Neurasthenia

The diagnosis of "neurasthenia" is made with CNS disease, caused by its exhaustion due to prolonged moral or physical overload. Most often the disease affects patients older than 20 years, mostly men.

The appearance of pathology can be preceded by long-term chronic diseases or exposure to toxic substances.

Pathology can be treated depending on the type of disease.

Code on the ICD 10:

• F00-F99 - Mental and Behavioral Disorders
• F40-F48 - Neuroses caused by stress, as well as somatoform disorders
• F48 - Other neurotic disorders
• F48.0 - Neurasthenic disorder

[1], [2], [3], [4], [5], [6],

Causes Neurasthenia

Causes of neurasthenia

In the emergence of neurasthenic disorders, a whole list of causes of all kinds is of great importance. Among them, for example, exposure to toxic substances, deficiency of vitamins, immunity disorders, oncological processes, etc. Often the disease occurs against the background of the disorder of metabolic processes. However, the main reasons are hidden in the incorrect arrangement and reassessment of the possibilities of the human psyche.

In most cases, pathology is provoked by moral and physical congestion, stress, anxiety.

Excess loads, which one has to experience a person, eventually lead to the impossibility of relaxation and rest. The fact that the body stops resting sooner or later manifests itself in overload. As a result, excessive depletion of the nervous component of the body is formed (so-called distress). Simultaneously with neurasthenic disturbances, increased irritability, pathological fatigue, insomnia, hot temper, frequent changes in mood increase.

Neurasthenic syndrome is more often observed in people at the peak of activity - from 20 to 45 years. According to statistics, men are more likely to get sick, but experts say that in recent years, the chances of men and women developing a nervous disorder have almost equaled.

[7], [8], [9], [10], [11]

Pathogenesis

Pathogenesis

Overexertion of brain activity leads to the onset of the disease. At the present time, many people are striving to improve their social status and financial situation, which can lead not only to the attainment of the goals set, but also to an overload of the organism, to negative emotions, to overwork. As a rule, such people because of the vanity created around them do not have time to observe the banal day regime, which would include enough time for rest, restoring energy, eating food.

An additional factor of stress is broken intimate life - the lack of full-fledged sex, a constant partner, the inability to relax during intimacy, etc.

Many try to compensate for the lack of rest using alcohol, smoking, gambling, visiting nightclubs. However, this does not solve, but only exacerbates the problem, since the body still does not experience rest.

Other factors that have a provoking effect on the development of a neurasthenic disorder are various infections, traumas with nerve endings, chronic sluggish diseases. These can be associated with such disorders as bulimia or anorexia (eating disorders). Some specialists also assign some role in the appearance of the disease to the hereditary factor.

Symptoms Neurasthenia

Symptoms of neurasthenia

The first signs of pathology may be as follows:

• sleep disturbance (disturbed sleep, restless sleep, difficult awakening, etc.);
• general feeling of fatigue, headaches, migraines;
• memory impairment, decreased concentration of attention;
• excessive emotionality, irritability;
• instability of temperature and pressure;
• heart rhythm disturbances;
• decreased sexual desire, possibly impotence;
• irritable bowel syndrome (increased gas production, alternation of diarrhea and constipation, impaired appetite, heaviness in the stomach);
• dizziness, noise in the ears, a sense of heaviness in the head.

The disease can proceed in different ways, depending on the form of neurasthenia.

Hypersthenic neurasthenia is characterized by excessive irritability and excitability, instability of mood. Such patients can easily lose their temper, they are impatient, do not restrain their emotions, can easily offend and even insult, without giving it much importance. They are annoyed with the slightest noise, do not tolerate excessive accumulation of people. They have reduced efficiency, absentmindedness, inability to concentrate. This is even more irritating. Along with sleep disorders, a feeling of fatigue, a negative mood, weakness, pain in the head.

The phase of irritable weakness, or transient cerebral neurasthenia, occurs in people with a relatively balanced nervous system who have experienced the first stage without taking any measures to cure. What is typical for this stage: a bad mood and irritation is replaced by physical or moral exhaustion, the patient is easily brought to scream, but he very quickly weakens and suffers from his own impotence. The person emotionally reacts even to trifling problems, but when making an important decision, as a rule, he can not concentrate and fix attention on something. He often throws an unfinished business, unable to withstand the growing general and nervous weakness. Sooner or later, complete exhaustion.

Hypostenic neurasthenia is the third stage of the disease. Sometimes it affects people, bypassing the first two stages - this happens in hypochondriac patients with labile nervous system. The main signs of this phase: a feeling of enduring weakness, apathy, loss of interest in anything. A person has a feeling of anxiety or sadness, unmotivated longing and uncertainty are piling on him. He becomes emotionally unstable and even tearful, focused on himself and his own sensations.

All stages of neurasthenia, when eliminating the cause of the disease, allow the patient to stand on his feet, restore sleep and activity. If the seizures recur, then their duration will grow, and the condition will be aggravated. This is how chronic neurasthenia develops - a psychogenic disorder with a protracted course. This condition should be treated in all possible ways, as many organs and systems in the body can suffer.

Many people confuse the attack of neurasthenia and psychosis, but there are differences between these two states, and they are quite significant. A patient suffering from a neurasthenic syndrome almost always realizes what is happening to him, and seeks help with purpose. A sick psychosis, as a rule, denies that he is ill, does not agree to treatment and rejects any attempts to help.

Neurasthenia in women

The clinical picture of the disease in women is rarely the same - it all depends on the cause and severity of the mental state. Common can be called such signs as an instant change in mood, loss of ability to rejoice, indifference and even bitchiness.

A woman with a neurasthenic syndrome almost never shows her discomfort. Outwardly, she can look confident, although internally, she reacts rather painfully to the disturbing factors. This reaction can manifest as a tremor in the hands and chin, the pallor of the skin. The patient periodically experiences heart pains, sharply criticizes relatives, refusing to understand or accept anything. Because of this, there are problems not only at home, but also at work, which brings the woman to the point of despair. The inability to fully relax and relax adds tension, accumulating a sense of fatigue. Over time, there is uncertainty, complete dissatisfaction with yourself, frustration and a kind of inhibition in your thoughts.

Dizziness with neurasthenia expressed, a woman can often be bothered by headaches (migraines) that do not last for several days. In some cases paresthesias and pulling pains in the limbs are possible.

Also for female patients characterized by sexual neurasthenia - a nervous breakdown, which is provoked by problems in the sexual sphere. The causes of this condition can be sexual dissatisfaction, self-doubt as in a woman, distrust of a partner. Symptoms of the disease are the same: irritability, nervousness, violations of libido, migraine, mood instability.

Neurasthenia in children

What forms of neurasthenic syndrome occur in childhood, and for what reasons - consider this issue in more detail.

• Neurasthenic disorder with a sense of anxiety and fear. The baby has inexplicable bouts of fear and anxiety, which lasts up to half an hour. Most often, such emotions arise closer to the night and can be supplemented by different visions. The child is afraid to remain alone, starts to fear dark premises, coming up with incredible terrible stories with mythical characters.
• Obstructive pathology. It is accompanied by obsessive actions and fear of various subjects and situations.
• Depressive disorders. Characteristic for older children. Appear in the form of low self-esteem, tearfulness, inhibition.
• Hysterical disorders. Most often observed in children 4-6 years. Expressed in the fall on the floor, screaming and crying, respiratory attacks.
• Asthenic disorders. The child is characterized by tearfulness, irritability, sleep and nutrition disorder. Typically, such violations occur in children who, in addition to school, also attend extra circles and classes.
• Hypochondriacal syndrome. Is manifested by excessive concern for themselves and their health, causeless fear of possible diseases.
• Neurotic stuttering. Formed at the age of 2 to 5 years. The fundamental factor is a considerable fright, a strong psychoemotional trauma.
• Progressing neurasthenia. Such a disorder develops as a result of long-term illness, for example, an inflammatory nature that the child is forced to endure for a long time. Even after recovery, the habits associated with the course of the illness remain.
• Sleep disturbances. There are difficulties with falling asleep, there may be sleepwalking, frequent nightmares at night.
• Eating disorders. They manifest themselves in refusing to eat, slow eating.
• Neurogenic enuresis. The main symptom is unconscious urination, mainly at night. Often the cause is fear or traumatic situations.
• Neurogenic encopresis. It is rare and manifests as an unconscious release of feces. In most cases, it is provoked by cruel punishments and excessive severity of the parents.

Success in the treatment of neurasthenic children depends on whether the cause of the disease is found and eliminated.

Complications and consequences

Effects

Complications of neurasthenic syndrome may occur in the absence of treatment, or in cases where treatment is performed, and the cause that provoked the disease remains.

• The loss of the ability to adapt socially - an enduring inner sense of discomfort blocks the establishment of social ties, a person does not need to communicate with other people.
• Depressive state - gradually developing extreme degree of lowering of the emotional mood.

The disease should be treated by a specialist psychologist or psychotherapist of the appropriate qualification, otherwise a neurasthenic disorder can become chronic, which significantly complicates further both the treatment itself and the rehabilitation period. Residual phenomena of the disease can impose an imprint on the character of a person, on his manner of communication. Often, even after the therapeutic course, the patient becomes closed, secretive, he has an irascible reaction to loud sounds, bright light, unpleasant odor. If the patient was initially an easily vulnerable person, the disease can be delayed, can not respond to therapy and acquire a chronic course, regardless of the completeness and timeliness of the treatment.

[12], [13], [14]

Diagnostics Neurasthenia

Diagnosis of neurasthenia

The diagnosis is based, first of all, on the patient's complaints, as well as on a careful external examination and instrumental research.

Objectively exclude the presence of systemic diseases, since the chronic course of many diseases can contribute to the appearance of some changes in the human psyche.

Instrumental diagnosis just allows you to exclude the presence of infectious, toxic or somatic lesions in the body. In addition, it is very important to make sure there are no damages directly to the brain (neoplasms, inflammation, neuroinfectious pathologies). To exclude the above violations carry out:

• computed tomography;
• magnetic resonance imaging;
• rheoencephalography (in order to assess the completeness of the cerebral circulation).

Differential diagnosis is performed with a depressive neurosis, with obsessive states, with panic disorders.

The success of diagnostic activities depends to a large extent on the trust and full dialogue between the doctor and the patient. Since neurasthenic disorder, unlike systemic diseases, can not be diagnosed on the basis of any analyzes, it is important to listen carefully to the patient, using the skills of psychology and establishing a trusting contact.

Thus, we can distinguish several basic methods that help in diagnosing a neurasthenic syndrome:

• assessment of complaints, collection of an anamnesis of the disease;
• neurologic examination of the patient, dialogue with him;
• if necessary, additional instrumental studies;
• consultations of specialized specialists (for example, psychiatrist, psychologist).

[15], [16], [17], [18], [19],

Treatment Neurasthenia

Treatment of neurasthenia

Treatment of the disease involves the use of methods of physiotherapy, reflexology, manual therapy. Sometimes even a special multivitamin diet is prescribed. Effective for this pathology sessions of relaxation and hypnosis. The patient is taught the skills of controlling his actions and actions, teaching positive thinking.

Drug treatment is prescribed as a complex course of therapy. This course includes the intake of biological stimulants, nootropics, antidepressants. Separately prescribe sedatives.

Therapy must be combined with a well-planned rest, minimizing mental labor. Patients need to explain the need for daily walks, mild physical activity, distractions (sports, sewing, knitting, drawing, modeling, etc.).

Before the beginning of treatment it is important to establish the cause of the disease and do everything possible to eliminate it. It is necessary to reduce or temporarily exclude the moral and physical stress on the patient, make up the regime of the day with a clear time schedule for sleep, rest and work. Patients are recommended to walk in the fresh air, a full sleep with a withdrawal and awakening at approximately the same time.

Treatment at home can only take place if the cause of the disease is not related to domestic conditions, with relationships within the family. When the home environment reminds the patient of any problems, then successful treatment at home is impossible.

Psychotherapy for neurasthenia

Psychotherapy is perhaps one of the main methods of treating patients with neurasthenic disorder. This technique provides for various types of therapeutic effects on the psyche.

• Persuasion therapy is a kind of treatment that involves providing the patient with information that convinces him of the correctness of certain actions. What can this give the patient? Under the influence of logical arguments his attitude to problems, to the situation changes, fears and experiences gradually lose their significance.
• Method of suggestion - direct or indirect. Suggestion of the patient can cause feelings, emotions, desires that will not be susceptible to conscious analysis of the person, that is, they will not be analyzed logically. After the session, the patient will believe that new thoughts in his head are thought out and compiled by him, albeit with the direct help of a specialist.
• The method of autosuggestion is the independent compilation of associations, the collection of information that is analyzed by the patient and reproduced by him. With this type of treatment, success is not immediately apparent, but only after 1.5-2 months of therapy. This method can include and procedures such as autogenous training and muscle relaxation - relaxation.

Psychotherapeutic techniques help not only to calm the patient, adjust it to positive thinking and give a charge of optimism. It is noticed that regular sessions with a psychologist allow to stabilize the work of the heart, normalize breathing, favorably affect neurological and vegetative processes inside the body.

Medications for neurasthenia

Medicinal treatment is carried out simultaneously with psychotherapy.

In the recent past, in the treatment of neurasthenic disorders, bromine and caffeine-based drugs were used. Now there is more quantity of the newest effective medicines which successfully treat disease, and also do not cause formation of dependence. Most of the drugs prescribed tranquilizers, neuroleptics, psychostimulants and antidepressants.

• Tranquilizing drugs calm emotions of tension, eliminate feelings of anxiety, fears. Such medications not only calm the nervous system - they improve sleep, making it deeper and longer. Initially, tranquilizers can cause side effects, such as drowsiness, a sense of lethargy, but over time these symptoms go away. Apply these drugs for individual indications.
  • Chlordiapoxide, Diazepam - sedatives and relaxing remedies. Normalize the state of the autonomic nervous system, facilitate the process of falling asleep, eliminate convulsions.
  • Oxazepam (analogue of Tazepam) - eliminates phobias, internal tension, irritability, normalizes mood. In standard dosages, psychoemotional activity is not depressed.
  • Lorazepam, fenozepam - reduce the manifestation of feelings of anxiety, relax the muscular system.
  • Nitrazepam (analogue of Radedorm) - improves the duration and quality of sleep.
  • Medazepam (analogue of Rudotel) - effectively soothes, without causing retardation and drowsiness.
  • Afobazol - reduces psychological discomfort and the effects of prolonged nervous tension, including irritability, tearfulness, anxiety, phobias, insomnia. Improves the mental and physical state of the patient.
• Neuroleptics - have a more pronounced soothing effect than tranquilizers. These drugs include Aminazine, Sonapaks, Reserpine, Melleril, Triftazin, Haloperidol, etc. The listed drugs are used in small doses and mainly at night, as they can cause a feeling of mental stiffness and lethargy, as well as lower blood pressure. An overdose of antipsychotics can cause a temporary depression of sexual desire.
• Antidepressant drugs are designed to improve mood. Of these drugs are most often resorted to the use of Imizin, Amitriptyline, Azafen and Pyrazidol. Antidepressants enhance the feeling of vivacity, increase appetite, but can also slow down sexual activity. Eglonil - one of the popular antidepressant drugs with neuroleptic and stimulating activity. Used to combat the state of apathy and anhedonia - a disorder in which the patient loses the ability to have pleasure and joy. The active ingredient of the drug is Sulpiride.
• Psychostimulating drugs are able to further excite the nervous system. Such drugs are used only in medical institutions, under the supervision of a doctor. In the pharmacy network, psychostimulants are released only on prescription.
• Phenibut is a well-known psychostimulant used to treat impaired attention and normalize human activity. Increases intellectual and emotional activity, restores memory and ability to concentrate attention. Can be used to eliminate asthenia and anxiety-neurological conditions that are characterized by anxiety, fears and insomnia. In childhood, the drug is prescribed for the treatment of stuttering, enuresis, nervous tic.

Any drug treatment must necessarily be complex, in combination with psychotherapy, physiotherapy (darsonvalization, snoterapiya, manual therapy, laser and reflexotherapy, galvanic collar), as well as with sanatorium-and-spa therapy.

Alternative treatment

Herbal treatment can be used either in the early stages of the disease, when the symptoms are not yet sufficiently expressed and require a mild sedative effect, or simultaneously with complex therapy under the guidance of a doctor.

1. Decoction based on herbs is prepared in this way: dry crushed grass (medicinal raw materials) is poured with boiling water and cooked on low heat, for 5 minutes (or kept in a water bath). The medicine is taken 1 tablespoon 3-4 times a day before meals. As restful herbs used bones, woolly pantherium, creeping thyme, bearberry ordinary.
2. Herbal infusions are prepared as follows: the medicinal herbal mass is poured very hot water (90-95 ° C) and insisted under a lid (it is possible and in a thermos). The duration of infusion is half an hour. Next, the drug is filtered and taken for 1 tbsp. Spoon up to 4 times a day. For the manufacture of infusions use such herbs as wild rosemary, hawthorn fruit, cranberry leaves, crushed rhizomes of valerian, leaves of oregano.
3. Tinctures of herbs are prepared by insisting raw materials on quality vodka or 40% medical alcohol. The drug is infused for 10 days in a dark place at room temperature. Eat 15-25 drops three times a day before meals. As a raw material for the preparation of tinctures, the flowers of hawthorn and rhizomes of aralia are most often used.

Massage with neurasthenia

Certainly, massage is not considered the main means in the treatment of neurasthenic disorders. However, it is advantageous to use it as an effective complement to the therapeutic course.

The main goal of the massage is to stabilize the psychoemotional state, normalize sleep, improve the functioning of the body's organs and systems, improve blood circulation, relax the muscular system.

Often massage procedures are combined with psychotherapy sessions, focusing on the occiput and cervical-collar area, as well as the spinal column area. All movements should have a relaxing, relaxing effect: thus, such movements as effleurage, claps, and strokes of the palm should not be used. Intensive influence is completely excluded.

One session lasts from about 15 to 20 minutes, is carried out every day for 2 weeks. With a strong moral or physical exhaustion of the patient, a session is allowed in a darkened room, using light strokes, rubbing, surface kneading. After the session, oxygen therapy is recommended for 10-15 minutes, or an oxygen cocktail with minerals and a rich microelemental composition.

Vitamins for neurasthenia

In the issue of treating neurasthenic disorders with vitamins, the main role is assigned to group B vitamins, and especially B¹. Thiamine soothingly acts on the nervous system, nourishing and improving the function of neurons, as a result of which the vegetative and central nervous system will soon normalize. To ensure the needs of the body in thiamine it is recommended to consume greens, in particular, parsley, dill, fennel. Also useful are plants such as chamomile, sage, clover and burdock. A lot of vitamin is contained in the leaves of cowberry or raspberry.

Other vitamins of this group B are important. They provide protection of nerve cells, stabilize the processes occurring in the brain, eliminate depression, dissatisfaction and doubt.

Where can I find the vitamins of group B:

• milk products;
• meat;
• cereals (mainly buckwheat and oat groats);
• greens, vegetables and fruits of green color;
• beans (peas, lentils, chickpeas, mung beans, kidney beans);
• rose hips.

You can also buy ready-made products in the pharmacy. For example, such multivitamin preparations as "Vitrum Century", "Neurobion", "Pentovit", "Kombilipen" are perfect.

Thanks to vitamins, you can not only strengthen the body, but also bring the nervous system into a normal balanced state.

Prevention

Prevention

The main point of preventive measures can be considered observance of a well thought out routine of the day, with a clear delineation of time for work, rest and sleep. Any potential patient should determine for himself the most suitable relaxing techniques that he can apply in case of nervous or physical overstrain - it can be swimming, massage and relaxing procedures, yoga or respiratory gymnastics, etc. Do not use as relaxation alcohol and other harmfulness.

In everyday life, you should avoid physical excessive stress and stressful situations. Often helps to change the situation, the nature of the activity - sometimes it's enough to organize a trip to the sea or on an excursion to another city, relax in a sanatorium, find a hobby of your own.

Making the mode of the day, you should allocate time for a full eight-hour sleep: while getting up and going to bed preferably at about the same time every day.

It is important not to allow conflict situations, to avoid disputes and scandals. Also, do not try to do all the work in one day. Remember that inveterate workaholics are the first contenders for the disease of neurasthenia.

Forecast

Forecast

Frequent and prolonged neurasthenic seizures have a very negative effect on the state and health of the nervous system. The disease drags the patient deeper and the treatment becomes more difficult with time. Repeated episodes of the disease significantly worsen the prognosis, creating all the conditions for the formation of persistent mental disorders. In addition, the disease undermines the immune system in the body. The person weakens, hypersensitivity appears not only to nervous irritations, but also to bacterial and viral infections.

From the above, it can be concluded that the earlier the treatment of the disease is started, the faster the recovery will come. In addition, it will be more persistent and durable. Needless to say, also, that the treatment scheme should be a competent doctor, taking into account all the individual characteristics of the body.

And finally, I would like to answer the actual question today: do you take in the army with a diagnosis of neurasthenia?

Reaction psychosis, severe neurotic disorders, deep depressive states with a change in personal character can become a reason for postponing or dispensing from the army on conclusion of military medical examination. If these disorders are moderately expressed, continue rarely and for a short time, have a favorable course and end in a compensated state, then military service is usually not contraindicated.

Neurasthenia in the list of diseases appears in the category "fit with limitations."

[20], [21], [22], [23]