With neurasthenia, the following somatic manifestations are most likely. Neurasthenia: how to overcome the state of neuropsychic weakness? Neurasthenia in women

30.11.2019

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What it is? Neurasthenia is one of the most common forms of neurosis. It is based on an acute conflict caused by increased requirements for oneself and the inability to comply with them.

It is diagnosed as nervous exhaustion as a result of prolonged exposure to the central nervous system of moral or physical overload, stress and anxiety. Incorrect placement and overestimation of mental capabilities leads to the development of neurasthenic syndrome.

The genesis of the disease is due to overstrain of brain activity as a result of excessive loads, leading to the impossibility of complete relaxation and good rest. As a result - the formation of distress () with a parallel increase in a high degree of nervousness, chronic fatigue, insomnia (sleep disturbance), emotional incontinence and sudden mood swings.

Neurasthenia can be preceded by long-term and sluggish chronic pathologies, exposure to toxins, various infections and injuries affecting the roots of nerve tissues, anorexia and bulimia, which provoke disturbances in metabolic processes.

Sometimes, they can cause neurasthenia - depression and manic-depressive states that are not associated with psychological problems, which manifests itself:

depressed state;
feeling of self-doubt;
isolation;
rapid fatigue.

Neurasthenia often develops in people at the most active age (20–45 years). If earlier, men dominated among the patients, now the number of neurasthenia in women is equal to the male morbidity.

Signs and symptoms of neurasthenia, forms of manifestation

manifestations of symptoms of neurasthenia in children and adults

Clinical signs and symptoms of neurasthenia can manifest themselves in various forms.

1) In the form of an asthenic variant (hypersthenic form). It is characterized by increased excitability and irritability, instability and mood swings. Such patients are characterized by violent emotionality and incontinence. They, not realizing themselves and not attaching special importance to their actions, can easily offend or offend someone. They are annoyed by large groups of people and the slightest noise.

There is a decrease in working capacity, absent-mindedness appears, it is difficult for patients to concentrate and they are even more irritated. In this phase of the disease, restless sleep does not bring a feeling of rest, on the contrary, a feeling of fatigue and weakness is formed, accompanied by a migraine.

2) In the form of transitional cerebral neurasthenia (irritable weakness). It is characterized by a manifestation in patients with a relatively balanced psyche, who underwent the first phase of the disease without any therapeutic measures.

This period is characterized by bad moods and irritability, followed by moral or physical fatigue... With any annoying factor, such people often cry out. The cry is quickly replaced by impotence, from which the person suffers even more.

Such patients are characterized by violent emotions to completely "trivial" problems, and they are not ready to make important decisions. There is no concentration and focused attention on the main thing. The increasing weakness of the nervous system and its exhaustion do not allow bringing the matter to its logical conclusion.

3) Hyposthenic variant of neurasthenia. It is the third stage of the disease. It develops, in the overwhelming majority, in people characterized by emotional lability with an unstable nervous system. Sometimes it manifests itself, bypassing the two previous stages of the disease. The main symptoms of neurasthenia of the hyposthenic form are manifested:

persistent weakness and apathy;
indifference and spiritual emptiness;
anxiety or sadness;
unmotivated melancholy and uncertainty;
emotional instability and tearfulness;
full concentration "on yourself beloved."

With the elimination of the cause of neurasthenia, all forms of the disease are treatable. Do not try to cope with it on your own - a psychiatrist and a neurologist know how to treat neurasthenia, they will draw up an effective treatment plan for the disease, prescribe a course of drugs. This will help prevent repeated attacks of the disease, which will be longer each time and ultimately lead to the development of protracted neurasthenia - psychogenic chronic disorders.

Signs of neurasthenia in women, especially

The manifestation of clinical symptoms and signs of neurasthenia in women very rarely have the same severity. Their occurrence is due to the causal factor and individual deviations in the state of the psyche. Among common symptoms appear:

loss of perception of the joys of life;
swings and instant changes in mood;
complete indifference and a manifestation of bitchiness.

It is because of their bitchiness that such women never show their feelings of discomfort on display. Outwardly, they are confident, but internally they perceive very painfully the disturbing factors. This can be seen by their pale appearance, by the tremors of the chin and hands.

Such women are characterized by sharp criticism of friends and relatives, they have no desire to adequately understand and perceive anything.

All this results in problems in different areas activity, bringing the patients to complete despair and heart pains. The inability to fully rest and relax, like a "snowball" accumulates many negative factors, showing:

tiredness and uncertainty;
complete dissatisfaction with life;
selectivity of attention;
lethargy of emotions and lethargy of thoughts;
the feeling of swimming in the environment;
long, not passing migraines;
pulling soreness in the legs with the possible development of paresthesias (numbness).

The manifestation of neurasthenia syndrome in women can also provoke sexual problems due to sexual dissatisfaction, distrust of a partner, or lack of confidence in their female attractiveness.

Symptoms and manifestations of neurasthenia in children

IN childhood neurasthenia syndrome manifests itself in various forms due to a wide variety of reasons, and this is not a play on words. The factors of its development should be considered in more detail.

Neurasthenic disorders due to fear and anxiety. Fears and anxiety in children develop as night approaches. Such emotions are accompanied by mysterious imaginary images, imagined by children in the form of scary characters. Symptoms of such neurasthenia in children are manifested in the form of fear of loneliness and fear of dark rooms.
Pathology of incomprehensible and alien states of obsession. It is manifested by a feeling of fear of a variety of objects and incomprehensible situations, accompanied by an obsessive urge to action.
Depressive states. This form of the disease is characteristic of children of puberty. Symptoms are due to the development of lethargy, tearful moods, and a low level of self-esteem.
Neurasthenic syndrome due to hysterical disorders. It is observed mainly in children under 6 years of age. Signs are expressed by affective-respiratory attacks - breath holding, fainting, tantrums, crying, a demonstrative fall with harsh scream.
Pathology provoked by asthenic disorders. It is characterized by irritation and moodiness, insomnia and refusal to eat. Such states are noted in extremely busy children who, in addition to school classes, attend additional training courses and various hobby groups.
Neurasthenic state against the background of hypochondriac syndrome. Caused by fear of possible infection various diseases... Such children require increased attention and care.
The factor of neurotic stuttering is logoneurosis. It can form from the age of two. The underlying cause is due to severe fright or psycho-emotional trauma.
A form of progressive neurasthenia develops during a period of prolonged illness. Subsequently, after a complete recovery, the child retains the habits characteristic of those that were during the illness (tearfulness, moodiness, increased attention requirements, etc.).
Neurasthenic disorders provoked by sleep disorders. They become a consequence of the difficulty with falling asleep, manifestations of sleepwalking and frequent nightmares are possible.
Neurasthenic conditions caused by eating disorders or disorders, enuresis or encopresis. The development of such pathologies is often provoked by the parents themselves, punishing children for eating slowly or for refusing to eat. Fear of punishment, or situations that traumatize the psyche associated with excessive parental severity, can cause nocturnal involuntary urination - the development of neurogenic enuresis, or the unconscious discharge of feces - neurogenic encopresis.

For any manifestations of signs of neurasthenia, treatment must be started immediately in order to prevent the consequences of the disease in the form of various internal pathologies. The effectiveness of the treatment of neurasthenic children largely depends on the correct diagnosis and timely elimination of the root cause of the disease.

How is neurasthenia treated? - techniques and preparations

The tactics of treating neurasthenia involves the use of various techniques - psychotherapy, including methods of persuasion, suggestion and self-hypnosis, autogenous training and muscle relaxation, is one of the main methods of treating neurasthenic disorders.

Classes are held aimed at acquiring skills in controlling their actions and actions, at teaching the correct lifestyle with positive thinking.

Regular communication with a psychologist stabilizes cardiac functions, normalizes breathing, and has a beneficial effect on the autonomic and neurological processes in the patient's body.

About drugs

Drug treatment of neurasthenia with drugs begins simultaneously with psychotherapeutic techniques. It includes: drugs of tranquilizers, antipsychotics, antidepressants and psychostimulants.

Tranquilizer drugs are selected individually according to indications. They are prescribed to eliminate emotional stress, fears and anxiety. Promotes deep and prolonged sleep, eliminating problems with insomnia.
Relaxing and sedative drugs in the form of "Chlordiapoxide" or "Diazepam" and "Nitrozepam" promote the process of falling asleep and eliminate the manifestation of seizures
Prescription of drugs from the group of anxiolytics, for example, "Oxazepam" is due to their property of eliminating phobias, irritability, tension and mood stabilization.
Lorazepam and Phenozepam have anti-anxiety and muscle-relaxing properties.
An effective sedative that does not cause drowsiness and lethargy is "Medazepam".
Helps to reduce psychological discomfort, due to prolonged mental stress, the drug "", which improves the psyche and physical condition of patients.
Antipsychotics have a pronounced sedative (sedative) property. It can be: drugs "Sonapax", "Aminazin", "Reserpine", "Triftazin", "Melleril" and "Haloperidol". These drugs and their dosage should be prescribed exclusively by a doctor, since an overdose will lead to a decrease in blood pressure and may be reflected in sexual oppression.
Among the antidepressants are effective "Amitripptyline", "Imizin", "Azafen" and "Eglonil". They help to improve mood, vigor and appetite. They have a stimulating activity, eliminating states of apathy, returning the patient to the peculiarities of the feeling of pleasure and joy.
To normalize emotional and intellectual activity, psychostimulant drugs are prescribed. The most famous is Phenibut. Promotes the restoration of memory impairment and concentration, eliminates asthenic, neurological and anxiety conditions. In children, it is used to stop the processes of stuttering, the nervous nature of tics and signs of bedwetting.

Any drug therapy will be more effective in combination with various therapeutic methods, including physiotherapy and other techniques in the form of:

darsonvalization;
sleep therapy;
manual techniques;
laser and reflexology;
galvanization of the collar area;
spa treatment.

Prevention of neurasthenia in adults and children

The basis of prevention is a well-thought-out, time-delimited regime. In case of nervous or physical overstrain, each person should have a stock of suitable relaxation techniques - swimming or yoga classes, breathing exercises, or relaxing techniques. To whom, what to your liking, which contributes to complete relaxation (addictions with alcohol are categorically excluded).

It is necessary to “bypass” conflicts and avoid stressful situations, try to avoid unbearable physical exertion. Sometimes, a change of job, a good rest in a sanatorium, or at sea helps to stabilize the nervous system. It must be found in the form of a hobby, an activity to your liking. Sometimes a clear sleep regime is enough to restore strength - go to bed every day and wake up at one specific time.

It is important to remember not to take on all the work and strive to complete it in one day. The first candidates for the development of neurasthenic syndrome are, first of all, workaholics.

Neurasthenia is one of the aspects of psychosomatic diseases, manifested as a result of physical and mental exhaustion of the body, its prolonged overload. Belongs to the category of asthenic neuroses in the fifth section of the ICD-10 - International Classification of Diseases. Most often, neurasthenia is observed at a young and middle age due to the tense rhythm of life, lack of sleep, lack of rest, and constant stressful situations. It can also manifest itself in children.

Neurasthenia occurs in chronic intoxications and weakening the body infections, endocrine disorders, malnutrition and vitamin deficiency, tumors. Can actively develop with diabetes mellitus... However, the main cause of neurasthenia is considered to be excessive stress on the central nervous system, which leads to distress. The patient's body does not get enough rest and relaxation, which results in chronic fatigue, lack of sleep and irritability for any reason.

Stages of development

Neurasthenia includes three leading forms of development:

hypersthenic syndrome;
irritable weakness;
hyposthenic syndrome.

Hypersthenic syndrome is accompanied by increased mental excitability, sharp temper, mood lability. Patients are easily agitated, unable to control themselves, in a position to offend others. Typical signs are decreased performance, distraction and lack of concentration on the work being done. The patient cannot long time to experience mental and emotional stress, is often distracted by side sounds, as a result of which he does not have time to complete a given amount of work. Neurasthenia of the first stage manifests itself in the form of complaints of painful sleep at night, anxious dreams, long falling asleep, which accompanies general violations sleep. As a result - a stable state of exhaustion and distress, daily discomfort in the head, weakening of memory, frustration internal organs.

The second stage of neurasthenia occurs with insufficient recovery from hypersthenia, manifests itself mainly in asthenics and choleric patients. Irritability changes emotional exhaustion... Nervousness manifests itself even in minor situations. The patient is not able to concentrate on any kind of work, fatigue and migraine appear very quickly, general fatigue and exhaustion of the body increase. He is temporarily distracted from work, but such a break does not bring brain and psychological rest. Countless efforts to start work again bring the individual to complete nervous exhaustion.

Signs of the third stage of neurasthenia initially appear in asthenics, suspicious and distrustful individuals with a sensitive nervous system. Hyposthenic neurasthenia is characterized by psychophysical apathy, lack of initiative, depressed mood, lack of interests. This state is reinforced by tearfulness and sensitive instability. The patient is fixed exclusively on personal immanent experiences and suspicious grievances, which further aggravates his general nervous state.

Symptoms of the disease

Neurasthenia includes multiple symptoms. The leading signs of the disease:

Symptomatology also looks at signs of sleep disturbance in a patient with neurasthenia. Poor sleep is caused by frequent waking up, disturbed sleep, feeling tired immediately after waking up. In this regard, the procedure for assimilating information and a decrease in efficiency are disrupted.

Neurasthenia causes a state of increased excitability in the patient, which appears in the form of shudders or screams with unexpected noise manifestations and touches. Any trivial situation causes him anxiety, picky, sometimes outbursts of anger. The patient's mood is labile. At the physiological level, neurasthenia is determined by the awakening of tendon and periosteal reactions, twitching of the eyelids and fingers, hyperhidrosis, tachycardia, increased pilomotor reaction, pronounced dermographism.

The main methods of diagnosis and treatment

Neurasthenia is diagnosed by a neurologist based on the patient's complaints, his examination and medical history. Neurasthenia can develop not only with protracted diseases, intoxications, but also with neuroinfections, inflammations, and brain neoplasms. To exclude such signs, it is necessary to carry out computed or magnetic resonance imaging. To determine the blood circulation in the brain, rheoencephalography is performed.

With neurasthenia, treatment is prescribed, depending on the identified foci of its manifestation and, accordingly, their complete elimination. The patient is prescribed antidepressant or sedative drugs of general and enhanced action, depending on the severity neurotic state... Strong tea and coffee, various tonics are recommended: calcium gluconate, ginseng root, the fruits of the Chinese magnolia vine, pantocrine. When determining the course of treatment for neurasthenia, it is important to take into account the age characteristics of the patient, since many psychotropic drugs are contraindicated for children. Lack of iron in the body can provoke mental disorder, so it is very important to replenish its resources with the help of special medicines.

Along with the use of a complex of drugs, it is necessary to normalize the daily regimen, give the body full sleep and rest, temporarily exclude mental work and the presence of stress factors, organize daily small walks in the fresh air, and undergo a course of psychotherapy. Autogenous training, methods of suggestion and hypnosis will help the patient get rid of obsessive depressive thoughts and have a new positive look at the world around him. Warm foot baths with soothing aromatic oils and other individual mood elevators will have a beneficial effect on the psychophysiological state of the body. The vitamin complex will strengthen immune system, preventing disruption of the functioning of internal organs. Adequate sleep, positive thinking and adherence to emotional stability will help to quickly return vital energy and fill yourself with fresh strength.

Neurasthenia is considered a disease of the twenty-first century, since today more and more people are subject to emotional and physical exhaustion due to irregular work schedules, the presence of daily stressful situations, a lack of nutrients in the body due to improper nutrition. All this leads to sleep disturbances, complete disorganization and distraction. Compliance correct regime sleep, rest and nutrition will prevent neurasthenia, always stay in an active life stream.

Very often "bad character" and "laziness" are not associated with a person's personality, but only indicate that he has problems with the nervous system. Neurasthenia is not excluded: what is it, what symptoms are manifested and how is it treated? Is it possible to get rid of the disease on your own?

What is neurasthenia?

Neurasthenia is mental disorder, belonging to the category of neuroses. For the first time they started talking about pathology back in 1869, when the work of the American neuropathologist George Miller Beard called Neurasthenia, or Nervous Exhaustion was published.

Today, this disorder is also known as asthenic-neurotic syndrome, or asthenic neurosis. First of all, pathology is associated with constant fatigue, irritability, inability to engage in mental or physical work for a long time. Neurasthenia signals the exhaustion of the nervous system.

Neurasthenia: the causes of the development of neurosis

Mental disorders are almost always provoked by the combined influence of several factors. In particular, neurasthenia occurs for the following reasons:

Biological factors	genetic predisposition (the presence of neurotic and mental disorders in close relatives) difficult pregnancy of the patient's mother (including accompanying infectious diseases) and birth trauma individual characteristics of the nervous system general weakening of the body against the background of smoking, drug addiction, alcoholism, chronic diseases physiological deprivation (short night rest, inadequate nutrition, etc.)
Psychological factors	children's psychological trauma (violence, parental alcoholism, fear, death of a close relative, etc.) prolonged stay in a stressful environment of any nature having to do monotonous, hard, or unpleasant work
Social factors	dysfunctional childhood lack of understanding in the family dissatisfaction with one's own life an unfavorable social circle, in which people with psychological disorders and a negative view of the world

Most often, a neurasthenic is a young man of 25-40 years old. In women, the disorder is somewhat less common, although the fairer sex is also not immune from it.

Neurasthenia: symptoms of an emerging disorder

The neurosis develops gradually. It goes through three stages (forms), each of which differs in symptoms:

Stage of neurasthenia	Key features
Hypersthenic neurasthenia	increased excitability and irritability excessive sensitivity to noise, talking, fast movements aggressive reaction to the slightest pathogen a sudden desire to offend / yell at others lack of ability to self-control distraction, incoherence, memory lapses procrastination tendency intermittent sleep, insomnia, nightmares, or too intense dreams constant feeling of tiredness, heaviness in the head, weakness headache, "neurasthenic helmet", discomfort in different parts of the body, general poor health
Irritable weakness	increased excitability and irritability against the background of rapid fatigue short but frequent attacks of neurasthenia (violent reaction to stimuli) tearfulness, impatience, fussiness photophobia, intolerance to noise and odors decreased control over the expression of emotions instability of mood with a predominance of depression, gloom, indifference sleep disorders disruptions in the digestive tract (heaviness in the stomach, constipation, heartburn, belching, loss of appetite) problems in the sexual sphere (decreased libido, impotence) rapid heartbeat or a feeling of a "frozen" heart, headaches
Hyposthenic neurasthenia	exhaustion, weakness, lethargy, drowsiness depression, apathy, anxiety, sadness tearfulness, instability of mood focus on somatic symptoms, hypochondria unpleasant or painful sensations throughout the body disappearance of sexual desire

Symptoms of neurasthenia get worse if left untreated. If at the hypersthenic stage, the disorder is mainly manifested by mood swings and increased excitability, then in a state of hyposthenia, fatigue, exhaustion, and lack of energy prevail. The patient gradually loses interest in what is happening, his performance deteriorates, the desire to do something disappears.

Sometimes the signs of neurasthenia disappear if a stress factor ceases to influence a person (for example, the volume of work is significantly reduced or the manager changes). The first sign of improvement is sleep normalization. But there is always the likelihood of repeated attacks, and each subsequent one is more severe than the previous one. Today they talk about the existence of periodic neurasthenia, that is, such that it worsens from time to time. In severe cases, it transforms into cyclothymia, an affective disorder associated with mood swings from depressive to persistently elevated.

Signs of neurasthenia in women and men - is there a difference?

In general, the symptomatology of the disorder does not depend on the gender of the patient. Another thing is that women usually show a little more temper, irritability, bad mood. Neurasthenia in men is less pronounced due to the habit of the representatives of the stronger sex to behave with restraint, little emotion, balanced. Nevertheless, at the inner level, all patients have fatigue, exhaustion, apathy - the only difference is in the degree of their manifestation.

Neurasthenia in women literally spills out. Men, on the other hand, prefer to hide the problem from others, which negatively affects the state of the body: almost all neurasthenics complain of premature ejaculation, situational impotence and other sexual disorders. In women, the intimate sphere of life does not suffer so clearly, although the level of sexual desire still decreases.

The main types of neurasthenia

The disorder always affects the physical well-being and the body's ability to function normally. And depending on which particular sphere has suffered the most, several types of neurosis stand out:

Genital neurasthenia, accompanied by disorders in the sexual sphere.
Gastrointestinal neurasthenia, which is characterized by problems in the digestive tract.
Cardiac neurasthenia, provoking an accelerated heartbeat, pain in chest etc.
Cerebral neurasthenia, primarily associated with a decrease in mental abilities, memory impairment, poor concentration at work.

The division is very arbitrary, since almost always the patient shows signs of all types of neurasthenia.

"Neurasthenic helmet": symptoms

One of the key signs of neurasthenia is the so-called “neurasthenic helmet”. What is it? This is a headache accompanied by:

a feeling of muscle squeezing;
the illusion of a tight "hoop" put on the skull;
tingling.

The onset of the syndrome is associated with an increase in receptor sensitivity, which is associated with an asthenic state and characteristic muscle tension. Sometimes a person instinctively tries to take off or straighten a hat, bandage, hoop: the sensations are so real. This is the "neurasthenic helmet", the treatment of which involves direct therapy for neurasthenia. When the neurosis itself disappears, the pains will also go away.

Neurasthenia: self-treatment

At the initial stage of the formation of the disorder, it is likely to be cured at home. For this, the patient needs:

Observe the mode of work and rest. Since it is overwork that often becomes a triggering factor for the development of neurasthenia, the patient is important recover mentally, physically, emotionally... It is advisable to take at least a short vacation and devote it to rest. And after returning to work, you need to limit yourself in work: do not take things home, take a short break every hour and a half, disconnect from problems on weekends, etc.
Eliminate the cause of the overvoltage. Neurasthenia arises as a reaction of the psyche to something that it is unable to "digest". And this factor needs to be removed. Most often we are talking about hard work, but also the cause of constant stress can be an uncomfortable environment in the family, money problems, bad relationships with friends, etc. Anything that makes you nervous is contraindicated in a neurotic.
Take care of the body. You should start eating right, taking vitamins, playing sports, walking in the fresh air: all this will help you recover as soon as possible. It is also advisable to give up alcohol, cigarettes and other stimulants (energy drinks, strong coffee or tea).

In many cases, a complete lifestyle change is shown to the neurasthenic. Searching for a new job, normalizing the daily routine, moving to another apartment - such steps not only help to remove the stress factor, but also make the psyche "start up".

Neurasthenia: treatment - drugs and psychotherapist help

Neurasthenia is a mental disorder and there is nothing strange about getting rid of it under the supervision of an appropriate specialist. The main direction of treatment is psychotherapy, during which the patient is helped to understand the problem and find ways to solve it. Additionally, it may be recommended:

acupuncture;
electrosleep;
massage;
the use of soothing teas and infusions (from chamomile, lemon balm, mint, valerian);
taking baths with needles, calamus, bran added to the water.

The use of medication is an extreme therapeutic measure. Medication does not fix the problem, it only makes you feel better temporarily. Although sometimes it is necessary: pharmacy products provide periods of "enlightenment" when a person can simply pull himself together. Among the most common drugs for neurasthenia:

Antioxidants (Mexidol).
Nootropics (Encephabol, Aminalon).
Tranquilizers (Alprazolam, Atarax).

Sometimes homeopathic or sedatives are prescribed. Treatment is usually outpatient, hospital is rarely indicated. For successful therapy, the support of relatives and friends is important: they should not aggressively respond to the irritability of a neurasthenic or reproach him for laziness - all these are signs of an illness that a person cannot suppress.

The prognosis of treatment is favorable. Neurasthenia responds well to therapy and about ¾ of people recover completely. But only if they follow all the recommendations of a specialist and, most importantly, they remove the main stress factor from their lives.

Article author: Maria Barnikova (psychiatrist)

Neurasthenia: how to overcome the state of neuropsychic weakness?

17.06.2016

Maria Barnikova

Neurasthenia affects both men and women equally. The causes, signs, and coping methods of the disorder are described in this article.

A separate group of non-psychotic level disorders includes pathological conditions with not pronounced changes in the mental sphere -. All disorders of this group can be described as debilitating neuropsychic weakness, the development and course of which, as well as methods of compensation, are due to the action of psychogenic factors.

There are various divisions of neuroses into separate types. The most common type of neurotic disorder is neurasthenia., also called asthenoneurotic syndrome or asthenic neurosis. In some sources of neurasthenia, due to the similarity of the symptoms manifested, it is equated with chronic fatigue syndrome, although according to the latest scientific research, these two psychogenic conditions have completely different pathogenesis and require different treatment.

What is neurasthenia? Description

Neurasthenia implies severe depletion of the nervous system, which is clinically accompanied by a number of specific signs. The leading symptoms of asthenic syndrome are a decline in endurance to physical and mental stress, fatigue from habitual activity, increased irritability, instability and rapid mood swings. Neurasthenia manifests itself as unpleasant somatic and neurological symptoms: cephalalgia, muscle pain of a psychogenic nature, autonomic dysfunctions, disruptions in the sleep-wake mode.

At the heart of neurasthenia is the breakdown of higher nervous activity, which is a reversible phenomenon regardless of the intensity and duration of the symptoms shown. Neurasthenia differs from psychosis by the complete absence of psychotic syndrome: manifestations of personality disorders do not reach the level at which a critical attitude towards their condition is lost and the adaptation of an individual in society is disrupted. This disorder proceeds without any signs with the person's full awareness of his illness. Neurasthenia is subjectively perceived by a person as a severe pathology. This asthenic disorder can significantly impair a person's quality of life.

Unlike psychopathies and psychosis, neurasthenia occurs after a real psycho-traumatic situation, which is combined with an excessive overload of the body and a lack of physiological amenities, for example: regular lack of sleep. The development of asthenic syndrome is facilitated by viral and bacterial infections, chronic intoxication of the body and other painful conditions of organs and systems.

Asthenic neurosis is determined with equal frequency in representatives of both sexes, while the overwhelming number of patients are mature people of working age over 25 years old. In women, the symptoms of neurasthenia are much more severe; in them, this disorder is often aggravated by more serious pathologies. In the last decade, neurasthenia has often been recorded in children and adolescents who are overloaded with educational activities, extracurricular sports or intellectual activity.

Most of the people who have been diagnosed with neurasthenia are residents of large metropolitan areas. However, to argue that asthenic neurosis is the result of a busy life in industrial centers is not entirely fair, since until now the mentality of villagers is used to attributing the symptoms of asthenic disorders to banal passing fatigue. In addition, not every village hospital has a vacancy for a neurologist and psychiatrist who can carry out competent diagnostic measures and differentiate this type of neurosis from other painful conditions.

Causes of neurasthenia

The most widely recognized today is the polyfactorial model of the etiological causes of neurasthenia. This construction is based on a comprehensive study of various factors, the impact of which initiates the onset of asthenic neurosis.

Among the most likely causes of the disease is a group of biological factors. Among them unfavorable heredity - a family history of neurotic and psychotic disorders, which were recorded in close relatives of the patient. Here is presented the severe course of pregnancy of the patient's mother, serious infectious diseases, complex flow generic activity and birth trauma to the infant. Among the biological reasons - the innate constitution of a person: features of the functioning of the nervous system.

The psychological foundations of neurasthenia include premorbid personality traits. Weighty the reason for the development of pathology arereceived in childhood. An extremely negative factor that creates the basis for the formation of neuroses is the long stay of the individual in a traumatic situation. A sudden onset of the disease is often recorded after intense, sudden stress, the circumstances of which are extremely relevant and important for a person.

Scientists also name the social causes of asthenic disorder. In this group: features of the psychological climate in the parental family, the conditions for upbringing and growing up... Plays a significant role and patient's social environment: social circle of a person, sphere of his interests, degree of satisfaction of personal claims.

Forms of neurasthenia

In clinical practice neurotic disorders conventionally divided into three separate forms:

hypersthenic (excitable);
irritable weakness;
hyposthenic (inhibitory).

All these forms reflect the severity of the course of neurasthenia, being specific stages of this disorder. Since asthenic neurosis is characterized by a gradual increase in the intensity of symptoms, that is, an aggravation of pathology, the above forms convey the sequence of phases of the disease. However, in many patients the painful condition is fixed in one definite form: at the first or second stage, that is, in fact, there is no negative dynamics. For this reason, the diagnosis is often formulated as follows: hypersthenic or hyposthenic neurasthenia, asthenic neurosis in the form of irritable weakness.

Symptoms of certain forms of pathology

The initial phase of the disease - the hypersthenic form is the most common type recorded in clinical practice. The main symptoms of this stage are: increased excitability of the central nervous system, excessive irritability and nervousness.

The individual exhibits inadequately strong responses to a minor stimulus. He is unnerved by the slightest noise, sharp and loud sounds, bright light, the ticking of a clock, the creak of doors. A person is unbalanced by the presence of people, their conversations and movements. For an accidental and insignificant reason, a person has outbursts of irritation and anger. The patient feels that he cannot control his emotions and restrain his impulses. He is able to offend and offend others, while he himself does not understand the nature of his aggression.

No less pronounced symptoms of a hypersthenic form: fussiness, impatience, impetuosity of actions. A patient with neurasthenia cannot wait, seeks to do everything at once, grabs several things at the same time. However, the individual's performance deteriorates significantly. At the same time, the decline in labor productivity is not due to rapid fatigue, but as a result of dispersal, inconsistency, inability to concentrate on the action being performed. Having started an activity, a person cannot be collected for a long time, because he is constantly distracted by external stimuli.

The leading symptoms of neurasthenia also include significant disruptions in the sleep-wake mode. In the daytime, the individual is lethargic and sleepy, and sleeps at night. restless sleep with sudden awakenings. He is overcome by nightmares, the plot of which often reflects the real worries of a person. With neurasthenia, both the process of falling asleep and the stage of awakening change to some extent. During the evening hours, the subject is unable to sleep for a long time. In the morning, he either wakes up much earlier than usual, or wakes up very late with a feeling of heaviness and weakness.

Constant symptoms of neurosis are debilitating headaches of a squeezing, constricting nature. There is even a special name for cephalalgia - "neurasthenic helmet". When tilting and turning the head pain spread to the back, as if descending along the spine. The intensity of pain increases after physical exertion or mental stress.

Intermediate stage of the disease is called "irritable weakness". This phase reflects the clinical essence of neurasthenia: a combination increased irritability with a very rapid depletion of the body's resources. During this period, sudden bouts of irritation reach their maximum intensity. Excessive excitability is accompanied by tearfulness unusual for a person. From outbursts of anger, the patient easily passes to tears arising from the fact that he is unable to overcome the obsessive feeling of "global" discontent. Lability of mood is pronounced: gaiety is quickly replaced by a depressive state. Signs of mental exhaustion are observed: the individual becomes lethargic, gloomy, apathetic to everything that happens.

Decreases or completely disappears appetite. A variety of digestive problems appear: constipation or diarrhea, heartburn and belching. Among vegetative symptoms, a frequent companion of neurasthenia is: fluctuations in blood pressure, increased heart rate, pulse lability.

Often, sympathoadrenal crises are recorded: the appearance of "flies" in front of the eyes, a feeling of instability and unsteadiness, a feeling of weakness in the limbs. At the slightest excitement, a person turns red or pale, feels chills or hot flashes. Frequent complaints of frequent urge to urinate, which are observed with anxiety. The attraction to the opposite sex is significantly reduced, men can find problems with potency.

The third stage of neurasthenia - hyposthenic phase - characterized by lethargy and weakness, all-consuming apathy, depression and a gloomy mood. A person cannot motivate himself to perform any actions, since all his thoughts are focused on unpleasant somatic sensations. However, in the emotional background there are no affects of melancholy, no pathological one is observed.

Diagnostics

Distinguishing neurasthenia from other pathological disorders is not difficult. An experienced physician is able to quickly differentiate asthenic disorder from other pathological states of the psyche. The main task is to exclude any organic lesions of the central nervous system and oncological pathologies accompanied by asthenic syndrome.

Treatment

In the treatment of neurasthenia, the leading role is played by measures aimed at eliminating or at least minimizing negatively influencing factors. The main emphasis in treatment is placed on the prevention of overload, optimization of the work and rest schedule, and ensuring a full night's rest.

During a conversation with a patient, the doctor explains to the patient the features of his condition and indicates the conditions, the creation of which is necessary to normalize the state of the psyche. Psychotherapeutic work also aims at teaching a person constructive forms of resistance and motivating the patient to make radical changes in their lifestyle. The goal of the doctor: to explain that the symptoms of neurasthenia are not a sentence, but surmountable circumstances with the exclusion of harmful factors. The task of the doctor is to establish negative circumstances together with the patient and take constructive measures to overcome their impact. Recommended interventions for treating the disorder include:

strict adherence to the daily routine;
sufficient and quality night rest;
revision of the diet and drawing up a menu of products with the most useful substances;
sufficient physical activity;
daily stay in the fresh air;
breathing exercises;
water treatments, in particular: tonic contrast shower.

Of particular importance for getting rid of neurasthenia is teaching the patient relaxation skills: autogenous training, self-hypnosis, techniques for relieving emotional stress. Among the fortifying measures: physiotherapy, massage, electrosleep.

The basis of drug treatment: natural adaptogens, stimulants, vitamin and mineral complexes. A patient with neurasthenia must be prescribed B vitamins and magnesium preparations.

Of sedatives prefer drugs vegetable origin, for example: persen (Persen). As a general tonic in the treatment of neurasthenia, agents that improve tissue metabolism are used, for example: calcium glycerophosphate (Calciiglycerophosphas). From medicines with a tonic effect, it is advisable to use a stimulant of the central nervous system - Pantocrinum (Pantocrinum).

With hypersthenic neurasthenia, muscle relaxant (Elenium) is often used in treatment. The hyposthenic form of neurosis often requires the use of tranquilizers, for example: Rudotel. For any form of neurasthenia, the antipsychotic thioridazine can be used in treatment, however, taking this antipsychotic requires careful study of the patient's history due to a wide range of side effects.

The prognosis of neurasthenia with a correctly selected treatment regimen and patient compliance with all medical measures is favorable. However, there is always a risk of relapse of neurosis, therefore, it is of particular importance to carry out preventive and general strengthening measures.

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Categories of people at risk:

spending little time in the fresh air;
leading a monotonous lifestyle, not rich in a change of impressions;
engaged in mental work.

The mechanism of development of neurasthenia is a disorder of brain activity, which ensures the adaptation of a person to external factors. As a result, somatic disorders occur in the nervous system, which are noted during the examination on an electroencephalogram.

THE REASONS

The main reason for the onset of neurasthenia is the exhaustion of the nervous system, which occurs as a result of a combination of various circumstances.

Factors contributing to the development of neurasthenia:

chronic lack of sleep;
lack of vitamins;
intoxication due to alcohol or tobacco dependence;
disturbances in the endocrine system;
damage to the body by bacterial and / or viral infections;
increased physical activity;
hereditary predisposition;
stress.

A person's constant dissatisfaction with his life - work, personal relationships, as well as frequent conflicts in the family can also aggravate the situation and initiate malaise.

CLASSIFICATION

There are three forms of neurasthenia:

Hypersthenic neurasthenia: the initial stage of the disease, characterized by increased excitability and irritability, which accompany the patient in all areas of his life. The patient can get nervous from the slightest noise, touch, reacts extremely irritably to the actions and words of the people around him, closes in himself. With hypersthenic neurasthenia, there is also a decrease in working capacity, apathy, and unwillingness to do everyday activities. Symptoms, as a rule, intensify in the morning - the patient complains of depressed mood, physical and psychological discomfort, feelings of weakness and fatigue.

Irritable weakness: the second form of the disease, which occurs in the absence of timely therapy of the first. It is characterized by a constant change of mood - frequent bouts of anger and irritability are replaced by periods of weakness, apathy, depression. Distinctive feature this stage is the short duration of alternating periods: they can last only a few minutes. Patients complain of memory impairment, loss of control over emotions, their appetite worsens. One of the main indicators that neurasthenia has passed into the second stage is serious sleep disturbances: difficulties with falling asleep and waking up, shallow, superficial sleep that does not bring a person a feeling of cheerfulness. The disease is accompanied by disorders that outwardly have nothing to do with the nervous system: indigestion, heartburn, belching, loss of appetite, feeling of heaviness in the stomach.

Hyposthenic neurasthenia: the last form of the disease, in which the patient experiences severe psycho-emotional and physiological weakness, accompanied by apathy, increased sleepiness, chronic fatigue... He loses interest in life, there is tearfulness, emotional instability. During this period, the patient is characterized by an obsession with his inner experiences and sensations, accompanied by a heightened perception of the indifference of others. There are signs of so-called neurotic depression.

SYMPTOMS

In patients with neurasthenia at different stages, general symptoms are noted, which differ in the frequency and intensity of manifestations. This, first of all, includes a decrease in working capacity: under the burden of internal experiences, the patient loses the ability to fully concentrate on mental activity. Physical activity also suffers. The reason for this is the exhaustion and apathy that accompany neurasthenia.

The disease is characterized by a regular headache that does not have pronounced localization and spreads throughout the head (diffuse). As a rule, it appears in the afternoon and intensifies in the evening. The pain is often accompanied by an unpleasant sensation of squeezing the head - this symptom was called by doctors a "neurasthenic helmet".

Suffers with neurasthenia the cardiovascular system: the patient is tormented, pain, squeezing and tingling in the heart, shortness of breath, increased blood pressure. At the same time, the skin color changes from pale to dark red in a short period of time.

Hypersthenic neurasthenia outwardly often manifests itself with symptoms such as trembling of the eyelids, fingers, chin, increased gesticulation, an increased, loud voice, increased sweating, excited glitter of the eyes.

With hyposthenic neurasthenia, on the contrary, there is muscle sluggishness and slowness of movements, dry skin, an extinct look, inhibition of reactions.

In some cases, patients with neurasthenia have disturbances in work. genitourinary system, which are manifested in an increased urge to urinate, lack of sexual desire, in men - premature ejaculation during intercourse, erectile weakness. These changes are reversible, and usually sexual dysfunction goes away when recovery occurs.

DIAGNOSTICS

Diagnosis of neurasthenia is not difficult. The disease is easily differentiated from other ailments associated with disruption of the central nervous system, due to the abundance of characteristic and well-expressed symptoms. At the first visit, the patient may be assigned a neurological examination in order to exclude organic damage to the central nervous system, however, this need arises quite rarely. The final diagnosis is made by the doctor based on the patient's complaints and a superficial examination.

TREATMENT

In the treatment of neurasthenia, the identification and elimination of the causes that caused it are of paramount importance. If the patient himself finds it difficult to determine what exactly served as the start for the disease, a psychologist or psychotherapist may be involved in the treatment. Not the last place is also drug treatment, as well as methods aimed at streamlining the patient's life.

The neurasthenia treatment method includes:

vitamin therapy;
a strict daily regimen, in which a certain time is allocated for work and rest, depending on the natural pace of life, workload, work schedule and the patient's temperament;
high-quality and timely nutrition, rich in vitamins and minerals necessary for the functioning of the nervous system;
obligatory 8-10 hours sleep;
if necessary, a temporary change of environment (sometimes a change of work);
daily stay in the fresh air for at least 30 minutes;
giving up bad habitsthat contribute to the intoxication of the body and the gradual depression of the nervous system;
refusal to watch depressive TV shows, films, reading books with negative content;
expanding the circle of hobbies and acquaintances;
in advanced cases, treatment in a hospital under constant medical supervision may be indicated, with the use of tranquilizers, antidepressants, nootropics, vasodilators, as well as medications that improve metabolic processes in the brain.

Excellent results are obtained from sports, especially those related to the aquatic environment - swimming, aquafitness, snorkeling, etc. Simple home hardening procedures, such as contrast showers, douches, foot and hand baths, also help well.

COMPLICATIONS

In the absence of timely treatment, neurasthenia can turn into protracted depressive psychoses, requiring more serious and prolonged correction. The increased production of adrenaline, which is accompanied by neurasthenia, negatively affects the functional state and work of internal organs, however, this symptom is temporary and disappears without a trace after recovery.

PREVENTION

Methods for the prevention of neurasthenia largely coincide with its treatment. To maintain psycho-emotional stability, one should, if possible, avoid nervous overload and stress, try to sleep at least 7 hours a day, and allocate enough time for rest and leisure.

RECOVERY FORECAST

All types of neurasthenia have a favorable prognosis for cure, provided that the patient carefully follows the doctor's recommendations. The transition of the disease to more serious conditions occurs rarely and solely due to the lack of timely and adequate psychological and medical assistance.

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