Varieties of neuroses, how neurosis differs from depression. Medical encyclopedia - neuroses What belongs to neuroses

Reversible mental disorder due to the impact of traumatic factors. For neurosis, the patient's awareness of the fact of his illness is characteristic. It is not accompanied by a violation of the perception of the real world.

Neuroses, a group of neurotic disorders - conditions that develop in healthy people against the background of stress, emotional or psychological trauma, insoluble life situations.

Neuroses differ in the etiology of occurrence (causes of neurosis), symptoms, manifestations. About 20% of the adult population of Russia suffers from one type of neurosis or another. Childhood neuroses are also a fairly common phenomenon, more and more common even at an early age.

Symptoms of neuroses are expressed as signs of emotional, mental discomfort, appear at the physiological level, and are often "masked" under the clinical picture of various diseases.

Neurotic disorders can go away on their own, but more often specialist help is needed to cure. Early diagnosis and a course of therapy help restore health, and denial and preference for a wait-and-see attitude contribute to the transition of neurotic symptoms into personality traits.

Neurosis, from the Greek word nevros, nerve, means reversible (functional) neuropsychic personality disorder. The causes of neuroses belong to the group of psychogenic, that is, those arising from the influence of mentally significant factors on a person that are not associated with disruptions in the functioning of internal organs, systems or diseases of the body.

Neuroses, neurotic disorders are characterized by a wide range of symptomatic manifestations affecting the emotional sphere, behavioral reactions, and also expressed in various somatic manifestations, for example, headaches, hyperthyroidism, dizziness, pain in the heart or stomach, dyspepsia, etc. may be accompanied by impaired sensitivity of the extremities, loss of vision, hearing, smell, paralysis. All these symptoms, which is important for the diagnosis of the disease, do not have a physiological basis, that is, they are not associated with a violation of the functioning of organs.

State of neurosis

The state of neurosis can bring both minor and significant discomfort to a person, affect his quality of life, performance, family and family relationships.

The state of neurosis is reversible, not accompanied by functional impairment of the body. The earlier treatment with a specialist is started, the faster the severity of the manifestation decreases and the patient's mental well-being returns.

Neurosis: physiological symptoms

In the state of "neurosis", the symptoms, physiological or somatic reactions of the body can be varied, long-lasting, chronic in nature, or manifest themselves periodically in a neurotizing situation, while waiting for it or immediately after. Some of the long-term neuroses are successfully "disguised" under various diseases of the cardiovascular system, digestive organs, and can manifest themselves in the widest range of symptoms.

The most common somatic symptoms of neuroses include the following manifestations:

• fatigue, decreased performance, not corresponding to the level of stress on the body;
• headaches, especially "tension headaches" associated with local increased tone of the muscles of the head and neck;
• changes in blood pressure, both increase and decrease, prolonged or abrupt;
• reactions from the cardiovascular system: changes in the rhythm of the heartbeat, chills, a feeling of heat, redness, sudden pallor of the skin of the face, neck, chest. These symptoms are often attributed to the clinical picture of vegetative-vascular dystonia;
• increased sweating;
• sleep disorders: insomnia, drowsiness, nightmares, frequent awakenings in the middle of the night;
• digestive disorders, disorders of the gastrointestinal tract: constipation, diarrhea, heartburn, etc.;
• decrease, increase, change in appetite of any form;
• dizziness, fainting, disturbances in the activity of the vestibular apparatus;
• pain in the region of the heart, chest, "cardioneurosis";
• not associated with diseases of the genitourinary tract or other factors, frequent urge to urinate;
• decreased sexual potency, libido, anorgasmia, vaginal dryness in women, erectile dysfunction in men;
• etc.

At a deep stage of some neuroses, symptoms may indicate apparent visual impairment, motor activity, neurotic (hysterical), stupor, blindness, etc. are known.

The multiple manifestations of neuroses, the symptoms of which may be similar to diseases, physiological pathologies, disorders of the activity of various organs and systems, make it difficult to diagnose the cause of poor health and pain. Often, the patient is the last to be examined by a neurologist after attempts to establish a diagnosis from a number of other specialists. Features of neurotic states - in psychosomatic manifestations of diseases without physiological genesis. Most often, when diagnosed with neurosis, symptoms can be found with a fairly clear attachment to certain situations or actions: getting ready for work, trips on the subway, traveling, the arrival of relatives, tests at school or reporting periods, etc.

Pain in neuroses most often occurs as a reaction to a traumatic or disturbing situation, a state of fear, thoughts of a possible failure or uncontrollable development of events.

Most often, the following localizations of pain in neuroses are noted: headaches, pain in the sternum (heart, central or lateral parts of the chest), peritoneum.

Pain in neuroses can be both prolonged, pulling, constraining movements or a part of the body, or sharp, stabbing. It can be accompanied by sensations of burning, heaviness, nausea, photophobia, reactions to sounds, smells, temperature fluctuations - depending on the type of neurosis, individual characteristics of the person.

With hypochondria, pain and signs of neurosis can be disguised as a disease, the development of which worries the patient most of all.

A neurotic condition can be a rather serious illness, accompanied by fatigue and exhaustion of the body due to sleep disturbances, appetite, the impossibility of full recovery, and a decrease in immunity. In such cases, secondary diseases or painful sensations that are not directly related to the mental state of a person, but are indirectly a consequence of it, join the symptoms of neurosis. The cure of such diseases can be difficult without the treatment of neuroses.

Signs of neurosis

Signs of neurosis, they are also symptoms, differ depending on the type of neurotic state, the degree of its severity, individual, physiological characteristics of a person.

There are psychological signs of neurosis, such as increased anxiety, mood instability, anxiety, irritability, suspiciousness, lability, emotional sensitivity or, conversely, apathy, a visible lack of reaction to what is happening, the tendency to "see everything in black", fears, phobias, aspirations over-control of any processes that do not bring satisfaction, insomnia or drowsiness, etc.

The physiological, somatic signs of neurosis include the following phenomena: tachycardia, heart palpitations, pain in the heart, dyspeptic disorders of the digestive system, accompanied by pain, panic attacks, dizziness, fainting, excessive sweating, chills, disturbed blood supply to the extremities, shortness of breath, feeling of coma in the throat, interfering with breathing or talking, appetite disturbances, changes in sexual desire, fluctuations in blood pressure, etc. Separately describe "muscle" symptoms, accompanied by excessive tension or decreased tone of muscle groups: tension headaches, tremors in various parts of the body, increased fatigue, weakness, pain in the neck, lower back, tic manifestations.

Types of neuroses

There are several classifications of types of neuroses. According to one of the most common, the options and types of neuroses are as follows:

• phobic neurosis, or anxiety neurosis;
• obsessive-compulsive disorder (movements, thoughts);
• neurasthenia, a manifestation of a psychosomatic disorder;
• reactive neurosis resulting from stress or situational disturbance;
• hysterical neurosis related to conversion neurotic disorders.

Adult neurosis is a fairly common disease. According to statistics, up to 20% of the adult population suffers from different types neurotic disorders.

Most often, the neurosis of adults arises as a result of a stressful, traumatic situation, and this trauma can be either conscious or unconscious by the person himself, suppressed, not perceived as a painful event.

The neuroses of pregnant women are considered a separate problem of neuroses in adults. It is generally accepted that pregnancy is a condition that, according to the general opinion, is always accompanied by emotional imbalance, tearfulness, irascibility, “whims”, and this is the normal behavior of pregnant women. However, such manifestations can be either a consequence of a change in the hormonal background of the expectant mother, or indicate the presence of neurosis or depression.

However, the physical and emotional consequences of pregnancy increase the likelihood of neuroses. These include not only hormonal "storms" and concerns about the child's health, but also lifestyle changes accompanying pregnancy and the subsequent period, additional stress on the woman's body, possible nutritional disorders, vitamin deficiencies associated with toxicosis of pregnant women or malnutrition, etc. ...

Diagnosis of neuroses during pregnancy and their timely treatment are very important for both the mother and the child. A healthy, mentally successful woman has a much higher chance of bearing, giving birth and raising a healthy baby.

Obsessive-compulsive neurosis (obsessive-compulsive disorder)

Obsessive-compulsive neurosis (the correct name is obsessive-compulsive disorder or obsessive-compulsive disorder) is characterized by increased anxiety, dissatisfaction, provoking a person to perform certain ritual actions. In this case, we can talk about both physical actions: constant cleaning, repeatedly returning home to check electrical and gas appliances, a water tap or locks on the door, counting cracks in the road, etc., and mental activity.

Obsessive neurosis is often accompanied by increased anxiety, depression, increased sweating, symptoms of tachycardia or palpitations, cold sensations without external causes.

Obsessive thoughts, the inability to stop thinking about something, attempts to imagine critical situations and ways to overcome them, incessant mental reproduction of conversations are also characteristic of obsessive-compulsive disorder. All obsessive actions, external or internal, are associated with attempts to control uncontrollable circumstances, to reduce anxiety. For example, constant "manic" cleaning, hand washing, bringing the skin to painful dryness and thinning, may not be associated with fear of contamination with bacteria or judging visitors, but indicate dissatisfaction with the work or family atmosphere. Obsessive actions are irrational, do not lend themselves to logical explanations and worsen a person's condition. Often people realize the futility of actions and try to get rid of the "bad habit", which, however, rarely improves overall health and in some cases contributes to the emergence of new rituals and symptoms.

Heart neurosis, or cardioneurosis, is a manifestation of a general neurotic state. With a neurosis of the heart, patients note disturbances in the heartbeat, tachycardia, pain in the region of the heart, aching or stitching, making it difficult to breathe. Often, similar symptoms are characteristic of asthenic neuroses that arise against the background of mental, physical overload, stress, and are caused by overwork. Reactive neuroses as a reaction to a traumatic event (illness, death of a loved one, divorce, family, professional problems, etc.) can also be accompanied by cardio-neurotic symptoms.

Asthenic neuroses are cured by improving the environment, maintaining a healthy lifestyle, and, if necessary, replenishing vitamin and mineral deficiencies. Reactive neurotic states in many cases go away on their own with the loss of the acuteness of the experience of the event that caused the neurosis.

Heart neurosis (cardioneurosis) must be differentiated from disorders of the cardiovascular system, psychosomatic disorders, etc. In true neurosis, painful sensations are observed in relation to a situation that causes anxiety, significant for a person, affecting him negatively. With pain in the region of the heart, provoked by a neurotic state, drugs used for angina pectoris, for example, nitroglycerin, do not work on a person. In this case, pain in cardioneurosis can be both minute and lasting hours.

Panic neurosis

Panic neurosis is usually understood as phobic neuroses, accompanied by panic attacks or a state of uncontrollable fear. Panic neurosis is characterized by pronounced anxiety, a feeling of loss of control over the situation, vegetative manifestations (palpitations, dizziness, fainting, tremors of the extremities, chills, etc.). The clinical picture can be supplemented by sensory disorders, motor disorders.

Panic neurosis is treated with psychotherapy, usually in combination with medications fortifying and sedative action.

Anxiety neurosis, phobic neurosis, can be associated with certain situations or manifest as a generalized phobia.

There are many conditions described as capable of causing phobias in humans. In fact, any object, situation, action can cause fixation and provoke a phobic disorder, depending on the personality type.

The most famous and common are agoraphobia, fears of open spaces, expressed in the fear of leaving the house, leaving the room alone or with a partner, or using transport. Agoraphobia is often accompanied by panic attacks.

Sociophobic fear neurosis manifests itself when it is necessary to make contact with someone, speak in front of an audience, be the center of attention of a group or one person.

Phobias not associated with specific actions or conditions are manifested by possible fears. For example, with thanatophobia, a person is afraid of death, his or her loved ones, carcinophobia occurs as part of a hypochondriac disorder and means fear of developing tumors, cancer, cardiophobia is accompanied by fear of diseases of the cardiovascular system (strokes, heart attacks).

Anxiety neuroses, which do not correlate with a specific situation, proceed with a less pronounced clinical picture, but are more often associated with the development of depressive conditions.

Neuroses in children

Neuroses in children are not as rare as adults might imagine. The state of neurosis in childhood occurs most often due to the misbehavior of parents and significant adults.

Even strongly accentuated deviations in the upbringing of a child do not always lead to neurotization. As a rule, a combination of biological, social and personal factors is necessary for the onset of neurosis in children. However, without a "trigger" on the part of an adult, neuroses are practically not observed in children.

When diagnosed by a specialist, the causes of neuroses in children are usually defined as destructive features of relationships in the family, between parents and children, and close relatives. It often happens that parents note a good understanding with a baby or adolescent, but at the same time they are in a state of conflict with each other. This influence of the family atmosphere cannot be regarded as favorable, and indicates a lack of attention to the child.

The factors that provoke long-term, persistent neurotic states in children include:

• Biological.

In the biological group of risk factors, there are features of the child's physical development that affect his mental and emotional status without a pronounced, obvious harm for health, but stimulating the sensitivity of the body: hypoxia during childbirth or during intrauterine development, frequent illnesses of the infant period, age characteristics (crises of 2-3 years and puberty are considered the most neurotically dangerous years), chronic disturbances in sleep and wakefulness at any age, lack of sleep, excessive physical, mental stress;

• Social.

Difficult relationships in complete and incomplete families, denial of one of the parents, authoritarian style of upbringing, hyper- or hypo-care, disagreement of parents or close relatives in educational methods, tyranny of one of the parents with no protection from the other, etc .;

• Psychological.

This group includes all possible negative types and varieties of impact on the child, psychotrauma, both on the part of parents and on the part of the environment: friends, fellow practitioners, teachers, as well as stresses associated with deaths, moving, divorces, etc.

The causes of neuroses and the factors contributing to them can have a significant impact on the entire life of a child or go virtually unnoticed. The individual characteristics of the child's personality give each event a special emotional color. Some traumas appear in the form of neuroses in children almost immediately, while others can have a significantly delayed impact and be forced out of consciousness.

It is almost impossible to predict how a particular child will react to a particular event. There are some statistics that allow us to assume the likelihood of developing neurotic conditions in a particular group of children with general characteristics (for example, who did not attend a preschool institution or suffered from frequent somatic diseases at an early age with certain consequences) for a specific event (for example, the beginning of school ). However, the strength of the influence of the child's personality, his constitutional factor and premorbid features on the likelihood of neurosis remains in the first place.

Some children are afraid of "Babu Yaga" and may be prone to developing anxiety neurosis after the story that she is expecting a child outside the door. Some will miss this information or not take it seriously.

The most prone to neurotization of personality are children with a developed "I", a strong desire for independence, difficult to adapt to parental instructions and dictates, if adults choose this tactic of interaction. It is precisely such children who are prone to insubordination without lengthy explanations, who do not tolerate rigid parental will, most often parents with at least strong character tend to educate by forceful methods, perceiving the characteristics of the child as manifestations of stubbornness and whims.

Many significant and minor factors affecting a child's development will determine his / her reaction. Children of neurotic-prone parents are more likely to respond in a similar way. The main method of prevention in this and any other case is a healthy lifestyle, harmonious methods of upbringing and support for a child in stressful situations.

With the manifestation of neuroses in children, it is important to remember: no matter what personal characteristics of the child lead to the disease, it is not his fault. Most often, the cause of neuroses is hidden in family relationships, in parents or persons replacing them.

Common childhood neuroses are subdivided into several groups.

Children's anxiety neurosis or anxious neurotic states in children differ in frequency, occur in a situation of possible traumatization. The most common anxiety neurosis in preschoolers and primary school children is associated with fear of the dark.

Most often, parents not only provoke, but also maintain anxiety with the fear of the dark. "A gray top will come and bite on the barrel", promises that owls will carry away those who do not sleep, babay, that dogs are already walking on the street, and scary tales, stories and films, accidentally or deliberately watched by a child, contribute to the development of neurotization.

Lack of communication with a significant adult at night, support, protection, fear of being alone without control over what is happening is the main cause of neuroses, expressed in fear of a specific or abstract character. Parents who practice authoritarian methods of bedding, which do not allow their child to come at night or sleep with a night light, reinforce neurotic states and provoke their transition into chronic ones.

Anxiety neuroses can be the cause of evening moods, overexcitement, unwillingness to go to bed. If there is a fear of other traumatic situations (features of a kindergarten, potty training, dogs, force-feeding), the deterioration of the child's condition is noted immediately before the occurrence of a possible anxiety.

At younger and older school age, anxiety neuroses are often associated with schooling and the situation in the classroom. It is statistically confirmed that first-graders who did not attend preschool institutions before the start of their studies are more susceptible to the development of anxiety neurosis due to the need to perceive new rules, be evaluated by other people, be in a large group of children, and accept a new person as an authority.

With "school neurosis", the child's state can be expressed not only in unwillingness to go to school, depression, deceit or skipping classes, but also in aggravation of night fears, enuresis, stuttering and other manifestations of personality neuroticization.

Obsessive-compulsive disorder in children manifests itself in involuntary, uncontrolled movements: grimaces, biting nails, blinking eyes, small movements of the head and neck ("pulling the neck"), tapping fingers on the table, pulling hairs from eyebrows, eyelashes, scalp, drawing in air nose ("sniffing"), attempts to "clear the throat", coughing, involuntary sounds, etc. Such a neurosis can also be accompanied by tic phenomena, however, tics occur only against the background of sharp emotional reactions, and are not observed all the time.

The phobic type of obsessive-compulsive disorder differs in the appearance of manifestations in a situation where a child is afraid of something: to answer in a lesson, speak to adults, visit a doctor, etc.

Treatment of this type of childhood neurosis primarily involves reducing the stress of the emotional background in the child and in the family. Making fun of children with obsessive-compulsive disorder, drawing attention to manifestations, punishment not only does not contribute to healing, but can also cause nervous breakdowns. Parents need to be aware that such movements, actions are not controlled and cannot be controlled by the child, but require a different way of therapy and not educational measures.

Hysterical childhood neurosis arises against the background of a discrepancy between the desired situation and the real one. Parents may notice the first manifestations in children 2-3 years old, when a sudden and unsatisfied need to buy a toy or pet someone else's dog leads to tantrums, loud crying, children fall to the floor, knock their feet and find it difficult to calm down.

In this age period, it is necessary to develop correct methods of educational influence. The "golden rule" of crises at an early age is to suppress a third of hysterics, a third to allow the child to be distracted, and a third of requirements (which is possible) to satisfy. The main strategy of parents and immediate family members is consistency. If the dad rejects all the demands, and with the grandmother you can shout and get the purchase of a toy, this leads to the consolidation of the child's reaction and contributes to the development of neuroticism. A single educational environment and uniform requirements have a positive effect on the psyche and development of children in all cases.

Hypochondriacal neurosis, the fear of getting sick, the search for signs of the disease most often develops in suspicious children in families with overprotection, in which the child's illness is put forward in the first place in the life of the whole family. The presence of a sick relative next to the baby and a lack of attention to the child in daily life, changing to custody during the illness, also affects the development of hypochondriacal neurosis.

Asthenic neurosis, neurasthenia is typical for both children and adults against the background of excessive physical, mental or emotional stress. Manifested by irascibility, irritability, decreased attention and ability to concentrate, as well as loss of appetite and restless sleep or difficulty falling asleep. It can cause stuttering of neurotic etiology, especially during the period of speech formation.

Enuresis (urinary incontinence), encopresis (fecal incontinence) can be manifestations of neurotic conditions in preschoolers. Authoritarianism, overly strict methods of upbringing, increased demands on the child from the parents are frequent reasons for these physiological manifestations of neurosis. However, it is worth remembering that enuresis and encopresis have many other factors that are not related to upbringing or the family atmosphere: disorders in the functioning of the child's central nervous system, diseases of the gastrointestinal tract, urinary tract.

Treatment of childhood neuroses is rarely carried out with medication. There are no "magic pills" that can relieve a child of whims, self-indulgence, lies, stubbornness or fears for which parents often mistake neurotic manifestations. In the course of therapy, the main task falls on the shoulders of not the doctor and the child, but his parents.

Neurosis and panic attacks

Panic attacks can develop both against the background of a neurotic disorder, and, according to sensations, occur without previous signs.

There are typical and atypical symptoms of panic attacks. The following manifestations are typical:

• sudden, not associated with a change in external or internal temperature, chills;
• trembling, tremors of the limbs or the whole body;
• increased sweating, hot flashes, fever;
• pain in the region of the heart, sternum, feeling of a "grip on the chest", breathing problems;
• tachycardia, or a false sense of a rapid heartbeat;
• vestibular disorders: dizziness, loss of stability;
• sudden fear of loss of consciousness, illness, death, accident, control over a situation or one's own body;
• nausea, retching, etc.

Such symptomatology can either constitute a complete clinical picture of neurosis, panic attack, or manifest itself as separate signs in various combinations.

Among the atypical symptoms, the most common are distinguished:

• convulsive seizures;
• a feeling of constriction in the throat, a "lump" in the larynx, making it difficult to breathe or speak;
• fainting, loss of consciousness;
• loss of sensitivity in the limbs, numbness;
• dysfunction of the organs of vision, hearing, smell.

Panic attacks are uncomfortable in and of themselves. However, more often a sharp decrease in the quality of life follows the first attack, manifesting itself as signs of neurosis and forcing a person to tensely wait for a new episode. Somatic and mental symptoms that occur after a panic attack are manifested in a feeling of fatigue, tension, a decrease in the level of pleasure from life, headaches, and hypochondria.

Often, in search of the cause of a condition, a person visits several specialists, depending on the symptoms accompanying neurosis and panic attacks: neurologists, gastroenterologists, therapists, endocrinologists, cardiologists, etc. organs that influence the formation of the clinical picture are not found. Symptoms appear against the background of the general health of the body. Neurosis and panic attacks are within the purview of psychiatrists. To cure the disease in this case, a combination of psychotherapy and medication is most often recommended.

According to some types of classification, there are varieties (psychogenic depression) related to neuroses. Despite the fact that neurosis and depression can (and often are) interrelated, provoked by similar circumstances, they refer to different types of diseases.

There are types of neuroses, provoked by seasonal endogenous depression, arising against the background of a decrease in the amount of daylight. Most often in such cases, asthenic neurosis develops, characterized by increased fatigue, weakness, irritability, and sleep disturbances. One of the main recommendations in such cases is an increase in the amount of daylight, walks, work and rest, a healthy lifestyle, vitamin preparations... Neurosis and depression of this etiology are cured in the same way.

At the same time, for example, reactive neurosis, which develops as a response to a significant stressful event, is a disease against which depressive states arise.

Panic attacks often lead to a depressed state with elements of depression.

In the diagnosis and differentiation of the causes of the patient's condition, it is important to highlight the endogenous factors of depression, its psychogenic etiology and the primary nature of the disease. Endogenous, internal factors, most often associated with a genetic predisposition and arising against the background of biochemical disorders, are not caused by a stress factor, but by deviations in the functioning of the body.

Psychogenic depression is characterized by such phenomena as decreased mood in the evening, combination with somatic diseases, lability, tearfulness, maintaining the usual pace motor activity(movement does not slow down), no family history of depressive episodes.

Psychiatric and neurological doctors are specialists who diagnose neurosis. Symptoms and treatment are carried out in a comprehensive manner, often enough psychotherapeutic effects without drug therapy, sometimes a combination of drugs and psychotherapy is necessary, as well as sanatorium rehabilitation or a course of therapy in a specialized clinic with subsequent observation. Some neurotic conditions only require support with vitamin and mineral preparations and a healthy lifestyle.

A neurosis, the symptoms and treatment of which are ignored by a sick person, can worsen, cause disturbances in the psychoemotional sphere with a complicated clinical picture.

Symptoms of neuroses are divided into mental and somatic, physiological manifestations. The clinical pictures of neuroses are characterized by a wide range of symptoms, of which the main ones associated with the mental and physical well-being of a person are distinguished. In each specific case, the signs of neurosis, their variations and set can be modified.

The mental group of the most common symptoms of a state of neurosis include:

• unreasonable constant or periodically, in certain situations, arising anxiety, fear of ordinary situations or fear of possible accidents;
• the clinical picture of the syndrome of "chronic fatigue": increased fatigue, a feeling of fatigue, which does not correlate with the volume of human actions. Rest, at night or for a long time while on vacation, inexpressibly contributes to the restoration of strength; when returning to the usual activities, a person still feels excessively tired;
• high sensitivity to sound, light, temperature effects, reaction to loud, prolonged sounds, bright light, temperature changes that do not correspond to the normal physiological reactions of a healthy body. Sensitivity, asthenia, irritability, not corresponding to the level of exposure to an irritating factor;
• increased anxiety, a tendency to worry without an obvious reason, worry about unfulfilled events;
• mood swings in one direction or another, irritability;
• outwardly erased primary reaction to stressful situations: isolation, withdrawal into oneself;
• fluctuations in self-esteem, dependence on the opinions of others, which goes beyond the conventional norm;
• obsessive actions, thoughts, rituals that have no logical justification.

The physical group of the most common symptoms of neuroses includes such phenomena as:

• disturbances in appetite and sleep in any form: increase, decrease, unevenness, fluctuations, inconsistency with the time and desires of the body;
• mismatch in the volume of the load and the feeling of fatigue after it, high fatigue after minor physical or mental work;
• symptoms of vegetative-vascular dystonia: dizziness, headaches, chills, cold extremities, changes in blood pressure, etc.;
• pain in the chest, heart (cardioneurosis), digestive organs;
• disturbances in the work of the gastrointestinal tract;
• sexual desire disorders, decreased potency, libido.

The clinic of neuroses can be similar to a wide range of somatic diseases. Establishing the correct diagnosis depends on the timing of the diagnosis, the frequency of manifestation of the symptoms of a neurotic state, the patient's contact with a specialist and the desire to receive help.

Specialists in psychiatric and psychotherapeutic directions are engaged in the treatment of neuroses. As with many other diseases, early and timely diagnosis contributes to a more successful and faster recovery. In a number of situations, for example, with childhood neuroses, neurotic conditions caused by family problems, it is recommended to participate in therapy for other persons involved in the situation.

The tactical choice of treatment for neurosis depends on the nature of the disease, its clinical picture, the severity of symptoms, age, gender, social situation of the patient.

Reactive neuroses, conditions that are mild or manifested as a result of a short-term traumatic situation, often go away on their own as the acute reaction to the event disappears, the traumatic factor disappears or a person's lifestyle changes.

If it is necessary to treat by a specialist, a course of therapy for neurosis is drawn up by a psychotherapist after taking an anamnesis, diagnostics and taking into account the individual characteristics of the patient.

The complex therapy recommended for neurotic conditions does not always include the use of medications. The psychotherapeutic effect can be combined with physiotherapy, spa treatment, normalization of the rest and work regimen. It is also important for the patient to try to avoid, and to his family - to protect him from situations of overstrain, both physical and psycho-emotional.

The use of medications helps to reduce the degree of manifestation of neurosis, but in most cases it does not cure the patient. Drugs are used, as a rule, for neuroses that can go away on their own (reactive neuroses) in order to alleviate the condition and strengthen the body, or with severe symptoms to relieve the severity of the manifestations of the disorder.

Medicines of the first choice for neurotic conditions are general strengthening drugs that help the body with physical, mental and emotional stress. These include vitamin and mineral complexes. The most important vitamins of group B (B1, B6, B12), as well as A, C, PP. Of the minerals, attention is paid to the frequent lack of magnesium in neuroses, its use is accompanied by the intake of potassium and calcium.

With increased anxiety, sleep disturbances, light sedatives, sedatives are used, mainly of natural origin: funds based on valerian, motherwort. Appointments of amino acids are possible.

With asthenic neuroses, increased fatigue, decreased performance arising against the background of overwork or stressful situations, it is advisable to prescribe nootropic drugs, tranquilizers, drugs that improve cerebral blood supply and metabolic processes (Afobazol).

The doctor prescribes drugs of any spectrum on the basis of anamnesis and diagnosis. Drug treatment of neurosis may also include antidepressants, anticholinergic drugs, anticholinergics, adrenomimetics, ganglion blockers. In chronic, acute, severe states of a neurotic nature, it is permissible to use psychotropic drugs under the strict supervision of a specialist.

Neurosis in adults and children is a reversible (curable) neuropsychiatric disorder. The earlier a person seeks help from a doctor, the more effective the course of therapy is and the faster a complete recovery from the disease occurs.

The most effective treatment of neurosis at the stage when the state of neurosis is just developing, there is no picture of masking neurosis as a somatic disease, mental changes have not affected the personality, as well as with active interaction of the patient with a specialist and a desire to be cured.

The use of hydroxyzine (Atarax) for neurosis

Hydroxyzine is a traditional psychotropic drug, a tranquilizer, used in the treatment of anxiety disorders since 1955. Hydroxyzine hydrochloride, a derivative of dephenylmethane, or Atarax with neurosis has an anti-anxiety effect, and also affects the body as an antihistamine, antipruritic and antiemetic agent.

The activity of the drug is aimed at reducing the amount of histamine, reducing anxiety and reducing the aggressiveness of the patient. The main advantages of the drug: the absence of addiction symptoms, drug withdrawal, a positive effect on the cognitive functions of the brain.

Atarax for neurosis is used in the case of anxiety disorders, mild depression, psychomotor agitation, adjustment disorders.

Additional areas of use of this medication are therapy for cessation of tobacco smoking, alcohol dependence, including with symptoms of delirium, a sedative in pediatric dentistry, for behavioral disorders, etc.

Currently, studies are being carried out, in a first approximation, confirming the effectiveness of the use of Atarax in generalized anxiety disorder and its advantages in comparison with a number of other drugs.

Atarax is contraindicated during pregnancy, childbirth, breastfeeding, etc. It is used in children and adults in strict accordance with the doctor's prescription, it is dispensed with a prescription.

Psychotherapy is considered the main method of treating neuroses, neurotic disorders. In the spectrum of psychotherapeutic techniques and directions, two main methods of psychotherapeutic assistance to the patient are distinguished: pathogenetic, aimed at the process of the emergence of neurotic reactions and their consolidation in a person's personality, and auxiliary, working with manifestations of neurosis symptoms. An auxiliary method is effective for complete cure only in combination with a pathogenetic direction.

In the symptomatic direction of psychotherapeutic methods, art therapy, body-oriented and breathing techniques, autogenic training, music therapy, hypnotic influence, exposure, and behavioral therapy are distinguished.

The pathogenetic methods of psychotherapy include cognitive, psychodynamic, existential, systemic, integrative methods and gestalt therapy.

A combination of methods of both directions is possible, for example, cognitive-behavioral therapy, which is effective in most neurotic conditions. Psychoanalytic methods (psychoanalysis) are found to be significantly less effective and capable of causing iatrogenic disorders with prolonged use.

Pathogenetic methods are aimed at working out and changing the patterns of human behavior when faced with a traumatic situation. The symptomatic direction works to alleviate the manifestation of neuroses, without eradicating the cause of their occurrence.

The generally accepted understanding of psychotherapy as conducting conversations with a specialist expands significantly in patients during the course of the course. Psychotherapy is not a one-sided method of influencing a client by a doctor, but a process of working on oneself with the help of a psychotherapist.

Different types of diseases that occur in people with different personality types often lead to the fact that some approaches to treatment are not effective in a particular case. The patient's awareness of the dynamics of his condition, the ability to report it and discuss new phenomena with the doctor is an important component of a successful healing process with the help of psychotherapy.

Clinic of neuroses: treatment in specialized institutions

Effective treatment of neuroses in medical institutions is based on an integrated approach and patient observation. The combination of psychotherapeutic, medication courses with rehabilitation programs and the possibility of the patient staying out of a traumatic situation under the supervision of specialists is often the most effective combination.

The Clinic of Neuroses (the new name is GBUZ SPC named after Solovyov under the Department of Health) is a specialized institution in Moscow, with a scientific and practical profile, which has existed for more than a hundred years. This neurosis clinic is engaged in the diagnosis and treatment of diseases and conditions such as depression, anxiety disorders, panic attacks, sleep and eating disorders in various forms and others. For residents of Moscow, treatment is provided free of charge.

Various medical institutions created on a commercial basis can also be called neurosis clinics. When choosing a specialist or a medical institution, it is necessary to pay attention to the certification of activities and the level of training of doctors.

Neuroses are functional disorders of higher nervous activity of psychogenic origin. The clinic of neuroses is very diverse and can include somatic neurotic disorders, autonomic disorders, various phobias, dysthymia, obsessions, compulsions, emotional-mnestic problems.

Neuroses belong to a group of diseases that have a protracted course pattern. This disease affects people who are characterized by constant overwork, lack of sleep, worries, grief, etc.

What is neurosis?

Neurosis is a set of psychogenic, functional reversible disorders that tend to last for a long time. The clinical picture of neurosis is characterized by obsessive, asthenic or hysterical manifestations, as well as a temporary weakening of physical and mental performance. This disorder is also called psychoneurosis or neurotic disorder.

Neuroses in adults are characterized by a reversible and not very severe course, which distinguishes them, in particular, from psychoses. According to statistics, up to 20% of the adult population suffers from various neurotic disorders. The percentage may differ in different social groups.

The main developmental mechanism is a disorder of brain activity, which normally ensures human adaptation. As a result, both somatic and mental disorders occur.

The term neurosis has been introduced into medical terminology since 1776 by a physician from Scotland, William Cullen.

Causes of occurrence

Neuroses and neurotic states are considered a polyfactorial pathology. A large number of reasons lead to their occurrence, which act together and trigger a large complex of pathogenetic reactions leading to the pathology of the central and peripheral nervous system.

The cause of neuroses is the action of a traumatic factor or a traumatic situation.

1. In the first case, we are talking about a short-term, but strong negative impact on a person, for example, the death of a loved one.
2. In the second case, it is said about the long-term, chronic impact of a negative factor, for example, a family-household conflict situation. Speaking about the causes of neurosis, it is the traumatic situations and, above all, family conflicts that are of great importance.

To date, there are:

• psychological factors in the development of neuroses, which are understood as the characteristics and conditions of personality development, as well as upbringing, the level of claims and relationships with society;
• biological factors, which are understood as the functional failure of certain neurophysiological, as well as neurotransmitter systems, making the sick susceptible to psychogenic influences

Equally often, all categories of patients, regardless of their place of residence, develop psychoneurosis due to such tragic events as:

• death or loss of a loved one;
• severe illness in loved ones or in the patient himself;
• divorce or separation from a loved one;
• dismissal from work, bankruptcy, business collapse, and so on.

It is not entirely correct to talk about heredity in this situation. The development of neurosis is influenced by the environment in which a person grew up and was brought up. A child, looking at parents prone to hysteria, adopts their behavior and himself exposes his nervous system to trauma.

According to the American Psychiatric Association the frequency of occurrence of neuroses in men it ranges from 5 to 80 cases per 1000 population, while in women it ranges from 4 to 160.

A kind of neuroses

Neuroses are called a group of diseases that arise in a person due to the impact of mental trauma. As a rule, they are accompanied by a deterioration in human well-being, mood swings and manifestations of somato-vegetative manifestations.

Neurasthenia

(nervous weakness or fatigue syndrome) is the most common form of neurosis. It occurs during prolonged nervous overstrain, chronic stress and other similar conditions that cause overwork and "breakdown" of the protective mechanisms of the nervous system.

Neurasthenia is characterized by the following symptoms:

• increased irritability;
• high excitability;
• rapid fatigue;
• loss of the ability to self-control and self-control;
• tearfulness and resentment;
• absent-mindedness, inability to concentrate;
• a decrease in the ability to prolonged mental stress;
• loss of habitual physical endurance;
• severe sleep disorders;
• loss of appetite;
• apathy and indifference to what is happening.

Hysterical neurosis

Vegetative manifestations of hysteria are manifested in the form of spasms, persistent nausea, vomiting, and fainting. Movement disorders are characteristic - tremors, tremors in the limbs, blepharospasm. Sensory disorders are expressed in sensitivity disorders in various parts of the body, pain, hysterical deafness and blindness may develop.

Patients seek attention relatives and doctors to their condition, they have extremely unstable emotions, their mood changes dramatically, they easily pass from sobbing to wild laughter.

There is a specific type of patient with a tendency to hysterical neurosis:

• Impressionable and sensitive;
• Self-perceived and suggestible;
• With mood imbalances;
• With a tendency to attract outside attention.

Hysterical neurosis must be distinguished from somatic and mental illnesses. Similar symptoms occur when, tumors of the central nervous system, endocrinopathy, encephalopathy against the background of trauma.

Obsessive-compulsive disorder

A disease characterized by the emergence of obsessions and thoughts. A person is overcome by fears from which he cannot get rid of. In a similar state, the patient often exhibits phobias (this form is also called phobic neurosis).

Symptoms of a neurosis of this form are manifested as follows: a person feels fear, which manifests itself in repeated unpleasant incidents.

For example, if a patient faints in the street, then in the same place the next time he will be haunted by obsessive fear. Over time, a person develops a fear of death, incurable diseases, and dangerous infections.

Depressive form

Depressive neurosis - develops against the background of prolonged psychogenic or neurotic depression. The disorder is characterized by a deterioration in the quality of sleep, a loss of the ability to rejoice, and a bad chronic mood. The disease is accompanied by:

• heart rhythm disorders
• dizziness
• tearfulness,
• increased sensitivity,
• stomach problems
• intestines
• sexual dysfunction.

Symptoms of neurosis in adults

Neurosis is characterized by mood instability, impulsive actions. Mood swings affect all areas of the patient's life. It affects interpersonal relationships, goal setting, self-esteem.

Patients have memory impairment, low concentration of attention, high fatigue. A person gets tired not only from work, but also from his favorite activities. Intellectual activity becomes difficult. Due to absent-mindedness, the patient can make many mistakes, which causes new problems at work and at home.

Among the main signs of neurosis are:

• unreasonable emotional stress;
• increased fatigue;
• insomnia or a constant desire to sleep;
• isolation and obsession;
• lack of appetite or overeating;
• weakening of memory;
• headache (prolonged and sudden onset);
• dizziness and fainting;
• darkening in the eyes;
• disorientation;
• pain in the heart, abdomen, muscles and joints;
• trembling hands;
• frequent urination;
• increased sweating (due to fear and nervousness);
• decreased potency;
• overestimated or underestimated self-esteem;
• uncertainty and inconsistency;
• incorrect prioritization.

People with neuroses often have:

• instability of mood;
• a feeling of self-doubt and the correctness of the actions being taken;
• an overly pronounced emotional reaction to minor stresses (aggression, despair, etc.);
• increased sensitivity and vulnerability;
• tearfulness and irritability;
• suspiciousness and exaggerated self-criticism;
• frequent manifestation of unreasonable anxiety and fear;
• inconsistency of desires and a change in the value system;
• excessive fixation on the problem;
• increased mental fatigue;
• decreased ability to remember and concentrate;
• a high degree of sensitivity to sound and light stimuli, reaction to minor temperature changes;
• sleep disorders.

Signs of neurosis in women and men

Signs of neurosis in the fair sex have their own characteristics, which are worth mentioning. First of all, women are characterized by asthenic neurosis (neurasthenia), caused by irritability, loss of mental and physical ability, and also leading to problems in sexual activity.

For men, the following types are characteristic:

• Depressive - the symptoms of this type of neurosis are more common in men, the reasons for its appearance are the inability to realize oneself at work, the inability to adapt to drastic changes in life, both in personal and public.
• Male neurasthenia... It usually occurs against the background of overstrain, both physical and nervous, most often workaholics are susceptible to it.

Signs of climacteric neurosis, which develops in both men and women, are heightened emotional sensitivity and irritability, beginning in the period from 45 to 55 years, decreased endurance, sleep disturbances, common problems with the work of internal organs.

Stages

Neuroses are diseases that are fundamentally reversible, functional, without organic damage to the brain. But they often take a protracted course. This is due not so much to the traumatic situation itself, but to the characteristics of a person's character, his attitude to this situation, the level of the body's adaptive capabilities and the system of psychological defense.

Neuroses are divided into 3 stages, each of which has its own symptoms:

1. The initial stage is characterized by increased excitability and irritability;
2. The intermediate stage (hypersthenic) is characterized by increased nerve impulses from the peripheral nervous system;
3. The final stage (hyposthenic) is manifested by a decrease in mood, drowsiness, lethargy and apathy due to the strong severity of inhibition processes in the nervous system.

A longer course of a neurotic disorder, a change in behavioral reactions and the appearance of an assessment of one's disease indicate the development of a neurotic state, i.e., the neurosis itself. An uncontrolled neurotic state within 6 months - 2 years leads to the formation of neurotic personality development.

Diagnostics

So what kind of doctor can help cure neurosis? This is done either by a psychologist or a psychotherapist. Accordingly, the main tool of treatment is psychotherapy (and hypnotherapy), most often complex.

The patient needs to learn objectively look at the world around him, to realize their inadequacy in some issues.

Diagnosing a neurosis is not an easy task that can only be done by an experienced specialist. As already mentioned above, the symptoms of neurosis manifest themselves in different ways in both women and men. It is also necessary to take into account that each person has his own character, his own personality traits, which can be confused with signs of other disorders. That is why only a doctor should be involved in making a diagnosis.

The disease is diagnosed using the color technique:

• All colors take part in the technique, and a neurosis-like syndrome manifests itself when choosing and repeating purple, gray, black and brown colors.
• Hysterical neurosis is characterized by the choice of only two colors: red and purple, which by 99% indicates the patient's low self-esteem.

To identify signs of a psychopathic nature, a special test is carried out - it reveals the presence of chronic fatigue, anxiety, indecision, self-doubt. People with neuroses rarely set long-term goals for themselves, do not believe in success, they often have complexes about their own appearance, it is difficult for them to communicate with people.

Treatment of neuroses

There are many theories and methods for treating neuroses in adults. Therapy takes place in two main directions - pharmacological and psychotherapeutic. The use of drugs of pharmacological therapy is carried out only in extremely severe forms of the disease. In many cases, psychotherapy is sufficiently qualified.

In the absence of somatic pathologies, patients definitely recommend changing your lifestyle, normalize the mode of work and rest, sleep at least 7-8 hours a day, eat right, give up bad habits, spend more time in the fresh air and avoid nervous overload.

Medicines

Unfortunately, very few people suffering from neuroses are ready to work on themselves, to change something. Therefore, drugs are widely used. They do not solve problems, but are only designed to relieve the severity of the emotional reaction to a traumatic situation. After them, it just becomes easier on the soul - for a while. Maybe then it is worth looking at the conflict (within oneself, with others or with life) from a different angle and finally solve it.

With the help of psychotropic drugs, tension, tremors are eliminated. Their appointment is permissible only for a short period of time.

With neuroses, as a rule, the following groups of drugs are used:

• tranquilizers - alprazolam, phenazepam.
• antidepressants - fluoxetine, sertraline.
• hypnotics - zopiclone, zolpidem.

Psychotherapy for neuroses

Currently, the main methods of treating all types of neuroses are psychotherapeutic techniques and hypnotherapy. During psychotherapy sessions, a person gets the opportunity to build an integral picture of his personality, to establish cause-and-effect relationships that gave impetus to the emergence of neurotic reactions.

Methods for treating neuroses include color therapy. The right color for the brain is beneficial, as are vitamins for the body.

Advice:

• To extinguish your anger, irritation - avoid the color red.
• At the moment of the onset bad mood exclude black, dark blue tones from your wardrobe, surround yourself with light and warm tones.
• Look for blue, greenish tones to relieve stress. Change the wallpaper at home, choose the appropriate decor.

Folk remedies

Before using any folk remedies with neurosis, we recommend consulting a doctor.

1. With restless sleep, general weakness, patients with neurasthenia should pour a teaspoon of verbena herb with a glass of boiling water, then leave for an hour, take in small sips throughout the day.
2. Tea with lemon balm - mix 10 g of tea leaves and herb leaves, pour 1 liter of boiling water, drink tea in the evening and before going to bed;
3. Mint. Pour 1 cup boiling water over 1 tbsp. a spoonful of mint. Let it brew for 40 minutes and strain. Drink a cup of warm broth in the morning on an empty stomach and in the evening before bed.
4. Valerian bath... Take 60 grams of root and boil for 15 minutes, let it brew for 1 hour, strain and pour into the bathroom with hot water. Take 15 minutes.

Forecast

The prognosis of neurosis depends on its type, stage of development and duration of the course, timeliness and adequacy of the psychological and medical assistance provided. In most cases, the therapy started on time leads, if not to a cure, then to a significant improvement in the patient's condition.

The prolonged existence of neurosis is dangerous with irreversible personality changes and the risk of suicide.

Prophylaxis

Although neurosis is treatable, it is better prevented than cured.

Prevention methods for adults:

• The best prevention in this case will be to normalize your emotional background as much as possible.
• Try to eliminate annoying factors or change your attitude towards them.
• Avoid overload at work, normalize work and rest.
• It is very important to give yourself adequate rest, eat right, sleep at least 7-8 hours a day, take daily walks, and play sports.

Neuroses are the most common type of psychogenias (painful conditions caused by the influence of traumatic factors); they are characterized by the partial nature of mental disorders (obsessive states, hysterical manifestations, etc.), a critical attitude towards them, the preservation of the consciousness of the disease, the presence of somatic and autonomic disorders. The development of neuroses occurs in different ways. Along with short-term neurotic reactions, their protracted course is often observed, which is not accompanied, however, by pronounced behavioral disturbances. Neurotic reactions usually arise to relatively weak, but long-acting stimuli, leading to constant emotional stress or internal conflicts (events requiring difficult alternative solutions, situations that give rise to uncertainty that pose a threat to the future).

Along with psychogenic influences, an important role in the genesis of neuroses belongs to constitutional predisposition. There are three types of neuroses: neurasthenia, obsessive-compulsive disorder, hysteria. Neurasthenia (asthenic neurosis). In the first place in the clinical picture are asthenic manifestations: increased mental and physical fatigue, absent-mindedness, dispersal, decreased performance, the need for long rest, which, however, does not give full recovery.

The most typical complaints are a lack of strength, lack of vigor, energy, low mood, weakness, weakness, intolerance to ordinary stress. Increased mental exhaustion is combined with excessive excitability (symptoms of irritable weakness), hyperesthesia. Patients are intemperate, quick-tempered, complain of a constant feeling of inner tension; even telephone calls, petty misunderstandings that previously passed unnoticed, now cause a violent emotional reaction that quickly dries up and often ends in tears. The most common neurasthenic symptoms also include headaches, sleep disturbances, various somatovegetative disorders (hyperhidrosis, dysfunctions of the cardiovascular system, gastrointestinal tract, respiratory system, sexual function, etc.

). Obsessive-compulsive neurosis is manifested by numerous obsessions (see Obsessive states), although the picture of each particular neurosis is usually relatively monomorphic. Agoraphobia, claustrophobia, fear of transport, public speaking, nosophobia (cardiophobia, carcinophobia, etc.) prevail in the circle of obsessive-phobic disorders.

) Neurosis of obsessive states in comparison with other neuroses reveals a much more pronounced tendency to a protracted course. If at the same time there is no significant expansion of symptoms, then patients gradually adapt to phobias, learn to avoid situations in which fear arises; the disease, therefore, does not lead to drastic violations of the way of life. Hysteria. In most cases clinical picture is determined by motor and sensory disorders, as well as disorders of autonomic functions that mimic somatic and neurological diseases (conversion hysteria).

The group of movement disorders, on the one hand, includes hysterical paresis and paralysis, and on the other, hyperkinesis, tics, rhythmic tremor, which increases with fixation of attention, and a number of other involuntary movements. Hysterical attacks are possible (see. Hysterical syndrome). Sensory disorders include anesthesia (often arising in the "amputation type" - in the form of "stockings", "gloves"), hyperesthesia and hysterical pain (the most typical headache is defined as "a hoop that tightens the forehead and temples", "hammered in a nail" and etc.

). Some forms of anorexia nervosa, stuttering, and enuresis belong to neuroses. In neuroses, in contrast to psychosis, the feeling of alienation of painful disorders, the desire to resist them, always persists. Neurosis-like states observed in the framework of endogenous psychoses are characterized by a greater polymorphism of manifestations and a tendency to further expansion of symptoms, abstract, bizarre, and sometimes ridiculous content of fears and obsessions, unmotivated anxiety.

Treatment of neuroses is complex, includes therapy with psychotropic drugs, psychotherapy aimed at resolving a conflict situation, general restorative agents, physiotherapy. Also shown is spa treatment; in case of persistent neurotic conditions, accompanied by affective (depressive) disorders and resistant to outpatient therapy, hospitalization is indicated. In drug therapy of neuroses, tranquilizers are most effective [diazepam (seduxen), sibazon, relanium, oxazepam (tazepam), chlordiazepoxide (elenium) at 10-50 mg / day, phenazepam at 1-3 mg / day, meprotan (meprobamate) at 200- 800 mg / day]. In more severe cases (persistent obsessions, massive hysterical disorders, etc.

) shown intramuscular, and in the hospital - and intravenous drip of tranquilizers (diazepam, chlordiazepoxide) or the appointment of neuroleptics in small doses [etaperazine - 4-12 mg / day, chlorprothixene - 15-20 mg / day, thioridazine (sonapax) -10- 50 mg / day, neuleptil (propericiazine) - 10-20 mg / day, eglonil - 100-400 mg / day], as well as drugs with prolonged action [fluorophene-zine-decanoate (moditen-depot) -12.5-25 mg , fluspirylene - 2-4 mg once every 1-2 weeks]. In patients with a predominance of asthenic manifestations, a combination of tranquilizers with piracetam (nootropil) or aminalon is effective. With pronounced affective (depressive) disorders, a combination of tranquilizers with antidepressants is indicated (amitriptyline in combination with chlordiazepoxide, etc.).

In cases with persistent sleep disorders, nitrazepam (eunoktin, radedorm) is prescribed at 5-15 mg, reladorm, fonazepam at 0.5-1.5 mg, teralen at 5-10 mg, chlorprothixene at 15 mg. In most cases, neurotic reactions are reversible. Prevention of neuroses includes a number of social and psycho-hygienic measures, including the creation of favorable family and household and labor conditions, rational vocational guidance, prevention of emotional stress, elimination of occupational hazards, etc.

Attention! The described treatment does not guarantee a positive result. For more reliable information, be sure to consult a specialist.

A neurotic disorder is a group of diseases that are triggered by predisposition and stress, both acute and chronic. Neuroses are manifested by exhaustion, irritability, sleep disturbances, demonstrativeness, and even impaired sensitivity.

To date, there is no single definite classification.

Types of neuroses and their characteristics

Different approaches distinguish from three to six common types of neuroses. ICD-10 classifies these conditions into sections F40 through F42, which contain the following disorders.

Classification of neuroses according to ICD-10

• Obsessive-compulsive disorder (thoughts) neurosis. This is a state of increased anxiety, which is accompanied by obsessive thoughts and actions that increase the anxiety and all accompanying symptoms. The cause of obsessive-compulsive neuroses is the conflict of needs and morality. Roughly speaking, the desires and needs of a person after a traumatic experience are recorded by the brain as dangerous. Although the need does not disappear anywhere, it is automatically devalued and this causes righteous anger in the body. There are several types of obsessive-compulsive disorder.
• (fear neurosis) - these are fears and phobias that arise so strongly and uncontrollably that they interfere with the normal social life of a person. The most common are agoraphobia, simple phobias, social phobias. A separate type of anxiety-phobic disorder is obsessive-compulsive, in which a person has internal "orders" for some thoughts or action, the failure of which is usually accompanied by an almost panic fear of the origin of something terrible.
• Hysterical neurosis is an unstable emotional state, which is accompanied by a demonstrative line of behavior and has vivid neurological manifestations - impaired sensitivity, sensory systems, movement disorders, and the like. One of the main causes of hysterical neurosis is a defensive reaction in response to a situation that is regarded by a person as insoluble.
• is the most common form of neurosis. At the heart of neurasthenia is the conflict between the requirements for oneself and the impossibility of conformity. This is manifested mainly by autonomic symptoms, which is commonly called astheno-neurotic syndrome or VSD. These are the types of neuroses and the forms of their manifestation. according to ICD-10.

It is based on the types of neuroses according to Freud, the psychotherapist, to whom we owe almost everything we know about neuroses in general. Another type of classification is clinical... Some names are repeated, some are not. There are 19 types of neuroses in total.

Clinical classification of neuroses

• neurasthenia - otherwise called the state of irritable weakness;
• obsessive-compulsive neurosis has been described above;
• neurotic depression - a protracted course of any neurosis;
• fear neurosis - phobias and fears described above;
• phobic neurosis;
• hypochondria - a painful obsession with one's health with excessive attention to the smallest manifestations of the disease;
• movement neurosis - obsessions and compulsions;
• anorexia nervosa - intentional refusal to eat;
• bulimia nervosa - excessive hunger;
• nervous exhaustion;
• neurosis of the stomach - a violation of tone, functionality and even the position of the stomach;
• panic attacks - attacks of pronounced anxiety that occur suddenly;
• neurosis of the heart - disorders of the heart;
• somatoform neuroses - disturbances in the work of certain organs, non-localized pain;
• laryngospasm and pharyngospasm;
• success neurosis - neurosis as a result of the sudden fulfillment of a long-standing plan or desire
• neurosis of guilt;
• the actual neurosis is associated with the sexual act.

Regardless of the classification, at the heart of any neurotic disorder are two factors - psychological and physiological.

Psychological factor is an internal conflict. The advantage is the conflict between needs and social expectations. For example, a person once experienced intense fear, which was the result of satisfying a need. Since then, on a subconscious level, needs are perceived as a source of danger. Physiological factor- This is primarily the concentration in the blood of certain hormones - endorphins, dopamine, adrenaline. Their concentration differs greatly under various stress conditions. This is how the body reacts to any stress. tied to the correction of these two factors and the combination of psychotherapy and drug treatment of neurotic disorders.

Neuroses include such functional disorders in nervous activity that are not accompanied by gross organic changes in the structure of the nervous tissue. However, this definition is very conditional, and it is explained by the fact that the nature of neuroses has been little studied for a long time. Some disorders in the general somatics of the body (anemia, metabolic disorders, exhaustion, etc.) are essentially only a background.

The main cause of neuroses is mental trauma, however, premorbid personality predisposition is also important (for example, emotional instability inherited from parents, mental vulnerability, etc.). Thus, neurosis is the result of an overstrain of the nervous system, a breakdown in nervous activity. The course of neuroses can be twofold. Some forms can develop gradually as a result of a number of conditions. In more rare cases, this condition may be congenital weakness of the nervous system. An unfavorable family environment, improper upbringing can exacerbate the manifestation of congenital nervous weakness and contribute to the formation of pronounced forms of neurosis. In other cases, neurosis can arise acutely as a reaction of the nervous system to certain unfavorable situations in the child's life. What is the basis of neuroses? What is the physiological mechanism of these disorders of nervous activity?

The works of I.P. Pavlova and his students helped to reveal the pathophysiological mechanisms that determine the development of neuroses. The essence of such disorders lies primarily in the imbalance between the irritable and inhibitory processes. We are talking about the so-called collision, "difficult meeting" (according to Pavlov), which occurs as a result of imbalance, which is inherent in the normal state of physiological activity of the cerebral hemispheres. Disruption of the interaction between the main nervous processes changes the course of higher nervous activity, which in the future can cause a pathological predominance of either an irritable or inhibitory process. The study of nervous children in schools allows us to distinguish among them mainly two groups. Children belonging to the first group are characterized by increased excitability of the nervous system, restlessness, and motor disinhibition. In life, these are overly mobile, noisy children who cannot sit quietly in class, stick to neighbors, cannot concentrate even for a short time, turn around, make noise. They quickly, without thinking, answer the teacher's questions, their speech is unnecessarily hasty. This behavior, apparently, is associated with the lability of the excitatory process and the weakening of internal inhibition. Less common is another group of children who are characterized by lethargy, apathy, motor deficiency, which is the result of a tendency to inhibition, inertia of the inhibitory process.

A number of different forms of neuroses are distinguished in the clinic. We will focus on the characteristics of only the main ones. These are neurasthenia, obsessive-compulsive disorder and hysteria. First of all, it should be said that all these neuroses have many common features, the main of which is the instability of the nervous tone. However, each of the identified forms has its own specific features, which justifies their isolation in clinical practice. It should be noted that the characteristic features inherent in one form or another of neuroses, of course, are more pronounced in adults. In childhood, the specificity of neurotic symptoms related to one form or another is often erased. At the same time, there are a number of features that are characteristic mainly of childhood.

Neurasthenia in children is characterized by depletion of the nervous system as a result of overwork, malnutrition, general physical weakening of the body or intoxication, anxieties and worries experienced. The appearance of such children is characterized by reduced fatness, pallor of the skin. They have deeply sunken eyes, blue circles under the eyes, sometimes a special sparkle of the eyes. Along with poor posture, uncertainty in movements, impetuosity and impatience are manifested. These children are characterized by increased irritability, anger, instability of mood. Usually such children get up with great difficulty in the morning, are capricious, sometimes cry for a long time before going to school. In the evening it is difficult to put them to bed, they are excited, cheerful. Restless sleep. Fears, screaming, twitching in a dream are noted. In school practice, these children are characterized by rapid exhaustion, they are tired of intellectual tension. Attention is unstable, memory is weakened. They often do poorly in school. Sometimes speech defects are found, more often in the form of accelerated hasty speech, turning into stuttering. There is a number of changes in the autonomic nervous system, which manifests itself in the form of increased sweating, instability of vascular tone (tendency to spasms). Hence the complaints of frequent headaches, stomach pains (colic), discomfort in the heart (palpitations, fading, etc.), lack of appetite, sometimes causeless nausea and vomiting. In some cases, an extremely unpleasant complication develops in the form of nocturnal urinary incontinence, which often becomes persistent and requires long-term treatment. It should be emphasized that urinary incontinence can be caused not only by neurosis, accompanied by autonomic disorders, but also by other reasons associated with organic lesions of the spinal cord or defects in the development of the genitourinary apparatus itself. Sometimes the course of neurasthenia can be accompanied by some movement disorders in the form of teak-like twitching of the eyelid, corner of the mouth, head. Since these symptoms are also characteristic of organic lesions of the central nervous system (meningoencephalitis, chorea), a thorough examination of such children by a specialist doctor is necessary. Often parents, pointing out such twitching in a child, consider them a bad habit, a prank, punish him, which, of course, does not contribute to the weakening of these symptoms, but may lead to their intensification.

Hysteria (hysterical neurosis) in children is characterized by a number of features. This is, first of all, heightened emotionality, excessive impressionability, a tendency to self-hypnosis and fantasy. Hysteria is characterized by a great variety of other symptoms. So, in mild cases of hysterical neurosis, pathology is mainly expressed in character traits. For a hysterical character, pronounced egocentrism is especially typical, the desire to attract the attention of others; in the absence of such attention from the surrounding hysterics, it can give a number of negative reactions - rudeness, affective outbursts, crying, etc. In more severe cases, hysterical neurosis is accompanied by seizures as a reaction to dissatisfaction with demands, as well as weakening or disappearance of some motor or sensory functions (paralysis, paresis, hysterical deafness, blindness), which are always temporary.

The complex complex of neuropsychic features that arises in a hysteric is due to peculiar pathophysiological mechanisms, the essence of which was studied by I.P. Pavlov.

Hysterical neurosis occurs most often in persons belonging to the so-called artistic type (according to Pavlov). As you know, in such people there is a certain predominance of the first signal system over the second, which determines a bright, concrete, figurative type of thinking. With a breakdown of nervous activity, the normal physiological variant of interaction between signaling systems is disrupted towards the already pathologically prevailing first signaling system. In addition, there is a violation of the interaction with the subcortical formations, the influence of which is enhanced in connection with the weakening of the regulatory role of the cortex. The predominance of subcortical influences leads to saturation with emotional moments, which explains the increased impressionability that characterizes the behavior of a hysterical. Hence the affective outbursts and impulsive actions characteristic of this group of people.

The symptoms of hysterical neurosis in children do not differ as brightly as can be observed in adults. It should be noted that there is some diversity of signs that characterize hysterical manifestations in children. So, sometimes hysteria can manifest itself in the form of increased impressionability, special fragility of the constitution. Such children, under the guise of external coldness, indifference, hide a large supply of emotional experiences. Every harsh word, careless hint, gesture from others can cause them a lot of severe suffering. They are affectionate and demanding in friendship, extremely touchy, jealous and suspicious. Daydreaming, a penchant for fantasy are not uncommon properties of their nature. They are also self-centered. However, it is expressed not in rude primitive demands on others in the sense of recognizing oneself, but in an overly painfully developed self-esteem. Hence the constant alertness, which takes the form of a kind of defensive reaction against possible infringements from others, sometimes painfully exaggerated. It is these children and adolescents (more often girls) that are characterized by a number of unpleasant somatic sensations: headaches, nausea, sometimes numbness in various parts of the body, a feeling of a ball in the throat, and attacks of nervous hiccups. The presence of a particular fragility of the internal constitution of such children, combined with great emotionality, can be an unfavorable background, especially in adolescence, in connection with the occurrence of sexual experiences that can lead to mental disasters. In some cases, in conflict situations, as well as in moments of mental trauma, the weak nervous system, the hysterics cannot cope and he reacts with a hysterical fit. A hysterical fit can develop immediately at the height of passion and be accompanied by crying or laughter. The patient falls (more often carefully), consciousness can be partially darkened, convulsions appear and various grimaces appear on the face, sometimes the patient bends over, takes pretentious (passionate) postures. Foam from the mouth, bite of the tongue, spontaneous urination and defecation are not common for an epileptic seizure. Pupils react to light normally. In some cases, a hysterical seizure can be expressed in a kind of numbness, decreased sensitivity

(hysterical stupor). Relatively rarely, the result of a nervous breakdown can be the development of hysterical paresis or paralysis: half of the body is taken away, weakness or immobility develops in the arm and leg on one side. Sometimes loss of speech or hearing may occur - hysterical mutism, deaf-mutism or loss of voice - hysterical aphonia.

All these pathological phenomena are of a temporary nature, usually they are not associated with structural lesions, but are the result of foci of stagnant inhibition that have arisen, as a result of which one or another motor or sensory function is turned off or weakened.

In other cases, hysterical neurosis manifests itself in the form of increased moodiness, tearfulness. Such children can sometimes cry for hours, demanding that others fulfill their desire, throw themselves on the floor, kick, shout, fight. Usually, the traits of egocentrism inherent in hysterics, in these cases, are manifested in the desire to put one's own mind, to attract the attention of others, to be in the center of attention, to rule. Some children early become despots in the family and, taking into account the weakness of their parents, use this to their advantage in the most rude form.

Failure to recognize their desire to excel on the part of those around them causes a number of aggressive actions in them. However, being weak natures, they often look for workarounds to prove to their peers their superiority, their exclusiveness. Hence the tendency towards pathological lies. Whole stories are invented, for example, about their relatives, supposedly very famous people... They also embellish their own actions and abilities. This pseudology, which in some children takes on a rather magnificent character, is a kind of cover for their own inferiority, weakness.

Obsessive-compulsive disorder. Obsessive states can manifest themselves in the intellectual sphere (obsessive thoughts, ideas, memories), in the emotional sphere (obsessive fears) and in the motor (obsessive movements, actions, actions).

In the emergence of obsessive-compulsive disorder in children and adolescents, the main role belongs to long-term traumatic situations associated with a conflict between desire and a sense of duty, emotional stress due to the consciousness of responsibility, increased demands on the child from the parents, etc. (G.E.Sukhareva, V.V. Kovalev). In children of preschool and partly primary school age, as well as in the presence of mental infantilism in adolescents, neurotic obsessions can arise under the influence of acute mental trauma, accompanied by fright.

The type of higher nervous activity and the characteristics of the child's character, as well as the methods of education, the somatic state and the environment, are of great importance for the emergence of this form of neurosis. The characterological features of this individual are alarming and suspicious traits that may be characteristic of his relatives, in particular the mother. Children who develop obsessive-compulsive disorder, in most cases, already in early childhood are characterized by increased fearfulness in front of everything new, unfamiliar. V preschool age they develop anxiety, suspicion, fear of infection, a tendency to create various prohibitions for themselves, belief in omens, addiction to games, the rules of which are similar to obsessive actions, adherence to a strict sequence of actions when dressing and morning toilet.

An anxious and suspicious character is formed under the influence of the environment, overprotection on the part of parents, constant conversations about possible painful conditions and outcomes. Children develop a peculiar form of thinking, an idea of ​​the particular difficulty of living an ordinary real life, establishing contact with others. Hence, the child does not simply perceive every phenomenon of the ordinary life order, but tries to analyze, to look for the "root of things." All this leads to fruitless philosophizing, reasoning, naked abstraction. These qualities lead to the separation of such children from real life. They become helpless, lost when it is necessary to fulfill a number of everyday requirements. Each stimulus for them is super-strong, impracticable, causing a collision of nervous processes.

The main types of obsessions in children and adolescents are obsessive fears (phobias) and obsessive movements and actions (obsessions). Depending on the predominance of one or the other, two types of neurosis can be conditionally distinguished: neurosis of obsessive fears and neurosis of obsessive actions. However, obsessive compulsions of a mixed nature are common.

In the neurosis of obsessive fears, the content of the statements depends on the age of the child and the causes of the neurosis (fear of infection, fear of injections, closed rooms, dark rooms, etc.). Children of primary school age and adolescence are dominated by fears associated with the awareness of their physical "I" or appearance. This also includes the fear of speech in stuttering. Fear for one's health is often transferred to loved ones and appears in the form of fear for the health of parents. A special type of phobic neurosis in adolescents is the neurosis of "expectation", which is characterized by anxious expectation and fear of failure when performing a task (V.V. Kovalev). At school age, the fear of expectation is often associated with the difficulty of verbal responses (self-doubt), with unpleasant conversations between parents, etc.

With obsessive-compulsive neurosis, younger children develop tics, coughing (often associated with previous somatic illnesses), and older children develop defensive reactions, often in the form of ritual reactions. All obsessive actions are closely associated with negative affective experiences, especially with obsessive fears. Children with obsessive fear of infection often wash or shake their hands. Concern for their own health or the health of their parents makes them perform conditional protective actions.

Various statements, fears, actions in obsessive compulsive disorder must be taken into account by the teacher. It is necessary to find out the causes of these conditions, advise you to contact a specialist for medical and psychotherapeutic measures. Only a doctor can carry out a differential diagnosis, see the difference between neurotic reactions and a sluggish form of schizophrenia (neurosis-like), requiring other methods of therapeutic action.

Some forms of asthenic conditions that develop in children after undergoing prolonged infections or traumatic brain injuries should be distinguished from neuroses in the proper sense.

Cerebral asthenia is an expression of the depletion of the nervous system, in which there is a weakening of the main nervous processes and a tendency to develop inhibition. Disorder of the cerebrospinal fluid causes a number of symptoms in the form of headaches, dizziness, and nausea. Reduced reactivity of the cortex causes some changes in the course of conditioned reflex activity, which is manifested in some lethargy of thinking, weakening of memory, rapid exhaustion in the classroom. This is primarily reflected in the child's performance and academic performance. Therefore, in the practice of selecting children for auxiliary schools, diagnostic errors are sometimes made, when a temporary weakening of mental activity in children as a result of nervous exhaustion is taken for mental disability such as oligophrenia.

A fundamentally important point in the work of doctors and pedagogical defectologists is the ability to distinguish between truly nervous children and those neglected in educational and pedagogical terms. Both children can have many similar traits in behavior: instability of mood, tendency to affect, rudeness, aggressive antics, poor academic performance, etc. However, with seemingly similar forms of behavior, the nature of these violations is different. Endurance, the ability to keep oneself in a team, the ability to control oneself and achieve the intended goal from a physiological point of view are largely due to the correct work of active cortical inhibition. I.P. Pavlov attached great importance to this type of nervous activity, pointing out that the inhibitory process keeps excitation "in a fist" and is the master in the cerebral cortex. The system of educational activities carried out from early childhood, when parents and educators point out to the child the correctness or incorrectness of his actions, encourage or apply reasonable punishment, first of all forms the consciousness of the child. The process of upbringing from a physiological point of view is, first of all, the training of conditioned reflex activity, the creation of the necessary stereotypes in behavior, certain skills and habits. Therefore, upbringing is always an active, effective process, the significance of which is enormous in shaping the personality of a young person. Through upbringing, we develop the best sides of his personality in the child and suppress the negative ones that prevent him from successfully moving forward on the path of life.

Diseases transferred by a child sometimes do not pass without leaving a trace, but pathologically change the basic properties of nervous processes, as a result of which various neurodynamic disorders may occur, which, of course, will affect the child's behavior. In such cases, we can meet with various forms of children's nervousness, caused by one or another pathology of the nervous system. At the same time, there are often children in life who are also characterized by negative traits in their behavior. They are rude, irritable, do not know how to control themselves (there is no necessary endurance), they are characterized by absent-mindedness, inattention in the classroom, their ability to work is low. Clinical and pedagogical studies of such children more often show that they did not tolerate any nervous diseases, that there were no other negative factors that could cause depletion of their nervous system. In these cases, it is often necessary to state that these children, first of all in the family, did not receive the proper systematic upbringing, the parents did not take care of them at all and they were left on their own. Hence, the formation of their consciousness and character took place chaotically, without the necessary corrections, instructions, i.e. without the active intervention of adults, and sometimes under the influence of immoral companions. In other cases (the only children in families), due to the unconsciousness of the parents, any reasonable upbringing was generally excluded. Such a child grows up in pampered conditions and turns into a little despot, master of the situation. Negative traits in the behavior of such children cannot at all be interpreted as the result of nervous pathology, these are the fruits, first of all, of poor upbringing.

Hence, in the clinical and pedagogical analysis of children with negative changes in character, it is always important to establish the root cause of behavioral disorders. It would be very wrong to associate various difficulties on the path of a child's development only with the pathology of the neuropsychic sphere. The term “nervousness” should not be unduly expanded, as many of the breakdowns in children’s behavior are the result of poor parenting.

Nervousness in childhood is not at all a stable condition, especially when it comes to forms that

They proceed according to the type of neurotic reactions. They also have the opposite development. The plasticity of the nervous system in children and its ability to compensate greatly contribute to this. However, in order to more quickly correct pathological changes in the child's nervous system, active intervention is necessary from both the doctor and the teacher. The correct direction of home education on the part of the parents is also of great importance.

Medical and pedagogical activities. The arsenal of medical influence in relation to nervous children is very large. Here, it is important to establish the correct mode of life for the child in the sense of a rational alternation of work and rest, timely nutrition, mandatory and sufficient time to stay in the fresh air, the use of the healing properties of physical education and sports. With some forms of nervousness, drug treatment is of particular importance, as well as some types of physiotherapy, mainly quartz (exposure to the mountain sun), water procedures, etc. However, it would be wrong to imagine that the treatment of an unbalanced nervous system, various pathological changes in the behavior of a child is only competence a doctor, and teachers and parents can be passive observers of how, after powders or procedures, a sharp improvement occurs in the behavior of a nervous child. This usually does not happen. Educators and parents, using the instructions of a specialist doctor, should actively participate in correcting the neuropsychiatric instability of the child. Only by joint efforts, by a single line of influence, lasting success can be achieved.

Undoubtedly, the role of teachers is very important here. The teacher observes the child in the class every day, knows the home environment well, and his help can be very valuable. First of all, it is necessary to find out if there are reasons that support the child's neurotic state in the home. If familiarization with everyday life allows you to establish a difficult family situation - frequent quarrels and scandals between parents, unequal attitudes towards children, etc., urgent action must be taken. Authoritative advice to parents from a doctor and teacher often makes them, at least outwardly, change family relations. Sometimes the home environment is of a different nature: excessive attention to the child, the fulfillment of all his desires, the creation

Greenhouse environment. This is no less harmful. The child learns to look at himself as a patient, tries to exaggerate his discomfort in order to prolong and intensify his attention to himself. Exceptional harm is caused by inconsistency in actions between the school and the family, as well as in the family itself - a different approach to the child on the part of the father and mother. It so happens that a doctor or teacher advises parents to adhere to certain rules in home education. These rules relate to the establishment of a normal daily routine, reducing the number of various entertainment. Some parents ignore the instructions of a teacher or doctor, do the opposite, allow themselves to speak disrespectfully about school, teachers, reduce their authority in the presence of children, and then they are surprised that the behavior of their son or daughter is getting worse. It is not uncommon for the mother to follow one line in relation to the child, demanding from him a clear fulfillment of his duties, adherence to the regime with regard to work and rest, and the father cancels all the instructions of the mother, sometimes in a rude form. Such a contradiction in the nature of the impact on the child leads to an even greater instability of the emotional-volitional sphere, to an increase in the frequency of affective breakdowns in behavior.

Sometimes the neurotic state in some children is supported by a conflict situation at school (violation of the correct relationship with the children's team). In these cases, the experienced educator must immediately eliminate the conflict and create healthy relationships in the classroom being led. There are frequent facts of exacerbation of neurotic reactions in connection with the difficulties of assimilating knowledge. Some children, as the program becomes more complex, experience difficulties and begin to receive unsatisfactory grades. This causes them a number of difficult experiences. In such cases, the teacher needs to organize help for such children from stronger students.

Light physical labor in the air is very useful for nervous children; it is useful to involve them in various circles of manual labor. Finally, with pronounced forms of depletion of the nervous system and unsatisfactory home conditions, children should be sent to a children's sanatorium or a sanatorium pioneer camp.

One of the effective forms of therapeutic and pedagogical impact on nervous and pedagogically neglected children is

Skillful influence is applied with the word (psychotherapy). Of course, not every conversation with a child can be attributed to psychotherapy. Here it is supposed to conduct individual, specially organized conversations of a doctor or teacher, in which, first of all, it is necessary to establish contact with the child. In these conversations, the child's wrong behavior is revealed, and the bad consequences that may arise and affect the child's health and life prospects are pointed out in a cautious manner. Here, advice is given on how to restrain your affects, strengthen the will, and develop the correct forms of behavior in a team. Skillful and systematic conduct of conversations often has an extremely beneficial effect in the sense of correcting the instability of the emotional-volitional sphere of nervous children.

§6. Diseases of the endocrine glands

The waste products of the endocrine glands - hormones - affect the metabolic processes in the cells and tissues of the body, on the growth of the body and puberty, on the mental development of a person, on the activity of various organs and systems. Endocrine glands contribute to the life and development of the body as a whole. These glands are closely related to each other, and are also interconnected with the nervous system. The general reactivity of the body, the course of a number of pathological processes, for example, infectious, wound healing, etc., depend on the state of the nervous system and the activity of the endocrine glands.

Under the influence of various harmful factors, the activity of the glands can be disrupted - a number of pathological conditions arise in the body, which are characterized by the originality of manifestations. The prolapse of the activity of individual glands can cause negative changes in both the physical and mental state.

Dysfunction of the glands is usually expressed either in increased (excessive) hormone production, or in a weakening of the activity of the gland. Both the first and the second violation are unfavorable for the body.

Consider the structure and function of some endocrine glands and diseases associated with their defeat.

The pituitary gland, or the lower appendage of the brain, is located in the middle of the base of the brain, in the deepening of the Turkish saddle of the sphenoid bone of the skull, with its leg it is connected to the region of the interstitial brain - the hypothalamus.

In the pituitary gland, three lobules are distinguished: anterior, middle and posterior. The pituitary gland produces a number of hormones. Pituitary hormones affect the activity of internal organs, the activity of other endocrine glands (gonads, adrenal glands), and vascular tone. In addition, the hormones of the pituitary gland directly affect the activity of the cells of the interstitial brain, the axons of which, in turn, regulate the functions of the pituitary gland, as a result of which a complex system of interaction is created - the neuroendocrine system.

When the pituitary gland is damaged, a number of disorders occur, which can manifest themselves in different ways. Let's point out the main ones.

With the defeat of the anterior lobe, growth disorders occur (Fig. 78), and in cases of hormonal hyperfunction, an accelerated growth of the body in length (gigantism) is observed. This disorder is more noticeable in adolescents who are characterized by abnormally tall stature. Most often they are tall, thin, with a narrow chest and pale skin. In some, the hands and feet are disproportionately enlarged. There is a lack of pulse, the limbs are cyanotic and cold to the touch. The genitals are often underdeveloped, in adolescent girls, the mammary glands are undeveloped, menstruation is late. Usually, the movements of these adolescents are awkward, motor skills are lagging behind in their development. From the psyche

In the middle - normal, on the left - a hypophyseal dwarf (height 100 cm), on the right - a patient with gigantism

They are more often characterized by general lethargy, apathy, they have poor, scattered attention, poor memory, although, as a rule, no pronounced intellectual disorders are observed. Due to their growth, they involuntarily attract the attention of others and are often made the object of rude jokes and witticisms, which causes them to be gloomy, withdrawn, sometimes irritable, prone to affects. Sometimes among them there are good-natured, simple-minded, weak-tempered, who quickly fall under the influence of other children.

Sluggish function, or dysfunction, of the pituitary gland can cause the opposite phenomenon - growth retardation, sometimes to a pronounced degree (dwarfism, dwarfism). Usually, a characteristic sign, in addition to small stature, is early withering of the skin, underdevelopment of the genitals. Usually, intellectual disabilities are not observed. Features of infantilism are noted, in some - a tendency to jokes, witticisms, a kind of euphoria (heightened cheerful mood). However, more often in connection with physical inferiority, mental infringement develops in the form of alienation from the team, isolation, suspicion, and aggressive outbursts. In addition to growth disorders, with damage to the pituitary gland, severe metabolic disorders (carbohydrate, fat) can occur. Moreover, in some cases, there is an increased metabolism, which can lead to a sharp emaciation (pituitary cachexia), which is rare in children. In other cases, on the contrary, there is a sharp obesity. Such children are characterized by excessive fat deposition, especially in the area of ​​the face, chest, buttocks, and abdomen. The genitals are underdeveloped. Usually, this group of patients is characterized by general lethargy, rapid fatigability, later, in adolescence, a feeling of their own inferiority grows.

The reasons leading to dysfunction of the pituitary gland are different. More often this is the effect of intoxication after past diseases, especially encephalitis, syphilis, tumors, tuberculosis, congenital anomalies.

The epiphysis, or superior cerebral appendage, is located between the optic hillocks and the quadruple, consists of glandular cells and neuroglia; associated with the diencephalon.

The pineal gland function is especially important in childhood, it functions until puberty. Starting from the age of seven, the pineal gland gradually decreases in volume, and by the age of fifteen, its function completely dies out and is almost completely replaced by the activity of the gonads, which by this time develop and begin to function intensively. The pineal gland inhibits the development of the gonads.

The destruction of the pineal gland (more often by a tumor, tuberculosis) leads to premature puberty. In such cases, in 7-8-year-old boys, the genitals correspond to the genitals of adult men. Girls 10-11 years old develop mammary glands, menstruation appears. In connection with the sharp shifts in the neurohumoral system, the psyche of such children acquires psychopathic features.

Thyroid. Located on the neck in front of the larynx and trachea. By the time of birth, she is fully formed. Consists of three lobules: two lateral and one median. Each lobule consists of vesicles - follicles containing a colloid.

The hyperfunction of the gland is characterized by an increased release of thyroxine, in connection with which thyrotoxicosis develops. In this case, the gland is markedly increased in volume (goiter). The disease is accompanied by various symptoms. The patient begins to complain of headaches, rapid fatigability, weakness. There is a sharp loss of body weight, sweating, increased heart rate. The psyche changes: the patient becomes highly excitable, suspicious, irritable. The ability to work drops sharply. A characteristic symptom of the disease is growing bulging (exophthalmos). Intelligence usually does not suffer. In childhood, pronounced forms of thyrotoxicosis are rare, sometimes erased forms take place. At the same time, children are capricious, irritable, impressionable, and it is difficult to concentrate. Restless sleep, terrible dreams are frequent. The hypofunction of the gland is associated with a decrease in the production of the hormone, more often in connection with the atrophy of the gland. Such a violation causes the development of two diseases: myxedema and cretinism.

Myxedema, or mucous edema, is observed in patients with insufficient thyroid function that occurs from early childhood with underdevelopment or insufficient thyroid function. The phenomena of myxedema are possible when the thyroid gland is removed or irradiated with X-rays. Clinically, young children have dry skin, swelling of subcutaneous adipose tissue, retardation of psychophysical development. If treatment is not started at an early age, profound mental retardation develops. In adolescents and adults, insufficient thyroid function is manifested by general weakness, dysfunction of the cardiovascular system and the gastrointestinal tract. Patients have special swelling of the skin, hair loss, splitting nails. They become lethargic, apathetic, drowsy, complain of chilliness (due to a reduced metabolism).

Cretinism often develops in those places (mountainous regions) where there is not enough iodine in the water, which is necessary for the formation of thyroid hormones. The development of cretinism occurs in utero, the child is born with certain physical disorders: imbalance of the skeleton and limbs, an increase in the size of the skull (Fig. 79). Intellectual development is different: from successful to significantly reduced.

Parathyroid glands. These are paired glands located along the back of the thyroid gland. The glands are structurally different from the thyroid gland and have their own hormonal secretion.

In case of damage, there is a violation of the exchange of calcium in the body and vitamin D, resulting in convulsions (tetany). True tetany is closely related to rickets. Children are more likely to have muscle cramps in the face, pharynx, arms, and legs (spasmophilia). In addition, tooth decay is observed. Sometimes there is a spasm of the glottis (laryngospasm) as a result of spasms of the muscles of the larynx in the form of isolated seizures. Increased excitability of peripheral nerves. Children are shy, absent-minded, prone to night fears, enuresis.

The thymus (thymus gland) is located behind the sternum. The thymus regulates the formation and functioning of the immune system, affects the growth and development of the body as a whole.

The thymus gland normally undergoes reverse development (atrophies) by the age of 13-15. Many researchers associate this period with the onset of puberty.

Aplasia and hypoplasia of the thymus is accompanied by symptoms of primary immunodeficiency (recurrent inflammatory diseases of the respiratory tract and intestines), which are often the cause of the death of the patient. With congenital thymomegaly, immediate death is possible. Tumors of the thymus gland (thymomas) in children cause respiratory distress due to tracheal compression. Thymomas can be combined with myasthenia gravis, etc. But in some cases, after removal of an asymptomatic thymoma, severe myasthenia gravis developed.

The adrenal glands (adrenal glands) are located in abdominal cavity over the kidneys. The gland consists of two layers - cortical and cerebral.

The adrenal glands secrete many hormones: adrenaline, carotene, cortisone, etc. The hormones secreted by the adrenal gland regulate metabolism in the body, increase the body's stability, and contribute to its adaptation.

The adrenal medulla produces the hormone adrenaline (fear hormone), which enhances the activity of the cardiovascular system, inhibits intestinal activity, and affects carbohydrate metabolism.

Adrenal dysfunction causes adisson's (bronze) disease. With it, there is a loss of appetite, weight loss, a drop in blood pressure, and sometimes seizures. Due to the deposition of pigment, the skin becomes bronze in color. More common in adolescents 14 - 16 years old. Overactive cortical substance causes a condition called hypercortisolism, accompanied by changes in the genital area.

The sex glands develop and function in the human body later than other endocrine glands. They have a great influence on the growth and development of the organism, the appearance of secondary characteristics characteristic of a given sex. The sex glands include: testes in men, ovaries in women.

Consider the painful manifestations that occur when the gonads are affected.

In boys who have undergone castration for one reason or another, as well as various testicular diseases that caused

A decrease in their function, in the period preceding puberty, eunuchoidism appears. Eunuchoids have a distinctive appearance. They are distinguished by their high growth (eu-nuchoid gigantism), but, which is typical, mainly due to the length of the legs. With age, secondary sexual characteristics do not appear. In young men, there is no hair on the face, pubis and armpits. The voice is weak, thin (the larynx is not developed). The chest is narrow. The skin is pale, rich in fatty layer. There is no sex drive. Neuter children are also somewhat retarded in mental development. Adult castrates are impulsive, irritable, childish.

Testicular hyperfunction occurs in some tumors. Then the opposite clinical picture is observed. Secondary sexual characteristics appear early, the voice coarsens, and sexual desires arise prematurely.

Disease-induced ovarian hypofunction in women is associated with a violation of the manifestation of secondary sexual characteristics (there is no pubic hair, the mammary glands and genitals do not develop, there is no menstruation, or they are irregular). Sometimes there is general obesity. Mental development changes. Ovarian hyperfunction often occurs with tumor lesions. Then the girls have all the signs of early puberty. When the tumor is removed, all pathological phenomena of early development disappear.

Having familiarized ourselves with the functions of the endocrine glands, we can establish how important they are in the general vital activity of the organism.

However, the activity of the endocrine glands is not isolated, but is subordinated to the reflex influences of the central nervous system.

Children with diseases of the endocrine glands with intact intellect are taught in a mass school. In cases of endocrinopathies, for example, with pronounced hypofunction of the thyroid gland, intelligence is reduced. These children go to a special school.