Why do I clench my jaw. Bruxism in adults: a harmless condition or a dangerous problem? Bruxism: predisposition. Risk group

Bruxism, or unconscious teeth grinding, can occur at any age. If in childhood this problem often goes away on its own, then adults without adequate treatment not enough. Ignoring this symptom can lead to many backfire, up to constant headaches and loss of teeth.

What is bruxism

Periodic bouts of bruxism occur in 10–15% of the adult population. They manifest themselves in the form of a strong compression of the jaws, creaking, tapping and clicking of teeth. It occurs as a result of spasm chewing muscles.

Most often, seizures occur in an unconscious state, during sleep. Waking up, a person does not remember what happened to him, and learns about such a peculiarity only from the words of his relatives.

Attacks of bruxism usually last from 10-15 seconds to a minute and are repeated at individual intervals. At the same time, a person's blood pressure rises, the pulse quickens, and breathing is difficult.

Teeth grinding has several official scientific names at once: bruxism, odontism, Carolini phenomenon.

Doctors do not consider this condition a pathology and equate bruxism with snoring, sleepwalking and nightmares.

Classification

Distinguish bruxism:

Day. This variety is quite rare, because in the waking state, people are usually able to control the movements of the muscles and jaws. Daytime bruxism affects men and women who are constantly under stress. To calm down, they chew on pens and pencils, bite their lips and inner sides cheeks, gnaw nails, chew foreign objects. At the moment when a person experiences strong tension or vivid emotions, his jaws involuntarily clench and creak, which can irritate others. Despite the fact that daytime bruxism from the outside seems to be just bad habit getting rid of it without the help of a psychologist is extremely difficult.
Night. Teeth grinding during sleep is much more common, and gender and age do not matter. During the night, there are usually several attacks, and the person may not even be aware of this until the symptoms of bruxism become apparent. Among the most striking manifestations are the erasure of tooth enamel, pain in jaw joints and gum damage.

If you get rid of daytime bruxism possible with the help of constant self-control, then the night requires more integrated approach to treatment. In addition, its diagnosis, especially early, is rather difficult, since it is almost impossible to notice seizures without outside help. A person can suspect this condition only by the totality of certain symptoms.

Symptoms

The main symptoms of bruxism include the following phenomena:

headache in the morning;
pain in the ears and paranasal sinuses;
discomfort after sleep in the jaws, neck, shoulders, and back;
pain during chewing;
toothache;
numbness of the jaws upon awakening;
visual enlargement of the jaw muscles;
increased tearing and eye irritation;
clicks in the maxillofacial joints;
dizziness;
tinnitus;
drowsiness, feeling of weakness;
depressed state, turning into depression;
loss of appetite;
insomnia or restless sleep.

Bruxism almost always provokes the erasure of enamel, which, in turn, leads to an increase in the sensitivity of the teeth: they begin to react to too hot, too cold, as well as sweet and sour foods. A visit to the dentist will help to detect odontism in time and take measures to eliminate it.

The reasons

In the treatment of gnashing, it is very important to establish the true cause of this phenomenon. All reasons can be grouped into 6 groups. Depending on the area in which the roots of the problem lie, a person may need to consult a certain narrow specialist.

In addition, at risk:

patients with Huntington's chorea;
persons with brain injuries or neoplasms in the organ;
people suffering from Parkinson's disease;
men who have genetic predisposition to bruxism.

Whatever the cause of bruxism, it is important to identify the problem in a timely manner and take measures to eliminate it.

Should bruxism be treated?

It may seem that bruxism is not so serious problem. However, if nothing is done, then a number of dental problems may occur:

In addition to dental problems, people suffering from bruxism may develop permanent psychological discomfort. They begin to feel like a hindrance, they develop an inferiority complex, become withdrawn and irritable. And if we add to this fatigue, constant headaches and spasms facial muscles, which are often companions of bruxism, then a person may well become depressed. Diagnosis

Grinding of teeth, especially if it occurs infrequently, is not a reason to be treated for bruxism. Only a doctor can make a diagnosis, and you should start with a visit to the dentist. According to the state of the coronal part, the specialist immediately recognizes the beginning Carolini phenomenon, and to confirm his suspicions, he can use a bruxchecker. This is a special kappa that is inserted into the mouth at night. By the nature of its damage, it is easy to determine which teeth have the maximum load at night.

The next specialist to visit if bruxism is suspected is a neurologist. If necessary, he will refer the patient to electromyography (EMG), a method that allows you to determine how well the masticatory muscles work, by measuring their electrical activity.

A dentist can also send an EMG, but it’s better to visit a neurologist to rule out pathologies in this area.

If there are no problems with neurology, it is worth paying a visit to a psychologist, otorhinolaryngologist, gastroenterologist and osteopath.

Treatment

After the final diagnosis, you need to immediately proceed to treatment. If the grinding of teeth is provoked by problems with the teeth, the therapy will be quick and will take place in the dentist's office.

Attention! Dental procedures for the restoration of teeth destroyed by bouts of bruxism, it is necessary to carry out only after the elimination of the main cause of this condition.

Treat respiratory or auditory tract is already more difficult, as well as to solve the problems of neurology and gastrointestinal tract. The longest to remove psychological reasons bruxism.

Be prepared for the fact that you have to learn to relax (both the nervous system in general and the masticatory muscles in particular). This can be achieved different methods, and it is desirable to use them in the complex.

Good for bruxism the following techniques relaxation:

Yoga and meditation. Almost all meditation techniques lovely way relax and relieve stress. You can learn yoga on your own, but it is better if an experienced instructor tells about its intricacies, and classes will take place in groups.
Breathing exercises. The simplest helps to relieve stress breathing exercises: deep breath through the nose, holding the breath for a few seconds, long exhalation through the mouth.
Physical exercise. Physical activity contributes to the removal nervous tension and stimulates the production of "happiness hormones" - endorphins.
Massage. You can relax your jaw and chin with self-massage. Grab your lower jaw with your palms and perform light circular motions fingers.
Relaxing baths. It is a good idea for people suffering from bruxism to get in the habit of taking a warm, relaxing bath before bed. For greater effect, you can use a variety of additives: sea salt, essential oils(lavender, sandalwood, valerian) herbal decoctions, oat straw, coniferous extract etc.
Compresses. To relieve tension from the jaw, you can use a warm, wet compress. Soak a tissue in warm water, squeeze and apply to the problem area - this will soothe the pain and relax the muscles.
Special exercises. good effect can be achieved if you regularly do exercises to relax the muscles of the jaws and chin:
1. Open your jaws and rest your tongue against the upper palate. This exercise is very useful to do before going to bed.
2. Press your fingers on your chin, pushing it back, open your mouth and close it with force. The lower jaw should be relaxed. This exercise should be repeated 15 times in the morning, afternoon and before bed.

In parallel with relieving stress, do not forget to take care of your teeth. It is impossible to cure bruxism in one day, and each attack has negative impact on enamel and gums.

To protect teeth from destruction, the dentist can pick up a special device. Most often used:

mouth guards for bruxism;
night or day tires;
trainers;
pads with a spring, pushing the lower jaw.

All these devices protect the teeth, but they do not cure bruxism. If the rattle is caused psycho-emotional state your doctor may prescribe:

taking sedatives medicines(Persen, Novo-Passit);
Botox injections;
psychotherapy sessions;
hypnosis.

Prevention

Having got rid of bouts of bruxism, do not forget about the prevention of this condition. Adhere to the following rules:

Make sure that your teeth are not clenched during the day.
Try to play sports.
Walk more on fresh air and walk more often.
Instead of strong tea and drink coffee herbal preparations from mint, lemon balm, linden, valerian, hops, chamomile, calendula, etc.
Adjust your diet: minimize sweets and fast food, increase the amount raw vegetables and fruits.
Adhere to a sparing daily routine: rest more, go to bed on time, do not load yourself with overwork.
Don't eat before bed.
In addition, use B vitamins, as well as calcium and magnesium supplements. However, this should be done after consulting a doctor and the necessary tests.
Avoid stress.

There is a theory that if you bring the jaw to fatigue during the day, the number of nighttime attacks of bruxism will be minimal. Therefore, nutritionists recommend chewing hard carrots, apples and nuts more often.

Compliance with these simple rules will help you forever forget about bruxism, which is so destructive to the teeth and annoying to loved ones.

What to do if you grind your teeth at night - video

Innocent at first glance, the grinding of teeth gives a lot of inconvenience to people suffering from bruxism and their immediate environment. Therefore, at the first signs of this condition, it is advisable to visit the right specialists, install true reason and start treatment.

In most mammals, jaw clenching is important defensive reflex, which allows you to defend yourself from dangerous predators. Scientists believe that humans inherited this reflex from their animal ancestors.

Even in young children, jaw tension is the first, and sometimes the only, reaction to stress. As the child grows older, there will be other reactions to such situations, and he will clench his jaw less often. But approximately 20% of people still have hyperactivity of neurons in the masticatory center (by the way, it is located in the brain). This hyperactivity is hereditary. Clenching teeth in this case is a psychosomatic reaction that allows you to reduce nervous tension through physical actions. Very often, people are not even aware that they are tensing their jaws or grinding their teeth.

Why is such a reaction dangerous? The problem is not in the clenching of the jaws itself, but in the reason for which it is caused. Such people usually have high level anxiety, which in itself cannot be called favorable factor. In addition, this constant compression of the teeth leads to abrasion of the enamel and other dental problems. Another common complication is headache, which patients describe as a pressure hoop-like headache caused by muscle tension in the face and neck. As a result, dysfunction of the temporomandibular joint occurs, which is also the cause constant pain. At the same time, due to the hypertrophy of the masticatory muscle, other changes occur - the lower jaw becomes more massive and wide, and the corners of the mouth constantly seem to be lowered.

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Doctors help to cope with this situation. But first, they conduct tests that allow you to assess the complexity of the problem. In especially severe cases polysomnography is done, that is, a study of night sleep, which captures the activity of the masticatory muscles in order to exclude other pathologies. Used to treat masticatory muscle hyperactivity various methods. In some cases, a special splint (kappa) is installed, which mechanically prevents the jaws from closing and helps to fight the habit of clenching the teeth. But in parallel, the cause of this phenomenon is also eliminated - that is, sometimes not only vitamins and light sedatives are prescribed, but also more serious neurotropic devices. If these methods do not bring desired result, the patient is given injections such as botulinum, the function of the masticatory muscle is preserved, but the muscles relax, and this makes it impossible to clench your teeth.

Bruxism is the involuntary grinding or clenching of teeth, which occurs as a result of contraction of the masticatory or temporal muscles. Most often, people grind their teeth due to neurogenic causes, but the phenomenon is also observed with malocclusion or poorly selected dentures. Pathology can be accompanied by pains of different facial muscle groups, temporomandibular joint, sleep disorders, tinnitus and leads to abrasion of tooth enamel, periodontitis, arthrosis of the temporomandibular mandibular joints.

Silicone cap to protect teeth

Bruxism varying degrees severity is diagnosed in 31% of the population. Since its root causes have not yet been particularly identified, the treatment of pathology is quite complex dental and psychosomatic problem. The choice of treatment regimen depends on the form and degree of development of the pathology. Important for effective treatment is how early the disease was detected. AT early form diseases, it is difficult to notice any violations, and in severe cases, dentin erasure, caries, inflammation of periodontal tissues are already observed, which occurs due to trauma to the teeth.

It is believed that teeth grinding in a dream occurs as a result of unresolved internal problems. psychological problems. This means that the phenomenon is observed as a consequence of repressed aggression, unrealized during the day. Therefore, at night, teeth grinding is more common than during the day - after all, at night a person cannot control the state of his facial muscles. Bruxism causes serious damage to the condition of the teeth, joints, and facial muscles. The load on the teeth in this condition exceeds the chewing load by more than 10 times.

Scientists at the University of Düsseldorf conducted a study among patients with bruxism and found that neither age nor gender affect the risk of developing the disease - the only constant reason that people grind their teeth in their sleep was only severe stress to which they were exposed during the day.

In fairness, it should be noted that short attacks up to 10 seconds can also occur in healthy, positively minded people. Therefore, the answer to the question of what it is - bruxism is generally recognized to lie in the neurogenic area.

There are 2 forms of the disease: day and night. During the day, a person involuntarily clenches his teeth due to nervous tension, and grinding his teeth in a dream occurs due to the fact that his teeth are clenched at a time when he cannot control himself.

A person grinds his teeth in a dream with a grinding sound or with a tapping of a tooth on a tooth for some time, which are clearly noticeable to those sleeping nearby. At this time, the pulse, respiratory rate, pressure may change. You can creak and chatter your teeth in your sleep once a week and several times a night. During the day, much depends on the patient's self-control, which can control the habit of clenching the teeth and minimize its manifestations.

The reasons

Why do they grind their teeth at night? Most researchers agree that the main cause of grinding teeth in sleep in adults is stress. Often nighttime teeth grinding is clearly manifested after severe emotional trauma. One of the opinions of researchers of sleep pathologies is that the cause of bruxism lies in the sphere of dysregulation of the depth of sleep and is on a par with such pathologies as snoring, somnambulism, nocturnal enuresis and . This is one of the most common reasons why a person grinds and grinds his teeth in his sleep.

Among the risk factors that cause bruxism in adults, one can also note gastrointestinal diseases, the use of stimulants and alcohol, smoking, etc. It is believed that the pathology may be the result of infection of the body with worms. Helminths inhibit the synthesis of vitamin B 12, prevent the absorption of other vitamins of this group, which are responsible for normal work nervous system. In some cases, such reactions can be caused by taking psychotropic drugs.

Nighttime teeth grinding as a dental problem

Often, pathology is observed in people with defects in the structure of the facial skeleton, with pathology of the joints connecting temporal bone with the lower jaw and malocclusion. Night grinding may well be an attempt to involuntarily correct defects malocclusion. The teeth grind to find a comfortable, more physiological position for the jaws. Sometimes pathology begins to manifest itself in the absence of certain groups of teeth.

The installation of crowns can also be the reason why people start grinding their teeth in their sleep. Therefore, it is customary to install temporary structures first. When making veneers on the front teeth, it is recommended to wear protective mouthguards at night for the first two weeks.

Diagnosis and symptoms

Diagnosis of the disease is not difficult and is based on personal complaints of the patient or relatives sleeping next to him (for example, a woman notices that her husband grinds his teeth). Bruxism in adults is manifested by painful sensations:

in the temporomandibular joints;
in the ears;
in paranasal sinuses nose
in the neck and shoulders;
in the head like migraines;
destruction of tooth enamel;
the appearance of caries;
abrasion of teeth.

The main symptom of the disease is a violation of the surface of the dentition. Chronic bruxism leads to the destruction of tooth enamel. This includes severe abrasions on the surface of the teeth. Cracks, breaks, rubbing are observed on prostheses. First of all, protruding crowns suffer. There are also sharp edges of the teeth, which can lead to chronic injuries of the buccal mucosa or tongue.

Frequent friction upper teeth o lower, of course, will not remain without consequences. Erased tooth enamel this is just the tip of the problem. Convulsive constant compression of the jaws leads to an overload of the joints and the development of temporomandibular syndrome. Over time, head and muscle pain radiating to the neck and back. Gradually, dysfunction of the temporomandibular articulation develops - this is a deformation articular surfaces, which is accompanied by prolonged facial pain in the temporal and parotid areas. AT rare cases at severe pain erroneously, it is the pathologies of the joints that can be considered as the cause of the painful condition.

The diagnosis can be confirmed by undergoing an examination on a polysomnograph, which registers a specific pattern of spastic contraction of the masticatory muscles. Polysomnography is also important to rule out epilepsy as possible cause the development of bruxism (other schemes are used for the treatment of epileptic pathologies).

Effects:

Muscle pain.
Erasing of teeth.
High tooth sensitivity.
Discomfort when chewing.
Temporomandibular joint dysfunction
Headache.
Changing the shape of the face.
Looseness of teeth.
Sleep disorders.

As a result of sleep disturbance, irritability, decreased concentration and other problems can be observed. In some cases, if you do not go to the dentist in time, the teeth can be erased almost to the root.

Treatment

How to treat bruxism and not grind your teeth? What to do if a person grinds his teeth at night? First of all, grinding of the teeth is a problem that can be minimized by conscious effort. That is, if you notice a habit of grinding your teeth at night, you must:

minimize all stressors;
learn auto-training and relaxation techniques - listen to relaxing music before going to bed, take an aromatic bath;
it is recommended to give a load on the chewing muscles before falling asleep - thoroughly chew an apple, carrot or anything else;
at night can be applied to the cheeks warm compress, which will help relaxation;
learn, if possible, to control yourself during the day - relax your muscles at the first sign of tension;
if the development of malocclusion has already begun, you should immediately contact the dentist;
to solve psychological problems, it is better to come to an appointment with a psychologist.

Andrew S. Kaplan, Associate Professor of Dentistry at New York University's Mount Sinai School of Medicine, recommends keeping your mouth and teeth in a lip-together, teeth-apart resting position throughout the day. Teeth should only touch when chewing food.

To stop grinding your teeth in a dream, you should eliminate all dental problems. The most effective today is the treatment of bruxism with the help of bioplastic night guards, for which they are put on the teeth and protect them from bruxism and abrasion. A cap for bruxism is made according to an individual cast of transparent material. Designs of double-jaw and single-jaw caps have been developed. When worn, the mouthguard is hardly noticeable. At the moment of an attack of chattering teeth in a dream, she takes on the pressure. However, the cap does not cure the pathology, but only minimizes its harmful effects.

Night mouth guard in adults with grinding of teeth:

help to get rid of squeaking teeth in a dream;
protect teeth from abrasion;
serves as a prevention of fractures of orthopedic structures;
protect against displacement of teeth;
will help reduce stress on the maxillofacial system.

With severe symptoms of teeth grinding at night, you can contact the maxillofacial surgeon to relieve muscle hypertonicity. Sometimes, when it is necessary to cure bruxism, it is necessary to first install a muscle relaxant mouth guard - a special splint that relaxes the muscles for up to two weeks. Some are helped by mechanical devices used to treat snoring.

If the disease progresses, in the most severe cases of bruxism in adults, injections of drugs to relax the masticatory muscles are prescribed (Botox injections are popular). As an additional drug treatment night teeth grinding adults should drink magnesium, calcium, B vitamins.

Bruxism, despite its seeming harmlessness at the very beginning of its occurrence, definitely needs as much as possible early treatment, since subsequently it can cause serious damage to the body, which will require serious financial investments.

List of used literature:

bruxism. Nlm.nih.gov. Archived February 12, 2012.
Robert AC Chat. Summary of: Use of the Grindcare device in the management of nocturnal bruxism: a pilot study (neopr.). British Dental Journal 215 24-25 (2013).
V.M. Becker R.A., Bykov Yu.V. Depressive patients in dental practice: dental complications of depression and its treatment // Mental disorders in general medicine. - 2016. - No. 1-2. - S. 45-51.

Why do adults grit their teeth? Teeth grinding (bruxism) is a rather unpleasant syndrome. According to statistics, about 15% of the world's population suffers from this phenomenon. Bruxism is most commonly seen during sleep. Teeth grinding during sleep can last up to several minutes. Moreover, the sleeping person himself does not even know about such a feature of his body.

What is bruxism?

Bruxism is spasm of chewing muscles followed by uncontrolled movement of closed jaws. In this case, the teeth tightly adhere to each other, friction is created and, accordingly, gnashing. This phenomenon may be accompanied the following violations: nocturnal respiratory arrest (apnea), falling blood pressure, slowing the heart rate. Bruxism is mostly nocturnal, but some people experience it during the day as well. During wakefulness, a person does not grind his teeth, but strongly clench his jaws. Usually, few people pay attention to this phenomenon, but in vain. The phenomenon itself, of course, is harmless, but over time it can lead to tooth decay.

bruxism symptoms

The patient is able to notice daytime bruxism himself, but relatives usually tell him about nighttime bruxism, who hear these sounds at night that interfere with sleep.

Manifestations of bruxism:

Grinding or grinding of teeth.
Morning pain in temporomandibular joints and muscles of face.
chronic inflammation joints leading to limited mobility mandible.
Due to the gradual erasure of tooth enamel, sensitivity to sweet, hot or cold increases.
Loosening, fractures and chipped teeth.
As a result of tooth abrasion and deformation, an anomaly of bite is formed.
Sleep disturbance leading to headaches, drowsiness and chronic fatigue syndrome.

What else is bad about bruxism?

Causes of grinding teeth in a dream

dental problems

Anomalies and pathologies of the jaw and dentition:
Inflammation in the area of dental implants.
Poorly fitted removable dentures.
Malocclusion.

Nervous disorders. Action of neurotoxins

The presence of chronic neurosis, exhaustion of the nervous system against the background of fairly long physical or mental stress can also cause bruxism. One of the most important functions sleep is the processing and disposal of the nervous system of unnecessary information. A person in a dream also experiences various daytime problems, cannot relax normally and begins to grind his teeth.

Nocturnal bruxism occurs during phases REM sleep and episodes restless sleep: active movement eyeballs involuntary muscle twitches.

Bruxism is often associated with sleep talking, snoring, sleepwalking, and sometimes enuresis.

People who grind their teeth in their sleep often gnaw on various objects (toothpicks, matches, pens, pencils or nails) at times of tension.

Action household poisons that poison nervous system person:

Alcohol.
Nicotine.
Nitro paints.

Inflammation of the temporomandibular joints

They usually lead to disruption functions of the mandibular joints. This disorder manifests itself as a click when opening the mouth, for example, when biting off large pieces or yawning. Chronic inflammation of the joints is the cause of increased nerve pulsations that stimulate involuntary spasm of the masticatory muscles. As a result of muscle contraction, the lower jaw begins to move and, accordingly, there is a grinding of teeth. Here is formed vicious circle: inflammation provokes muscle spasm, which itself supports this inflammation, provoking a violation normal ratio articular surfaces.

Theory about the influence of helminths

There is an opinion that the cause of grinding teeth during sleep is helminthic infestations. However, there is no connection between the manifestations of bruxism and the presence of helminths in the body. Any person can grind their teeth, even one who has never had worms. But still there is a little bit scientific explanation the fact that people who have worms can grind their teeth in their sleep:

First, the presence helminthic invasions can lead to patient anxiety.
Secondly, a clear deficiency of vitamin B12. In the presence of intestinal helminths in the body, the synthesis of vitamin B12 is reduced. Neuromuscular transmission worsens, which can lead to disruption of the temporomandibular joints and chewing muscles.
Thirdly, the same deficiency of vitamin B12. The amount of oxygen entering the brain decreases, which can lead to changes in the depth of sleep and the appearance of involuntary muscle contractions.

bruxism treatment

Before you start treating bruxism, you need to find out probable causes its occurrence. Based on this, a dentist or other specialist will prescribe treatment. So, if this phenomenon is based on stress, then a person needs to consult a psychologist or psychotherapist. In this case, he will have to get acquainted with special techniques that will help get rid of stress. You can use other ways to get rid of stress: airing the room, walking in the fresh air, relaxing baths with various sedatives. aromatic oils, balanced diet.

The main methods of treatment:

Treatment with folk methods

Relax jaw muscles possible with the help self-massage and special compresses. Also, before going to bed, you can work out your muscles, gnaw on some hard fruit or vegetable: celery stalks, an apple, carrots. Helps rinsing oral cavity decoction of chamomile. Chamomile relieves tension and inflammation. In some cases, the doctor may prescribe vitamin and mineral complexes or sedatives.

Bruxism refers to a phenomenon from a wide variety of medical fields. Therefore, when prolonged episodes of teeth grinding occur, it is imperative to be examined by at least two specialists: a dentist and a neuropathologist.

Involuntary squeezing teeth

Asked by: vera111

Gender Female

Age: 50

chronic diseases: Diabetes type 2, hypothyroidism, hypertension, depression

Hello, I clench my teeth involuntarily. Jaws tense, but I don't grind my teeth. I don't notice it at night, but during the day it happens all the time. Help me please. It started a year ago, but somehow in periods, and now a month has not passed. I took phenotropil, maybe from him? I take Physiotens 0.2 twice a day, Coraxan 7.5 twice a day, Eutherox 175 1 rvz per day, veroshpiron 100, trigrim 10 mg, atorvastatin 20, asparkam, serlift 200 mg. Serlift helps me with depression.

3 answers

Don't forget to rate the doctors' answers, help us improve them by asking additional questions on the topic of this question.
Also do not forget to thank the doctors.

Hello.
Tension in the lower jaw may be associated with experienced stress and anxiety, causing a specific activity of the muscular system.
You need to go to a psychotherapist and learn relaxation, the method of emotional unloading and anti-stress therapy. This will help you deal with this problem in the future.
Psychotherapy should be the main treatment for depression. It will allow you to understand at what moments it is most difficult for you to cope with your condition, and which, on the contrary, bring you closer to recovery, as well as learn methods psychological correction their mood and stabilization of the state as a whole.
If necessary, the doctor will add you antidepressants and other medications leading to an improvement in the mood background and its stabilization.
Either way, psychotherapy will improve the quality of your present life and bring you closer to recovery. For this, in addition to consultations with a psychiatrist, you will need to work with a psychotherapist in person or via Skype.
You can read more about the treatment of depression here: http://preobrazhenie.ru/psychiatry/trechenie-depressii

vera111 2017-10-15 13:59

Dear Dorothy Vyacheslavovna! Thank you for the answer! Serlift at a dose of 200 mg per day can cause jaw tension. I tried to reduce. The dosage was only 25 mg and after a few days it manifested itself in the form of drowsiness, fatigue, weakness, and I again increased the dosage to 200 mg and everything became. In place, but now there is a problem with jaw tension. I haven’t taken serlift for three days now, but instead I began to take phenotropil, and so far I feel good about depression, but the tension of the jaw has not completely disappeared, although it has noticeably decreased. 1) should I replace serlift with fluoxetine or another antidepressant, but what. It would not make me gain weight because I have diabetes. While taking the surlift, I absolutely feel calm, joyful, I don’t have any worries, I have energy to the best of my health. But the tension of the jaw became unbearable.

Antidepressants do not cause extrapyramidal disorders. you describe the symptoms neurotic disorder. It is necessary to change the treatment regimen and focus on internal psychological work. Tablets are secondary here. Look for just such a doctor.
Serlift cannot be replaced with phenotropil, because it is completely different groups medicines. The latter is generally extremely rarely used by psychiatrists, since it does not give desired effect for treatment mental disorders. It is more used in neurology, as a nootropic.

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