Neurasthenia (asthenic neurosis) — the pathological condition of nervous system of the person resulting from its exhaustion at a long mental or physical overwork. Most often the neurasthenia occurs at people of 20-40 years, women have some less than at men. It develops at a long physical overstrain (hard work, an insufficient dream, lack of rest), frequent stressful situations, personal tragedies, the long conflicts. Emergence of a neurasthenia can be promoted by somatic diseases and chronic intoxications. Treatment of a neurasthenia depends on its look. The fundamental moment is elimination of a causal factor of a neurasthenia.
Neurasthenia (asthenic neurosis) — the pathological condition of nervous system of the person resulting from its exhaustion at a long mental or physical overwork. Most often the neurasthenia occurs at people of 20-40 years, women have some less than at men. It develops at a long physical overstrain (hard work, an insufficient dream, lack of rest), frequent stressful situations, personal tragedies, the long conflicts. Emergence of a neurasthenia can be promoted by somatic diseases and chronic intoxications.
Classification of a neurasthenia
The neurasthenia is classified by clinical forms as:
- Hyper sthenic form
- Irritable weakness
- Hyposthenic form
These forms can be shown as phases of course of a neurasthenia.
The most frequent symptom of a neurasthenia is the headache. It has diffusion character and, as a rule, arises at the end of the day. Pressure sense on the head as if squeezing of the head a heavy helmet ("the neurasthenic's helmet") is characteristic. The second complaint of patients with a neurasthenia is dizziness which consists in feeling of rotation in the head, but is not followed by feeling of rotation of surrounding objects. Such dizziness is frequent arises at strong nervousness, physical activity, change of weather, etc. The symptoms connected with cardiovascular violations are characteristic: increase of pulse (tachycardia), feeling of heartbeat, the pressing or pricking pain in heart, arterial hypertension, redness or pallor of integuments. They can appear at the slightest nervousness of the patient, even during lively conversation.
At a neurasthenia the dispepsichesky phenomena are possible: heartburn, deterioration in appetite, eructation. Weight in a stomach, a meteorizm, causeless ponosa or locks. Patients can have frequent desires to an urination (pollakiuriya) which are becoming frequent at nervousness and passing at rest. Sexual desire is often lowered. Men have a premature ejaculation leading to reduction of time of sexual intercourse that forms feeling of weakness and dissatisfaction at patients.
The hyper sthenic form of a neurasthenia is shown by the increased irritability, emotional lability and high excitability. Patients easily fly into a rage, shout at colleagues or relatives, often show impatience, cannot behave and are capable even to offend people around. They are irritated by extraneous noise, a conversation, any sound, a big congestion of people or their bystry movement. Decrease in working capacity is characteristic, and it occurs not so much at the expense of exhaustion how many due to primary weakness of active attention: absent-mindedness and not concentration, impossibility "to get" into gear and to concentrate on the carried-out business. Having begun work, a sick neurasthenia it is not capable it is long to maintain the mental tension necessary for its performance and easily distracts (often rises because of a table, leaves the workplace, reacts to foreign sounds and actions of colleagues). After such derivation it is difficult for it to begin work again. It repeats many times during the working day and as a result of people manages to make nothing. Patients also complain of sleep disorders in the form of problems with falling asleep, frequent night awakenings, the disturbing dreams connected with day experiences. As result — heavy morning awakening without feeling of rest, not clear head, bad mood, constant feeling of fatigue and weakness. The similar morning condition of patients with a neurasthenia can improve a little by the evening. The pressing headache ("the neurasthenic's helmet") or constant feeling of weight in the head, a memory impairment, feeling of discomfort in various areas of a body is characteristic.
Irritable weakness — the second phase of a neurasthenia which comes at persons of choleric temperament or people with balanced strong type of nervous system in cases if at the first stage recovery did not happen, and action of a pathogenic factor proceeds. For the patient still of character strong irritability, but it quickly dies away and is replaced by mental exhaustion. Patients are easily excited and shout, but such first reaction is replaced by feeling of powerlessness and offense and often turns into crying. Mental reactions with opposite emotional states arise on any, even to the most trifling, an occasion. In the second phase of a neurasthenia of the patient with huge work starts performance of any business or work, it is not able to concentrate. Trying to concentrate on some occupation, he quickly is tired, the headache amplifies and it cannot think clearly that does. The increasing general and nervous weakness forces it to give up the begun business with feeling of full powerlessness. After a while the patient tries to start working again, but because of nervous exhaustion throws it again. Breaks between such attempts to work do not improve a situation as they do not bring mental rest to the patient. Therefore repeated attempts to work can bring the patient with a neurasthenia to a condition of full exhaustion.
The hyposthenic form develops as the third phase of a neurasthenia. It can arise from the very beginning of a disease at adynamic, disturbing and hypochondriac people with weak type of nervous system. Constant slackness, physical and mental weakness, passivity, decrease in mood, lack of interests is characteristic of this form or a phase of a neurasthenia. Patients have sadness and some uncertain uneasiness, but the expressed attacks of alarm or melancholy are not characteristic of them. The lowered mood is combined with the expressed adynamy and often shown by emotional instability and tearfulness. Because of feeling of constant fatigue and the general weakness patients cannot gather to start any physical or mental work at all. They are concentrated on the internal feelings and a thought of the state suppress them even more. Ipokhondrichesky complaints to various feelings proceeding from internals are characteristic.
After some time at cancellation of a pathological factor or performing adequate therapy at suffering from a neurasthenia the dream begins to be restored and gradually there is a recovery. At repeated emergence of attacks of a neurasthenia their duration increases, and depressions are aggravated.
Diagnostics of a neurasthenia
The diagnosis of a neurasthenia is made by the neurologist on the basis of characteristic complaints of the patient, history of development of a disease and survey. At clinical inspection it is necessary to exclude existence of chronic infections, intoxications or somatic diseases which initial display can be a neurasthenia. The neurasthenia can develop and as manifestation of organic damage of a brain (a tumor, inflammatory diseases, neuroinfections) therefore for its exception of the patient survey on computer (brain KT) or magnetic and resonant (brain MRT) the tomograph. For assessment of brain blood circulation at a neurasthenia carry out a rheoencephalography.
Treatment of a neurasthenia
In treatment of a neurasthenia the great value belongs to identification of an etiologichesky factor as a result of which it arose, and whenever possible to its elimination. It is necessary to reduce mental and physical activity by the patient, to introduce a high security of work and rest. Observance of the correct daily routine, withdrawal to a dream and awakening in the same hours is important. Foot walks before going to bed, fresh air, the vitaminized food, change of a situation are useful to patients with a neurasthenia. The rational psychotherapy and autogenic trainings is recommended to them.
Carry out the all-strengthening treatment, appoint gopantenovy acid, calcium glycerophosphate, sometimes in a combination with iron medicines. Bromine and caffeine in individually picked up dosages are effective. Therapy of cardiovascular violations is carried out by hawthorn tincture, medicines of a valerian and motherwort.
At a hyper sthenic form of a neurasthenia tranquilizers are shown: chlordiazepoxide, nitrazepam; at sleep disorders — sleeping medicines: , zolpidy. At treatment of a hyposthenic form of a neurasthenia apply small doses of diazepam, , , to fonturatseta. Recommend coffee, strong tea, medicines with the toning effect: ginseng, Chinese magnolia vine, root of an araliya Manchurian, .
At all forms of a neurasthenia purpose of thioridazine is possible. In small doses he acts as antidepressant and makes the stimulating impact on nervous system therefore it is applied at a hyposthenic form. In high doses it shows sedative effect that allows to use it in treatment of a hyper sthenic form.
Consultation of the physiotherapist for selection of effective physiotherapeutic methods of treatment of a disease is recommended to patients with a neurasthenia. At a neurasthenia the electrodream, massage, reflexotherapy, an aromatherapy and other procedures can be applied.
Forecast and prevention of a neurasthenia
The neurasthenia has the most optimistical forecasts among all neurosises. However often there is a transition to the chronic form which is difficult giving in to treatment.
The main thing in the prevention of development of a neurasthenia is observance of the correct work-rest schedule, application of relaksiruyushchy techniques after a nerve strain, avoiding of physical overworks and stressful situations. Activity change, blackout from work, active recreation is important. In certain cases the holiday and a trip on rest helps to prevent development of the beginning neurosis.