Asthenia

Asthenia or progressive psychopathological disease occurs against the background of many ailments, causing disruption of all body systems. Let's consider the causes of pathology, types, methods of diagnosis and treatment.

The disease manifests itself in increased fatigue, decreased performance (physical, mental). Patients complain of sleep problems, increased irritability, lethargy and other vegetative disorders. It is difficult to diagnose the disease, since its symptoms are similar to many ailments. Therefore, special testing is used to detect it, based on the results of which a course of therapy is selected for the patient.

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Epidemiology

The disease is one of the most common medical syndromes. It occurs with infectious diseases, somatic and psychopathological ailments. Post-traumatic, postpartum and post-traumatic periods are an excellent background for its development. Because of this, specialists from different fields encounter it. Since it can be a sign of an incipient disease or accompany it during an exacerbation.

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Causes asthenia

The causes of the disease may be associated with increased mental or physical stress, various diseases that exhaust the body. Improper organization of work and rest, unhealthy diet, mental and nervous diseases also provoke it. In some cases, signs appear at the initial stage of damage to internal organs or after an acute illness. In addition, asthenic syndrome refers to clinical manifestations of electromagnetic radiation of the microwave range.

But most often the pathology is associated with exhaustion of higher nervous activity and prolonged overstrain. Deficiency of nutrients, metabolic disorders, increased energy expenditure and any other factors causing exhaustion of the body provoke the disease. Even a change of job, changes in personal life, moving or quarrels with loved ones are risk factors and can cause the corresponding symptoms. People who abuse alcohol, smoke, drink a lot of tea and coffee are at risk.

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Pathogenesis

The development of asthenic syndrome is directly related to pathophysiology. The main link is the violation of the RAS - reticular activating system. This system is a neural network responsible for managing all energy resources of the body. It controls the coordination of voluntary movements, endocrine and autonomic regulation, memorization, sensory perception.

Since the RAS is responsible for a large number of neurophysiological connections, it is important in modulating psychological attitudes, intellectual functions and physical activity. Psychopathological dysfunction generates a signal that leads to an overload of the RAS due to disturbances in the management of energy resources. This is reflected in the patient as increased anxiety, fading physical and mental activity.

Another important factor influencing the development of asthenia is a failure of biological rhythms. The system regulates the secretion of hormones (somatoliberin, thyroliberin, corticoliberin), controls blood pressure, temperature, state of wakefulness, affects performance and appetite. The functioning of this system is intensively disrupted in the elderly, during long-distance flights and during shift work. Normal functioning of the biological clock prevents the development of the disease.

Mechanisms of development

The main mechanism of asthenic syndrome is associated with the reboot of the activating reticular formation. The mechanism is responsible for synchronizing all aspects of human behavior and controls energy resources.

In clinical practice, the most common variants of psychopathological illness are:

• Asthenia as a symptom of a certain disease (somatic, infectious, mental, endocrine and others).
• A temporary condition caused by the impact of provoking factors. These can be various diseases, mental and physical overload, medication or surgery. As a rule, this indicates a reactive or secondary form. When the provoking factors are eliminated, the unfavorable symptoms go away.
• Chronic fatigue syndrome is not only one of the leading symptoms of the pathology, but also a provoking factor. Constant weakness, fatigue and irritability lead to social and physical maladaptation.

Patients with this disorder suffer from regular mood swings, loss of self-control, tearfulness, and lack of self-confidence. Physically, this manifests itself as: pain in the heart, tachycardia, unstable blood pressure, and gastrointestinal problems. In addition, the following are possible: increased sweating, intolerance to bright light, temperature changes, and loud sounds.

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Symptoms asthenia

Symptoms include three mandatory components:

1. Own clinical manifestations.
2. Disorders based on the pathological condition of the disease that caused the disorder.
3. Symptoms that arise as a result of a psychological reaction to illness.

The manifestations of asthenic syndrome increase during the day, in the morning the symptom complex is weakly expressed or absent. But in the evening the pathology reaches its maximum manifestation. Let's consider the main signs of the disease:

• Fatigue

This symptom is found in all forms of the disease. Good sleep and rest do not relieve fatigue. During physical labor, general weakness and unwillingness to do work arise. During intellectual work, difficulties arise when trying to concentrate, memory, intelligence and attentiveness deteriorate. The patient experiences difficulties in verbally expressing his own thoughts. It is difficult to concentrate on one problem, to choose words to express ideas or emotions, absent-mindedness and inhibition are observed. It is necessary to take breaks and break down the tasks into stages. All this leads to the fact that the work does not bring the desired results, fatigue increases, causing anxiety, self-doubt and self-doubt.

• Vegetative disorders

Psychopathological disease is always accompanied by dysfunction of the autonomic nervous system. Patients suffer from tachycardia, blood pressure fluctuations, constipation, pulse instability, pain in the intestines, chills, a feeling of heat and increased sweating. In addition, appetite decreases, headaches appear and libido may decrease.

• Sleep disorders

Regardless of the form of asthenia, sleep problems of various natures arise. These may include difficulties falling asleep, frequent night awakenings, intense and restless dreams, a feeling of fatigue and exhaustion after sleep. In particularly severe cases, patients develop the feeling that they do not sleep at night, but in reality this is not the case. The disease is accompanied by daytime sleepiness, problems falling asleep and poor quality of sleep.

• Psycho-emotional defects

This symptom occurs due to decreased productivity and increased patient attention to this problem. Patients become hot-tempered, irritable, tense, lose self-control. A state of depression, sharp mood swings, unfounded optimism or pessimism are noted. The increase of such symptoms leads to neurasthenia, hypochondriacal or depressive neurosis.

Temperature with asthenia

Subfebrile temperature in anxiety states and psychological ailments indicates vegetative instability of the nervous system. This is due to the fact that psychogenic factors disrupt thermoregulation. Regular daily fluctuations in body temperature indicate neurotic and pseudo-neurotic conditions. Such signs complicate the diagnostic process, as they can be a sign of focal infection and other lesions of the body. In this case, antibacterial therapy only worsens the asthenic condition and somatic symptoms.

If subfebrile temperature is accompanied by poor health, which manifests itself in the form of weakness, rhythmic hyperthermia, mood changes, then this indicates a disorder of internal circadian rhythms. In addition to problems with thermoregulation, asthenic syndrome also causes other pathologies, for example, sore throat, tremors of the limbs, and others.

Treatment depends on the true cause of the pathology. If temperature jumps are caused by a psychopathological disease against the background of chronic diseases, then treatment of the underlying cause is required. For this, patients are prescribed antibiotics, antihistamines and antidepressants, but only after a comprehensive examination of the body.

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Headache with asthenia

Headaches in neurasthenic diseases are one of the most unpleasant and constant symptoms. It is this manifestation of the disease that makes one seek medical help. In medical practice, special diagnostic criteria are used that allow one to determine the degree of headaches and tension:

• As a rule, episodic pain lasts from 30 minutes to 7 days. If the discomfort is chronic, the pain is incessant.
• The pain is squeezing, compressing and constricting in nature. It is localized on both sides of the head, but one side may hurt more.
• Everyday physical activity does not increase discomfort, but everyday and professional activities aggravate the situation.
• As the unpleasant sensations intensify, symptoms such as photophobia, phonophobia, nausea, gastrointestinal pain, anorexia, and migraine appear.

The pathology is based on chronic emotional stress, which is formed under the influence of many factors (past illnesses, physical and emotional overload). If the pain is chronic, then along with the asthenic syndrome, migraine and neurosis develop. This symptom entails various disorders: sleep problems, poor appetite, irritability, nervousness, weakened attention. Based on this, we can conclude that headaches with asthenia are part of the psychovegetative complex.

Asthenia in children

Asthenic syndrome in childhood is a psychological condition that causes a number of behavioral deviations. The child becomes capricious, whiny, has frequent mood swings, inability to concentrate, and increased lability. The disease is difficult to recognize, since the child is already emotionally unstable due to his age. But if your child suddenly becomes lethargic, his behavior has changed significantly for the worse, tearfulness, frequent whims, and other unfavorable signs appear, then this indicates asthenia.

Symptoms in children are weakly distinguished, unlike in adults. As a rule, these are worries, fatigue, emotional instability. Asthenia can appear against the background of other diseases, but sometimes its symptoms are confused with age-related changes. If the above-described signs are left unattended, they will begin to progress and cause a number of complications.

Treatment of pathology in childhood begins with determining the true cause of the disease. Because sometimes unfavorable symptoms indicate a hidden disease. If the diagnostics did not reveal anything, it is recommended to visit a psychologist. In addition, it is necessary to establish the baby's daily routine, organize proper nutrition and spend more time with the child.

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Asthenia in adolescents

Psychopathological disorder in adolescence is associated with hormonal changes in the body and social development. At this age, any event, even a minor one, can cause mental trauma. Increased stress and obligations contribute to the development of pathology.

Signs of the disease:

• Increased fatigue
• Irritability
• Inability to concentrate
• Headaches without physiological prerequisites
• Painful sensations in the heart, gastrointestinal tract, dizziness
• Lack of confidence in oneself and one's own abilities.
• Difficulty performing simple tasks, problems with learning

If the above symptoms are left unattended, they will progress. As a result, the teenager will withdraw into himself, begin to avoid peers and relatives. Treatment begins with a comprehensive examination of the body. Since in some cases, the disease occurs due to hidden diseases. The help of a psychotherapist, drug therapy and the use of general tonics are mandatory. The help of the patient's parents is of great importance. They should support the child and set him up for a positive treatment result.

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Asthenia during pregnancy

During pregnancy, a woman has to face many problems, including psychopathological ones. Most often, this disease is encountered in the first and third trimesters. Asthenia requires a comprehensive medical and obstetric examination.

• I trimester – nausea, headaches, sleep disorders, gastrointestinal problems and constipation are caused by symptoms typical of autonomic dysfunction, which disappear after adequate rest. A feeling of constant fatigue is possible, which indicates the intense nature of the disease. In this case, a deterioration in the general condition, weight loss, and various biological disorders are observed. Such a condition requires hospitalization and medical supervision.
• II trimester – at this stage, increased fatigue and weakness are caused by the increase in the volume of the ovum and the woman’s body weight. Asthenic symptoms appear along with functional disorders of the gastrointestinal tract, itching of the skin, pain in the bones and muscles, and insomnia. As a rule, adequate rest eliminates the above-described ailments, and regular exercise prevents their occurrence. But in some cases, severe forms of the syndrome occur. The woman has constant headaches, high blood pressure, weakness, and iron deficiency anemia. Similar symptoms occur with polyhydramnios, nephropathy, and benign recurrent cholestatic jaundice.
• III trimester – the disease has a pronounced character, accompanied by high blood pressure, anxiety, breathing problems, pain in the abdomen and lower back, and impaired ability to work. These symptoms can occur as a result of a viral infection, fetal malformations, diabetes, or Rh immunization.

Expressed vegetative disorders are observed in multiple pregnancies. This condition is diagnosed in 15% of pregnant women. Very often, the cause of the malaise is a low hemoglobin level, poor nutrition, stress, lack of rest and lack of sleep. Without proper nutrition, symptomatic treatment and compliance with hygiene recommendations, the pathology can lead to serious complications.

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Postpartum asthenia

Asthenic disease in the postpartum period is not uncommon, which is caused by many factors. First of all, it is the hormonal and physiological recovery of the body. After childbirth, the endocrine system is rebuilt, since the body needs to produce milk. During this period, fever, sweating and weakness are possible. Another factor of the disease is anemia, that is, anemia. It occurs after a cesarean section, with postpartum bleeding or serious blood loss during childbirth. A significant decrease in hemoglobin entails oxygen starvation, weakness, dizziness and fainting.

Unpleasant symptoms appear due to the overload of the cardiovascular system. The thing is that during the period of gestation the blood volume increases by 1.5 times, which affects blood pressure and heart function. After childbirth, these systems return to normal abruptly, which causes discomfort. Asthenia can be caused by postpartum depression. In this case, the woman feels depressed, has bouts of melancholy, weakness and irritability. Do not forget about the adaptation period, since the birth of a child requires psychological adaptation.

Main features:

• Weakness
• Irritability
• Rapid fatigue
• Mood swings, tearfulness
• Headache and muscle pain
• Intolerance to bright light, strong odors and loud sounds
• Sleep disorders

When the above symptoms appear, it is necessary to understand that if they are not caused by a certain disease, then they are temporary. The disease can disguise itself as serious damage to the body. So, if weakness and causeless fatigue occur along with sharp pains in the lower abdomen, swelling of the legs, blood in the urine, pain when urinating, chills and fever, then urgent medical care is required. In all other cases, it is recommended to spend more time in the fresh air, not refuse help from loved ones, eat well, get enough sleep and avoid stress.

Asthenia scale

Based on the MMPI questionnaire (Minnesota Multidimensional Personality Inventory), a scale of asthenic condition was developed. This system is necessary to determine the degree of the disease. It was developed taking into account the data obtained during the treatment of patients with different forms of the disease.

The scale is used to quickly determine the severity of the disease. It includes items for assessing the patient's nervous excitability, performance, and aggressiveness. Some questions provide information about the quality of sleep and the state of the reproductive system.

Subjective Asthenia Rating Scale (MFI-2O)

No.	Offers	Answers
1	I feel healthy	Yes, it's true 1 2 3 4 5 No, it's not true
2	Physically I am capable of little.	Yes, it's true 5 4 3 2 1 No, it's not true
3	I feel active	Yes, it's true 1 2 3 4 5 No, it's not true
4	Everything I do gives me pleasure	Yes, it's true 1 2 3 4 5 No, it's not true
5	I feel tired	Yes, it's true 5 4 3 2 1 No, it's not true
6	I feel like I get a lot done in a day.	Yes, it's true 1 2 3 4 5 No, it's not true
7	When I do something, I can concentrate on it.	Yes, it's true 1 2 3 4 5 No, it's not true
8	Physically I am capable of a lot.	Yes, it's true 1 2 3 4 5 No, it's not true
9	I'm afraid of the things I need to do.	Yes, it's true 5 4 3 2 1 No, it's not true
10	I think I accomplish very little in a day.	Yes, it's true 5 4 3 2 1 No, it's not true
11	I can concentrate well.	Yes, it's true 1 2 3 4 5 No, it's not true
12	I feel rested	Yes, it's true 1 2 3 4 5 No, it's not true
13	It takes me a lot of effort to concentrate.	Yes, it's true 5 4 3 2 1 No, it's not true
14	Physically I feel in bad shape.	Yes, it's true 5 4 3 2 1 No, it's not true
15	I have many plans	Yes, it's true 1 2 3 4 5 No, it's not true
16	I get tired quickly	Yes, it's true 5 4 3 2 1 No, it's not true
17	I have very little time to do	Yes, it's true 5 4 3 2 1 No, it's not true
18	I feel like I'm doing nothing	Yes, it's true 5 4 3 2 1 No, it's not true
19	My thoughts are easily distracted	Yes, it's true 5 4 3 2 1 No, it's not true
20	Physically I feel in great condition.	Yes, it's true 1 2 3 4 5 No, it's not true

Key to the scale:

Form of disorder	Questions
Psychic	7,11,13,19
Physical	2, 8, 14, 20
General	1, 5, 12, 16
Decreased activity	3, 6, 10, 17
Decreased motivation	4, 9, 15, 18

If after answering all the questions the patient scores 30-50 points, then there is no disorder. From 51-75 – mild form of asthenia, 76-100 – moderate form, 101-120 – severe.

Asthenia syndrome

Asthenic syndrome is a condition of the body that is characterized by increased fatigue, depletion of vital forces and energy resources.

Main symptoms:

• Irritability
• Weakness
• Increased excitability
• Frequent mood swings
• Tearfulness
• Sleep disorders
• Intolerance to bright light, strong smells and sounds
• Disorders of the autonomic nervous system

The above symptoms increase gradually. At the initial stage, fatigue and increased tiredness appear, later irritability, impatience, mood swings.

The manifestation of the syndrome largely depends on the causes that caused it. If the malaise appeared after acute illnesses, then, as a rule, it takes the form of emotional weakness, tension and increased sensitivity. After craniocerebral injuries, the disease is characterized by severe headaches and problems with the vegetative system. The early stages of hypertension and atherosclerosis are accompanied by severe fatigue, weakness and mood swings.

The syndrome may occur as a result of prolonged emotional or intellectual overstrain. Infectious and non-infectious diseases, intoxication, are another cause of asthenia. The risk category includes people with an unbalanced or weak type of higher nervous activity.

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Forms

ICD 10 defines a progressive psychopathological disorder with the following meaning: systematic complaints of general weakness, increased fatigue regardless of the load, decreased performance, muscle and headaches, sleep disturbances, inability to relax and irritability.

ICD 10, that is, the International Classification of Diseases, 10th revision, classifies asthenia into several classes at the same time:

V Mental and behavioral disorders

F00-F09 Organic, including symptomatic mental disorders

• F40-F48 Neurotic, stress-related and somatoform disorders

F48 Other neurotic disorders

F48.0 Neurasthenia

• F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors

XVIII Symptoms, signs and abnormal findings in clinical and laboratory studies, not elsewhere classified.

R50-R69 General symptoms and signs

• R53 Malaise and fatigue

F48.0 Neurasthenia.

The fact that the disease is included in several categories is explained by the fact that it manifests itself in many diseases and has many symptoms. If there is a need to identify the primary disease, then additional coding is used.

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Complications and consequences

If left untreated, asthenic syndrome can lead to serious consequences. First of all, it is neurasthenia, depressive state, hysteria and even schizophrenia. If the disease is chronic, it causes lack of concentration, absent-mindedness, memory problems. If the disease is caused by infectious or viral diseases, it can lead to secondary damage to the body. In this case, the immune system and the body as a whole are significantly impaired.

Vegetative syndrome does not cause irreversible changes, but in severe forms, hospitalization in special clinics is indicated. In addition, the patient is assigned a limited degree of working capacity. Timely visit to the doctor, correct diagnosis, a course of drug therapy and physiotherapy procedures allow you to quickly return to your usual life.

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Diagnostics asthenia

Diagnosis of asthenia is a differential study, the main goal of which is to identify the true symptoms of the disease and not to confuse them with chronic fatigue syndrome. Various methods are used for this, but more reliance is placed on assessment scales and tests, with the help of which it is possible to establish the type of malaise and isolate it from other diseases.

Comparative characteristics of signs of asthenia and fatigue:

Fatigue	Asthenia
Physiological phenomenon	Pathological process
Decreased excitability of the body and functional activity due to overexertion (passes after rest and sleep)	Decreased excitability and functional activity of the body, which does not disappear after rest and sleep
Occurs after intense or prolonged stress	The tension is constant
It goes away after rest	Doesn't go away after rest
Does not require medical consultation	Requires medical attention because it is chronic, irrational and difficult to reverse.

Disease occurs due to disturbances in the use of energy resources, and fatigue occurs due to their depletion.

In addition, additional studies are used. For example, magnetic resonance imaging, positron emission tomography and computed tomography allow us to exclude tumors, cysts and progressive diffuse brain lesions. In this case, the pathology is symptomatic, not pathological. In each individual case, the doctor prescribes a number of laboratory tests, electroencephalography, ultrasound, ECG and other diagnostic procedures.

Asthenia test

Various tests for diagnosing asthenic conditions allow differentiating asthenia from other body disorders. The advantage of this method is its simplicity and quick results.

The simplest is a test questionnaire. The proposed assumptions must be carefully read and assessed, in relation to your current state. The test uses several answer options: no, incorrect, perhaps, so, true, absolutely true.

Test

1. I work under a lot of stress.
2. I find it difficult to concentrate on anything.
3. My sex life does not satisfy me
4. The wait makes me nervous.
5. I experience muscle weakness
6. I don't feel like going to the cinema or the theatre.
7. I am forgetful
8. I feel tired
9. My eyes get tired when reading for a long time.
10. My hands are shaking
11. I have a poor appetite
12. I find it difficult to be at a party or in a noisy company.
13. I don't understand what I read that well anymore.
14. My hands and feet are cold
15. I am easily offended
16. I have a headache
17. I wake up in the morning tired and not rested.
18. I sometimes get dizzy
19. I have muscle twitching.
20. I have a ringing in my ears
21. I am concerned about sexual issues
22. I feel heaviness in my head
23. I feel general weakness
24. I have pain in the crown of my head
25. Life for me is connected with tension.
26. My head feels like it's tied with a hoop
27. I wake up easily from noise.
28. People tire me out
29. When I'm nervous, I break out in sweat.
30. I can't sleep because of restless thoughts

For each answer, points are awarded according to the following scheme:

• 1 - no, not true
• 2 - perhaps so
• 3 – correct
• 4 - absolutely correct

You can score from 30 to 120 points for the test.

• 30-50 points – no asthenia
• 51-75 points – weak
• 76-100 points – moderate
• 101-120 points – pronounced.

There is another questionnaire developed by G.V. Zalevsky and consists of 141 questions-statements. Each item reflects situations in which the subject is required to change already established elements of his behavior. The questionnaire consists of 7 scales, each of which is assessed according to the parameters of mental rigidity.

The SMIL questionnaire is another test that represents a shortened version of the MMPI and consists of 11 scales. The first three are evaluative, as they measure the degree of reliability of answers, the sincerity of the respondent and the correction due to caution. The remaining scales evaluate personality traits and are basic. The test results are interpreted as a graphical personality profile.

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Differential diagnosis

Another feature of the disease is that it must be differentiated from ordinary fatigue, which occurs after mental or psychological stress. Pathological weakness develops gradually and persists for a long period of time (months, years), does not go away after adequate sleep and rest, and therefore requires medical care.

Treatment asthenia

Treatment of asthenic syndrome depends on pathological signs and the identified provoking disease. At the initial stage, the patient undergoes a comprehensive examination of the body and therapy for the identified disorders. This helps prevent a destructive effect on the psycho-emotional state.

The main stages of treatment:

1. Daily routine – all patients need to establish a daily routine, that is, allocate time for proper rest and sleep, time for work, exercise and other things that are important for normal well-being and the nervous system.
2. Nutrition – a healthy diet is the key to the body’s recovery. Products containing protein, tryptophan, amino acids and vitamins are useful for patients – turkey, cheese, bananas, eggs, bran bread, fresh berries, fruits, vegetables and cereals.
3. Drug therapy – a course of antidepressants or homeopathic remedies is prescribed. Adaptogens, i.e. drugs of natural origin, are most often used. They can also use folk remedies, for example, soothing herbs, various physiotherapy procedures and spa treatment.

All the above stages are part of the body's recovery course, as they allow you to normalize your well-being without side effects. To prevent relapses, preventive measures are recommended that minimize stress and its destructive impact on the body.

Prevention

Preventive measures for autonomic disorders are aimed at preventing psychopathological symptoms that depress the central nervous system and the entire body.

Preventive measures:

• Timely and comprehensive treatment of any diseases and their further prevention.
• Good rest and sleep.
• Rational, healthy nutrition.
• Minimization of stressful situations and nervous disorders.
• Regular physical activity.
• Frequent walks in the fresh air.
• The use of pharmacological drugs that reduce fatigue (glucose, vitamin C, ginseng, eleutherococcus) and increase the protective properties of the immune system.

Compliance with the above recommendations will prevent the development of asthenic syndrome and protect the body from the negative influence of external irritants.

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Forecast

The prognosis of asthenic syndrome depends entirely on the form of the disease, the individual characteristics of the patient's body and the effectiveness of the treatment. Thus, if the malaise is of a post-infectious nature, the prognosis is favorable, since various methods of therapy allow the body to fully recover without any complications.

Provided the correct treatment, the psychological, cerebral, neurotic and functional forms have a favorable prognosis. In case of a long course, the disease causes serious complications, in some cases irreversible, transforming into neuroses, schizophrenia and chronic depression.

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Asthenia and the army

The presence of symptoms of asthenic disease may be the reason for the commission's refusal for those wishing to join the army. As a rule, this concerns advanced psychopathological disorders, accompanied by serious mental and body dysfunctions.

Particular attention is paid to neurocirculatory asthenia, as it is characterized by persistent and pronounced vegetative-vascular disorders. If the malaise is accompanied by hypertensive reactions, persistent cardiogy, arterial pressure lability and pronounced symptoms that do not respond to treatment, then conscription may be denied or recognized as temporarily unfit for military service.

Asthenia is rightfully considered a disease of modern times, since frequent stress, nervous experiences and negative influence of the external environment cause its pathological symptoms. In order to overcome weakness and increased fatigue, it is necessary to strengthen the body, rest, eat well and lead a healthy lifestyle with a minimum of stress and worries.

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