Among those whose professional activities are connected with irregular working hours, night shifts, the symptoms of this condition occur to one degree or another in 90% of cases.
Asthenia worsens the quality of life of patients, and severe forms of the disorder can completely deprive patients of their working capacity.
Research on the causes of pathology, the mechanism of its development, measures for diagnosis and treatment continues today, although scientists and physicians around the world have already made great strides in understanding why this syndrome occurs.
The causes of the disease
Asthenia (from the Greek. Asthenia – “impotence”) is a general pathological reaction of the body to any stimulus threatening a decrease in energy resources. According to ICD-10, this state has the code R53.53
Pathology often develops in women of young, working age, but it can occur in men, children, and elderly people (senile type of asthenia).
The etiology of the syndrome is very wide. This condition may occur for the following reasons:
- Mental and psychophysiological problems. Asthenic syndrome can be triggered by overload and depletion of the nervous system: triggers – stress, intensive preparation for exams, competitions, hard work, requiring constant concentration, unresolved psychological conflicts.
- Brain lesions of organic genesis: TBI, contusions, concussions, tumors and cysts.
- Vascular brain changes. Strokes, heart attacks and other vascular accidents, age consolidations, atherosclerosis, encephalopathy.
- Intoxication of the body with psychoactive substances, alcohol.
- Somatic diseases. Chronic diseases (gastric and duodenal ulcers, bronchial asthma, diabetes, arterial hypertension) and long-term, persistent infections, oncological pathology, diseases of the blood and connective tissue.
The causes of the disease in childhood are more often acute respiratory diseases, which occur frequently and in severe form, as well as suppressed, unexpressed emotions of anger, resentment, fear, and psycho-traumatic situations in the family.
The above states or their combination are triggers that trigger complex neuropsychological processes leading to the development of asthenic syndrome.
Normally, to any stimulus, the organism of a healthy person gives an answer in the form of a reaction peak, which has a certain period of extinction. The more powerful the stimulus, the greater the peak and the longer the period of extinction. From such peaks and periods, a “working background” and normal performance are formed.
What happens when the body experiences an asthenic condition?
Even the smallest stimulus gives a maximum peak, after which the recovery period is disturbed. This is due to the fact that the patient’s nervous system is exhausted, weakened under the influence of certain causal factors.
Such an excessive response to any trigger leads to the fact that the nervous system is in constant, chronic tension, the body does not relax, there is no adequate recovery period.
The asthenic condition includes increased excitability, and at the same time, excessive exhaustion of the nervous processes with an appropriate clinical picture.
Symptoms of the disease
The clinical picture of asthenic disorder is diverse. Patients often complain of:
- Constant fatigue, not disappearing after a good rest, sleep.
- Weakness, fatigue.
- Drowsiness, feeling of weakness.
- Permanent feeling of sleepiness.
- Sleep disturbances: difficulty falling asleep, superficial sleep. After awakening, the forces of asthenic syndrome do not recover, unlike the usual fatigue, there is no sense of cheerfulness and energy.
- Increased anxiety.
- Labile mood (characterized by sharp drops in it).
- Emotional instability: tearfulness, episodes of irresistible aggression.
Not only psycho-emotional reactions suffer, but also the will qualities of the individual. Patients may experience restlessness, inability to bring things to a logical conclusion. Memory is disturbed, absent-mindedness appears, impossibility of concentration, the ability for long-term mental work is lost.
When asthenia, the symptoms of a vegetative nature are frequent, and they have a “volatile” character: the patient is worried about “one thing or another”, there are a lot of complaints, a person literally every day new symptoms appear, then the old ones disappear. However, when a patient is examined, organic disorders of the functioning of the internal organs are not observed.
The vegetative manifestations of asthenic syndrome may include the following subjective signs of abnormalities in the function of internal organs:
- low-grade body temperature (37-37.5 C);
- chilliness or sensation of heat in the whole body (“hot flashes”);
- feeling short of breath;
- unpleasant sensations in the heart area (patients are described as “whining”, “tingling”, “pressing”);
- discomfort during the digestive tract;
- the instability of the stool according to the type of constipation or diarrhea;
- muscle pain.
In laboratory and instrumental examinations about patient complaints from the systems under study, no pathological abnormalities are observed.
Very often, against the background of a patient’s depleted nervous system, numerous vegetative signs of the disease, a person develops a depressive syndrome: depressed mood, apathy, gloomy suicidal thoughts prevail.
In different patients, the severity of the syndrome can individually vary. Asthenic manifestations can manifest themselves in a mild degree: a person lives with the disease, losing somewhat the quality of life, but maintaining efficiency and socialization. In another case, the psychological state of the patient can be severe and requires skilled medical care. Any signs of this condition that have disturbed a person for more than 2 months are a reason to consult a doctor.
Forms of the disease
Depending on what the cause of the pathology is, there are varieties of asthenic syndrome, each of which has its own specific features of the clinical picture. The main forms of the syndrome are:
- Psychogenic. It occurs if the basis of the disease are traumatic situations (conflicts, stress). An inadequate neuro-emotional stress arises in a psycho-traumatic situation, it depletes the patient’s body.
- Vascular. Often develops in the elderly due to vascular changes in the brain. Distinct clinical symptoms are tearfulness, forgetfulness, confusion, excessive sentimentality. Tears in this case are the maximum manifestation of emotional involvement, they appear in any minor events, “trivial” reasons for a healthy person.
- Traumatic. It occurs as a result of injuries: head injury, contusions. Characterized by the fact that a person reacts to a minor irritant by an excessive aggressive reaction: verbal or even physical. After the outburst of aggression, the patient feels an extreme degree of physical and psycho-emotional exhaustion and fatigue.
In practice, often erased or combined forms with a mixed, variable clinic.
There is another classification of asthenia, according to which it happens:
- Primary. This is an independent disease caused by psychogenic and constitutional features. Patients, as a rule, have a thin physique, tall, do not tolerate physical, emotional stress, stressful situations.
- Secondary. Symptoms of the disease occur on the background of somatic, infectious diseases, and injuries. Clinical signs of asthenia can be the result of the use of drugs (antidepressants, sleeping pills, diuretics), alcohol intoxication, occupational hazards.
How to treat pathology?
Before starting treatment of manifestations of asthenia, the doctor should exclude all possible somatic diseases that have similar clinical symptoms. Having only ascertained that the patient does not have organic lesions of the internal organs, “guilty” in the patient’s complaints, the doctor develops a comprehensive program of therapy.
Treatment of asthenic syndrome in children and adults requires an individual approach, especially when choosing medicines.
If to present the scheme of drug treatment in general, for clarity, it is possible to identify the main (drugs that are often prescribed at the beginning of treatment) and additional parts (drugs recommended after stabilization of the patient’s condition).
The main part of drug treatment includes the following groups of drugs:
- Sedatives (Persen) – contribute to the removal of excessive anxiety, tension, relax the body, remove the height of the peaks in response to the stimulus.
- Vascular (Cinnarizine) – improves blood circulation in the brain.
- Nootropes (Nootropil) – are prescribed for excessive weakness, have a stimulating effect.
- Sleeping pills (Melakson, Donormil) – recommended for sleep disorders.
An additional part of drug therapy is prescribed after the relative stabilization of the patient’s condition while taking the medication, the purpose of additional treatment is to replenish energy reserves, the earliest recovery of the body. The doctor may recommend:
- Adaptogens (ginseng, eleutherococcus, lemongrass).
- Vitamins of group B (Neuromultivitis).
- Vitamins with antioxidant action (vitamins A, E, C).
Admission of adaptogens is undesirable to carry out at the beginning of therapy, when the patient’s body is in a deep exhaustion. So you can “pull out” from the body and so almost spent energy.
This group of drugs should be taken in strict accordance with the instructions for use or on the recommendations of the doctor after the patient has achieved a stable positive dynamics in the treatment while taking sedative, nootropic or hypnotic drugs.
Physical activity is proven to reduce the level of anxiety, depressive disorders, relieves excessive emotional stress.
Useful in asthenia walking, gymnastics, tennis, fitness. It is useful to combine the load with water procedures, physical and reflexotherapy.
Classes with a psychotherapist, both individual and group, auto-training, proper breathing training, relaxation is an important part of successful treatment.
Rational psychotherapy, autogenic training allow the patient to better understand the nature of his illness. And when you know “the enemy in the face,” it is much easier to fight him.
The first sessions of psychotherapy usually take place with a specialist, then the patient, after mastering the technician, can continue the treatment independently at home.
Asthenic syndrome is a disease that requires the help of specialists and a serious approach to treatment. You should not try to cope with the disease yourself, treated with folk remedies or on the advice of relatives and friends. If you find yourself with symptoms indicating an asthenic condition, you need to consult a doctor.
The following sources were used to prepare the article:
Yudelson Ya. B., Makarova MA, Kugeleva A. O. Treatment of functional asthenia // Journal of Smolensk State Medical Academy – 2003.
Yudelson Ya. B. New possibilities for the treatment of functional asthenia and anxiety // Journal of the Smolensk State Medical Academy – 2007.
Turusheva A.V., Frolova E.V., Degriz Zh. M. Evolution of the Theory of Senile Asthenia // Journal of Vestnik of the North-West State Medical University. I.I. Mechnikova – 2017.