What does neurosis mean? Neurosis. Causes, symptoms and treatment of pathology. Causes of obsessive-compulsive neurosis

Neurosis is one of the most common neuropsychiatric diseases. The main cause of neuroses is psychotrauma, the importance of which is determined not by physical impact, but by informational value. In other words, neurosis is a disease that occurs as a result of exposure to information.

Neuroses and neurotic conditions are reversible disorders nervous activity. Psychotherapy for neuroses is most often successful.

The development of the disease is influenced by both genetic properties nervous system, as well as personal attitudes and views that were formed during life.

What is also important is the individual’s ability to critically assess what is happening, which allows one to determine a strategy for adequate behavior even in a difficult situation, the ability to overcome difficulties and find solutions in dead-end situations.

The prevalence of patients with various neuroses reaches about 40-45% of all patients. Over 5% of the Russian population suffers from severe neuroses.

Types of neuroses:

• Hysteria or hysterical neurosis;

• Obsessive-compulsive disorder (obsessive-compulsive disorder), which includes bulimic neurosis and hypochondriacal neurosis.

The so-called “neuroses of internal organs”, psychogenic somatic disorders, are a manifestation of one of the types of neuroses - hysteria, neurasthenia or obsessive states.

Violations of mental functions that were formed under the influence of information are not as severe as the consequences of severe physical injuries, and most importantly, they are reversible.

However, if neurosis is not treated, it can seriously affect your personal life. A person often begins to experience negative experiences and is constantly in a destructive state:

• pessimistic;

• unsure of himself;

• angry;

• irritated;

• unhappy;

• tired; tired

• passive;

• dissatisfied;

• scared;

• alert;

• tortured;

• pathetic;

• sad;

• broken;

• apathetic.

A person suffering from neurosis ceases to notice the joys and pleasures of life. If you leave everything as it is, then as a result the disease will develop and progress. Therefore, it is better to take one of two options:

1. Start changing yourself and your life.

2. Seek help from a specialist, which will solve the problem faster and more efficiently.

A disease such as neurosis, the symptoms and treatment of which can be determined by a specialist, is an etiologically complex pathology. The clinical picture of the disease is very clear and may appear mild at first, so many simply do not pay attention to the symptoms.

The disease has a long course. There are neurotic disorders different types. In this case, a person loses performance due to the inability to concentrate on daily activities. Depending on the stage and type of disease, appropriate treatment is prescribed.

What is pathology, types of disorders

What is neurosis and how to treat it? This is the question faced by most people who have been diagnosed with this problem. represent personality disorders at the behavioral level. In this case, pathological changes in the autonomic nervous system often occur with characteristic signs.

Neurosis - what it is and why it occurs will be interesting to know for many who suffer from this disease. The etiology of the disease lies in the intrapersonal conflict that occurs with reduced psychological protection. A person becomes sensitive to various little things.

Neurotic disorders occur without functional impairment of brain activity. However, a breakdown occurs against the backdrop of an already existing conflict. In this case, a wide variety of provoking factors may be present. The body can respond to minor effects with psychosomatic manifestations. People are exposed to the disease long time living in stressful situations.

The types of neuroses are as follows:

1. Neurasthenia. Occurs with prolonged exposure to the psyche of any provoking factor. These include problems in your personal life, troubles at work, and internal conflicts. At the same time, the psyche works towards repression. The forms of neuroses in this group are characterized by increased irritability of a person, even over small things that do not cause any reactions in healthy people.
2. Hysteria. Forms of neurosis of this type are characteristic of women. Men suffer from this type least often. In this case, psychological perception becomes irrational. A person is hostile to the world. Even a minor nuisance leads to a nervous breakdown and prolonged hysterics.
3. Obsessive-compulsive neurosis. The types of neuroses of this type have an extensive classification. This pathology is characterized by the presence large quantity unreasonable fears. Such patients are afraid of dying, of contracting a terrible disease, and always exaggerate the danger.

Neuroses, the classification of which is quite diverse, despite the absence of obvious changes in work internal organs, often manifested by pronounced physiological signs. Each type has its own characteristic symptoms.

Causes of the disease

Neurotic disorders have their own causes. The doctor tries to identify them, because only by identifying the provoking factor can one effectively recover. The classification of neuroses identifies separate causes for each type. They are based on a person’s prolonged stay in a stressful situation.

Chronic neurosis, the types of which are also diverse, often occurs in the presence of a traumatic situation for the psyche. This may be a previously unresolved internal conflict that may begin in childhood. The classification of neuroses allows us to distribute the causes depending on the type of manifestations.

The disease can continue for a considerable period. The main thing that distinguishes pathology is the inability of a person to quickly recover from what he received. That is, some provoking factor operates constantly. It could be:

• long and hard work;
• constant conflicts at home;
• dissatisfaction with oneself.

Some types of neuroses tend to progress. This is an extremely unfavorable factor. Representatives of the stronger sex react sharply to sexual failures and lack of opportunity to express themselves as individuals. The causes of neurosis in men may lie in dissatisfaction with oneself.

Only a neurologist or psychotherapist can make an accurate diagnosis. The causes of neuroses may be the following:

• dead-end and difficult situations from which it is difficult to find the right way out;
• inability to relax and unwind;
• an increased sense of responsibility, which provokes tension;
• overwork;
• difficult emotional situation at home or at work.

Neurosis, the causes of which also lie in the traumas of adolescence and childhood, is sometimes very difficult. A neurologist recognizes the problem immediately by its characteristic symptoms. The cause of the disease is the inability to digest the situation that has arisen. With neurosis, a vicious circle occurs. A person is unable to get out of it. Neurotic disorder intensifies when trying to resist the situation.

What is it and what are the characteristics of this pathological process? The disease develops slowly, stress accumulates gradually. In this case, a provoking factor can be constant employment at work, which requires a lot of effort and dedication. When a person ceases to control the load, the first signs of a neurotic state appear, characterized by increased sensitivity to any stimulus.

Diseases that occur in a severe form and lead to weakening of the body can also provoke pathology. These include HIV, AIDS, oncology and even influenza. In this case, the body begins to suffer not only physically, but also psychologically. It is difficult for such people to recover.

Whatever the type of illness, the reasons always lie in a weak psyche, which is not able to recover quickly, but is prone to self-destruction.

Symptoms of the disease

Currently, there is a classification that identifies certain stages of neurosis. Depending on this, symptoms appear. An experienced neurologist can determine the presence of the disease based on certain signs already at the first consultation.

Symptoms of neuroses may be the following:

• aggressive behavior that manifests itself even under minor stress;
• tendency to fall into despair even over trifles;
• increased tearfulness.

Signs of neurosis are complemented by touchiness, which is not typical in a given situation. A person can be upset even when healthy people They don’t pay any attention to minor difficulties. At the same time, such patients tend to exaggerate the problem and invent it.

Symptoms of neurosis in women increase as they fluctuate menstrual cycle. As a rule, closer to menstruation, the signs of the disease become more pronounced. The woman becomes especially vulnerable. Constant anxiety complements symptoms in adults. A person never relaxes, but constantly maintains a tense state. This can also be seen in the muscles. They are often tense and overly mobile. It is quite difficult for sick people to maintain a relaxed state.

How does the disease manifest itself? Often a person becomes fixated on a certain problem. She literally can't get it out of his head. Performance suffers. Neuroses in adults, the symptoms and signs of which often prevent a person from leading a normal lifestyle, worsen social adaptation. The neurologist often notes manifestations of constant fatigue and the inability to concentrate on incoming information. All this is due to a shift in the focus of perception towards the exciting problem. The person seems to notice nothing except the traumatic situation or thought.

If the disease affects children, they become difficult to learn, which reduces their performance compared to their peers. Manifestations also include increased sensitivity to sound and light effects. Patients perceive any rustle with irritation. It is very easy to piss off such a person.

This mental disorder also provokes early awakening. People with this disease have trouble sleeping and have nightmares. The sleep is superficial. Any rustle causes a sharp awakening and increased anxiety.

Additional symptoms

A neurologist or specialist in psychology can determine pathology by the presence of obsessive states. At the same time, disturbances appear in the activities of many organs. Most often the gastrointestinal tract is affected, increased sweating, tachycardia and racing occur. blood pressure. A person may experience nausea, dizziness and vomiting.

Manifestations often relate to sexual function. Libido decreases and there is no satisfaction after sexual intercourse. Many patients look for an excuse not to have sex, as their sensations become dulled.

Signs of the disease are manifested by muscle spasms. The syndrome is often present restless legs. Convulsions may occur. Sudden deafness or paralysis overtakes a person with hysteria at the most unexpected moment. A severe attack can also manifest as sudden fainting, which is accompanied by loss of coordination and dizziness.

People with obsessive-compulsive disorder often panic, since any symptom that appears is attributed to a terrible disease. Moreover, any painful sensation can provoke despair and tears. Patients begin to suspect that they have cancer. Nervous tension causes the muscles to spasm, which causes an increase in symptoms.

The diagnosis of neurosis also applies to behavioral disorders. A patient who consults a doctor, usually at the last stage, almost completely loses normal adaptation. Such people try to avoid increased attention and become anxious, even if they were simply looked at in some way wrong.

Types of neurotic disorder, the symptoms of which are often associated with memory impairment, have the ability to manifest themselves in the form of constant drowsiness. Decreased mood, anxiety states followed by apathy, belong to the advanced stage of the pathology.

Neuroses, the symptoms and treatment of which should only be determined by a psychotherapist and neurologist, occur with varying degrees of intensity.

Methods of treating the disease

Neurosis is treated comprehensively. The disease can be treated only if the main provoking factor is identified. Many people are interested in how long neurosis lasts. Sometimes, pathology can last for decades or more.

In severe forms, treatment of neuroses is carried out in a hospital. In this case, various anti-anxiety drugs are used medicines in the form of injections. How to cure neurosis? First of all, you need to contact a specialist who will help diagnose the stage of the pathology. It is important to know which doctor treats neurosis. This problem is dealt with by a psychotherapist and a neurologist.

In most cases, the disease can be successfully treated, of course, provided that the patient himself is aware of the presence of the disease. An unfavorable prognosis for those who treat the pathology at home.

The number of psychotherapy sessions is prescribed by the doctor, and also determines how long this stage is treated and how long you need to visit the hospital. Anti-anxiety medications help restore normal psychological balance. The man relaxes. Is it possible to cure neurosis forever with just pills? The answer is clear: of course not. Drugs only help to bring a person out of a critical situation for him.

Treat psychoneurosis with enough time. It is impossible to solve an old problem in 40 minutes of consultation. First, the doctor determines the stage of the disease and the severity of the symptoms. Then he begins to ask leading questions.

Neurosis is curable, but there is no point in relying on a single visit to the doctor. Psychotherapy involves a large number of sessions. But first of all, the patient must understand the delusion of his thoughts, see their exaggeration.

Additional treatment information

Neurosis and how to treat the disease are of interest to many who are faced with this problem. If a severe attack occurs, which is accompanied by a breakdown, then first of all the patient is prescribed sedative drugs. These include relaxants and herbal products. After the attack has stopped, individual psychotherapy is prescribed.

What medications can be used must be discussed with your doctor. Additionally, medications for the gastrointestinal tract are often prescribed, as the patient complains of stool disorders, nausea and vomiting. But after high-quality psychotherapy, discomfort and false manifestations quickly disappear without special therapy.

Only a doctor treats neuroses. It is not possible to get rid of the disease using any home remedies. A man's disease is easier to treat than a woman's. Perhaps this is associated with increased hormonal activity of the fairer sex and frequent fluctuations in estrogen and progesterone at different phases of the menstrual cycle.

In this case, the disease quickly passes, and the body recovers due to individual approach to the problem. Bad thoughts are gradually replaced by positive attitudes. First of all, the doctor begins to work with old injuries, identifying what caused damage to the person when he was still a child.

The specialist’s task is to bring the patient’s condition to complete recovery. There are many practices for this. It’s as if the problematic situation is taken out of the depths of the subconscious and worked through. There are ways to destroy a negative image. At the same time, the person’s lost ability to recover from stress returns.

It is recommended to present a negative image on a piece of paper or draw it, then burn it. Again, mentally or realistically. Such pathological conditions related to neuroses, treatment is provided depending on the intensity of the manifestation. There are a great variety of techniques available. The doctor will determine which one to use.

Treatment of additional types of neuroses

Facial nerve neurosis is treated in a comprehensive manner. With this type of pathology, painful sensations in the jaw may occur. A person feels constrained when speaking. Numbness and paralysis may be felt. Often the patient becomes frightened, falsely believing that he is having a stroke. In this case, fear may cause blood vessels to spasm, causing a sharp jump in blood pressure with an accompanying heartbeat.

Your doctor may recommend sedatives and muscle relaxants. In this case, light massage is also effective. However, the main therapy falls precisely on psychological approach. Against the background of such diseases, a phobia often develops, manifested by uncontrollable irrational fear. A person begins to visit all the doctors, complaining of pain in almost every system of the body. In this case, the therapist refers the patient to see a psychotherapist.

Often neurasthenia turns into depression. A vicious circle is created. Depressive disorders give rise to apathy; any trouble throws a person out of balance and triggers the mechanism of neuroses. This state turns back into apathy. Sick people try not to leave their homes and avoid events that involve large gatherings of people.

The doctor’s task is to convey to the patient the safety of the space around him. A psychotherapist helps a person get out of his comfort zone and step by step overcome emerging barriers to socialization. Some people, on the contrary, avoid loneliness. In this case, the doctor tries to harmonize the person’s relationship with himself, resolving the existing internal conflict. People with this type of neurosis often do not like themselves. They are not satisfied with their position in society, appearance, etc.

The specialist tries to improve a person’s relationship with the outside world and himself. In this case, various techniques are used to play out problematic and painful situations. The doctor points out the exaggeration of fears. The use of drugs and psychotherapy gives a good prognosis and stabilization of the condition. Whether neurosis can be treated in a particular case can only be said by a doctor.

Today there is hardly a single person with an absolutely healthy psyche. Complexes, fears, phobias, increased anxiety, constant feelings of guilt - all this is cultivated by demands modern society, since childhood, including people in the pursuit of success, recognition, money. And on this soil neuroses grow successfully. What does even someone who considers himself generally “normal” need to know about them?

Neurosis - what is it?

Neurotic disorder, psychoneurosis, neurosis are equivalent names for the category of protracted psychogenic disorders associated with a temporary disruption in the functioning of the psyche. This term was first used in 1776 by the Scottish doctor W. Cullen. And although the concept is widespread in clinical practice, it is still not precisely defined what neurosis is: the meaning of this word has been revised many times, however, the final verdict has not been made.

The term is usually used to designate one of the functional disorders of higher nervous activity, which is accompanied by hysterical, asthenic or obsessive manifestations and a decrease in overall performance. According to various sources, about 1-3% of people suffer from neuroses. Moreover, neurotic disorders can be observed in both adults and children.

The development of a neurotic disorder is always associated with negative influence stress factors, including:

1. High expectations. A person who is constantly trying to “jump in over his head” will not be able to withstand such a rhythm for long. The feeling of an impossible plan can crush anyone.
2. Great physical or mental stress. Prolonged fatigue of any type leads to the formation of neurosis. If the body does not have time to recover from the load, it begins to react to what is happening in the ways available to it, primarily through psychosomatic symptoms.
3. Loneliness, unsettled personal life. The absence of someone close to you significantly increases the chances of developing a disorder. Prolonged stay in the company of oneself does not allow a person to fully realize social needs, which is why signs of neurosis begin to appear.
4. Inadequate self-esteem. Both having a high and low opinion of yourself is harmful to your mental health. In both cases, we are talking about an unrealistic perception of the world, and such distortions are favorable for the formation of all kinds of disorders.
5. Severe stressful situations. Post-stress disorder develops in those who have experienced a traumatic situation: a terrorist attack, an accident, fighting, natural disasters, attacks, etc. Signs of neurosis almost always appear in men who took part in military operations (Afghan neurosis).
6. Childhood trauma. The child is vulnerable. Everything that happens to him before adolescence lays the foundation of his personality. Children whose parents were prone to violence, were addicted to alcohol or drugs, and used overly harsh parenting methods are more likely to become neurotic in the future.

Almost always, the causes of neurosis lie in the characteristics of a particular person. Some people perceive what is happening so painfully and sensitively that their psyche simply cannot cope with the load. By the way, the reaction to negative environmental factors is largely determined genetically. If the parents were suspicious, worried, and depressed, then the children will most likely inherit this pattern of behavior.

Due to increased emotionality, representatives of the fairer sex are more often susceptible to nervous disorders. Often the causes of neurosis in women are associated with entering the menopausal period, when hormonal changes exhaust the body, and the approach of old age forces one to begin to trim down the results of life, which are not always satisfactory.

OCD, neurasthenia and hysterical neurosis - what is it? The main types of neurotic disorder

A huge number of neuroses are conventionally divided into three key types. Among them:

Type of neurosis	Symptoms
Obsessive-compulsive disorder (OCD) is a mental disorder associated with the formation of obsessive habits/thoughts/actions in the patient and the development of fears (phobias).	obsessive thoughts, fears, memories and actions that do not give a person pleasure and are perceived by him as painful obsessive habit of counting steps or cars of any color, knocking a pen on the table a certain number of times and other useless rituals inability to get rid of obsessive experiences, inability to “turn off” them increased level anxiety, suspiciousness hypochondria, expressed fear of getting sick (most often phobias relate to STDs, AIDS, cancer), which is why the patient regularly visits doctors often – claustrophobia (fear of closed spaces) or agoraphobia (fear of open spaces) the desire to avoid any painful or difficult situations that cause fear
Neurasthenia (astheno-nervotic syndrome) is a neurotic disorder that occurs under the influence of mental trauma, physiological restrictions (hunger, lack of sleep) and hard work.	tachycardia even with minor exertion cold extremities increased sweating insomnia decreased appetite, alternating with sudden attacks of extreme hunger excessive sensitivity to light, sound, smells, temperature changes severe headaches noise in ears hypochondria mood swings, irritability decreased learning ability, decreased work productivity memory loss, inability to concentrate
Hysterical neurosis (hysteria) is a personality disorder associated with a tendency to dramatize, theatricality and the need to attract attention.	increased egocentrism very pronounced emotionality (including “theatrical” techniques - tears in public, wringing of hands, lamentations, etc.) obsessive desire to always be the center of attention tendency to exaggerate everything constant change of hobbies demonstrative, unnatural behavior mood swings suggestibility, the desire to pass off an ordinary acquaintance as close friendship or love autonomic disorders (disorder of the gastrointestinal tract, burning and itching of the skin, dizziness, fainting, numbness of certain parts of the body, in severe cases - the development of deafness and blindness) “Munchausen syndrome” (simulation of symptoms of the disease) hysterical attacks, which the patient remembers after they are over

Separately, depressive, phobic and hypochondriacal neuroses are distinguished. Although to one degree or another they may be included in the structure of OCD, neurasthenia or hysteria.

The psychosomatic (somatoform) state of neurosis is characterized by symptoms of a somatic disease (gastritis, angina, etc.) with ideal laboratory tests: that is, vegetative signs arise under the influence of active mental processes, but at the same time the body is physically healthy.

Neurosis: symptoms of a developing disorder

Neurosis does not arise out of the blue. It is formed over a period of time, during which a person goes through three main stages:

1. Neurotic reaction. Represents reversible and short-term actions, emotions, experiences. It is during this period that the first signs of neurosis appear: increased excitability, causeless crying, increased anxiety, fixation of attention on the negative, loss of vitality.
2. Neurotic state. During this time period, a disruption occurs in the system interpersonal relationships. A person begins to look at others from the point of view of neurosis: with hysteria, he demands 100% attention from them, with OCD - respect for meaningless rituals and emerging phobias, with neurasthenia - adjustment to changeable moods. Symptoms of neurosis are becoming more and more obvious, but at the same time the patient’s condition is still reversible.
3. Neurotic personality development. In the absence of proper treatment, the disorder leads to personality mutation and the formation of new character traits. Paranoia, pedantry, increased punctuality, painfully high or low self-esteem, excessive emotionality may develop - depending on the type of neurosis.

“Young” neurosis, the signs of which are just beginning to “bloom,” is best treated. If the problem was not noticed in the first two stages, then further treatment may be ineffective, since the personality changes that have occurred are difficult to correct.

Acute neurosis: symptoms

Acute neurosis is a temporary state into which a person falls immediately after a traumatic situation (or against the background of severe fatigue/negative thoughts, etc.) Symptoms are usually expressed through:

• hysterical attack;
• nausea, vomiting;
• dizziness, fainting;
• abdominal pain;
• headaches;
• blurred vision;
• sweating;
• accelerated heartbeat;
• trembling of limbs.

The emerging signs of neurosis in adults resemble an attack. It is impossible not to notice it, since it knocks a person out of normal life for some time. The patient does not stay in this state for long, but it is not always possible to recover from it: at a minimum, a fear develops of a recurrence of the attack at an unfavorable moment - at school, at work, on the street, etc.

Chronic neurosis: symptoms

Chronic neurosis is a “dormant” disorder. As a rule, it is associated with a change in a person’s personality. This form of neurosis occurs when signs of pathology are completely ignored for a long time (usually lasts from six months to two years).

Standard symptoms of a chronic disorder:

• persistently increased level of anxiety;
• insomnia or persistent nightmares;
• excessively weak or too active appetite;
• inadequate self-esteem;
• mood swings;
• irritability;
• touchiness;
• increased fatigue.

Signs of a chronic disorder are often perceived only as personality traits. Symptoms of neurosis in women are especially often triggered in this way: others attribute any “problems” in behavior to PMS or simply bad character. This is where the serious difficulty of further therapy lies: it is difficult to separate a real person from the neurotic “patina” on him.

Neurosis: treatment

The method of treating a neurotic disorder is selected taking into account the characteristics of a particular case. Psychotherapeutic methods commonly practiced include:

• finding out the root cause of neurosis;
• breathing training;
• training in relaxation methods and methods of removing fixation on a traumatic event;
• changing negative attitudes to positive ones.

Sometimes hypnosis is used. If a specialist considers this necessary, he may recommend drug therapy using drugs that normalize brain processes of excitation and inhibition. For exacerbation of neurosis, Elenium, Relanium, Sibazon, Seduxen, Amizil are indicated.

At home, the patient is recommended to exercise, practice meditation and breathing exercises, to walk alot. Signs of neurosis in women can be relieved well by keeping a diary: the stress splashed out on the pages ceases to have such a strong influence on the patient’s life. Drawing, listening to relaxing music or simply liking music helps a lot.

Neurotic disorders can “catch” anyone. Therefore, you should not be afraid of sudden symptoms of neurosis: in today's realities they are very common. You just need to contact a psychotherapist as soon as possible. The sooner help is provided, the higher the chances of complete restoration of the patient’s personality.

Functional disorders of higher nervous activity psychogenic origin. The clinical picture of neuroses is very diverse and may include somatic neurotic disorders, autonomic disorders, various phobias, dysthymia, obsessions, compulsions, and emotional and mental problems. A diagnosis of “neurosis” can be made only after excluding clinically similar psychiatric, neurological and somatic diseases. Treatment has 2 main components: psychotherapeutic (psychocorrection, training, art therapy) and medication (antidepressants, tranquilizers, antipsychotics, restoratives).

General information

Neurosis as a term was introduced in 1776 in Scotland by a doctor named Couplen. This was done in contrast to the previously stated statement by G. Morgagni that the basis of each disease is a morphological substrate. The author of the term “neurosis” meant functional health disorders that did not have organic damage to any organ. Subsequently, the famous Russian physiologist I.P. made a great contribution to the doctrine of neuroses. Pavlov.

In ICD-10, instead of the term “neurosis”, the term “neurotic disorder” is used. However, today the concept of “neurosis” is widely used in relation to psychogenic disorders of higher nervous activity, i.e., caused by the action of chronic or acute stress. If the same disorders are associated with the influence of other etiological factors (for example, toxic exposure, trauma, previous illness), then they are classified as so-called neurosis-like syndromes.

IN modern world neurosis is a fairly common disorder. In developed countries various forms neurotic disorders affect 10% to 20% of the population, including children. In the structure of mental disorders, neuroses account for about 20-25%. Since the symptoms of neurosis are often not only psychological, but also somatic in nature, this issue is relevant both for clinical psychology and neurology, and for a number of other disciplines.

Causes of neurosis

Despite extensive research in this area, the true cause of neurosis and the pathogenesis of its development are not known for certain. For a long time neurosis was considered an information disease associated with intellectual overload and a fast pace of life. In this regard, the lower incidence of neuroses in rural residents was explained by their more relaxed lifestyle. However, studies conducted among air traffic controllers refuted these assumptions. It turned out that, despite the intense work that requires constant attention, quick analysis and response, dispatchers suffer from neuroses no more often than people in other professions. Among the reasons for their illness were mainly family troubles and conflicts with superiors, rather than overwork during work.

Other studies, as well as the results of psychological testing of patients with neuroses, have shown that it is not the quantitative parameters of the traumatic factor (multiplicity, strength) that are of decisive importance, but its subjective significance for a particular individual. Thus, external trigger situations that provoke neurosis are very individual and depend on the patient’s value system. Under certain conditions, any, even everyday, situation can form the basis for the development of neurosis. At the same time, many experts come to the conclusion that it is not the stressful situation itself that matters, but the incorrect attitude towards it, as destroying a personal prosperous present or threatening the personal future.

A certain role in the development of neurosis belongs to the psychophysiological characteristics of a person. It has been noted that people with increased suspiciousness, demonstrativeness, emotionality, rigidity, and subdepression are more likely to suffer from this disorder. Perhaps the greater emotional lability of women is one of the factors leading to the fact that the development of neurosis in them is observed 2 times more often than in men. Hereditary predisposition to neurosis is realized precisely through the inheritance of certain personal characteristics. In addition, an increased risk of developing neurosis exists during periods of hormonal changes (puberty, menopause) and in persons who had neurotic reactions in childhood (enuresis, logoneurosis, etc.).

Pathogenesis

The modern understanding of the pathogenesis of neurosis assigns the main role in its development to functional disorders of the limbic-reticular complex, primarily the hypothalamic part of the diencephalon. These brain structures are responsible for ensuring internal connections and interaction between the autonomic, emotional, endocrine and visceral spheres. Under the influence of an acute or chronic stressful situation, integrative processes in the brain are disrupted with the development of maladaptation. However, no morphological changes were noted in the brain tissue. Since disintegration processes cover the visceral sphere and the autonomic nervous system, in the clinic of neurosis, along with mental manifestations, somatic symptoms and signs of vegetative-vascular dystonia are observed.

Disruption of the limbic-reticular complex in neuroses is combined with neurotransmitter dysfunction. Thus, a study of the mechanism of anxiety revealed a deficiency of noradrenergic systems of the brain. There is an assumption that pathological anxiety is associated with an abnormality of benzodiazepine and GABAergic receptors or a decrease in the amount of neurotransmitters acting on them. The effectiveness of treating anxiety with benzodiazepine tranquilizers confirms this hypothesis. The positive effect of antidepressants that affect the functioning of the serotonergic system of the brain indicates a pathogenetic connection between neurosis and disorders of serotonin metabolism in cerebral structures.

Classification

Personal characteristics, the psychophysiological state of the body and the specific dysfunction of various neurotransmitter systems determine the diversity clinical forms neuroses. In domestic neurology, there are three main types of neurotic disorders: neurasthenia, hysterical neurosis (conversion disorder) and obsessive-compulsive disorder. All of them are discussed in detail in the corresponding reviews.

Depressive neurosis, hypochondriacal neurosis, and phobic neurosis are also distinguished as independent nosological units. The latter is partly included in the structure of obsessive-compulsive disorder, since obsessions are rarely isolated and are usually accompanied by obsessive phobias. On the other hand, in ICD-10, anxiety-phobic neurosis is included as a separate item called “anxiety disorders”. According to the characteristics of clinical manifestations, it is classified as panic attacks (paroxysmal vegetative crises), generalized anxiety disorder, social phobias, agoraphobia, nosophobia, claustrophobia, logophobia, aichmophobia, etc.

Neuroses also include somatoform (psychosomatic) and post-stress disorders. With somatoform neurosis, the patient's complaints are fully consistent with the clinical picture of a somatic disease (for example, angina, pancreatitis, peptic ulcer, gastritis, colitis), however, during a detailed examination with laboratory tests, ECG, gastroscopy, ultrasound, irrigoscopy, colonoscopy, etc., this pathology is not detected. There is a history of a traumatic situation. Post-stress neuroses are observed in persons who have survived natural disasters, man-made accidents, military operations, terrorist attacks and other mass tragedies. They are divided into acute and chronic. The first are transient and appear during or immediately after tragic events, usually in the form of a hysterical attack. The latter gradually lead to personality changes and social maladaptation (for example, Afghan neurosis).

Stages of development of neurosis

In their development, neurotic disorders go through 3 stages. In the first two stages, due to external circumstances, internal reasons or under the influence of treatment, neurosis may cease to exist without a trace. In cases of prolonged exposure to a traumatic trigger (chronic stress), in the absence of professional psychotherapeutic and/or medicinal support for the patient, the 3rd stage occurs - the disease passes into the stage of chronic neurosis. Persistent changes occur in the structure of the personality, which remain in it even with effectively carried out therapy.

The first stage in the dynamics of neurosis is considered to be a neurotic reaction - a short-term neurotic disorder lasting no more than 1 month, resulting from acute psychological trauma. Typical for children. As an isolated case, it can occur in completely mentally healthy people.

A longer course of a neurotic disorder, changes in behavioral reactions and the emergence of an assessment of one’s illness indicate the development of a neurotic state, i.e., neurosis itself. An uncontrollable neurotic state for 6 months - 2 years leads to the formation of neurotic personality development. The patient’s relatives and the patient himself talk about a significant change in his character and behavior, often reflecting the situation with the phrase “he/she was replaced.”

General symptoms of neuroses

Autonomic disorders are multisystem in nature and can be either permanent or paroxysmal (panic attacks). Disorders of the nervous system function are manifested by tension headaches, hyperesthesia, dizziness and a feeling of unsteadiness when walking, tremors, shudders, paresthesias, muscle twitchings. Sleep disturbances are observed in 40% of patients with neuroses. They are usually represented by insomnia and daytime hypersomnia.

Neurotic dysfunction of the cardiovascular system includes: discomfort in the cardiac region, arterial hypertension or hypotension, rhythm disturbances (extrasystole, tachycardia), cardialgia, pseudocoronary insufficiency syndrome, Raynaud's syndrome. Respiratory disorders observed in neurosis are characterized by a feeling of lack of air, a lump in the throat or suffocation, neurotic hiccups and yawning, fear of suffocation, and an imaginary loss of respiratory automaticity.

On the part of the digestive system, dry mouth, nausea, loss of appetite, vomiting, heartburn, flatulence, vague abdominal pain, diarrhea, and constipation may occur. Neurotic disorders of the genitourinary system cause cystalgia, pollakiuria, itching or pain in the genital area, enuresis, frigidity, decreased libido, and premature ejaculation in men. A disorder of thermoregulation leads to periodic chills, hyperhidrosis, and low-grade fever. With neurosis, dermatological problems may arise - rashes such as urticaria, psoriasis, atopic dermatitis.

Typical symptom many neuroses is asthenia - increased fatigue both in the mental sphere and physical nature. Anxiety syndrome is often present - a constant expectation of upcoming unpleasant events or danger. Phobias are possible - obsessive-type fears. With neurosis, they are usually specific, related to a specific object or event. In some cases, neurosis is accompanied by compulsions - stereotypical obsessive motor acts, which can be rituals corresponding to certain obsessions. Obsessions are painful intrusive memories, thoughts, images, desires. As a rule, they are combined with compulsions and phobias. In some patients, neurosis is accompanied by dysthymia - low mood with feelings of grief, melancholy, loss, despondency, sadness.

Mnestic disorders that often accompany neurosis include forgetfulness, impaired memory, greater distractibility, inattention, inability to concentrate, an affective type of thinking and some narrowing of consciousness.

Diagnostics

The leading role in the diagnosis of neurosis is played by identifying a traumatic trigger in the anamnesis, data from psychological testing of the patient, studies of personality structure and pathopsychological examination.

The neurological status of patients with neurosis does not reveal any focal symptoms. There may be a general revival of reflexes, hyperhidrosis of the palms, tremor of the fingertips when stretching the arms forward. The exclusion of cerebral pathology of organic or vascular origin is carried out by a neurologist using EEG, MRI of the brain, REG, and ultrasound scanning of the vessels of the head. In case of severe sleep disturbances, it is possible to consult a somnologist and conduct polysomnography.

A differential diagnosis of neurosis with clinically similar psychiatric (schizophrenia, psychopathy, bipolar disorder) and somatic (angina,

Treatment of neurosis

The basis of neurosis therapy is the elimination of the impact of a traumatic trigger. This is possible either by resolving a traumatic situation (which is extremely rare), or by changing the patient’s attitude towards the current situation in such a way that it ceases to be a traumatic factor for him. In this regard, psychotherapy is leading in treatment.

Traditionally, in relation to neuroses, complex treatment is used, combining psychotherapeutic methods and pharmacotherapy. In mild cases, only psychotherapeutic treatment may be sufficient. It is aimed at revising the attitude towards the situation and resolving the internal conflict of a patient with neurosis. Among the methods of psychotherapy, it is possible to use psychocorrection, cognitive training, art therapy, psychoanalytic and cognitive behavioral psychotherapy. Additionally, training in relaxation techniques is provided; in some cases - hypnotherapy. Therapy is carried out by a psychotherapist or medical psychologist.

Drug treatment neurosis is based on the neurotransmitter aspects of its pathogenesis. It has a supporting role: it facilitates work on oneself during psychotherapeutic treatment and consolidates its results. For asthenia, depression, phobias, anxiety, panic attacks, the leading antidepressants are: imipramine, clomipramine, amitriptyline, St. John's wort extract; more modern ones - sertraline, fluoxetine, fluvoxamine, citalopram, paroxetine. In the treatment of anxiety disorders and phobias, anxiolytic drugs are additionally used. For neuroses with mild manifestations, herbal sedatives and short courses of mild tranquilizers (mebikar) are indicated. In case of advanced disorders, preference is given to benzodiazepine tranquilizers (alprazolam, clonazepam). For hysterical and hypochondriacal manifestations, it is possible to prescribe small doses of antipsychotics (tiapride, sulpiride, thioridazine).

Multivitamins, adaptogens, glycine, reflexology and physiotherapy (electrosleep, darsonvalization, massage, hydrotherapy) are used as supportive and restorative therapy for neurosis.

Prognosis and prevention

The prognosis of neurosis depends on its type, stage of development and duration of course, timeliness and adequacy of the psychological and medicinal assistance provided. In most cases, timely initiation of therapy leads, if not to cure, then to a significant improvement in the patient’s condition. The long-term existence of neurosis is dangerous due to irreversible personality changes and the risk of suicide.

A good prevention of neuroses is to prevent the occurrence of traumatic situations, especially in childhood. But the best way maybe self-education correct attitude to upcoming events and people, developing an adequate system of life priorities, getting rid of misconceptions. Adequate sleep, good work and an active lifestyle also contribute to strengthening the psyche. healthy eating, hardening.

In our age of overabundance of information, stress and crazy speeds, the problem of mental health, or more precisely, ill-health, is becoming almost the most important.

As you know, mental health, the same “healthy spirit” that ancient healers loved to talk about, is an integral component of health in general. Alas, features modern life make us extremely vulnerable to various mental disorders. And the disease does not distinguish whether the person in front of it is young or old, man or woman.

In terms of prevalence, mental health disorders are now among the leaders after cardiovascular diseases and cancer. According to WHO, more than 560 million people on the planet already suffer from various mental illnesses. And almost every second person is in danger of contracting a mental illness during their lifetime.

Very often companions modern man such serious psychoneurological diseases as neurosis And psychosis .

What lies behind the terms neurosis and psychosis?

We are so used to throwing around the words “hysterical”, “neurasthenic”, “psychopath” that we often forget that we use them as curses or even ridicule. medical terms. Meanwhile, there is nothing funny in these words.

Neurosis

Neurosis can be briefly described as follows:

• This is nervous exhaustion, a long-term chronic disorder that can develop in a person against the background of stress or a traumatic event.
• The personality of a patient suffering from neurosis usually does not undergo major changes. The person maintains a critical attitude towards the disease; he can control his behavior.
• As a rule, neurosis is manifested by vegetative, somatic and affective disorders.
• This is a reversible (curable) disease.

The most common types of this disease are:

• neurasthenia (asthenic neurosis, fatigue syndrome);
• hysteria (hysterical neurosis);
• various phobias (fears, panic attacks) and obsessive states (obsessive neurosis).

One of the main reasons for the formation of neurosis is stress in the broadest sense of the word, be it a childhood trauma, an unfavorable climate in the family, a crisis at work, nervous strain, interpersonal conflict or emotional shock.

According to medical statistics, the state of neurosis is familiar firsthand to 10-20% of the population of our planet, and from various types psychosis affects approximately 5% of the world's inhabitants.

Psychosis

Speaking about psychosis, it is necessary to note the following:

• This is a mental disorder characterized by inappropriate human behavior and an atypical reaction to events and phenomena.
• Manifests mental disorders, in particular, disturbances in the perception of reality (hallucinations, delusions).
• It develops unnoticed by the patient and may be a consequence of pathologies of the endocrine and nervous systems.
• Capable of completely changing the patient's personality.
• This is a difficult to cure disease.

Psychoses according to their origin are usually divided into:

• Endogenous , that is, associated with internal causes (somatic diseases, hereditary mental disorders, age);
• Exoorganic caused by external factors (infections, intoxications, etc.) or directly related to a violation of the structure of the brain (trauma, hemorrhage, neoplasms, etc.).

The first group includes:

• affective insanity;
• senile (senile);
• affective;
• schizophrenic;
• epileptic;
• symptomatic psychosis, etc.

The exogenous group includes:

• reactive acute psychosis;
• intoxication;
• infectious;
• alcoholic psychosis, etc.

Signs of psychosis and neurosis

Symptoms of psychosis

Recognizing warning signs is sometimes not easy, but you should pay close attention to any changes that appear in the character and habits of a loved one.

Characteristic symptoms of psychosis are:

• decreased performance or febrile activity;
• mood swings;
• irritability, suspicion;
• desire for self-isolation;
• unexplained change of interests;
• sleep disturbances, decreased appetite;
• careless attitude towards one's appearance;
• increased vulnerability and other atypical reactions to events and phenomena;
• impaired coordination of movements;
• incoherent speech;
• hallucinations, delusions.

Symptoms of neurosis

It is quite difficult for a non-specialist to identify a nervous disorder. And yet the clinic of neurosis has characteristic features.

Neurosis may be indicated by:

• decreased cognitive abilities;
• depressed mood, tearfulness;
• self-doubt, low self-esteem;
• irritability, dissatisfaction;
• frequent changes of mood;
• obsessive thoughts;
• fixation on bad news and events;
• unmotivated anxiety states;
• poor appetite ;/li>
• violations in the sexual sphere;
• increased sensitivity to noise, light, vibrations, etc.

Children's fears and facial tics are also symptoms of neurosis.

Very often in everyday life people confuse the concepts of “neurosis” and “neurasthenia”. Let us repeat once again: neurasthenia is a type of neurosis, one of its most common forms.

Characteristic symptoms of neurasthenia are:

• decreased intellectual abilities;
• dizziness (the so-called neurasthenic helmet);
• increased fatigue;
• chest pain;
• mood swings;
• low self-esteem;

Treatment of neuroses and psychoses

Only a (psychoneurologist, psychotherapist, psychiatrist) who has undergone appropriate training and has sufficient practical experience in helping patients with neurological and mental disorders can conduct a competent diagnosis of the disease, identify its causes and offer adequate treatment.

Treatment of psychoses and neuroses (including treatment of neurasthenia) is, as a rule, a whole complex of measures that includes many stages.

So, a combination of the following methods helps to achieve a good result:

• drug therapy;
• phytotherapy;
• psychotherapy;
• hardware treatment;
• water procedures;
• special gymnastics;
• therapeutic diet and etc.