Neuroses( Neurotic disorders) - Causes, symptoms and treatment. MF.
Neurotic disorders violate only certain areas of mental activity, are not accompanied by psychotic phenomena and gross violations of behavior, but they can significantly affect the quality of life.
The group of neurotic disorders does not include neurotic symptom-complexes that accompany mental( schizophrenia, etc.), somatic and neurological diseases.
The number of people with neurotic disorders in recent decades has increased significantly. The prevalence of neuroses is from 2 to 76 per 1000 population for men and from 4 to 167 per 1000 population for women.
Classification of neuroses
- anxious-phobic( including obsessive-compulsive) disorders;
- hysterical( predominantly conversion) disorders;
- neurasthenia.
Anxiety-phobic disorders
One of the most common forms of mental pathology.
Among the psychopathological manifestations of anxiety and phobic disorders, panic attacks, agoraphobia and hypochondriacal phobias should first of all be considered.
1. Panic attacks:
Sometimes the anxiety reaction manifests itself in the form of a nightmare panic. The people with whom this happens lose control of their actions, almost do not understand what they are doing, it seems to them that death is approaching. With a sudden appearance of a real threat, anyone can panic. However, some experience recurring and unpredictable panic attacks for no apparent reason, and this disease corresponds to a diagnosis of panic disorder.
Panic attacks are periodic short-term panic outbreaks that occur suddenly and peak within 10 minutes.
Panic attacks occur with a frequency of once a month or more often, which often leads to social disadaptation of patients.
In the majority, this disorder develops at the age of 15 to 35 years, and this diagnosis is at least twice as likely to be posed to women as to men.
Panic attacks are characterized by at least 4 panic symptoms from the following list:
- Boosting or increasing heart rate,
- Active sweating,
- Small or large tremor,
- Feeling of shortness of breath or shortness of breath, sensation of suffocation,
- Discomfort or chest pain,
- Nausea orabdominal discomfort,
- Dizziness,
- Feeling of abnormal lightness or heaviness,
- Pre-state,
- Fear of losing control or going insane,
- Fear of death,
- Feeling of scipeneniya or tingling,
- Hot flashes or chills.
Criteria for diagnosing "Panic disorder"( according to DSM - IV ):
- Periodically recurring unexpected panic attacks,
- For at least a month after one of the attacks, at least one of the following symptoms is noted:
- concern about the possibility of new attacks,
- concern about attacks or their consequences,
- significant changes in behavior caused by attacks.
2. Agoraphobia , contrary to the original meaning of the term, includes not only the fear of open spaces, but also a number of similar phobias( claustrophobia, phobia of transport, crowds, etc.).Agoraphobia, as a rule, manifests in connection( or after) with panic attacks and is essentially a fear of being in a situation fraught with the danger of a panic attack. As typical situations that provoke the emergence of agoraphobia, a trip to the metro, stay in the store, among a large crowd of people, etc. become
3. Hypochondriac phobias( nosophobia) is the obsessive fear of a serious illness. Most often, cardio-, carcinoma- and insultophobia, as well as syphilo- and AIDSophobia are observed. At the height of anxiety( phobic raptus), patients sometimes lose critical attitude to their condition - they turn to doctors of the appropriate profile, they need a survey.
Types of phobias
♦ Nature phenomena:
Air - anemophobia( Anemophobia)
Nephophobia clouds
Cold, ice and frost - cryophobia( Cryophobta)
Nights - Nyctophobia
Darkness - scotophobia( Scotophobia)
- Eosobobia( Eosophobia)
of sunlight - fengophobia( Phengophobia)
Light - photophobia( Photophobia)
Flash of light - selaphobia( Selaphobia)
Thunder and lightning - bronfoophobia( Brontophobia)
Electrophobia( Electrophobia)
Bright light - photo augliaphobiaPhotoAugliaphobia)
Loud noise - whetherirofobiya( Ligyrophobia)
Space phenomena - kosmikofobiya( Kosmikophobia) Meteor - meteorofobiya( Meteorophobia)
Komet - kometofobiya( Cometophobia)
Moon -selenofobiya( Selenophobia)
Borealis - aurorafobiya( Auroraphobia)
Stars - astrofobiya( Astrophobia)
Suns -heliophobia( heliophobia)
Drought - kserofobiya( Xerophobia)
Flooding - antlofobiya( Antlophobia)
Mist - gomihlofobiya( Homichlophobia)
Hurricane - lilapsofobiya( Lilapsophobia)
Lakes - limnofobiya( Limnophobia)
Rec or running water - potamofobiya( Potamophobia)
Seas and the oceanin - talassofobiya( Thalassophobia)
chasm - kremnofobiya( Cremnophobia)
Rain - ombrofobiya( Ombrophobia)
Shadow -stsiopofobiya( Sciopophobia)
Snow - hionofobiya( Chionophobia)
-gidrofobiya Water( Hydrophobia)
Wind - ankraofobiya( Ancraophobia)
Heights- acrophobia( acrophobia)
Woods - hylophobia( hylophobia)
Plants - botanofobiya( Botanophobia)
Trees - dendrofobiya( Dendropriobia)
Fungi - mikofobiya( Mycophobia)
Colors - antrofobiya( Anthrophobia) and Fragrances - olfaktofobiya( Offactophobia)
♦ Animal World:
Animal - Zoophobia( Zoophobia)
furs and animal skins - dorafobiya( Doraphobia)
Wild animals - agrizoofobiya( Agrizoophobia)
Ants - myrmecophobia( Myrmecophobia)
people - fear of bees( Apiphobia)
Ptits- ornithophobia( Ornithophobia)
Bulls - taurofobiya( Taurophobia)
Horses- gippofobiya( Hippophobia)
Cats -aklyurofobiya( Aclurophobia)
Cours - alektorofobiya( Alektorophobia)
Dogs - cynophobia( Cynophobia)
Mice - muzofobiya( Musophobia)
Rats - zemmifobiya( Zemmiphobia)
Otters - lyutrafobiya( Lutraphobia)
Pisces -ichthyophobia( Ichthyophobia)
Shark - selachophobia( Selachophobia)
mollusks -ostrakonofobiya( Ostraconophobia)
Frogs - batrahofobiya( Batrachophobia)
Zhab - bufonofobiya( Bufonophobia)
bacteria and germs -verminofobiya( Verminophobia)
Insect -akarofobiya( Acarophobia)
Moth - mottefobiya( Mottephobia)
Parasites - parazitofobiya( Parasitophobia)
Reptile-herpetophobia
Snake - officio phobia( Ophidiophobia)
Spiders-arachnephobia
Worms-scleriphobia
♦ Situations:
of Close scrutiny of others - skoptofobiya( Scoptophobia)
Touch - afenfosmofobyya( Aphenphosmophobia)
sexual harassment-kontreltotofobiya( Contreltophobia)
Rape - virginitifobiya( Virginitiphobia)
Accident - distihifobiya( Dystychiphobia)
atomic explosion - atomosofobiya( Atomosophobia)
Radiation - radiophobia( Radiophobia)
Physical or moral punishment- rhabdomophobia( Rhabdophobia)
Spanking - mastigophobia
Critics - Enissophobia( ASIS)
To be linkednym - merintofobiya( Merinthophobia)
To appear strangled - pnigofobiya( Pnigophobia)
choke - anginophobia( AngmophobJa)
Be in the crowd - ohlofobiya( Ochlophobia)
Dinner and lunch conversations - deypnofobiya( Deipnophobia)
get dirty - rhypophobia( Rhypopnobia)
be hypnotized- hypnophobia( Hypnophobia)
Litigation - Liticaphobia
Marriages - Gamophobia
Surgical operations - Tomophobia
Religious ceremonies - Teleophobia
Staying alone - isolophobia(Isolophobia)
hear good news - evpofobiya( Eupohobia)
be overlooked - atazagorafobyya( Athazagoraphobia)
ridicule - katagelofobiya( Katagelophobia)
♦ Substances:
Alcohol - metilofobiya( Methyphoba)
Wines - oynofobiya( Oenophobia)
noxious fumes- aerophobia( aerophobia)
Dust - amathophobia( amathophobia)
faeces - koprofobiya( Coprophobia)
Rotting matter -seplofobiya( Seplophobia)
Nutrition - tsibofobiya( Cibophobia)
Garlic - alliumofobiya( Alliumphobia)
Meat - karnofobiya( Carnophobia)
Vegetables-lahanophobia( Lachanophobia)
Gold - Aurophobia
Metalophobia( Metallophobia)
Poison - iophobia( lophobia)
♦ State:
Alginophobia pain
Dizziness when looking down - Illyngophobia
Nausea - dinofobiaDinophobia)
fainting or weakness - astenofobiya( Asthenophobia)
Fatigue - kopophobia( kopophobia)
Night ejaculation - oneyrogmofobiya( Oneirogmophobia)
Menstruation - menofobiya( Menophobia)
Aging -gerontofobiya( Gerontophobia)
Dreams -oneyrofobiya( Oneirophobia)
Solitude -monophobia(Monophobia)
Wrath - angrofobiya( Angrophobia)
Lesions - kakorrafiofobiya( Kakorrhaphiophobia)
dependent on others - soteriofobiya( Soteriophobia)
Failures - atychiphobia( Atychiphobia)
forget something or have forgotten - atazagorafobiya( Athazagoraphobia)
Liberty -elevterofobiya(Eleutherophobia)
Fun -herofobiya( Cherophobia)
Imperfections - atelofobiya( Atelophobia)
Jealousy - zelofobiya( Zeiophobia)
Fool - heliophobia( Geliophobia)
Love - erotophobia( erotophobia)
Love -filofobiya( Philophobia)
Memories - mnemofobiya( Mnemophobia)
Poverty -Penyaphobia
Wealth-Plutobobia( Plutophobia)
Acknowledgments -Doxophobia( Doxophobia)
Joy-Hedonophobia( Hedonophobia)
Responsibility - Hypengyophobia
♦ Diseases:
Diseases general - patofobiya( Pathophobia)
certain diseases -monopatofobiya( Monopathophobia)
Angina -anginofobiya( Anginophobia)
memory loss -amnezifobiya( Amnesiphobia)
Blindness -skotomafobiya( Scotomaphobia)
Disease brain - meningitofobiya( Meningitophobia)
Cancer Cancerophobia
Heart attack - cardiophobia
Cholera-chorophobia
Constipation-Coprastasophobia
Infections - molismophobia(
) Diabetes Diabetic phobia( Diabetophobia)
Rabies - cinephobia(Cynophobia)
Grippa- febrifobiya( Febriphobia)
Wounds - tripanofobiya( Trypanophobia)
Injury - travmatofobiya( Traumatophobia)
Madness - dementofobiya( Dementophobia)
pruritus - acarophobia( Acarophobia)
Leprosy - leprofobiya( Leprophobia)
Lice - ftiriofobiya(Phthiriophobia)
rhinitis - epistaksiofobiya( Epistaxiophobia)
Phobias - fobiofobiya( Phobophobia)
Poisoning -toksikofobiya( Toxicophobia)
Polio - poliozofobiya( Poliosophobia)
Hemorrhoids -proktofobiya( Proctophobia)
Shock - gormefobiya( Hormephobia)
sexual perversion - parafobiya(Paraphobia)
Skin diseases - dermatoziofobiya( Dermatosiophobia)
Syphilis -luifobiya( Luiphobia)
Tuberculosis - ftiziofobiya( Phthisiophobia)
vaccination - vaktsinofobiya( Vaccinophobia)
-kipridofobiya Sexually transmitted diseases( Cypndophobia)
♦ Items:
Asymmetric things - asimmetrifobiya(Asymmetriphobia)
Small items - microphobia( Microphobia)
Great subjects - megalophobia( Megalophobia)
Sacred subjects -hagiopathia( Hagiophobia)
Motor-motorophobia( Motorophobia)
Bicycles -cyclophobia( Cyclophobia)
Bibliophobia books
Chronometrophobia watch
Cyberphobia computers
Crosses and crucifixes -staurophobia
Crystallophobia Crystal and crystals crystalophobia
Pedophobia dolls
New medicines -neofarmofobiya( Neopharmaphobia)
Tissues -tekstofobiya( Textophobia)
feathers -pteronofobiya( Pteronophobia)
Flutes - aulofobiya( Aulophobia)
Machines - mehanofobiya( Mechanophobia)
Mirrors - katoptrofobiya( Catoptrophobia)
money -hrometofobiya( Chrometophobia)
needles andstickssneeze items - aichmophobia( Aichmophobia)
Bullets -ballistofobiya( Ballistophobia)
Firearms - hoplophobia( Hoplophobia)
Nukes - nukleomitufobiya( Nucleomituphobia)
paper - papirofobiya( Papyrophobia)
Pins - enetofobiya( Enetophobia)
Razors - ksirofobiya( Xyrophobia)
Telephones-Phone Phonophobia( Telephonophobia)
♦ People:
People generally -antropofobiya( Anthropophobia)
Society - social phobia( Sociophobia)
Bald - peladofobiya( Peladophobia)
Bearded - pogonofobiya( Pogonophobia)
beautiful woman - kaliginefobiya( Caligynephobia)
Uglies -teratofobiya( Teratophobia)
own reflection in the mirror -eysoptrofobiya( Eisoptrophobia)
poor and begging - gobofobiya( Hobophobia)
thieves -stselerofobiya( Scelerophobia)
Children -pedofobiya( Pedophobia)
Innocent Female - partenofobiya( Parthenophobia)
The Chinese -sinofobiya( Sinophobia)
clown -coleofobiya( Coulrophobia)
Dentists -dentofobiya( Dentophobia)
foreigners - xenophobia( Xenophobia)
British - Anglophobia( Anglophobia)
Frantsuzov - Francophobe( Francophobia)
Nemtsev - tevtofobiya( Teutophobia)
Greeks - gellofobiya( Heliophobia)
Homosexuals - homophobia(Homophobia)
Androphobia male
Japanese - Japanophobia
Judeophobia Jews
Pentheraphobia
Old people - Gerontophobia
Popes - Papathobia( Papaphobia)
Politicians- politicianphobia( Politicophobia)
Priests - ierofobiya( Hierophobia)
prostitutes - kipridofobiya( Cypridophobia)
Robbers - harpaxophobia( Harpaxophobia)
Russkih- russophobia( Russophobia)
Relatives -singenezofobiya( Syngenesophobia)
Women - ginofobiya( Gynophobia)
Adolescent - ephebiphobia(Ephebiphobia)
Representatives of the opposite sex - heterophobia( Heterophobia)
Sorcerers and witches - Wiccaphobia
♦ Action:
Swim-ablutophobia
Go to bed - clinophobia
Drive a carksofobiya( Amaxophobia)
give birth - malevziofobiya( Maleusiophobia)
Moving away -tropofobiya( Tropophobia)
Dress - vestifobiya( Vestiphobia)
works at the computer - kiberfobiya( Cyberphobia)
Cooking - mageyrokofobiya( Mageirocophobia)
crossing the street - agyrophobia( Agyrophobia)
Dance-Chorophobia
Take Decisions -Decidophobia(
) Do not fulfill your duty - paralipophobia( Paralipophobia)
Get treated -pharmacophobia( Pharmacophobia)
Go to the doctor - latrophobia
Treat teeth-odontophobia( Odontophobia)
Drink -Dipsophobia
Eat, swallow - phagophobia( Phagophobia)
Fly-Aviophobia( Aviophobia)
Operate( for surgeons) -ergiosiobia( Ergasiophobia)
Write - graphophobia(
) Kissing -philemophobia(
) Learn -Sophophobia
Treat( in physicians) - opiofobia( Opiophobia)
Move - kinetophobia( Kinetophobia)
Express your opinion -doxophobia( Doxophobia)
Train ride - Sidiodromophobia
Travel - Hodophobia(
) Go to theschool -discusaleinophobiaa)
Talking -lalophobia
Talking on the phone - Phonophobia(
) Speaking publicly - Glossophobia
Sleeping-somnophobia( Somniphobia)
Sitting - Catophobia( Kathisophobia)
Thinking -photonemophobia( Phronemophobia)
Working -ergofobiya( Ergophobia)
walk - ambulofobiya( Ambulophobia)
Wash - abultofobiya( Abultophobia)
Having sex - koitofobiya( Coitophobia)
sinned - enoziofobiya( Enosiophobia)
lost innocence -primeyzodofobiya( Primeisodophobia)
Steal - kleptofobiya( Kleptophobia)
Sectiontsya in public -disabillofobiya( Dishabillophobia)
urinate -urofobiya( Urophobia)
long wait - makrofobiya( Macrophobia)
plump - obezofobiya( Obesophobia)
opens his eyes - optofobiya( Optophobia)
returns home - nostofobiya( Nostophobia)
♦ Body and parts:
Unattractive body -dismorphophobia( Dysmorphophobia)
Blood-hemophobia( Homophobia)
Body odor -osmophobia( Osmophobia)
Eye - ommetaphobia( Ommetaphobia)
The total left-side of the body is left-phobia( Levophobia)
Total dextrophobia on the right side of the body - Dextrophobia
Penis in a state of erection - Medortophobia
Erection loss - Medomalacuphobia( Medomalacuphobia)
Female genitalia - Kolpophobia
Hair-chaetophobia(
) Hand-circophobiaI( Chirophobia)
Knees - Genophobia( Genuphobia)
Nudes -gammonophobia( Gymnophobia)
Odontophobia teeth( Odontophobia)
Wrinkle-rhythiphobia( Rhytiphobia)
Baldness - phalacrophobia(
) Associated with the time and death of
Death(Thanatophobia)
Cemeteries - co-metrophobia
Time and clock-chronophobia
Corpse-necrophobia( Necrophobia)
Decay and decay - seplophobia
Grave - placophobia( AS412ASAS) Being buried alive- tafefobia( Taphephooia)
♦ Colors:
color in general -hromofobiya( Chromophobia)
Black-melanofobiya( Melanophobia)
Purple -porfirofobiya( Porphyrophobia)
Yellow - ksantofobiya( Xanthophobia)
Red -eritrofobiya( Erythrophobia)
White -leykofobiya( Leukophobia)
♦ Numbers:
Number in general - numerophobia( Numerophobia)
Numbers 8 - Octophobia( Octophobia)
Numbers 13 - Triskadekaphobia
♦ Seats:
Certain places-Topophobia
Its homes are ecophobia(
) Surroundings of their home-yicophobia( Eicophobia)
Hospitals - nozokomefobiya( Nosocomephobia)
houses generally -domatofobiya( Domatophobia)
empty room - tsenofobiya( Cenophobia)
Rooms generally -koynonifobiya( Koinoniphobia)
Ruins - atefobiya( Atephobia)
-skolinofobiya School( Scolionophobia)
Street - agyrophobia( Agyrophobia)
Empty space -spatophobia(
) Closed-space Claustrophobia
Open spaces, people are agoraphobia
Theaters-theatrophobia
Forests, dark thickets - nihilophobia(
) Dark placesgrofobiya( Lygophobia)
Heights -aeroakrofobiya( Aeroacrophobia)
narrow corridors - stenofobiya( Stenophobia)
Churches -ekkleziofobiya( Ecclesiophobia)
Bridges -gefirofobiya( Gephyrophobia)
tallest building - batofobiya( Batophobia)
4. Obsessive-compulsive disorder( obsessive-compulsive disorder)
With this obsessive-compulsive disorder, they literally persecute a person and poison his entire existence-communication, work, rest. Attempts to fight them, as a rule, are unsuccessful, and this further aggravates anxiety.
Obsessions ( obsessions) is the incessant repetition of undesirable, often painful thoughts, ideas and inclinations, which can not be got rid of by effort of will. There is always a sense of their violence. The patient realizes that obsessive thoughts originate in him( unlike a schizophrenic patient who is sure that someone is controlling his thoughts).The content of obsessive thoughts is unacceptable for the patient or meaningless, so he tries to fight them.
Obsessive acts of are stereotyped, repetitive, outwardly aimless actions, which often have the form of a ritual. There are four main types of such actions:
- cleansing( most often washing hands and rubbing surrounding objects);
- check;
- the actions connected with clothes: dressing in a special sequence, infinite clothes distribution;
- account( often in the form of listing items and aloud).Funny children's counters( "king, prince, king, king's son. ..") for a patient with an obsessive account can be a real torture.
Obsessive account in some cases is an obsession( account to oneself), in others - obsessive action( account aloud, for example, to the breath).In obsessive action there is a subjective component - attraction, or compulsion, and objective - ritual( caused by the attraction of real actions that can be either noticeable or imperceptible to others, for example, counting to the breath).Rituals are always associated with an inner feeling of incompleteness of any actions: "It is better to remake than to unfinish".So, the doctor can repeatedly re-read the test results, several times to call back to the pharmacy to check whether the prescription is correctly written. In adolescence and adolescence, especially in girls, there is often an obsessive urge to touch the face or straighten the hair( a combination of checking and cleansing).
Hysterical disorders
As a rule, people with signs of mental infantilism are inclined to hysterical reactions: with the lack of independence of judgments, suggestibility, egocentrism, emotional immaturity, mood instability, mild irritability, impressionability.
Hysterical neurotic disorders are observed in women 2 times more often than in men.
Clinical manifestations of hysteria are mainly observed in the form of neurological and somatic symptoms, belonging to the category of conversion, from Latin.conversio - the transformation, replacement, in other words, that cause the transformation of psychological conflicts into somato-neurological manifestations.
In the clinical picture of conversion hysteria, three main categories of symptoms can be distinguished:
- motor,
- sensory disorders
- autonomic disorders simulating somatic and neurological diseases.
Movement disorders are represented by violations of two types: hyperkinesis or other involuntary movements( trembling, flinching, etc.) and manifestations of akinesia( paresis, paralysis).Hyperkinesis in hysteria can have various forms: tics, rough rhythmic tremor of the head and limbs, intensifying with attention fixation, blepharospasm, glossolabial spasm, horeiform movements and twitchings, but more organized and stereotyped than with neurologic chorea. Unlike organic hysterical hyperkineses depend on the emotional state, are modified by the mechanism of imitation, combined with unusual postures and other hysterical stigms( lump in the throat, fainting), temporarily disappear or weakened by switching attention or under the influence of psychotherapeutic influences.
Sometimes, in response to psychogenic effects, often minor( small quarrel, unpleasant news, sharp remark, etc.), generalized convulsive movements occur, accompanied by vegetative manifestations and a disturbance of consciousness that form a picture of a hysterical fit. The symptomatology of a hysterical fit is diverse, in severe cases it is accompanied by a loss of consciousness and a fall. Unlike epileptic paroxysms in hysteria, consciousness is not lost completely, the patient has time to fall so as to avoid serious damage.
Sensory disorders are most often manifested by sensitivity disorders( in the form of anesthesia( = lack of sensitivity), hypo( = decrease) and hyperesthesia( = increase)) and painful sensations in various organs and parts of the body( hysterical pains).Skin sensitivity disorders can have the most bizarre arrangement and configuration, but most often they are localized in the limb region.
Isteroneurotic psychogenic reactions can be short-lived, episodic and disappear spontaneously, without treatment. There is also a long, for several years, fixation of hysterical manifestations. Patients with functional hysteroneurotic disorders in order to eliminate organic pathology require a thorough somatic and neurological examination.
Neurasthenia
Complaints of "unbearable" fatigue, complete "prostration", a decrease in vitality, a decline in physical and mental strength, lack of vigor, energy, weakness, weakness, intolerance to normal loads predominate. Every act, even movement, requires, according to the patients, the greatest efforts.
Patients are particularly sensitive to external stimuli( irritating sounds of dripping water, ticking of the clock, "stunning" the creaking of doors, slamming the transom) and physiological sensations( hyperpathy, excessive perception of sensations associated with normal physiological functions of the body - palpitations, strengthened peristalsis,).One of the constant symptoms of hyperesthesia are tension headaches. They are variable and diverse( pressure, constriction, tingling in the forehead and occiput, sensation of "stale" head, etc.) and cause great concern to patients. With sharp turns of the head or a change in the position of the body, pain sensations radiate along the spine, extending to the trunk and limbs, noise and ringing in the ears, a sense of instability, which patients call dizziness. Hyperesthesia of the skin is also possible, when the head can not be touched and even combing the hair causes pain. The intensity of headaches varies, most often they arise and intensify due to mental stress, but the deterioration of the state may be due to bad weather or a trip in the transport.
The ability to maintain the previous working rhythm with neurasthenia is significantly limited. In some cases, working capacity falls quickly and labor activity becomes impossible due to a rapidly developing sense of physical fatigue. In other cases( this mainly applies to intellectual pursuits), due to absent-mindedness, dispersal, labor productivity sharply decreases, it is difficult for patients to follow the thought of the interlocutor, during the lecture, to finish reading the necessary document, to understand the meaning of the text repeatedly read.
Causes of neuroses
The cause of neuroses is rarely sudden and severe injuries( death of close people, life-threatening situations, natural disasters, unexpected misfortunes).Neurotic reactions usually occur with relatively weak, but long( or repeatedly) acting stimuli, leading to a constant emotional tension, internal conflicts, to disagreement with oneself. As typical, having the greatest pathogenetic significance for the emergence of neurosis in modern psychiatric literature, events that generate uncertainty of the situation, which threaten the future or require making difficult alternative solutions, are usually considered. Pathogenic may be events leading to the formation of an insoluble and painful situation for the individual( the state of ambivalence, according to W. Brautigam, 1972), excluding the implementation of motivated behavior( frustration).Examples of such situations can be the forced continuation of production activities that do not correspond to creative aspirations and professional interests, the impossibility of divorce due to children or any other circumstances, despite constant family conflicts.
Treatment of neuroses
Helping patients with neurotic disorders provides a set of therapeutic effects, which includes, along with psychotherapy, treatment of psychopharmacological and restorative means. Widely used physiotherapy procedures, exercise therapy. Of great importance are social activities aimed at eliminating conflicts, mental and physical overloads, traumatic situations, and removing a patient from such situations.
Treatment of neurotic disorders is best performed in profiled departments;they are often called sanatoriums or departments( clinics) of neuroses.
In the treatment of obsessive-compulsive disorders , serotonergic antidepressants are primarily used.
Drug therapy for hysteroconversion disorders , , especially for episodic, short-term hysterical reactions, is performed by tranquilizers prescribed in small doses and short courses. Acute states with coarse hysterical fits accompanied by attachment of dissociative disorders are stopped by parenteral( intravenous drip) injection of tranquilizers. In some cases, when hysterophobic manifestations acquire a protracted character, there is a need for combined therapy - the addition of neuroleptic drugs.
Medical treatment of neurasthenia includes the use of psychotropic drugs, as well as general restorative therapy aimed at the activation of metabolism and the restoration of body functions.
Psychotherapy
Panic attacks
In recent years, scientists have come to the conclusion that biological problems are just one of the causes of panic attacks. They believe that people who are panic-stricken can have very high sensitivity to certain bodily sensations and misinterpret them( as a sign of the disease).Without trying to understand the possible cause of their feelings, for example, "I ate something wrong" or "an unpleasant conversation with the boss," people who are prone to panic become more and more worried that they can not control themselves, fear the worst, lose their understanding of realityand quickly fall into a panic. Assuming that their "dangerous" sensations can return at any time, they thereby prepare themselves for the following bouts.
In stressful situations, many people get more breathing, there is hyperventilation of the lungs. Apparently this "unusual" breath makes people think that they are in danger or even die from suffocation. And they panic.
When performing biological tests, doctors cause hyperventilation or other physiological sensations in patients using medication or instructing how to breathe correctly, do exercises or just think in a certain way. As might be expected, people with panic disorder experienced great anxiety during the tests, especially when they believed that their bodily sensations were dangerous or uncontrollable.
Thus, on the path to healing, the first step is the ability of patients to understand the nature of panic attacks, to understand the real causes of physiological sensations. The next is to learn how to correctly interpret your feelings directly in stressful situations, to control anxiety, for example, by using relaxation techniques or breathing exercises, as well as distracting from your feelings - for example, by tying up a conversation.
Obsessive-compulsive disorder( ASW)
Behavioral psychotherapy of the neurosis of compulsive states is based on a combination of obsessional provocation and prevention of ritual. Provocation of obsession reduces the painful experiences caused by this obsession, whereas the method of preventing ritual allows you to shorten the time spent performing the ritual. For example, consider the following case: our patient is afraid that if he lifts the toilet seat before urinating, he will necessarily get AIDS( even at home).However, being a well-bred man, he nevertheless raises the seat every time before peeing. He can calm down the alarm, only washing his hands for 5 minutes. The patient hates this ritual, as it takes time and is noticeable to others. When provoking an obsession, the patient is offered to raise the toilet seat with his hands( at the same time one should not sit with toilet paper or raise it with the toe of the boot);thereby, as it were, "increase" the risk of contracting AIDS( in fact, it is impossible to get infected in this way).Anxiety in the patient increases, and at this moment they give a new task: to reduce the time of washing hands to 4 minutes. Behavioral therapy, of course, should be accompanied by psychological support and a detailed account of AIDS in order to ease the patient's anxiety and strengthen the mood for recovery. When the tasks are repeated, the anxiety associated with touching the toilet bowl and the time of the performance of the ritual are gradually reduced. The patient begins to understand that he can cope with his painful sensations even without a ritual.
Hysterical neurosis
Classical psychoanalysis, considered to be a specific approach to the therapy of hysterical disorders, helps only a small part of the patients who perceive this approach positively. For the majority of patients, integrative psychotherapy is more effective, based on the synthesis of various psychotherapeutic concepts and the adoption of elements of suggestive and cognitive, individual and group, behavioral and other types of psychotherapy. When dominance in the clinical picture of conversion manifestations, hypnosis is used, which has a positive but sometimes short-term effect. With the help of hypnotic suggestion, it is possible to return the repressed ideas, emotions, memories and thereby suppress the phenomena of hysterical dissociation( psychogenic amnesia, dissociative fugue with partial or full amnesia, amnestic barriers in the disorder of multiple personality with the restoration of self-control).Direct confrontation of the patient with the underlying diseases with his own psychological problems can be the first step in the therapeutic process. In some cases, the use of directive suggestion is shown, however, the application of this method requires experience, high qualification and some caution. In the course of further therapy, neurolinguistic programming is also used, based on the postulate of the plurality of descriptions of any event occurring. The hypothesis underlying neurolinguistic programming allows us to present any unfavorable fact in a favorable light and consider it as a source of positive resources for the patient. Under the influence of this method, the attitude of the individual to the environment and to himself changes.