigue, intolerance to loud sound and bright light;
• excessive sweating;
• eating disorders - gluttony or starvation;
• fainting, pressure surges.

Diagnostics

Only a highly qualified specialist can diagnose neurosis, since the symptoms are very nonspecific. This may require consultation with doctors of various specialties:

• therapist;
• endocrinologist;
• gastroenterologist;
• cardiologist;
• neurologist.

Before scheduling a consultation with a psychiatrist, the patient is prescribed an examination. Taking into account the complaints, the doctor selects the necessary studies:

• MRI, CT;
• Ultrasound of the thyroid gland, genital organs;
• ECG;
• Echocardiography;
• Fibrogastroduodenoscopy.

Early diagnosis makes it possible to treat neurotic disorders in the early stages.
The Yusupov Hospital has its own diagnostic center with modern equipment of European quality. Doctors at our clinic regularly attend conferences, receive scientific titles and master new treatment methods. When diagnosing neurosis, differential diagnosis is carried out with other diseases:

• enteritis, gastritis;
• psychopathy;
• angina pectoris;
• hypothyroidism;
• adrenal tumor.

The main difference between neurotic disorders and somatic pathology is that as a result of examinations of internal organs, no deviations from the norm are observed. To confirm neurosis, special psychological tests are carried out: anxiety, the Zung and Beck depression test, the K. Leonhard questionnaire.

Causes of the disease

Neurosis is dangerous due to a drop in the social standard of living and a loss of authority in society. To overcome the disease, you should know the cause that led to stress and exhaustion of the central nervous system. Perhaps a person has an insoluble problem that prevents him from relaxing every day and keeps him in constant tension. One of the main causes of the disease is character and genetic predisposition.

The main factors influencing the human nervous system and leading to neuroses:

• constantly being in a stressful situation, associated, for example, with the work of a rescuer or medic, who face danger every day;
• pregnancy and childbirth can cause the development of neurosis - when the mother’s still fragile body is not able to withstand stress and constant worry about the baby;
• lack of funds, poor living conditions - if a person is unable to change anything in his own life for a long time, he begins to become depressed and develop neurotic disorders;
• excess body weight has a strong impact on self-esteem and causes apathy and obsessive states;
• heredity becomes a decisive factor, because Stress affects entire generations in a family;
• childhood psychotrauma associated with humiliation in the family and school.

Every day a person faces various problems that can throw him off balance for a long time. Stress can be caused by a sudden illness or death of a loved one, job loss, or bankruptcy. The nervous system is capable of overcoming stress, but when negative emotions accumulate and affect the human psyche for a long time, a malfunction may occur. If neurosis is not treated for a long time, psychological problems will worsen and outpatient treatment will be required.

Prerequisites for development

The occurrence of this mental illness depends on many factors in life. The following situations have impacts:

• experiences and mental stress, this applies mainly to schoolchildren and students who are very worried during the session;
• lack of solution to the problem, which is why a person is constantly under pressure of various kinds;
• attention is distracted;
• infection of the body with toxins due to long-term illness or poor nutrition; those who drink a lot of alcohol and smoke (not only tobacco) especially suffer from neuroses of this type;
• self-hypnosis, leading to the fact that a person actually begins to get sick.

People are already accustomed to thinking that neurosis is the norm. But there are individuals who consider this a problem and suffer from it, escaping with alcohol, nicotine and work. If we consider the problem in detail, then neurosis is a protective reaction of the brain to stressful situations or a tense environment.

The disease manifests itself not only in adults, but also in children. Childhood neuroses include such influences on the brain as an aggressive attitude or overprotection and humiliation.

Heredity can also lead to the disease, then the disease can manifest itself in adolescence. Upbringing also has an impact. Permissiveness leads to the fact that when communicating with peers and getting into situations where the child hears “no,” he gets a nervous breakdown.

Treatment of neurosis

Is neurosis dangerous, how to overcome it and avoid it - the doctor will tell you, who will prescribe the correct treatment, relying on symptoms and laboratory tests. During therapy, the patient will be offered psychological and medication assistance.

The doctor will carry out a set of measures aimed at relaxing muscles and strengthening the body through massage, physical activity and breathing exercises.

General recommendations for the treatment of neurosis:

• maintaining a day and night routine, proper healthy sleep should be at least 8 hours;
• early hours of rising contribute to a charge of energy for the whole day;
• proper nutrition;
• rejection of bad habits;
• moderate consumption of caffeinated drinks;
• walks in the park;
• playing sports.

Treatment with drugs

Medicines are prescribed as aids in the fight against neurosis. It is not recommended to carry out self-therapy with drugs, due to the short duration of the effect and the return of the problem. Depending on the stage of neurosis and the general picture of the disease, medications of varying strengths and modes of action are prescribed.

1. To obtain a slight sedative effect and relieve tension, plant-based sedatives are prescribed. You can take these medications on your own. The category of sedatives includes: motherwort tincture, Valerian, Corvalol. They have a cumulative effect that lasts for some time.
2. Nootropic drugs: “Glycine”, “Tenoten” are designed to replenish the loss of vitamins and help with exhaustion of the body. Prescribed for severe mental stress and alcohol withdrawal.
3. Drugs in the categories antidepressants and tranquilizers are only available by prescription, due to their strong psychotropic effects and frequent cases of drug withdrawal syndrome. Take medications in these categories strictly according to the prescription, first increasing the dose and then gradually reducing it. Tranquilizers relieve a person from obsessive states, panic attacks, and normalize the patient’s social life. In the category of psychotropic drugs, the most famous are: Phenazepam, Afobazol, Zopiclone.

Psychotherapy

Treatment of any form of neurosis involves corrective therapy, during which the doctor talks with the patient, examining the symptoms of the disease and explaining the reasons for their occurrence. The patient must learn to see the logical connection between a particular problem and his disorder.

Psychotherapy is carried out using auto-training attitudes, which are reinforced through repetition and relaxation. The person will be asked to relax and imagine himself in comfortable conditions, and the setting phrase will be pronounced: “Nothing bothers me, I’m calm.”

Recommendations for getting rid of neurosis using psychotherapy:

• eliminate bad thoughts;
• abstract from the negative;
• concentrate on the positive aspects;
• relax in nature;
• choose a hobby for yourself;
• to have a pet.

It should be understood that psychotherapy works only if the patient desires to recover.

Massage

The massage is aimed at general strengthening and relaxation of the body. Massage therapy sessions can improve blood flow to muscles pinched by spasms.

The cervical region and collar area are especially carefully treated to relieve spasm and eliminate nervous tics of the neck. Massage movements on the spinal region of the back affect active points and help break up salt deposits. Massaging the chest and stomach area will help eliminate swelling. Working out your hands and feet helps avoid trembling in your hands.

Breathing exercises

Breathing exercises will relieve tension and muscle spasms. You can do the exercises every day, but you need to monitor your well-being: if you feel dizzy or have dark vision, it is better to stop the practice and consult your doctor.

The exercises consist of mastering proper breathing.

1. Stand up straight, hands at your sides, inhale slowly, inflating your stomach like a ball, mentally feeling how your whole body is filled with oxygen, and as you exhale, draw in your stomach.
2. Take a comfortable position, arms relaxed, back straight: while inhaling, fill your chest with oxygen and raise both arms up in a circular motion. Exhale, returning your arms to the starting position.

Signs of other psychogenic neurotic disorders

Obsessive-compulsive neurosis actually includes obsessions (obsessions) and phobias (obsessive fears).
Obsessive disorders are represented by obsessive thoughts that are stereotypically repeated and extremely painful for the patient. Compulsions are repeated behaviors that purport to prevent harmful or dangerous events that are extremely unlikely to occur. The patient is formally critical of ritual actions, but cannot overcome them on his own. Phobic disorders include fear of certain situations. The patient is critical of his own phobic experiences, understands their alienness, strives to overcome them, but cannot free himself from them. The following obsessive fears are encountered:

• Agoraphobia is a persistent fear of being in crowds of people, fear of public places (workplaces, shops, streets, open squares, theaters, concert halls), and independent long trips on various types of transport;
• Claustrophobia – fear of closed spaces;
• Thanatophobia – fear of death;
• Cancerophobia – fear of cancer;
• Cardiophobia is the fear of severe heart disease.

Hysterical neurosis includes conditions that arise in patients with an obvious or objectively proven conflict situation (violation of interpersonal relationships, insoluble problems), even if the patient denies it.
More often, such conditions arise and stop suddenly. Some of them (anaesthesia and paralysis) gradually develop and persist for a long time. There is no connection between the mental disorder and neurological or physical disorders. The “benefits” for the patient and the clearly psychogenic nature of the disorders raise suspicions about attitudinal behavior. These specific psychopathological manifestations are disease states with specific pathogenetic mechanisms. Hysterical amnesia is manifested by impaired memory for recent stressful events, accompanied by depressive feelings. Memory loss is often partial. It is not caused by intoxication or organic brain damage.

Hysterical movement disorders reflect the patient’s subjective ideas about an alleged neurological disease, but the nature of the complaints does not correspond to real organic disorders. The presence of movement disorders allows the patient to avoid a difficult psychotraumatic situation. The intensity of the manifestation of disorders is closely related to the number of people who are present near the patient. Patients use the violations themselves to attract the attention of others.

Hysterical neurosis can be manifested by the following motor disorders:

• convulsive seizures;
• paralysis (complete and partial);
• hyperkinesis (excessive violent motor acts that occur against the patient’s will);
• contractures (stiffness of joints);
• mutism (a condition when the patient does not answer questions and does not even make it clear that he hears them);
• hysterical stupor (depressed mental state, manifested in silence, inhibition, inactivity).

The patient may experience convulsions similar to epileptic seizures.
All these disorders are not caused by organic damage to the organ or other disease. There are no signs such as tongue biting, involuntary urination, consequences of sudden falls, or loss of consciousness. Sensory disturbances during hysteria are manifested by a variety of sensitivity disorders:

• anesthesia (loss of sensitivity to pain);
• hyposthesia (decreased pain sensitivity);
• hyperesthesia (increased pain sensitivity);
• paresthesia (sensation of itching, burning, crawling).

Sensory disturbances often correspond to areas of innervation.
Patients experience bright, unusual hysterical pains. There is loss of hearing and vision. Depressive neurosis is a condition that is determined by the depressive triad: decreased mood, mental and motor retardation. Symptoms of the disease are moderately expressed, affect the patient’s behavior, but allow the individual to maintain social adaptation. Patients' ability to concentrate and self-esteem decreases. Night sleep disturbances and anxiety are typical.

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Psychotherapy

In order to alleviate neurotic symptoms (by taking antidepressants), psychotherapy is carried out:

• Cognitive-behavioral therapy – formation in the patient of the correct reaction to the situation, strengthening his adequate assessment of his behavior in a traumatic situation, changing the way he responds to it;
• group psychotherapy – takes place for 1.5 hours daily or weekly, in the form of discussions. Topics are determined in advance; they relate to the biography, behavior of group members, and life situations. Group therapy has rules: strict confidentiality, sincerity of participants, experience “here and now,” specificity of topics. Groups can be closed - with a constant composition of participants, or open - someone comes, someone stops visiting;
• hypnotherapy - suggestion is carried out in a special state of the patient, hypnotic. The session includes 4 stages: hypnotization, therapeutic suggestion, therapeutic rest, dehypnotization;
• autogenic training;
• breathing exercises for relaxation and concentration;
• non-verbal methods of psychotherapy - music therapy, art therapy, dancing and pantomime.

The most effective treatment is a combination of antidepressant medication and cognitive behavioral therapy.

Drug therapy

The course of neurosis is associated with a simultaneous decrease in the level of brain serotonin, therefore long-term use of antidepressants - selective serotonin reuptake inhibitors - is prescribed for treatment. At the initial stage of treatment with antidepressants, their adverse reactions may occur, and the patient’s condition may worsen. In view of this, it is important not to stop taking the prescribed treatment, but only to reduce the dose of the drugs. Then, as tolerance improves, the dosage is gradually increased to the recommended values. Over time, the symptoms of neurosis decrease and the patient's condition improves.

Important: the antidepressant must be selected by a doctor! The selection takes into account the individual tolerability of the drug and its effectiveness for specific neurotic symptoms.

For the treatment of neuroses accompanied by insomnia or poor sleep, sedative and hypnotic antidepressants are prescribed. Sometimes, with great caution and in small doses, in short courses (to avoid addiction), tranquilizers are prescribed. When treating neuroses with concomitant weakness, memory loss, and asthenia, nootropic drugs are used. The duration of treatment is usually several months; if necessary, the course must be repeated.