state of neurosis. Neurosis: what is it and how to treat it? Medical treatment of neurosis

Neurosis: types, signs, methods of treatment

Maria Barnikova

Neurosis is a common disorder recorded in children and adults. Read about the causes, symptoms, types and treatments of neurosis.

A separate niche among psychogenic diseases is occupied by neuroses, also called neurotic disorders. Neurosis- a collective term denoting certain types of neurotic disorders that are reversible and are characterized by a persistent protracted course of the disease.

Neurosis can occur in men and women of different ages, regardless of their social status, level of education, material security, marital status. In a special risk group for the development of neurotic disorders are people who are at the natural biological stages of life - during puberty and in the phase of withering body functions.

Often, neurosis is fixed in children during puberty, when abrupt changes in the hormonal background make the teenager particularly susceptible to various life phenomena. However, in children, neurosis most often resolves on its own and does not entail the development of dangerous and protracted mental disorders. At the same time, a neurosis that has arisen in adults in the period of approaching old age is fraught with the development of mental disorders and often becomes the cause of diseases of the internal organs.

Neurosis implies the manifestation in the patient of a variety of painful phenomena that have arisen as a result of prolonged exposure to negative ones or have developed as a result of acute ones. The leading factor initiating the formation of neurosis is the presence of unresolved internal conflicts in the subject or the external pressure of negative circumstances.

At the same time, the above aspects do not necessarily have to have a high intensity of action: neurosis can be the result of significant mental overstrain or prolonged unrest. The clinical symptoms of certain types of neuroses are numerous and varied, however, the dominant position among the signs of neurotic disorders is occupied by the asthenic status of the patient, the presence of either irrational fears, or the demonstration by the subject of reactions of hysterical content.

What can neurosis lead to? Neurosis in the vast majority of cases is the cause of a decrease in a person's mental activity, a decrease in physical endurance and work productivity, and a deterioration in the quality of work. In addition, the progression of neurosis leads to the fact that a person has pronounced negative character traits - conflict, irritability, aggressiveness, which ultimately leads to limited contacts in society and worsening relationships in social groups. With untimely or incorrectly performed treatment, neurosis can be transformed into psychotic disorders, which are characterized by a change in the structure of the patient's personality.

Causes of neurosis

From the point of view of physiological teachings, neurosis is a pathological state of the body caused by prolonged disruptions in the higher nervous activity of a person. This phenomenon is a consequence of excessive activity of the psyche with an excess of simultaneously ongoing nervous processes occurring in the cerebral cortex of the cerebral hemispheres. In the framework of the physiological theory, neurosis is the result of an overstrain of the nervous system due to long-term or short-term exposure to stimuli that are excessive for the capabilities of the subject's psyche.

Scientists put forward other hypotheses, according to which the cause of neurosis is a combination of two factors: the presence of an irritant that is excessive in strength and the specific features of a person's personality portrait. At the same time, the significance of the acting stimulus depends to a greater extent not on its intensity, spontaneity, and the existing threat. The cause of neurosis is precisely how a person perceives and interprets this stressor. As studies show, the attitude to the experienced situation and, accordingly, the emergence of affective emotions depends on the individual characteristics of the individual, namely: the way a person has to respond to any danger signal and the speed of response to the presented stimulus.

The real functional state of the body also plays a significant role among the causes contributing to the emergence of neurosis. In a high risk group for the occurrence of neurotic disorders are people who lead an unhealthy lifestyle, do not observe the regime of work and rest, experience enormous mental overload and mentally overwork. The development of neurosis also depends on the type of activity that the subject conducts and his attitude to the duties performed. Among the causes of neurosis are the realities of our turbulent modernity with an abundance of negative information and excessive demands on a “successful” person.

It should be emphasized that neurosis is not a hereditary, genetically determined disorder. Its appearance is almost always associated with the conditions in which the subject grew up and was brought up. The main cause of neurosis in children is growing up in a dysfunctional family. Living with drinking relatives, frequent scandals between parents, overly expressive expression of feelings by ancestors lays the ground for the formation of neurotic reactions in a child.

Neurosis can arise not only because of the prolonged experience of negative feelings. Very bright and intense positive emotions can also cause neurosis. Therefore, upbringing according to the "carrot-and-stick" type often leads to neurotic disorders.

Also, children very often imitate the behavior of their parents. If it is customary in a family to achieve what they want with the help of tantrums or to prove their case by completely ignoring their household members, then a baby with a fragile psyche will most likely develop an asthenic state, depressive moods or hysterical habits over time. In the future, such a person will become a real despot in the family or will be a talented "hysteric" in order to commit illegal acts and not be punished. Since a habit is formed in a person very quickly, and a neurotic simply lacks an inner core to abandon a harmful behavior model, most children who grew up in a dysfunctional environment have various types of neurosis.

From the point of view of psychoanalytic theories, neurosis is a product that has arisen due to the existence of an unresolved conflict in the depths of the human psyche. Such a psychological conflict often arises due to the lack of satisfaction of the existing basic needs of the individual. The foundation for neurosis is the existence of a real or imagined threat to the future, which the person interprets as an unsolvable problem.

Among other causes of neurosis:

• social isolation of a person;
• contradictions between instinctive drives and moral norms;
• total control by others;
• excessive need for recognition and protection;
• unsatisfied thirst for power and glory;
• unfulfilled need for personal freedom;
• the desire to perform all actions perfectly;
• and inability to have a good rest;
• lack of skills to competently respond to.

The biological cause of neurosis is insufficient production of certain neurotransmitters and a malfunction in the functioning of neurotransmitter systems. Such defects make a person overly susceptible to the action of various stimuli, reward him with emotional lability and deprive him of the possibility of functional resolution of difficult situations.

Among the reasons predisposing to the onset of neurosis, scientists call acute viral and infectious diseases that worsen the overall resistance of the body to negative factors. Of particular importance in the development of neurotic disorders is given to pernicious habits of a person. Chronic alcoholism, the use of psychoactive substances primarily "hit" the nervous system, rewarding the person with painful neurotic reactions.

Symptoms of neurosis

Before proceeding to the treatment of neurosis, it is necessary to make a clear differentiation of the human condition from psychotic disorders. The criteria for the selection of neuroses are the following aspects:

• The leading role in the formation of neuroses is assigned to the action of psychogenic factors.
• A person is aware of the abnormality of his condition and makes efforts to compensate for the painful symptoms.
• Neurotic disorders are always reversible.
• An objective examination of the patient does not show any symptoms of personality change.
• The patient retained criticism of his condition.
• All the symptoms that arise give the person the difficulties he feels.
• The subject is willing to cooperate with the doctor, he tries to make efforts to achieve success in treatment.

Among the symptoms of neuroses, two large groups can be distinguished: psychological signs and physical phenomena. Let's describe them in more detail.

Psychological signs of neurosis

The psychological (mental) symptoms include factors:

• Lack of emotional stability in the subject.
• Frequent mood swings for no apparent reason.
• The appearance of indecision and lack of initiative of a person.
• Lack of adequate self-esteem: excessive underestimation of one's abilities or overestimation of one's own abilities.
• The appearance of obsessive uncontrollable fear.
• Experiencing feelings, anticipation of any trouble.
• Excessive nervousness, irritability.
• Restlessness and fussiness of action.
• Conflict and aggressiveness towards others.
• Critical and cynical attitude to what is happening.
• Uncertainty in one's own aspirations, inconsistency of desires.
• Excessive reaction to the slightest changes in the habitual way of life.
• Tearfulness without any objective reasons.
• Suspiciousness, vulnerability, impressionability.
• Resentment, pickiness to the words of other people.

A common symptom of neurosis is the fixation of attention on a traumatic event. A person obsessively reflects on the drama that has happened, analyzes the past, looking for confirmation of his guilt. He is not able to focus on positive thoughts, because all thoughts are fixated on the negative aspects of life.

Symptom of neurosis a significant decrease in human performance. The person is unable to perform the usual amount of work. The subject's quality indicators of labor are deteriorating. He quickly gets tired of standard loads.

Common symptom of neurosis deterioration of cognitive and mnestic functions. The person has trouble concentrating. It is difficult for him to extract the required information from the depths of memory. He cannot answer the question quickly as his thinking is slow.

Common symptoms of neurosis - increased sensitivity to external stimuli. A person reacts intensely to loud sounds and notices barely audible noises. He cannot stand bright light and is uncomfortable with sunlight. A symptom of neurosis is meteosensitivity: the subject painfully endures changes in weather conditions. A change in climatic zones for a person with a neurosis provides a significant increase in painful symptoms.

Common symptoms of neurosis include: various sleep problems. It is very difficult for a person to fall asleep at the usual time due to a significant overexcitation of the nervous system. Having fallen into a dream, a person is forced to "watch" nightmares. He often wakes up in the middle of the night in a cold sweat from the frightening pictures he saw in his dream. In the morning, the subject feels overwhelmed, as his sleep does not provide a burst of energy. In the first half of the day, a person feels overwhelmed and sleepy, but after lunch his condition improves.

Physical signs of neurosis

The physical symptoms of neurotic disorders include a variety of autonomic disorders, neurological defects, and somatic problems. The most common symptoms of neurosis are the following phenomena:

• chronic headache of a pressing or compressive nature, which is called the "helmet of a neurasthenic";
• discomfort or pain in the region of the heart, perceived by a person as heart defects;
• pain syndrome in the epigastric zone, heaviness in the stomach;
• dizziness, difficulty keeping balance, unsteady gait;
• jumps in blood pressure;
• the appearance of "flying flies" before the eyes, deterioration of visual acuity;
• weakness and trembling in the limbs;
• feeling of a "lump" in the throat, difficulty taking a deep breath, feeling short of breath;
• change in eating habits - compulsive overeating, refusal of food, loss of appetite;
• various dyspeptic disorders;
• vegetative defects - excessive sweating;
• violation of the heart rhythm;
• frequent need to urinate;
• the appearance of problems in the intimate sphere - a decrease in sexual desire, the inability to have sexual intercourse, a change in the menstrual cycle in women.

Often, neurosis is the cause of impotence in men and makes it impossible for women to conceive and bear a child. Quite often, neurosis leads to a variety of somatic problems, including gastritis, pancreatitis, cholecystitis. A consequence of the neurotic state of a person is hypertension and cardiological problems. Therefore, timely treatment of neurotic disorders is a guarantee of good health and well-being of a person.

Types of neurotic disorders

Doctors distinguish several independent types of neuroses, which are characterized by the dominance of certain clinical signs. The most common types of neurotic disorders are:

• hysterical neurosis;
• anxiety disorder.

Neurasthenia

Neurasthenia has another name: astheno-neurotic syndrome. Among ordinary people, this type of neurosis is often called chronic fatigue syndrome. Neurasthenia is characterized by the following symptoms:

• increased irritability;
• high excitability;
• fast fatigue;
• loss of the ability to self-control and self-control;
• tearfulness and resentment;
• distraction, inability to concentrate;
• decreased ability to prolonged mental stress;
• loss of habitual physical endurance;
• severe sleep disturbances;
• loss of appetite;
• apathy and indifference to what is happening.

A patient with this type of neurosis develops heartburn and a feeling of heaviness in the epigastric region. The subject complains of intense headache, sensations of sinking heart, worsening of opportunities in the intimate aspect. With this type of neurotic disorder, depressive moods of the cyclothymic level predominate in a person.

obsessive-compulsive disorder

Obsessive-compulsive disorder is a borderline status, fraught with rapid transformation into a mental form - obsessive-compulsive disorder. Patients with this type of neurosis are vulnerable, suspicious, sensitive persons. The main symptom of obsessive-compulsive disorder neurosis is the presence of uncontrollable painful thoughts, obsessive thoughts, meaningless images that arise.

A common symptom of this type of neurosis is experiencing feelings of anxiety and anticipation of imminent troubles. Stereotypical reflections, characteristic of this type of neurosis, overcome a person constantly and force him to resort to peculiar ritual actions. The person regularly makes absurd, from an objective point of view, decisions, trying to protect himself from the coming catastrophic events that he invented.

Hysterical neurosis

Hysterical neurosis, also called hysteria, is a common pathology, more often recorded in women than in men. This type of neurotic disorder It is manifested by the acted demonstrative behavior of a person in order to attract the attention of others. The person rolls up theatrical performances: violently sobs, screams loudly, convulses, so that they pay attention to her and satisfy desires.

Hysteria is a kind of flight into the disease, when a person can imitate the symptoms of various diseases and firmly believe in his incurable illness. It has been established that a hysteric can inspire himself with absolutely any disease and successfully imitate the symptoms characteristic of the disease.

The main symptom of hysterical neurosis is frequent seizures with convulsions of a tonic nature. During such a crisis, the patient's face takes on a reddish or pale hue. A person's eyes are closed during an attack, but the pupils retain a reaction to light. A fit of hysteria is preceded or accompanied by wild laughter or inappropriate sobs.

Another important symptom of hysterical neurosis is the patient's lack of sensitivity. If the hysteric has set himself a certain goal, then in order to achieve it, he can, in the literal sense, walk on coals and not feel pain. May develop hysterical deafness or blindness, a variety of speech disorders, such as stuttering.

The treatment of this form of neurosis is a long and painstaking process that requires a competent selection of medications. With inadequate treatment of hysterical neurosis, the patient may develop significant mental defects that completely change the characterological portrait of the individual.

anxiety neurosis

This type of neurosis is a precursor to anxiety-phobic or generalized anxiety disorders. This disease is characterized the presence of obsessive irrational fears and persistent anxiety in a person. At the same time, the patient's fear of anxiety neurosis has no real grounds. The subject worries excessively about his own future, anticipates failures and problems, constantly feels excitement and anxiety.

With this type of neurosis, excessive motor tension is observed, manifested in the fussiness and randomness of the patient's actions. The person feels that his nerves are taut, like a string, and he cannot relax. Symptoms of autonomic activity are observed: dry mouth, irresistible thirst, increased heart rate, increased sweating.

Treatment of neurosis

How to get rid of neurotic disorders? Today, many methods of treating neuroses have been developed and successfully applied. However, no general recommendations can be given, since the treatment regimen should be selected exclusively on an individual basis after a thorough examination of the patient and the determination of the correct diagnosis. The main task of the doctor is to determine the origin of neurosis, establishing the true cause of the disorder.

Medical treatment of neurotic disorders typically includes antidepressants, benzodiazepine tranquilizers, anxiolytics, herbal sedatives, B vitamins, and minerals. In cases where neurosis is caused by some disturbances in the blood supply to the brain, it is advisable to use nootropic drugs and agents that improve the functioning of the nervous system.

It must be remembered that pharmacological treatment only helps to eliminate the symptoms of the disorder and improves the patient's well-being. However, medications are unable to act on the cause of the disease, so it is impossible to completely get rid of neurosis with their help.

Currently, the main methods of treating all types of neuroses are psychotherapeutic techniques and hypnotherapy. To completely get rid of neurotic disorders, it is advisable to conduct treatment with the help of psychodynamic, interpersonal, cognitive-behavioral and gestalt therapy. Psychoanalysis is often used in the treatment of neuroses. During psychotherapy sessions, a person gets the opportunity to build a complete picture of his personality, to establish cause-and-effect relationships that gave impetus to the emergence of neurotic reactions.

In the treatment of neurosis, an important place is given to the normalization of the regime of work and rest and the construction of the correct nutrition schedule with a properly composed menu. Of great importance in the treatment of neurotic disorders is also teaching the patient relaxation techniques and performing autogenic training.

Neurosis, regardless of its type and severity of symptoms, is subject to a complete cure. However, in order to achieve a stable and lasting result, a person needs to reconsider the existing way of thinking and “cleanse” his life program from destructive links that prevent freedom from fears and anxieties.

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Functional disorders of higher nervous activity of psychogenic origin. The clinic of neuroses is very diverse and may include somatic neurotic disorders, vegetative disorders, various phobias, dysthymia, obsessions, compulsions, emotional-mnestic problems. It is possible to establish the diagnosis of "neurosis" only after excluding psychiatric, neurological and somatic diseases similar to it in the clinic. Treatment has 2 main components: psychotherapeutic (psychocorrection, trainings, art therapy) and medication (antidepressants, tranquilizers, antipsychotics, restorative drugs).

General information

Neurosis as a term was introduced in 1776 in Scotland by a doctor named Kuplen. This was done in opposition to J. Morgagni's earlier assertion that each disease is based on a morphological substrate. The author of the term "neurosis" meant by it functional health disorders that do not have an organic lesion of any organ. Subsequently, the well-known Russian physiologist I.P. Pavlov.

In ICD-10, the term "neurotic disorder" is used instead of the term "neurosis". 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 effects, trauma, illness), then they are referred to as so-called neurosis-like syndromes.

In the modern world, neurosis is a fairly common disorder. In developed countries, from 10% to 20% of the population, including children, suffer from various forms of neurotic disorders. 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 the diverse 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 high pace of life. In this regard, the lower incidence of neuroses in rural areas was explained by their more relaxed lifestyle. However, studies conducted among air traffic controllers have refuted these assumptions. It turned out that, despite the hard work that requires constant attention, quick analysis and response, dispatchers suffer from neuroses no more often than people of other specialties. Among the reasons for their morbidity, mainly family troubles and conflicts with superiors were indicated, rather than overwork in the process of work.

Other studies, as well as the results of psychological testing of patients with neurosis, 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, the external trigger situations that provoke a neurosis are very individual and depend on the patient's value system. Under certain conditions, any situation, even everyday, can form the basis for the development of a neurosis. At the same time, many experts come to the conclusion that it is not the stressful situation itself that matters, but the wrong attitude towards it, as destroying the 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 is noted that people with increased suspiciousness, demonstrativeness, emotionality, rigidity, and subdepression are more likely to fall ill with 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 personality traits. In addition, an increased risk of developing neurosis exists during periods of hormonal changes (puberty, menopause) and in individuals 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 providing internal connections and interaction between the autonomic, emotional, endocrine and visceral spheres. Under the influence of an acute or chronic stressful situation, a violation of integrative processes in the brain occurs with the development of maladjustment. At the same time, no morphological changes in the brain tissues are noted. Since the processes of disintegration 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.

Disorders of the limbic-reticular complex in neuroses are combined with neurotransmitter dysfunction. Thus, the study of the mechanism of anxiety revealed the insufficiency of the noradrenergic systems of the brain. There is an assumption that pathological anxiety is associated with an anomaly of benzodiazepine and GABAergic receptors or a decrease in the number of neurotransmitters acting on them. The effectiveness of anxiety therapy with benzodiazepine tranquilizers supports this hypothesis. The positive effect of antidepressants affecting the functioning of the serotonergic system of the brain indicates a pathogenetic relationship between neurosis and disorders of serotonin metabolism in cerebral structures.

Classification

Personal characteristics, the psychophysiological state of the body and the specifics of the dysfunction of various neurotransmitter systems determine the variety of clinical forms of neuroses. In Russian neurology, the main 3 types of neurotic disorders are distinguished: neurasthenia, hysterical neurosis (conversion disorder) and obsessive-compulsive disorder (obsessive-compulsive disorder). All of them are discussed in detail in the corresponding reviews.

Depressive neurosis, hypochondriacal neurosis, phobic neurosis are also distinguished as independent nosological units. The latter is partly included in the structure of obsessive-compulsive disorder, since obsessions (obsessions) rarely have an isolated character and are usually accompanied by obsessive phobias. On the other hand, in the ICD-10, anxiety-phobic neurosis is taken out as a separate item with the name “anxiety disorders”. According to the peculiarities of clinical manifestations, it is classified as panic attacks (paroxysmal autonomic 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 fully correspond to the clinic of a somatic disease (for example, angina pectoris, pancreatitis, peptic ulcer, gastritis, colitis), however, upon detailed examination with laboratory tests, ECG, gastroscopy, ultrasound, irrigoscopy, colonoscopy, etc., this pathology is not detected. In the anamnesis there is a presence of a traumatic situation. Post-stress neuroses are observed in people who have experienced 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 the tragic events, as a rule, in the form of a hysterical fit. The latter gradually lead to a change in personality and social maladjustment (for example, an Afghan neurosis).

Stages of neurosis development

In its development, neurotic disorders go through 3 stages. In the first two stages, due to external circumstances, internal causes, or under the influence of ongoing treatment, neurosis can 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 medication support for the patient, the 3rd stage occurs - the disease passes into the stage of chronic neurosis. There are persistent changes in the structure of the personality, which remain in it even under the condition of 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 psychotrauma. Typical for childhood. As a single case, it can occur in completely mentally healthy people.

A longer course of a neurotic disorder, a change in behavioral reactions, and the appearance of an assessment of one's illness indicate the development of a neurotic state, that is, a neurosis proper. An uncontrolled neurotic state within 6 months - 2 years leads to the formation of a neurotic personality development. Relatives of the patient and he himself speak of a significant change in his character and behavior, often reflecting the situation with the phrase “he/she was changed”.

General symptoms of neuroses

Vegetative disorders are polysystemic in nature, can be both permanent and paroxysmal (panic attacks). Disorders of the function of the nervous system are manifested by tension headache, hyperesthesia, dizziness and a feeling of instability when walking, tremors, shudders, paresthesias, muscle twitches. Sleep disorders 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, an imaginary loss of respiratory automatism.

On the part of the digestive system, dry mouth, nausea, decreased appetite, vomiting, heartburn, flatulence, unclear 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, premature ejaculation in men. Disorder of thermoregulation leads to periodic chills, hyperhidrosis, subfebrile condition. With neurosis, dermatological problems can occur - rashes like urticaria, psoriasis, atopic dermatitis.

A typical symptom of many neuroses is asthenia - increased fatigue both in the mental sphere and in the physical one. Often there is an anxiety syndrome - a constant expectation of upcoming unpleasant events or dangers. Phobias are possible - fears of an obsessive type. In neurosis, they are usually specific, related to a particular subject or event. In some cases, neurosis is accompanied by compulsions - stereotypical obsessive motor acts, which can be rituals corresponding to certain obsessions. Obsessions - painful obsessive memories, thoughts, images, drives. As a rule, they are combined with compulsions and phobias. In some patients, neurosis is accompanied by dysthymia - low mood with a feeling of grief, longing, loss, despondency, sadness.

The mnestic disorders that often accompany neurosis include forgetfulness, memory impairment, 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 the identification of a traumatic trigger in the anamnesis, the data of the patient's psychological testing, studies of the personality structure and pathopsychological examination.

In the neurological status of patients with neurosis, no focal symptoms are detected. Perhaps 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, ultrasound of the vessels of the head. With severe sleep disorders, it is possible to consult a somnologist and conduct polysomnography.

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

Treatment of neurosis

The basis of the treatment of neurosis is the elimination of the impact of a traumatic trigger. This is possible either with the resolution of a traumatic situation (which is extremely rare), or with such a change in the patient's attitude to the current situation, when it ceases to be a traumatic factor for him. In this regard, leading in the treatment is psychotherapy.

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

Drug treatment of neurosis is based on the neurotransmitter aspects of its pathogenesis. It has an auxiliary role: it facilitates work on oneself in the course of psychotherapeutic treatment and consolidates its results. With asthenia, depression, phobias, anxiety, panic attacks, the leading antidepressants are: imipramine, clomipramine, amitriptyline, St. John's wort extract; more modern - sertraline, fluoxetine, fluvoxamine, citalopram, paroxetine. Anxiolytic drugs are additionally used in the treatment of anxiety disorders and phobias. With neuroses with mild manifestations, herbal sedative preparations and short courses of mild tranquilizers (mebicar) are indicated. With advanced disorders, preference is given to tranquilizers of the benzodiazepine series (alprazolam, clonazepam). With hysterical and hypochondriacal manifestations, it is possible to prescribe small doses of neuroleptics (tiapride, sulpiride, thioridazine).

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

Forecast and prevention

The prognosis of neurosis depends on its type, stage of development and duration of the course, the timeliness and adequacy of the psychological and medical assistance provided. In most cases, timely therapy leads, if not to a cure, then to a significant improvement in the patient's condition. The long existence of neurosis is dangerous with 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 can be to cultivate the right attitude to incoming events and people, to develop an adequate system of life priorities, to get rid of delusions. Strengthening the psyche is also facilitated by sufficient sleep, good work and an active lifestyle, healthy nutrition, hardening.

Scottish physician William Cullen.

In all cases, the psychogenic factor is conflicts (external or internal), the action of circumstances that cause psychological trauma, or a prolonged overstrain of the emotional and / or intellectual spheres of the psyche.

The term has undergone numerous revisions and has not yet received an unambiguous definition. In addition, it is worth noting that in medicine and biology, various functional disorders of higher nervous activity can be called “neurosis”.

In general, at the moment, both psychological factors (personal characteristics, conditions for its maturation and upbringing, the formation of relationships with society, the level of claims) and biological factors (functional deficiency of certain neurotransmitter or neurophysiological systems) are distinguished as factors predisposing to the development of neurosis. making patients vulnerable to certain psychogenic influences).

Selection criteria

The main criteria for separating neurotic disorders from mental disorders in general are:

• the leading role of psychogenic factors in the occurrence and decompensation of painful manifestations;
• functional (reversible) nature of mental disorders;
• absence of psychotic symptoms, dementia, progressive personality changes;
• egodystonic (painful for the patient) nature of psychopathological manifestations, as well as the preservation of the patient's critical attitude to his condition.

Symptoms

Mental symptoms

• Emotional distress (often for no apparent reason).
• Indecision.
• Problems in communication.
• Inadequate self-esteem: underestimation or overestimation.
• Frequent experience of anxiety, fear, "anxious expectation of something", phobias, possible panic attacks, panic disorder.
• Uncertainty or inconsistency of the system of values, life desires and preferences, ideas about oneself, about others and about life. Cynicism is common.
• Instability of mood, its frequent and sharp variability.
• Irritability. (see more: Neurasthenia)
• High sensitivity to stress - people react to a minor stressful event with despair or aggression
• Tearfulness
• Resentment, vulnerability
• Fixation on a traumatic situation
• When trying to work, they quickly get tired - memory, attention, mental abilities decrease
• Sensitivity to loud noises, bright lights, temperature changes
• Sleep disorders: it is often difficult for a person to fall asleep due to overexcitation; sleep superficial, anxious, not bringing relief; drowsiness is often observed in the morning

physical symptoms

• Headaches, heartaches, abdominal pains.
• Often a feeling of fatigue, increased fatigue, a general decrease in performance. (see more: Neurasthenia)
• Vegetative-vascular dystonia (VVD), dizziness and darkening in the eyes from pressure drops.
• Vestibular disorders: difficulty keeping balance, dizziness.
• Appetite disturbance (overeating; malnutrition; feeling of hunger, but fast satiety when eating).
• Sleep disorders (insomnia): poor falling asleep, early awakening, waking up at night, lack of feeling of rest after sleep, nightmares.
• Psychological experience of physical pain (psychalgia), excessive concern for one's health up to hypochondria.
• Autonomic disorders: sweating, palpitations, fluctuations in blood pressure, disruption of the stomach, cough, frequent urination, loose stools.
• Sometimes - decreased libido and potency

Connection of neuroses with other diseases and symptoms

Headache

Headaches occur in various mental conditions and diseases. It usually occurs in case of emotional overstrain or in case of suppression of one's emotions, for example, the emotion of anger. The headache may also be hallucinatory (psychalgia).

Vegetovascular dystonia

Vegetovascular dystonia is a violation of the autonomic nervous system. Unlike the somatic nervous system, which obeys the mind and controls the muscles, the autonomic nervous system works automatically and ensures the functioning of the organs and systems of the body. In a situation of danger, the autonomic nervous system mobilizes the forces of the body, increases blood pressure, etc., to cope with the danger. In the event that a person often cannot actively respond to what he considers dangerous (for example, due to social factors) and is forced to suppress his arousal, and also if many situations that are not dangerous cause him a feeling of fear (or if he suffers from panic attacks), then the autonomic nervous system begins to malfunction, errors accumulate and its imbalance occurs, which leads, in addition to the immediate symptoms of VVD, to disruption of the work of various organs.

Panic disorder, phobias, anxiety

Various anxiety disorders (panic attacks, phobias, constant background anxiety) often accompany neurosis.

Treatment

There are many methods and theories for the treatment of neuroses. In the treatment of neurosis, psychotherapy and, in rather severe cases, drug treatment are used.

According to most psychoanalytic schools, it is necessary for the patient to become aware of his contradictions, to build a more accurate picture of his personality. The main task of psychotherapy is to help the patient himself to realize all the interrelations, the totality of which determined the development of neurosis. The result of psychotherapy consists in the patient's understanding of the real relationships between his life experience, the system of his relations with other people formed in this experience, the situation with which they came into conflict, and the manifestations of the disease. At the same time, it is very important to draw the attention of the patient not only to his subjective experiences and assessments, but also to the external conditions of his social environment, to its features.

Karen Horney believed that awareness of her contradictions is categorically not enough, it is necessary to create psychotherapeutic conditions for changing her personality, which will allow her to get away from neurotic ways of protecting herself from the world.

Color diagnostics

Preferred Colors: Neurotic Personality Disorder can only be diagnosed by repeatedly selecting secondary colors (purple, brown, black, and gray) as preferred.

Rejected colors:

see also

• Obsessive-compulsive disorder (compulsive disorder)
• Anxiety neurosis (fear neurosis)

Notes

Literature

• Melman Ch. La nevrose obsessionelle. Seminar 1988-1989. Paris: A.L.I., 1999.
• Pradeille B. Apologie de la Nevrose. Paris: Persee, 2008.
• Karen Horney. "Our Inner Conflicts", "Introspection", "The Neurotic Personality of Our Time".

Links

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See what "Neurosis" is in other dictionaries:

neurosis- See synonym: Neurotic disorders. Brief explanatory psychological and psychiatric dictionary. Ed. igisheva. 2008 ... Great Psychological Encyclopedia

Painful disorder of the nervous system, which does not entail visible changes in the nerves themselves. Dictionary of foreign words included in the Russian language. Pavlenkov F., 1907. NEUROSIS is a nervous disease in general, in which no visible ... ... Dictionary of foreign words of the Russian language

NEUROSIS, neurosis, husband. (from the Greek. neuron fiber, nerve) (med.). Disorder, disease of the nervous system without noticeable anatomical changes in the nervous tissue. neurosis of the heart. hysterical neurosis. Explanatory Dictionary of Ushakov. D.N. Ushakov. 1935 1940 ... Explanatory Dictionary of Ushakov

Speaking of neurosis in simple terms, this disease can be described as a negative perception of the world around us. Most people often experience many of the symptoms and signs of a bad mood in those around them. A spoiled mood can be expressed in the form of attacks of aggression, symptoms of depression, screaming and other conditions that deviate from the generally accepted norm. The totality of the above phenomena can be designated using the term "neurosis". It is important to mention that such a stay in this state can take a long period of time. This description of the disease is rather simplified. In order to find out what neurosis is, one should study this disease in more detail.

Neurosis is a condition caused in most cases by prolonged, hard-to-experience stressful situations.

Neurosis in psychology is a disease that leads to psychogenic and functional disorders that are reversible. Hysterical, asthenic and obsessive state are the most common manifestations of this pathology. In patients with this diagnosis, there is a decrease in physical and mental performance. To summarize all of the above, we can say that neurosis is a neurotic disorder.

The development of the disease is facilitated by various aggressive factors, the influence of which is reflected in the human psyche. These factors include:

1. Prolonged stress and situations that traumatize the psyche.
2. Emotional upheavals and situations that cause a violation of the psycho-emotional balance.
3. Intense intellectual activity.

Many experts in the field of medicine attribute the pathology under consideration to diseases of the nervous system that are chronic. According to doctors, various factors that have a high degree of influence on the human psyche provoke an overstrain of nervous processes. From the point of view of psychoanalysis, the development of neurosis is associated with the presence of internal conflicts in the mind of the individual. There is no consensus in the medical community regarding the causes of the onset of the disease and its nature.

According to generally accepted norms, mild signs of neurosis are not a deviation from the norm, as long as there is no risk of possible complications for life.

Types of neurotic disorder

Let's look at the main types of neurotic disorders that have a high degree of prevalence. First of all, neurasthenia should be singled out, which manifests itself in the form of chronic fatigue syndrome, migraine attacks and problems associated with a decrease in concentration. This form of neurotic disorder has three stages of flow:

1. At the initial stage of the development of neurasthenia, there are no somatic symptoms, and the clinical picture itself manifests itself only in the form of increased irritability.
2. Significantly later, symptoms of chronic fatigue and problems with concentration are observed.
3. At the final stage of the disease, physical weakness, apathy, lethargy and asthenic syndrome are added to the listed symptoms.

The hysterical form of neurosis is characterized as a change in the behavior pattern, which becomes more unpredictable due to irritability, nervousness and inadequate perception of the surrounding world. The development of the disease is accompanied by various seizures, hypotension, attacks of hysterical arthralgia and the appearance of pain. In a separate category of patients, symptoms such as hyperkinesis, bouts of vomiting, nausea and dizziness are recorded. A hysterical attack is accompanied by increased arousal, unreasonable aggression and attempts to harm yourself and others.

The depressive form of a neurotic disorder is accompanied by insomnia, sudden emotional swings, and a lack of a positive outlook on one's own life. Somatic symptoms include arrhythmias, dizzy spells, sexual dysfunction, gastrointestinal disturbances, hypotension, and hypersensitivity. Many patients with this diagnosis have low self-esteem, despondency and apathy. Obsessive-compulsive disorder has a similar manifestation. The main difference between this form of the disease and the depressive one is that the patient loses the ability to control his own emotions, which leads to rash acts.

The hypochondriacal form of neurosis is characterized as a feeling of intense fear of difficult life situations. Also, this type of pathology can manifest itself in the form of fear of complex and rare diseases. This neurological disorder is accompanied by the appearance of obsessive thoughts and signs of hysteria, which have specific symptoms.

Reasons for the development of pathology

Before we talk about how dangerous neurosis is, let's look at the reasons for its occurrence. According to experts, a combination of physiological and psychological factors has a certain influence on the development of the disease. These factors include strong emotional stress that appears when dissatisfied with one's own life. Often, the development of the disease is preceded by various life difficulties, forcing the individual to be under the influence of stress for a long time. Various bouts of absent-mindedness can cause neurosis, which entail certain consequences. For example, consider the situation in which the included iron caused a fire. It is this manifestation of absent-mindedness that can cause the development of pathology.

Experts also identify diseases that affect the state of the immune system. According to statistics, the tendency to disease increases with the systematic use of alcoholic beverages and tobacco products. An important role in the question of the cause of the development of neurosis is assigned to diseases of the central nervous system, which are accompanied by increased sensitivity to prolonged intellectual and physical stress. Psychologists say that neurosis is characteristic of people with a certain type of personality. Problems associated with a negative perception of the outside world, internal conflicts, low self-esteem and suggestibility can be the root cause of a neurotic disorder.

Clinical picture

Symptoms of neurosis in men and women manifest themselves in the form of various psychopathic and somatic disorders. It is important to note that each form of the disease has its own specific manifestations, which greatly facilitate the correct diagnosis.

Among the psychopathic symptoms of the disease, inadequate perception of one's own "I", chronic fatigue, decreased performance, problems associated with concentration, and sleep disturbances should be distinguished. The development of the disease is accompanied by a decrease in self-confidence and the appearance of indecision. Being in such a state, a person loses the incentive to do various things, because he has a firm belief that his plans are doomed to failure. Psychologists say that most of the above symptoms contribute to the formation of an inferiority complex and make a person plunge into voluntary isolation from the outside world.

Among the somatic symptoms of a neurotic disorder, experts note the appearance of a pain syndrome localized in the region of the heart muscle. Also, many patients experience symptoms of increased anxiety and vegetovascular dystonia, hypotension, tremor, and increased sweating. A sharp drop in blood pressure can cause fainting or loss of consciousness.

Signs of a neurotic disorder

The following signs of neurosis, which are pronounced, allow specialists to easily diagnose the presence of pathology:

1. Difficulties in establishing communication links with other people.
2. Increased tearfulness, anxiety and irritability.
3. The presence of causeless fears, personality disorders and panic attacks.
4. Fatigue, decreased intellectual abilities and problems with concentration.
5. Increased sensitivity to stress, manifested in the form of despair or unreasonable aggression.

Many forms of neurosis are characterized by such signs as conflicting desires and the absence of a clear life position. The development of the disease may be accompanied by an unstable emotional state, indecision, resentment and obsession with internal conflict. The pathology under consideration also has physiological signs of development. Most often, the disease is preceded by an increase in sensitivity to various stimuli, pain in the heart, gastrointestinal tract or head, and insomnia. At a certain stage of the course of the disease, the appearance of chronic fatigue, problems associated with the functionality of the musculoskeletal system, a decrease in potency and libido are noted. Also, the pathology under consideration may be accompanied by a vegetative disorder and loss of appetite.

Therapy Methods

The treatment of neurosis is based on a complex effect, which is carried out with the help of medications and methods of mental correction. . It is important to note that the use of potent drugs is permissible only when the disease is severe. In other cases, the main emphasis is on psychotherapy.

The task of the psychotherapist is to teach the patient to perceive the world around him correctly. To do this, all efforts should be directed to resolving internal conflicts and eliminating the causes of violation of psycho-emotional stability. Expanding the circle of interests also helps to reduce the severity of the disease. Stress therapy involves the patient's involvement in a situation that provokes a neurotic attack. After that, the specialist discusses with the patient the reasons for the committed actions and ways to deal with the manifestations of neurosis. In the treatment of this disease, it is very important to find the right ways to get rid of the problem.

The lack of positive dynamics in treatment can lead to the development of a chronic form of the disease. Chronic neurosis is practically not amenable to psychotherapy and requires the use of potent drugs from the category of antidepressants, antipsychotics and tranquilizers. As additional means of therapy, nootropic drugs and psychostimulants are used.

Quite popular is the question of how to treat neuroses in adults when psychotherapy does not achieve a lasting result. In this situation, techniques such as auto-training, music therapy and hypnosis are used. The latter involves immersion in a trance with the help of a specialist to change the psychological attitude that provokes an attack of neurosis. Music therapy and auto-trainings imply an independent solution of internal conflicts. Listening to music files that set you up for a positive perception of the world around you, allows you to normalize the psycho-emotional balance. It can be both special music for relaxation, and favorite compositions that are associated with pleasant memories.

An independent attitude to cheerfulness, activity and positive perception helps to achieve the same results as a long course of psychotherapeutic treatment.

Prevention methods

There are many techniques to prevent the development of neurosis. The risk of developing a neurotic disorder can be reduced by clearly distinguishing between work and leisure. In order to reduce the impact of stress on the state of the psyche, you should pay attention to various hobbies. Moderate physical activity, increasing the scope of interests and expanding the circle of acquaintances also make a positive contribution to the psycho-emotional state of a person.

Many experts recommend that their patients keep a diary in which they offer to describe various life difficulties and methods for solving them. You can normalize your own well-being by taking a course of vitamins, good sleep and a healthy diet. An important role in this matter is assigned to the refusal to take alcoholic beverages and tobacco products.

- a large heterogeneous group of transient functional disorders caused by acute or chronic psychological trauma. Clinical symptoms are extremely diverse, with maladjustment, restrictive behavior, mood disorders, neurotic symptoms proper (anxiety, asthenia, phobias, obsessions) and somatovegetative disorders always observed. Self-consciousness and criticism of one's own state are completely preserved. The diagnosis is made on the basis of complaints, anamnesis of the disease and the patient's life history. Treatment - psychotherapy, drug therapy.

General information

Accurate data on the prevalence of neurotic disorders are not available. According to official statistics, 0.4-0.5% of the population suffers from neurosis, however, experts in the field of psychology and psychotherapy are critical of this figure, noting that it reflects only cases of dispensary registration in state medical institutions. Thus, patients undergoing treatment in numerous private psychological and psychotherapeutic centers remain unaccounted for. We should not forget that a significant part of patients suffering from neuroses do not turn to psychologists and psychotherapists at all, being ashamed of their "weakness" or regarding the manifestations of the disease as personality traits.

Causes of neurotic disorders

Neurosis is always based on extreme stress, due to the inability to change an unbearable situation. At the same time, the specific causes of the development of a neurotic disorder can vary significantly. In some cases, the impetus for the emergence of neurosis becomes a clear acute stressful situation (for example, breaking up an important relationship or losing a job). In others, internal tension increases slowly, imperceptibly to others, and a person seems to fall ill for no apparent reason, with seemingly complete or almost complete social and personal well-being.

Psychoanalysts believe that neurotic disorders arise as a result of a deep psychological conflict that prevents the satisfaction of important needs or poses an insurmountable threat to the future patient. The famous American psychologist and psychoanalyst Karen Horney considered neurosis as a contradiction between various defense mechanisms designed to protect the patient from humiliation, neglect, aggression, total control and other influences that violate the natural fundamental rights of any person.

One way or another, all researchers of neurosis agree that the disease is based on an explicit or hidden internal conflict, a contradiction between various needs, feelings, desires, and adaptive psychological mechanisms. Predisposing factors that increase the likelihood of developing neurotic disorders are considered to be certain features of the character, personality and life history of the patient.

Neurosis often occurs in overly sensitive, emotional, impressionable patients who have a rich imagination and well-developed imaginative thinking, or in psychologically rigid patients who are poorly aware of their feelings and are having a hard time experiencing any life changes. Unfavorable conditions of upbringing are of great importance: neglect, rejection and inattention to the needs of the child, excessive guardianship, connivance, the tendency of parents to create an idol from the child, contradictory upbringing, etc.

Biological factors, in particular, the individual level of neurotransmitters in the brain, have a certain influence on the development of neurotic disorders. The initially existing mild anomaly turns out to be a “point of vulnerability” and under stress, along with other factors, provokes disturbances in the integrative activity of the brain. With the development of neurosis, neurotransmitter dysfunction increases, which causes a further deterioration in the patient's condition.

Classification of neurotic disorders

The great diversity and polymorphism of the clinical manifestations of neurotic disorders complicate a clear division of neuroses into groups or types, which leads to different points of view as to which neuroses should be included in one group and which should not. Domestic medicine traditionally recognizes three types of neurosis: obsessive-compulsive disorder, hysterical neurosis and asthenic neurosis (the old name is neurasthenia), but this classification is at odds with practice. For example, it does not reflect one of the most common groups of neuroses today - anxiety disorders, identified by ICD-10 as a separate syndrome.

This discrepancy gives rise to different approaches to the systematization of neuroses. When making a diagnosis in clinical practice, many specialists prefer to use a classification created taking into account the causes of development and the prevailing symptoms of the disease. In this classification, the following disorders of the neurotic level are distinguished:

• Anxiety-phobic disorders. The main symptom of the disease is a sharp increase in the level of anxiety, sometimes turning into a phobia. These disorders include generalized anxiety disorder, panic attacks, agoraphobia, claustrophobia, social phobia, and other simple and complex phobias.
• Obsessive Compulsive Disorders. The leading symptom is obsessive thoughts and obsessive actions.
• Asthenic neurosis(neurasthenia) - disorders of the neurotic level, the clinical picture of which is dominated by asthenic syndrome.
• Somatoform disorders. In terms of clinical manifestations, such disorders resemble somatic diseases, but do not have a real physical basis. Unlike patients with artificial disorders, patients with somatoform disorders do not take any action to simulate the disease and actually feel unpleasant symptoms.
• Dissociative disorders. This group includes dissociative disorders of movements and sensations and other similar disorders of the neurotic level, previously called hysterical neurosis.

Symptoms of neurotic disorders

All neuroses are accompanied by emotional, psychological and autonomic disorders. Autonomic symptoms include pre-syncope, dizziness, feeling unsteady, trembling limbs, muscle twitching, muscle cramps, increased heart rate, pain and discomfort in the chest, high or low blood pressure, feeling cold or hot, feeling of suffocation, lack of air or incompleteness. inhalation, yawning, appetite disorders, various dyspeptic disorders, frequent urination, pain, itching and discomfort in the perineum, sweating, chills and a slight causeless fever. Characteristic features of vegetative disorders are their inconstancy and polysystemic nature.

With all neurotic disorders, sleep disturbances are observed: difficulty falling asleep due to thoughts associated with a traumatic situation, or due to excessively acute perception of any external signals (clock ticking, street noise, sounds of steps from neighbors), frequent awakenings, superficial sleep, vivid or nightmare dreams, feeling of weakness and weakness after a night's sleep. Often the patient suffers from drowsiness during the day, and from insomnia at night.

Another obligate sign of neuroses is asthenia. Patients do not tolerate stress, quickly exhausted. Neurotic disorders are accompanied by instability of mood, irritability and decreased performance of varying severity. The sexual side of patients' lives also suffers - sexual desire disappears or decreases, the duration of sexual intercourse decreases, sexual contacts do not bring former satisfaction, various disorders occur (impaired potency, premature ejaculation).

With neurotic disorders, affective disorders are observed. The general background of mood decreases, patients feel sadness, melancholy and hopelessness. Habitual pleasures (delicious food, hobbies, communication with friends and family), which previously brought joy, become indifferent. The range of interests narrows, patients become less sociable and begin to avoid contact with other people. Depressions or subdepressions often develop. The level of anxiety rises. Patients see the future as unfavorable, dysfunctional. They live in anticipation of an indefinite catastrophe, tend to focus too much on negative scenarios.

Unlike the above manifestations of neurosis, obsesias and phobias do not occur in all patients. These two signs are closely related, however, in the clinical picture, as a rule, one of the two symptoms predominates. Obsessions are involuntary intrusive thoughts, cravings, fears, or memories. To get rid of obsessions, patients perform compulsive actions, often taking the form of complex rituals.

Phobias are called obsessive fears of objects or situations that at the moment do not pose a real danger to the patient. There are three types of phobias: simple phobias (isolated fears of spiders, flying, birds, clowns, etc.), agoraphobia (fear of open spaces, places that cannot be left unnoticed, and situations in which you can be left without help) and social phobia (fear of situations in which the patient is the center of attention of others).

Diagnosis and treatment of neurotic disorders

Diagnosis of neurosis is complicated by a small number of objective symptoms that allow one to unequivocally judge the presence or absence of a disorder. The patient's complaints and anamnesis of the disease are of primary importance in making a diagnosis. In addition, the doctor conducts psychological testing using special standardized questionnaires (BVNK-300 adapted by Bakirova, Cattell's 16-factor questionnaire, etc.). In the process of diagnosis, organic pathology is excluded, which could provoke the appearance of psychological and somatovegetative disorders. If necessary, the patient is referred for consultations to medical support. Depending on the symptoms present, tranquilizers, antidepressants and antipsychotics are used.

A general strengthening treatment is prescribed, which includes physiotherapy exercises, massage, taking vitamins and microelements. Of great importance is a change in lifestyle: compliance with the regime of work and rest, moderate physical activity, exposure to fresh air, a balanced diet, and the rejection of bad habits. Sometimes a change of activity is required. With timely initiation of treatment, the prognosis is favorable. Symptoms disappear, patients return to normal life, but with severe stress, relapses are possible. With late treatment and non-compliance with the recommendations of the doctor, there is a tendency to a protracted course.