- 1 What is neurosis
- 2 The reasons
- 3 The mechanism and stages of the disease
- 4 Classification
- 5 Symptoms
- 6 Conclusion
Pathology is characterized by a long course, requires differential diagnosis with other similar diseases. Treatment is usually carried out comprehensive, including psychotherapy and medication.
What is neurosis
The concept first appeared in medicine at the end of the 18th century, in contrast to the morphological theory of the origin of all diseases. The term was introduced by a Scottish physician, Purchased, to distinguish a separate group of pathologies that are not associated with organic lesions.
Later Russian scientist-physiologist Pavlov made a great contribution to their study. Currently, according to the ICD, the more correct concept of “neurological disorder” is used. In the coding system, they are denoted by ciphers from F40 to F48.
Despite the fact that the causes of neurosis have been clarified for a long time, there is no reliable data on the origin of the pathology. For a long time they were associated with the intense pace of life of citizens, as well as the features of their professional activities. But as practical studies have shown, nervousness is mainly caused by intra-family and interpersonal conflicts.
At the same time, the degree of stressful impact is determined not so much by the objective force of stress, as by its subjective perception. That is, for neurotics, certain individual triggers matter, triggering the mechanism of disease development. Therefore, psychoneurosis often occurs and progresses against the background of minor, in the opinion of others, events, while for a particular individual they can be very significant.
A great influence on the formation of pathological reactions also have personality traits of the patient. For example, women with psychoneurosis suffer 2 times more often than the representatives of the stronger sex due to increased emotional lability. Also, inadequate reaction to stressful situations are more prone to people of a particular psycho-emotional warehouse: demonstrative, suspicious, depressed.
Often, neuroses develop in adolescents on the background of age-related changes in the endocrine system. Hormonal imbalance also affects the mental state of women during menopause. In children, other specific disorders of nervous activity — logoneurosis or enuresis — often become the cause of neurosis. We can not exclude the influence of such factors as genetic predisposition.
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The mechanism and stages of the disease
The pathogenesis of neurosis is associated with the activity of certain parts of the brain, mainly the hypothalamus. The breakdown of its functioning leads to disruption of the interaction and internal connections between the endocrine, vegetative and other spheres.
In the absence of organic lesions of the brain structures, disintegration of these processes is observed, leading to maladaptation and the appearance of pathological reactions. Since the activity of the autonomic nervous system is disrupted, somatic symptoms arise along with mental disorders. Most often develops vegetative-vascular dystonia.
All neuroses in their development go through three successive stages. The first two, despite their duration, can be attributed to acute conditions, and the third is already considered a chronic form of the disease:
- Neurotic reaction. It is a response to psychotrauma, usually lasts no more than a month, characteristic of childhood. In adults, mentally healthy people can be observed as isolated cases.
- Neurotic state. It has all the signs of neurosis, but with the help of psychotherapy, medication passes without consequences. The duration of this stage can vary from six months to 2 years, if the impact of the traumatic situation does not diminish.
- The third stage is the neurosis itself in a chronic form. At this stage, pathological changes become resistant, drug treatment and psychotherapy are not amenable.
If you do not start therapy during the first or second stage, when neurasthenia can be cured without consequences, the personality structure changes irreversibly. The condition of the patient in the third stage is characterized by the close people with the phrase “the person seemed to have changed.”
Personality characteristics, the specificity of the disease development mechanism, the general condition of the body determine the variety of forms of neurotic states. Some of them are united under one general concept (like panic attacks or claustrophobia), others are divided into separate groups.
In modern neurology, several types of neurosis are considered:
- conversion disorder (or hysterical neurosis);
- obsessive compulsive disorder, abbreviated OCD;
- anxious and phobic;
- somatotrophic disorders;
- post-stress disorders.
Each type of pathology is characterized by its own symptoms, although often mixed varieties are found.
Diagnosis of different types of neurosis requires a professional approach. Neurologists use various methods to identify the disease and its causes: testing, pathopsychological examination, the study of the structure of the patient’s personality.
For making a differential diagnosis, exclusion of cerebrovascular and organic disorders are assigned instrumental studies. However, already at the initial examination, on the basis of complaints and specific symptoms, it is possible with a high degree of accuracy to determine the type of neurotic disorder.
The second name of the pathology is asthenic neurosis. Most often occurs in men aged 20 to 40 years, develops against the background of prolonged physical or mental overload. It is a depletion of the nervous system, which contributes to the presence of somatic diseases and bad habits.
The main symptom of neurasthenia is a diffuse headache that appears towards the end of the day. She seems to be squeezing her head, therefore, she is called the “neurasthenic helmet”. Often there are also dizziness, tachycardia, increased pressure.
Patients often complain of disorders of the gastrointestinal tract: dyspepsia, lack of appetite, epigastric pain, flatulence, constipation or diarrhea. A characteristic sign of neurosis in men is premature ejaculation on the background of reduced sexual desire.
The latter two factors together have an especially negative effect on the patient’s psychophysical state, aggravating neurasthenia. Depending on the stage of development of the pathology, anxiety or apathy is noted.
Obsessive-compulsive disorder or neurosis of obsessive-compulsive disorder is much less common than neurasthenia. The reasons are, presumably, the hereditary features of neurohumoral regulation in combination with external trigger factors.
Clinically, the disease is manifested by two main symptoms – obsessions and compulsions. The first are obsessive thoughts that are impossible to get rid of. They include fears, doubts, memories, views. Compulses are actions by which the patient tries to distract from obsessions, to lower the level of his own anxiety. They can be performed both explicitly (repetitive movements, grimaces) and mentally.
It makes up about a third of all diagnosed neurotic disorders, it is more common in women. The risk group also includes people with an unstable, immature psyche and a demonstrative personality (mainly children with burdened heredity, adolescents). Being demonstrative is the most important distinguishing feature of this type of disorder, since it is “in public” that its symptoms appear most clearly.
Signs of hysterical neurosis in women and men are very numerous and varied:
- coordination disorders;
- aphonia or stuttering;
- finger tremor;
- partial paralysis;
- temporary loss of hearing, sight;
- pain in the region of the heart, stomach, and other internal organs (the range of somatic manifestations is limited only by the patient’s imagination);
- epiphriscule-like seizures;
Signs of the disease always appear suddenly, but if there are other people nearby, they end in the same way. Despite the pronounced symptoms of neurological or somatic diseases, organic lesions or brain pathology are absent.
In this form of neurosis, symptoms manifest, above all, by a characteristic triad: decreased activity, inhibition of speech and thinking, low mood. At the same time, the overall positive outlook on the future is preserved, the ability to work and the ability to interact with others are not lost either.
This specific symptom of a depressive neurosis (called the symptom of “hope for a brighter future”) makes it possible to distinguish it from depression. The disease occurs against the background of a prolonged stressful situation, which the patient is trying not to solve, but to hide from others. This is a key factor leading to the intensification of the main symptoms and the occurrence of somatic disorders. The latter include fluctuations in blood pressure, dizziness, gastrointestinal dysfunction.
This symptom complex, usually manifested in persons prone to suspiciousness and anxiety, is an inadequate attitude to the state of health (one’s own or close people). The patient has apathy, outbreaks of irritability, dejection, sleep disturbances, loss of appetite.
Against the background of deterioration of the general condition, somatic symptoms of neurosis appear: cephalalgia, dizziness, cardiac arrhythmias, pain. At the same time, the patient perceives them as signs of dangerous diseases (cancer, tissue necrosis), constantly thinks about them, often seeking medical help.
According to ICD-10, it is classified as anxiety disorders, including mental disorders such as panic attacks, social phobias, generalized disorder, claustrophobia, agoraphobia, logophobia and other fears.
The main, common to all types of diseases, symptoms are:
- social isolation, difficulty in establishing contacts;
- a high degree of self-doubt, dependence on the assessment of others;
- hypersensibility, tendency to experiences.
The first symptoms of neurosis usually manifest themselves in childhood, and heredity in combination with the characteristics of upbringing acts as a cause. Such children are distinguished by shyness, fearfulness, which by adolescence are transformed into isolation.
At the same time, the patient has an acute need for social contacts, but because of fear of criticism, condemnation or hostility from others, he avoids communication.
Against the background of a strong or prolonged psycho-traumatic situation, a patient suffering from somatotrophic neurosis has symptoms of various somatic diseases.
The clinical picture may fully correspond to the pathology of the cardiovascular system, stomach, intestines, but during a thorough instrumental and laboratory examination no organic lesions are detected.
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The causes of neurotic disorders of this type are very severe stresses: military actions, natural or man-made disasters, terrorist acts. Persons who have experienced similar situations experience a response in the form of a neurosis, the symptoms of which depend on the form of the course of the disease.
An acute disorder looks like a hysterical fit, which quickly and without consequences goes away. The chronic form is characterized by a gradual change in personality along with social maladjustment, which is often observed in participants in military operations (“Afghan syndrome”, for example).
When symptoms characteristic of neurosis appear, its treatment in adults or children should begin immediately. First of all, a qualified diagnosis is necessary, including a differential one. Therapy should also be prescribed and carried out under the supervision of a physician of the appropriate profile.
It is necessary to treat the disease with special preparations or psychotherapeutic methods, and the use of folk remedies is permissible only as a supplement. At the same time, the main factor of successful treatment is the identification and elimination of the psycho-traumatic factor.