Psychasthenia gravis

The diagnosis of "psychasthenia" is established for personality disorders characterized by self-criticism based on low self-esteem, as well as hypertrophied self-analysis with excessively high demands on oneself.

The main signs of the pathology are considered to be increased anxiety, suspiciousness, lack of self-confidence, indecision, and a feeling of inferiority.

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Epidemiology

The disease can be first suspected in childhood. However, the main patients who visit doctors with complaints similar to psychasthenia are young people from 18 to 35 years old.

According to statistics, it is extremely rare for patients to seek first aid for psychasthenia after the age of 40.

The majority of patients are men. Women suffer from psychasthenia 50% less often.

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Causes psychasthenia gravis

Most cases of psychasthenia develop as a result of certain events that traumatize the human psyche. Of course, the presence of provoking factors is important for the disorder to appear:

• intellectual (thinking) mindset;
• introversion;
• nervous exhaustion associated with prolonged and excessive mental stress or with systemic diseases.

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Pathogenesis

Predisposition plays a fundamental role in the development of the disease. External factors only give impetus to the development of the disorder or exacerbate the pathology that has already arisen. Predisposition can be laid down in childhood and depends on the peculiarities of upbringing and some negative moments experienced in childhood.

The famous doctor Pavlov considered psychasthenia to be the result of general mental weakness with accompanying weakness of thinking. General mental weakness may be associated with insufficient activity of the subcortex, since pathology mainly affects people of an intellectual disposition. This is where the predominance of a passive defensive reflex of increased caution is formed.

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Symptoms psychasthenia gravis

Psychasthenia is characterized, first of all, by excessive suspiciousness, negative self-hypnosis and a rich imagination of the patient. A person's behavior, changes in his character - everything reveals the instability of the internal state. Such people are vulnerable, impressionable, sometimes - timid. Despite high demands on themselves, in life they are usually indecisive, lack confidence, often worry and worry about trifles.

The first signs of the disease are growing self-doubt, a feeling of hopelessness and despair. A general feeling of fear is noticeable, which is mainly associated with plans for the future, with any new beginnings and changes.

Externally, psychasthenia can be suspected by the presence of the following symptoms:

• inability to make independent decisions;
• a tendency to consult with everyone and on any matter;
• excessive pedantry in everything;
• constant skepticism.

The patient becomes slow, "slow-witted." His movements may be slow.

Speech in psychasthenia is also slow. The patient speaks slowly, as if thinking over and weighing each word. In addition to monotony, the patient's conversation may be distinguished by excessive fantasy: speech abounds in all sorts of conjectures, fabrications, and false conclusions.

Cognitive processes are inhibited in psychasthenia. A person feels the possibilities in himself, but is afraid to implement them in life, since he does not see any positive. Often, with psychasthenia, the normal perception of the real world is disrupted and self-perception is absent.

Memory in psychasthenia may deteriorate, physical and mental fatigue develops, vegetative manifestations are unstable. Nevertheless, the patient tends to remember all important dialogues and situations, which he can go over in his memory for a long time, dwelling on every little thing.

Characteristic signs of psychasthenic syndrome:

• a person is in torment caused by his own thoughts; he tries to think everything through as carefully as possible;
• Excessive suspiciousness and overthinking often lead to problems in communication, since the patient may try several times to return to a conversation in which, in his opinion, he was misunderstood.

Outwardly, a psychasthenic gives the impression of a modest, shy and sensitive person, although his conclusions and even actions may indeed be misunderstood.

Complications and consequences

Most often, psychasthenia develops into all sorts of obsessive states, somatoform disorders. Psychasthenics gradually abandon all initiatives, new types of activity, and live either in the past or in an unreal, fictitious future.

Over time, the existence of psychasthenics is filled with anxiety, worry, apprehension, negative thinking, skepticism, mistrust appear. All this can be accompanied by the appearance of obsessive thoughts.

It is interesting that sooner or later patients with psychasthenia develop fears of mental disorders. They are afraid of deterioration of work capacity, constant fatigue. Indeed, neurotic problems often join psychasthenia, which significantly worsen the prognosis of the disease. The consequences of neurotic disorders can be alcoholism, drug addiction, prolonged depression, sexual disorders.

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Diagnostics psychasthenia gravis

The diagnosis is primarily based on general information about the patient's complaints and those around him. To clarify the diagnosis, the doctor may focus on the following questions:

• when deviations occurred;
• what prompted their emergence;
• Are there similar disorders among relatives?

Additional factors in the development of pathology may include excessive mental and physical stress.

To make a correct diagnosis, the doctor may prescribe certain tests. Thus, general blood and urine tests are prescribed without fail, because their indicators can be used to judge the state of the body as a whole, as well as to suspect some hidden and chronic diseases. If such suspicions arise, the patient will inevitably receive a referral for examination of the kidneys, metabolic processes, and determination of the hormonal background in the body.

Instrumental diagnostics may be appropriate if the doctor has already made a diagnosis, but he needs to clarify some points. Among the instrumental studies, the following are the most relevant:

• ECG – allows you to evaluate the work of the heart;
• Ultrasound of the thyroid gland and abdominal organs – helps to identify chronic diseases and pathologies of the endocrine system, which can directly affect the occurrence of psychasthenia;
• Ultrasound of the cerebral vessels – Dopplerography – indicates the presence of cerebrovascular disorders and tissue oxygen starvation.

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Differential diagnosis

Differential diagnostics of psychasthenia is carried out with other personality manifestations that can accompany many mental illnesses:

• schizophrenia;
• atrophic brain processes;
• neurasthenia.

It is sometimes difficult even for an experienced professional psychiatrist to correctly diagnose psychasthenia. Therefore, it is very important to use the maximum number of possible methods and studies for diagnosis.

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Treatment psychasthenia gravis

Psychasthenia does not have the status of a disease in medicine: it is only a minor mental disorder. However, despite this, psychasthenia should be treated to prevent complications. Moreover, people with psychasthenia have increasing problems in society, which significantly complicates their existence.

Correction of psychasthenic disorder is aimed at eliminating obsessive thoughts, conditions, fears and unreasonable anxiety.

Treatment consists of taking medications and using psychotherapeutic methods. The doctor may prescribe the following medications:

• Tranquilizing agents:

	Dosage	Side effects	Special instructions
Chlordiazepoxide	The pills are taken orally from 0.005 to 0.01 g up to 4 times a day. At the end of the course, the dose is gradually reduced.	Sleep disturbances, vestibular disorders, decreased libido, and seasickness may occur.	The drug is incompatible with ethyl alcohol.
Lorazepam	Usually, for psychasthenia, the drug is taken 2 mg per day, divided into 3 doses. It is possible to prescribe 1 mg three times a day. The maximum daily dosage is 10 mg.	Fatigue, muscle weakness, constipation, and loss of appetite may occur.	Lorazepam is discontinued gradually, with a slow reduction in dosage. Otherwise, withdrawal symptoms may occur.

• Neuroleptics:

	Dosage	Side effects	Special instructions
Propazine	Propazine is taken orally, with food, from 25 to 100 mg up to 4 times a day.	During treatment, trembling in the limbs, dizziness, and sometimes convulsions may occur.	During treatment, you must not drink alcohol or drive. You should regularly monitor your blood pressure and heart rate.
Azaleptin	The drug is used from 50 to 200 mg of the drug up to 3 times a day, after meals.	During treatment, drowsiness, headaches, dry mouth, and rapid heartbeat may occur.	Azaleptin enhances the effects of alcohol and also worsens alcohol intoxication, so the simultaneous use of the drug with alcoholic beverages is strictly contraindicated.

• Antidepressants:

	Dosage	Side effects	Special instructions
Befol	For psychasthenia, take orally, 30-50 mg twice a day.	Low blood pressure, heaviness and pain in the head.	Befol is not used in cases of a tendency to hypotension.
Pyrazidol	The drug is usually taken from 50 to 150 mg per day (in two doses). The treatment course can last up to 1 month.	During treatment, thirst, increased sweating, nausea, and dizziness may occur.	Pyrazidol is contraindicated for the treatment of patients with hepatitis.

In addition to medications, in case of psychasthenia or exhaustion of the nervous system, the body will also need vitamins. In pharmacies, you can choose high-quality complex products that will provide the nervous system with all the necessary substances.

• Vitabalans Multivit is prescribed for mental and emotional overload. The drug consists of vitamins of group B, vitamins A, E and ascorbic acid, supplemented with minerals magnesium and calcium. The listed components are often used for exhaustion and nervous overexcitement.
• Milgamma is a vitamin remedy that regulates the psycho-emotional state. The composition of the drug is represented by vitamins of group B, which are indispensable in pathologies of the nervous system.
• Complivit is a general tonic complex vitamin preparation recommended for use in cases of increased mental and physical stress.

For the fastest possible recovery of the nervous system in psychasthenia, it is recommended to follow the principles of healthy nutrition and additionally take special combined vitamin complexes. As a result of this approach, it is possible to achieve an increase in the quality of life, improve adaptation processes, and prevent the development of complications.

Physiotherapy is another method that helps speed up the recovery of patients with psychasthenia. Physiotherapy consists of a number of completely safe and useful procedures that support the main treatment and even enhance the effect of some medications.

• Electrical stimulation is the effect of electric current on a specific area of influence. This method helps to strengthen or weaken the processes that occur in the central nervous system.
• Electrophoresis is used for deeper penetration of drugs into the skin layers. As a result of electrophoresis, the need for the amount of the drug decreases, and the duration of its action increases.
• Electrosleep is used to slow down the nervous system's response. This provides a calming and anti-stress effect, which is especially necessary for patients suffering from chronic fatigue and mental overload.
• Hydromassage and Charcot's shower are procedures based on the effect of water, which is supplied under pressure. Water, as is known, relaxes and calms a person, gives him strength and energy.

Traditional treatment will also help stabilize the nervous system in psychasthenia. For example, the following recipes can be used as auxiliary means:

• drink rosehip infusion with honey and lemon throughout the day. This will calm the nervous system and strengthen the body;
• regularly take an infusion of lemongrass or ginseng (if there are no contraindications - for example, hypertension);
• take baths with pine needle decoction for 20 minutes twice a week;
• inhale essential oils of rose, lavender, mint or geranium.

It would also be useful to treat with herbs, which, when used correctly, have an extremely positive effect on the human body.

1. Take 2 tbsp. oregano, pour 0.5 l of boiling water, leave for 60 minutes. Drink 100-150 ml three times a day before meals. It is not recommended to take the infusion during pregnancy.
2. Take 2 tbsp. of valerian root, pour 0.5 l of boiling water, leave for 1 hour. Drink 100 ml three times a day as a cure for fatigue, sleep disorders, irritability.
3. Take 2 tbsp. of fireweed, pour 0.5 l of boiling water over it, leave for at least 1 hour. Drink 100 ml 15-20 minutes before meals. This medicine will help with insomnia, headaches and nervous exhaustion.
4. Take 2 tbsp. of sweet clover, pour 400 ml of boiling water, insist, filter and drink twice a day. Sweet clover infusion soothes, relieves spasms, facilitates the perception of reality. The infusion can be combined with mint and lemon balm preparations.

Many doctors are convinced that natural remedies, such as homeopathy, help eliminate nervous system disorders. Homeopathic preparations help smooth out sudden mood swings, increase productivity, solve problems with falling asleep, and overcome moral and physical exhaustion.

Often, when treating psychasthenia, specialists resort to prescribing homeopathic remedies of the Heel brand:

• Valerianaheel is a combined herbal homeopathic remedy that is prescribed orally in the amount of 15 drops three times a day. The duration of administration is up to 4 weeks. In rare cases, the drug can provoke an allergy.
• Nervoheel is a multicomponent drug approved for use in patients aged 3 years and over. Tablets are taken 1 hour after meals, 1 tablet under the tongue. Duration of treatment is up to 3 weeks.
• Ignatia Gommacord is a homeopathic preparation with sedative and antispasmodic effects. Take 10 drops of the preparation three times a day, under the tongue. No side effects have been observed when taking the remedy.
• Cerebrum Compositum is a homeopathic remedy that combines the properties of a nootropic and psychotropic drug, as well as an antispasmodic. As a rule, the drug is administered intramuscularly, 1 ampoule 1-3 times a week. During treatment, rashes on the body may sometimes appear, which disappear without a trace after discontinuing the medication.

Prevention

Prevention of psychasthenia should begin in early childhood. Factors such as the child's adaptation to a group, physical education (especially team games), attendance at various clubs, sections and classes play a major role.

So-called "useful" entertainments are also suitable - travel, excursions. The child's life should be rich and interesting. However, excessive loads on the child's body should not be allowed, you can not force the baby to do something against his will.

It is important to accustom all household members to a daily routine, which should provide time for both work and rest. Neither excessive work nor idle time should be allowed.

In addition, any person should beware of various injuries, including head injuries. It is known that many disorders of the nervous system, including psychasthenia, arise as a result of craniocerebral injuries of varying severity.

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Forecast

Experts agree that it is impossible to completely get rid of psychasthenia. However, it is possible to correct the patient's behavior and improve his worldview.

Complex treatment often helps to bring the condition of a psychasthenic to the level of a practically healthy person.

Much in the success of treatment depends on the patient himself, on his character and desire to recover. If the course of the pathology is protracted, and the patient himself is pessimistic, then one cannot count on an absolutely favorable prognosis.

Psychasthenia is a rather complex condition, the subtleties of which have not yet been fully clarified. Some specialists call this disorder a disease, while others call it a feature of nervous activity. Nevertheless, psychasthenia requires medical and psychological correction: this will significantly facilitate a person's existence in society and improve the quality of life.

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