Astheno neurotic behavior. Aseptic necrosis of the femoral head

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A condition called avascular necrosis of the glans femur, occurs quite often. Women get it several times less often than men. It is typical that 2/3 of patients are young people 20-45 years old. This is a rapidly progressing disease.

With absence proper treatment threatens joint dysfunction and, ultimately, loss of ability to work.

This is why it is important not to miss the first symptoms of the disease.

The main causes of the disease

Femoral head- This is a closed compartment, sensitive to circulatory disorders that change the architectonics of the bone.

The head is supplied with blood through three small arteries. When one of them stops (disrupts) the blood supply, necrosis (ischemia, necrosis) occurs in the area of ​​the head that the damaged artery supplied.

The essence of asthenic necrosis is a violation of microcirculation and further necrosis of the area bone tissue in the head of the femur bone. As a result, the integrity of the cartilage covering this area is disrupted, and secondary deforming arthrosis develops.

Vascular causes

Common Causes cessation of blood supply to the femoral head by the artery:

• compression or twisting of an artery due to injury,
• its blockage with a small blood clot,
• venous stagnation,
• prolonged vasospasm,
• increased blood viscosity,
• impaired venous outflow.

Vascular disorders increase intraosseous pressure, leading to mechanical destruction of bone tissue.

About mechanical theory

The vascular theory of causes is complemented by the “mechanical” theory. According to it, the head of the femur experiences “overwork.”

Impulses about this are sent to the cerebral cortex.

Reverse signals lead to vasospasm or blood stagnation, disruption metabolic processes, accumulation of decay substances in the bones.

As a result, the physicochemical and structural properties of the bone change, which is gradually destroyed with difficulty in local blood circulation.

Metabolic disorders and pathological conditions

Among them as the causes of the disease are in the lead:

• prolonged use of alcoholic beverages;
• long-term use of corticosteroids in large doses; patients with arthritis or bronchial asthma take corticosteroid hormones (metipred, prednisolone, etc.) for a long time;
• chronic pancreatitis;
• large doses of radiation exposure;
• decompression sickness;
• osteomyelitis;
• sickle cell anemia and other diseases,
• injuries (hip bruise, dislocation hip joint, femur fracture, etc.).

One of the causes of the disease is a congenital defect in the form of hip dislocation (hip dysplasia).

Symptoms and diagnosis of the disease

Stages aseptic necrosis of the head of the hip joint with distinctive symptoms:

1. Initial. Pain serves as a starting point clinical manifestation. It grows to a maximum and becomes unbearable within the first two or three days. Usually appears in the groin, less often in the thigh, knee joint, and lower back. The joint retains its full mobility.
2. Second– impression fracture. The patient has constant severe pain in the joint even at rest. Over a period of several days to six months, vascular disorders develop. Atrophy of the thigh muscles is possible. The sore leg seems to decrease in volume. Movements are limited. There is a slight limp in the gait.
3. Third– secondary arthrosis. Over 6-8 months, the bone beams are destroyed and the head of the femur is deformed. There is severe pain in the joint. Movements are limited in three directions. When walking, there is initial pain, moderate lameness, and a desire for support.
4. Fourth. When the disease lasts more than 8 months, complete destruction of the head occurs. Constant pain in the joints of the hip and knee, in the lower back. Movements are severely limited. Atrophy of the muscles of the buttocks and thighs is severe. The affected leg becomes shorter; in the more severe version, it lengthens.

Diagnostic methods

Widely used methods of diagnosing the disease relate:

1. MRI. Early stage detected by magnetic resonance or computed tomography. This diagnostic method almost 100% detects the disease when x-rays “do not see” it. Therefore, during the first weeks of the disease, diagnosis using MRI is a priority.
2. Radiography. Aseptic necrosis on x-ray becomes noticeable only at 2-3 stages of the disease. When the disease has been “experienced” for more than a year, its signs appear very clearly in the photographs. At this stage, a tomogram is not needed.
3. Radioisotope scanning. This method shows unequal absorption of the radioactive drug by pathological and normal bone tissue. The administered dose of the drug serves as a “tag” for the abnormal zone in the bone. The result is a two-dimensional image showing the affected areas of the bone.

Radiographs of patients with various stages of aseptic necrosis of the femoral head: from a - initial stage, to d - complete destruction of the bone.

Treatment and pain relief using conservative methods

Drug therapy

To the main groups of medications, used to treat the disease include:

• Anti-inflammatory non-steroidal drugs , for example, indomethacin, piroxicam, butadione, etc. They help reduce pain in the hip and groin. This group of medications does not cure the disease. But due to the analgesic effect, reflex muscle spasm during pain is prevented. These medications are especially effective in the first six months of the disease.
• Vasodilators, for example, trental, theonicor. They eliminate stagnation in blood circulation. As a result, arterial blood flow is activated and spasms of small vessels are relieved. Vascular night pain in the affected joint is reduced. Effective in the first 6-8 months of the disease.
• Bone tissue regenerators. Products containing vitamin D (calcium D3 forte, oxidevit, natecal D3, etc.) help stimulate the recovery process. These drugs promote the accumulation of calcium in the head of the affected femoral bone.
• Calcitonins effectively stimulate bone formation and eliminate bone pain. These include miacalcin, sibacalcin, alostin, etc.
• Chondroprotectors(chondroitin sulfate and glucosamine) provide nutrition to cartilage tissue and restore the structure of damaged cartilage. The treatment is effective over a period of 8 months.

Therapeutic gymnastics and massage

One of the most important methods treatment of necrosis of the femoral head is physiotherapy . Without it, it is impossible to overcome the progressive deterioration of blood circulation in the area of ​​the femoral head and the increasing atrophy of the thigh muscles.

It is necessary to choose exercises to strengthen the muscles and ligaments of the sore leg. Moreover, there should be no pressure on the head of the femoral bone without active flexion-extension of the legs.

An example of a static exercise is a small straight leg raise in a supine position. The leg is supported by weight. Fatigue will appear, although the joints do not work. The set of exercises should be carefully considered with your doctor.

Massotherapy used as an additional treatment method. But if you do it competently, without harsh pressure, it will bring real benefits. By massaging the thigh muscles and back, blood circulation improves.

Orthopedic rules

It is very important to follow the orthopedic regimen. Many experts are against long-term use of crutches and bed rest at the onset of the disease.

In their opinion, this threatens:

• progressive muscle hypertrophy,
• formation of persistent pain syndrome,
• violation of motor stereotypes.

For facilitating the course and shortening the duration of the disease required:

• walking up to 20 min. at an average pace,
• walking up the steps,
• swimming,
• exercises on an exercise bike,
• using a cane in the first weeks and during long walks,
• fight against excess body weight.

It is necessary to exclude inertial loads on the joint in the form of lifting heavy objects, jumping, and running.

Surgical treatment of the disease

Surgical intervention is resorted to when conservative measures are unsuccessful.

Femoral head decompression

The surgical method of decompression consists of drilling a canal into the area of ​​the femoral head with no blood flow. The drill passes along the greater trochanter and neck of the femur.

Goals of decompression:

• increased blood supply to this area due to the growth of new vessels in the formed channel (puncture),
• decrease in intraosseous pressure in the femoral head.

By reducing blood pressure, pain is reduced in 70% of patients.

Fibula autograft transplantation

Unlike decompression, a fragment is transplanted into the drilled cavity fibula, located on the vascular pedicle. Such a graft from one’s own body improves blood flow and strengthens the femoral neck.

Hip replacement

It consists of completely replacing the damaged hip joint with an artificial one. A titanium pin (or zirconium) with an artificial head at the edge of the joint is inserted into the formed cavity of the femur bone and fixed.

At the same time, the second articulating part of the joint is operated on, inserting a concave bed to rotate the new head in it. Correctly performed surgery eliminates pain and restores joint mobility.

Timely and competent treatment of necrosis of the head of the hip joint in most patients results in improvement within several months of therapy.

In another part of the patients, the condition stabilizes, which does not lead them to surgical measures.

Video: What systemic diseases can provoke the development of GBC necrosis

Asthenic neurosis is a disease that was first described by the American physician Beard in 1880. Asthenic neurosis is one of the most common forms of neurosis. It is characterized by increased excitability and increased exhaustion. Its causes are the same as those of other types of neurosis - psychological shocks against the background of acute and extremely negative emotions. However, the following points should be emphasized, which serve as additional unfavorable factors: lack of consistency, planning and rhythm in work; negative emotions related to work; irregular alternation of work and rest. Large overloads (both mental and physical) can be harmful, especially for people of an asthenic type. Poorly organized family life and daily routine often contribute to the detection of neurasthenia.

Asthenic neurosis develops as if in stages. Initially, external psychogenic trauma causes a painful reaction with massive vegetative symptoms in the form of various unpleasant sensations in the heart, breathing, “nervous” shortness of breath develops, and unstable blood pressure is detected. As a result of this, a depressed mood appears and, finally, “mental processing” of everything that happened to the person, an idea of ​​\u200b\u200bthe disease is formed.

The asthenic symptom complex is very polymorphic (multiple). Polymorphism depends on the initial state of the body, on the cause that caused the disease, on the individual’s responses.

I.P. Pavlov divided this neurosis into two clinical forms: hypersthenic and hyposthenic. A mixed form was subsequently described. Neurasthenia can begin with one form and change during its course. It should be noted that with neurasthenia, regardless of its form, there are common (they are also called “end-to-end”) symptoms: headaches, sleep disturbances, various unpleasant sensations throughout the body and various somatic and autonomic disorders. Headaches are an almost obligatory symptom of neurasthenia, they can be periodic or constant. The whole head or individual areas hurt. With neuroses in general and, in particular, with neurasthenia, sleep disturbance syndrome occupies a special place. The nature of the sleep disorder is heterogeneous. The most common disorder is sleep disturbance. Sleep occurs several hours after the patient goes to bed. Falling asleep is prevented by an influx of thoughts related to past events of the day. “Fragmentary sleep” is often observed, in which the patient, through a short time wakes up and then goes back to sleep. And so on throughout the night. As a result, the patient sleeps only a few hours. Sometimes patients note that their sleep is superficial, shallow and accompanied by difficult dreams. And finally, the most unpleasant thing, according to patients, is that sleep does not bring a feeling of vigor and relaxation.

Somato-vegetative disorders occupy a significant place in the clinical picture of neurasthenia. The most pronounced complaints are from the heart and vascular system. There is a tendency to spasms of the heart vessels, which is why unpleasant functional sensations appear in the heart area (without organic lesions). Unstable blood pressure is observed, sweating increases, and there may also be functional disorders from the outside gastrointestinal tract. Reflexes are increased. There is a sensitivity disorder. For some, this manifests itself in the fact that they cannot tolerate bright light, they perceive noise acutely, ordinary sound seems very loud, and any touch to the body feels painful. Others have a perception outside world dulled. This indicates a decrease in sensitivity. Such people experience a feeling of constant fatigue and weakness. In some patients, a decrease in performance is observed in the evening, while in others this phenomenon is observed throughout the working day.

A very significant sign of an asthenic state with neurosis is the loss of interest in many things that previously occupied a person, and especially in his favorite activity.

Patients are restless motorly. They find it difficult to stay still. The wait is painful. Irritability over trifles is expressed. There is increased sleepiness during the day due to poor night sleep, the clinical picture reveals absent-mindedness, and it is difficult to concentrate on any one subject. Due to the narrowing of attention span, patients complain of poor memory. During recovery, attention and memory are quickly restored.

The mood is depressive, tearful. People with feeling; duty and responsibility are worried about the fact that they are not coping with the matter. They stay after work and take papers home, all of which aggravate their condition. Temporary sexual disorders are noted.

Despite the similarity of signs of fatigue with an asthenic state, there are significant differences. If the decrease in performance due to fatigue is completely removed after active rest and a good night's sleep, then with an asthenic condition, treatment is also required. The asthenic state is closer to the concept of “overwork.” When overwork changes; are more persistent in nature and acquire a certain inertia. Fatigue should be considered as transition state to asthenia. Discomfort due to overwork is colored by negative emotions. Coping with asthenic neurosis and choosing competent treatment Only a specialist in a neurosis clinic or a specialized dispensary can.

The following observation can serve as an illustration of asthenic neurosis with astheno-depressive syndrome.

Patient M., 31 years old, works as a translator, has higher education. As a child, I grew up as a weak, frail child. Transferred chicken pox, rubella. I often caught colds. Then she got stronger. She graduated well from high school. I was studying rhythmic gymnastics. After graduating from school, she entered the pedagogical institute at the faculty foreign languages. She graduated successfully and worked all the time as a translator. She was sociable, balanced, cheerful by nature and loved company. She married the man she loved. Has a 7 year old daughter and a 6 month old son. She lived well and amicably with her husband.

The illness began after her husband arrived from the resort, when he announced to her that he was leaving for another woman. For the patient, it was “a bomb exploding at her feet.” At first I didn’t believe my husband’s message. When I came to my senses, I began to feel bad.

She developed weakness, lost her appetite, and lost noticeable weight. Trifles irritated me. I practically couldn’t work. On the one hand, indifference appeared; they even stopped being interested in children. On the other hand, she thought a lot about how her future life would turn out. In this condition she was sent to the hospital.

On examination: fragile physique, mournful facial expressions; complexion pale. Arterial pressure reduced. Unpleasant sensations in the heart area. Extremely exhausted both mentally and physically. In the hospital, despite outwardly correct behavior, she is somewhat fussy, cries, and cannot occupy herself with anything. The attitude towards the events that took place is correct and adequate. Against the background of massive psychotherapy in combination with medication and physiotherapeutic treatment, an established regimen, the patient’s condition leveled out, asthenic neurosis and its manifestations disappeared. The patient returned to her previous job.

Asthenic neurosis, or neurasthenia, is a psychological disease that occurs as a result of prolonged physical or emotional stress. Most often, the nervous system is depleted in people from 20 to 45 years old, during the period of active life. Working 24 hours a day, lack of rest, conflicts at work or in personal life, constant stressful situations invariably lead to the appearance of neurasthenia. The main point in the treatment of neurosis is to eliminate the main cause of the disease.

Treatment of neurasthenia

When treating any psychological disease, and asthenic syndrome in particular, it is necessary to use A complex approach. This method of therapy includes eliminating the main cause of neurosis, normalizing the daily routine, using medications and psychological techniques.

First of all, you need to change your daily routine

For clarity, you can write down all the important events point by point and pay great attention to rest. Treatment of asthenic neurosis involves clear regulation of the time of going to bed and the time of waking up. It is recommended to do this before going to bed hiking in the park, thus saturating the body with oxygen.

It is also necessary to pay attention to the diet; it is better to replace flour and fatty foods with vegetables and fruits. You can’t overeat at night; yogurt or a light vegetable salad will come in handy. A change of scenery would be a good idea; if your planned vacation is still far away, take an exciting walk on the weekend.

New impressions at the beginning working week will allow you to perform your immediate duties with great pleasure. In cases where your main place of work involves a busy schedule, especially with night shifts and nervous stress, you will have to think about changing your workplace.

Use of medications

• To improve anabolic processes, doctors recommend taking calcium glycerophosphate and iron.
• Also assigned on an individual basis medicines, containing caffeine and bromine.
• Asthenic neurotic disorder involves taking tranquilizers, the dosage regimen and dosage of which is prescribed only by the attending physician.
• For hyposthenic neurosis, medazepam, trioxazine, strong coffee or tea are taken.
• Thioridazine in small volumes has an antidepressant effect, and with increasing dosage it has a calming effect.
• Sleeping pills are not prescribed for this form of manifestation of the disease.
• For the hypersthenic variety of neurasthenia, it is recommended to take oxazepam and elenium.

Regardless of the form of the disease, treatment of neurasthenia is also carried out using physiotherapy: aromatherapy, soothing massage, reflexology will allow tense muscles to relax and calm down. Electrophoresis with calcium and bromine ions is also widely used.

It’s a good idea to use autogenic training and swimming in the pool to treat disorders of the nervous system. Traditional medicine allows the use of medicinal herbs to normalize sleep and strengthen the nervous system. Valerian, motherwort, and hawthorn tincture have long been used by people to calm and treat insomnia.

Contact a specialist

If you can’t cope with a difficult situation on your own, it’s time to seek help from a doctor. A psychiatrist or neurologist can identify the symptoms of asthenic neurosis and prescribe appropriate treatment. In psychology, there are various methods for treating neurasthenia in women and men: individual and group psychotherapy, psychoanalysis. The doctor decides which method is best for the patient after individual communication with the patient.

The main goal of treating mental disorders is to reassess the situation that caused asthenic neurosis. An experienced psychologist will help you figure out what is important and what is secondary in a patient’s life, what is worth spending your energy on, and what can be skipped.

Reassessing life values ​​will allow you to look at the current situation from a different angle and change your attitude towards it. It often happens that a person sets difficult goals for himself, and then blames himself for not achieving them.

Symptoms of asthenic neurosis

The symptoms and signs of neurasthenia are varied. The appearance of the following symptoms cannot be ignored:

• Headache. Very often people do not pay due attention to it. Taking a pill at the end of the working day will help you get rid of this unpleasant feeling for a while. Some people experience a feeling of tightness, as if a narrow hat was put on their head or an iron hoop was compressing the circumference of the head. There are frequent cases of dizziness, and there is no sensation of objects rotating.
• Rapid heartbeat or tingling in the heart area. Even during a calm conversation, the patient may suddenly become agitated, blush, or, on the contrary, turn pale.
• Increased blood pressure.
• Dyspeptic phenomena. In children and adults it is observed poor appetite, diarrhea or constipation, bloating, heartburn.
• Frequent urge to urinate is observed only in moments of strong excitement and stops with the onset of peace of mind.
• Decreased sexual desire for a partner.
• Insomnia. The main symptom of neurasthenia is sleep disturbance. Difficulty falling asleep and restless, fragmentary sleep do not allow the patient to feel rested and full of energy. As a result, absent-mindedness, memory problems, and instability of attention appear.
• Decreased performance. Due to changes in the patient's behavior, productivity begins to decline.
• Increased irritability. Sharp sounds capable of unbalancing a person suffering from neurasthenia. A slamming door or loud laughter can cause a whole host of negative emotions. In children, this is observed when visiting public places - the circus, cinema, concert halls.

The presence of the listed symptoms does not indicate a diagnosis of asthenic neurosis; perhaps it is ordinary overwork and chronic lack of sleep. In any case, you should consult a specialist about this.

Establishing diagnosis

The diagnosis of neurasthenia in children and adults is made by a neurologist after initial examination, studying the patient’s complaints and based on studying the general history of the sick patient. During diagnosis, tumors and inflammatory processes, taking place in the brain, intoxication, chronic infectious diseases. To do this, the patient undergoes a magnetic resonance imaging scan. Also important indicator to set character cerebral circulation rheoencephalography is used.

Prevention of disease

In psychology, asthenic neurosis has the most favorable prognosis among other mental illnesses. A timely diagnosis provides a greater chance of full recovery. In advanced cases, neurasthenia becomes chronic diseases central nervous system, difficult to treat.

To prevent the occurrence of neurosis, you need to maintain a balanced work and rest schedule, avoid constant emotional overload and physical exhaustion. You need to learn how to use relaxing techniques to relieve stress and physical fatigue. The causes of neurasthenia also lie in the desire to do everything, and the resulting disappointment, if this was not done, can cause breakdown. Good method Getting rid of asthenic neurosis is a change of environment, a trip on vacation.

It is especially worth noting the emergence of neurosis in children. Heavy school load additional classes and sections, computer games can provoke the appearance of neurasthenia in a child. In this case, the role of parents in treatment is especially important. important role. If the situation is getting out of control and you can no longer cope with it on your own, it’s time to turn to child psychologist. An experienced specialist will tell you how to treat neurasthenia in children; sometimes it is enough to reduce the workload and spend more free time on fresh air.

Life in a metropolis proceeds at a frantic pace, which leaves its mark on the life of every person. Constant stress at work, long hours of standing in traffic jams, lack of sleep, setting difficult tasks can lead to neurasthenia. This psychological illness Mostly middle-aged people are affected, and there is no division by gender. On initial stage Usually it is enough to spend more time relaxing, communicating with friends, and traveling.

A change of environment will help get rid of neurosis. However, in case of prolonged mental disorder, it is better to seek help from a specialist. An experienced psychiatrist or neurologist will prescribe courses of restorative therapy, relaxing massage, physiotherapy, and, if necessary, medications. Moderate exercise, walks in the fresh air, good sleep– these are the main components of a healthy lifestyle.

Asthenic neurosis, which is better known under the term neurasthenia, is a pathological condition of the central nervous system that arose against the background of prolonged stress of a mental nature.

Often this disease occurs against the background of long-term chronic diseases or exposure to toxic substances on the body. Depending on the form of manifestation of asthenic neurosis, treatment methods and duration of therapy differ. In this article, we will look at how to treat neurasthenia and the causes of asthenic neurosis.

Neurasthenia is a pathological condition of the nervous system that occurs as a result of its exhaustion during prolonged mental or physical overload. The conversation about who a neurasthenic is should begin with a description of the pathology itself. The asthenic form of neurosis manifests itself as a combination of irritable weakness with increased excitation of the nervous system. The presence of this disease leads to a rapid decrease in performance and disruptions in work autonomic system arising under the pressure of stress factors.

Personal tragedies and protracted conflicts often contribute to the development of neurasthenia.

Experts note that there are certain favorable conditions for the development of the disease. These include chronic poisoning of the body with toxins and diseases of a somatic nature. Most often, this disease is observed in people who spend most of their time doing hard “mental” work.

Types of neurasthenia

1. Neurosthenics are people suffering from asthenic neurosis, which is divided into two types: The first type of neurasthenia manifests itself against the background of increased stress associated with performing professional duties. This form of the disease appears between the ages of twenty and forty-five years. IN medical language
2. , the term “exhaustion neurosis” is used to refer to this type of disease. The second form of the disease is reactive.

In most cases, the causes that trigger the development of the disease are strong emotional shocks. Such reasons include: the death of loved ones, separation from loved ones or divorce of relatives. Most often, this form of the disease manifests itself in childhood and adolescence.

Causes of the disease The causes of the development of neurasthenic disorders of the nervous system can be of various types.

. In addition to vivid emotional shocks and stress, symptoms characteristic of the disease in question can appear under the influence of poisonous toxins on the body, with a decrease in the quality of the immune system and a deficiency of vitamins. Quite often, asthenic neurosis develops against the background of metabolic disorders. But it is important to note that the main reason for the development of this form of neurosis is an overestimation of the capabilities of one’s own psyche and incorrect placement of life priorities. Often, signs of the development of the disease are observed in women seeking to build their own careers. Often light form

Asthenic neurosis manifests itself in young people who are beginning to independently organize their lives. The risk group susceptible to various neuroses includes people who do not tolerate both physical and psychological stress. Most common symptom

neurasthenia is a headache

Experts identify three main phases in the development of this pathology, which have their own characteristic differences. The initial stage of the disease has a hypersthenic form, in which the symptoms of neurosis are perceived as ordinary fatigue.

It is at this stage of the disease that problems such as increased irritability and sleep problems appear. Attacks of aggression can be triggered by various little things, including a loud sound, speech, or attempts by people around to start a conversation on a sensitive topic for the patient. The second stage of the disease is characterized as irritable weakness.

People with choleric temperament are more susceptible to this form of the disease. Being at this stage of neurosis, patients have to make a lot of effort to complete their professional tasks. The situation is complicated by increased fatigue and problems with concentration. Often, prolonged brain activity leads to migraines and poor health, which forces a person to give up work for some time. The third phase of the development of the disease is the hypersthenic form of the disorder, which manifests itself in the form of increased sensitivity to irritating factors. This form of the disease is characterized by changes in behavioral patterns such as incontinence and lack of patience. In the reverse form of hypersthenic disorder, mental asthenia is more pronounced. Against the backdrop of the development of neurasthenia, the level of interest in events occurring in life decreases, chronic fatigue is observed,

constant drowsiness

and lack of desire to work.

Clinical picture Cerebral neurasthenia manifests itself as neurotic disorders in the form of migraine attacks and sleep problems. In addition, the disease is characterized by various vegetative-visceral symptoms. The neurasthenic helmet is one of the main symptoms of the disease, which manifests itself in the form of feelings high blood pressure, in the head area. In addition, many patients suffer from attacks of dizziness, which manifests itself as a feeling of spinning in the head. This symptom occurs during prolonged physical exertion, when the weather changes, and also during severe excitement. Anesthetic neurosis is also characterized by cardiovascular problems, which manifest themselves in the form of acute

Neurasthenia is a neurosis characterized by a combination of increased excitability with irritable weakness

One of important signs development of neurasthenia - a gradual decrease in performance. Chronic fatigue, drowsiness and problems with concentration lead to a decrease in work productivity. Insomnia contributes to such disorders. Even if the patient manages to fall asleep, in the morning he feels exhausted and sleep-deprived. In situations with more severe forms of the disease, the patient develops increased anxiety and various phobias. Personal and career failures lead to decreased self-esteem.

The duration of the disease depends on the presence of certain factors and characteristics of the course of asthenic disorder. In addition, it is necessary to take into account the characteristic personal characteristics, the presence of chronic diseases and the patient’s living conditions.

How does asthenic neurosis manifest in women?

Women, unlike men, are more susceptible to this nervous disorder. The fair half of humanity most often manifests a sexual form of the disorder, which manifests itself in the form of a decrease in the level of performance, increased irritability and problems in intimate life. Often the appearance of neurasthenia leads to a decrease in libido, the emergence of a categorical perception of one’s own appearance and other changes in the functioning of the nervous system.

Signs of neurasthenia in women appear under the influence of various factors, which significantly complicates the classification of symptoms. To diagnose a disorder, it is necessary to pay special attention to the condition mental health patient. Among the symptoms characteristic of “female” neurasthenia are frequent changes in mood, indifference, and lack of desires and aspirations. The presence of illness can be determined by the lack of joy and increased pickiness.

How does neurasthenia manifest in men?

Let's look at what neurasthenia in men is and how it manifests itself. According to experts, in this case, neurasthenia is closely related to functional activity. The disease manifests itself in the form of causeless irritability, as well as muscle weakness, which can, at a certain stage in the development of the pathology, lead to pain.

Based on statistical data published annually by WHO, we can say that the stronger sex is more likely to have a chronic form of asthenic psychosis. Most often, symptoms characteristic of the disease appear in men who are actively involved in sports and people with a choleric temperament. This form of pathology is characterized by the following symptoms:

• problems with concentration;
• nervous weakness;
• migraine attacks are frequent and have a long duration;
• rapid decline in physical and psychological performance.

Chronic neurasthenia at a certain stage of development leads to the patient’s inability to cope with the simplest logical tasks.

Neurasthenia is the most common form of neuroses

Diagnostic methods

In order to make a correct diagnosis, it is enough for an experienced specialist to identify the presence of the main symptoms characteristic of asthenic neurosis.

However, before prescribing treatment, the possibility of organic damage to the central nervous system should be excluded. Most neuroses tend to transform into chronic form

However, according to experts, this condition can be corrected.

Treatment methods The choice of treatment method is made by the doctor based on the severity of the disease and individual characteristics patient's personality. Today, specialists use both traditional medicinal methods and physiotherapy. Besides

conservative treatment, the patient is recommended to spend as much time as possible relaxing, doing yoga, attending massage and acupuncture sessions. But it should be mentioned that such methods do not always achieve lasting results. The main goal of therapy is to identify the cause that caused the development of neurasthenia and its neutralization

. Many experts recommend that their patients radically change their lifestyle in order to eliminate factors that negatively affect the state of the nervous system. Among these factors, chronic insomnia, frequent alcohol consumption and stressful situations associated with work duties should be highlighted. Unwillingness to change your own life significantly complicates the treatment of the disease. You can achieve lasting results only by following all the recommendations of a specialist. Considering drug treatment. An increased dosage of this drug has a sedative effect on the body, which helps get rid of insomnia. Many experts recommend that their patients completely give up bad habits and stick to a proper daily routine. It is chronic lack of sleep and the effect on the body ethyl alcohol lead to dysfunction of the nervous system.

Experts say that many patients cope remarkably well with neurasthenia on their own. You can avoid mental and physical exhaustion only through a sober analysis of your own abilities. The disease in question is quite common in the modern world, but only a few people know how to cope with it. stressful situations. In order to avoid neurasthenia, you need to learn to abstract yourself and react correctly to the acceleration of the rhythm of life.

For clinical picture neurasthenia is very characteristic of general neurotic disorders

Possible complications

In conclusion, the topics of what neurasthenia is, symptoms and treatment of a nervous disorder should be considered possible complications asthenic psychosis. Timely lack of therapy can lead to loss of ability to social adaptation. In this condition, the patient begins to experience discomfort when communicating with other people and tries to avoid others.

In addition, problems with identifying irritating factor may lead to the appearance depressive syndrome. In this case, patients experience a gradual development of a decrease in emotional mood.

In big cities, with their daily intense physical and mental stress, it is extremely difficult to maintain optimal mental balance. Therefore, it is the urbanized population that is most susceptible to the occurrence of symptoms of the so-called chronic fatigue or neurasthenia - an alternative name for such mental disorder like asthenic neurosis.

This disorder of mental functions occurs in people of both sexes, but men get it much more often. At the same time, its manifestations in women are more dramatic and massive.

Asthenic syndrome, which is characterized by fatigue and loss of strength, is not specific to neurasthenia and can form the basis of many other mental illnesses, ranging from depression to schizophrenia, therefore in itself as an independent diagnostic sign this syndrome is not considered, and to diagnose neurasthenia it is necessary to compare it with other patient complaints. Differential diagnosis requires extensive knowledge and experience from the specialist.

In a general sense, neurasthenia is a neurosis characterized by easily occurring irritability and fatigue, as well as decreased productivity in everyday work due to a drop in mental tone.

The reasons causing this condition may be:

• acute or chronic traumatic situation;
• intense mental work combined with physiological deprivation (for example, lack of sleep);
• intrapersonal and interpersonal conflicts;
• infectious diseases;
• chronic intoxication (including alcoholism);
• endocrine disorders;
• malnutrition.

The neurasthenic process is heterogeneous and occurs in stages. The first manifestations of asthenic neurosis are moderately expressed, they do not lead to significant maladaptation, and if adequate measures are taken at such an initial stage therapeutic measures, you can avoid aggravation of symptoms at subsequent stages of the disease.

There are three main stages of asthenic neurosis:

• hypersthenic form of neurasthenia;
• irritable weakness;
• hyposthenic form.

At the first, hypersthenic stage, unreasonable irritability and increased excitability arise. A person begins to react painfully to the most insignificant stimuli, for example, the sound of the TV or the sound of rain outside the window.

Under hot hand Those around you are easily surprised by such a person’s loss of self-control. It becomes difficult for the patient to cope with professional responsibilities, however, not due to fatigue or exhaustion, but due to scattered attention and distraction from the task, inability to concentrate on it. A person has difficulty falling asleep, often wakes up, and does not feel the usual vigor in the morning. During this period, there are frequent complaints of weakness, fatigue, constant headache, loss of strength, various unpleasant sensations in the body and rapid heartbeat.

At the second stage, the stage of irritable weakness, much more pronounced exhaustion and fatigue are added to excitability and irritability. Reactions of irritation become violent and numerous, and the reasons for this become more insignificant. Cognitive impairments, in particular attention deficits, become obvious to the person himself.

Concentration drops critically, work falls out of hand. The patient still complains of somatic illness - bad dream, pain in various parts of the body. In some cases, depression may develop or libido may decrease, even leading to impotence in men. If treatment of the disease is not undertaken at this stage, it progresses to the final hyposthenic form.

At the hyposthenic stage of neurasthenia, the manifestations of the disease reach their maximum. Patients experience increasing apathy, impotent weakness, explosive irritability, they are completely absorbed in their unpleasant sensations. Mobilization to carry out everyday tasks is unthinkable for them, since persistent fatigue makes them inactive and passive.

All this gives rise to intense hypochondriacal complaints, of which there is no shortage. The depressive mood background is visible to the naked eye. Anxiety may appear, and in some cases patients become tearful.

Appeal for psychiatric help necessary for such manifestations of asthenic neurosis, since chronic course with periodic exacerbations can lead to the development of cyclothymia.

What are the common symptoms and signs of neurasthenia?

Regardless of the stage of the pathology, asthenic neurosis is characterized by:

• asthenic-hypochondriacal and depressive-hypochondriacal complaints;
• sleep disturbances with superficiality, difficulty falling asleep or frequent awakenings;
• increased tendon reflexes, eyelid tremor and some other neurological signs;
• increased sensitivity (hyperesthesia) of the skin;
• sexual dysfunction in the form of decreased libido, erectile dysfunction, impotence, vaginismus, etc.;
• patient-perceived cognitive decline.

Despite the abundance of complaints from patients with neurasthenia, their subjective painful perception of their illness as extremely severe, which is caused by a depressive mood, it is extremely important to convey to them the understanding that asthenia of this type responds well to therapy and can pass without a trace, leaving no changes in the psyche and human personality.

Diagnosis of asthenic disorders

Being a mental illness of the neurotic spectrum, neurasthenia is diagnosed by a specialized specialist. In this case, the psychiatrist must, based on a face-to-face conversation with the patient and his medical history, distinguish the pathology from other related diseases that occur with asthenic syndrome. Such differential diagnosis will allow you to select an adequate therapeutic regimen.

Many people suffering from manifestations of neurasthenia for a long time they try to cope with it in other ways, but if the pathology has gone far and requires drug intervention, then such efforts will not bring results.

How is neurasthenia treated and what can you do yourself?

Treatment of asthenic neurosis is complex and involves the application of known efforts by the patient himself, since the first recommendation of therapy is to eliminate the causes that provoked the disease. It is in this matter that, in addition to drug support, you can do a lot yourself.

So, everyone can identify the cause of physical or mental fatigue, irritability and nervousness. If the patient is busy with an overwhelming job with constant pressure and hassle, it is worth simply changing it to a simpler and calmer one, which requires vacation and mandatory weekends for proper rest.

If a person falls ill due to constant conflicts and turmoil in the family, it is worth reviewing and adjusting the style of relationships between its members in order to create comfortable conditions at home that are conducive to recovery.

Mental exhaustion due to insufficient and malnutrition (for example, as a result of a special tendency to varied diets) can be well treated by establishing a balanced diet of proteins, fats, carbohydrates, vitamins and microelements.

Acupuncture and similar methods alternative medicine also sometimes give their results if the patient believes that this will help him recover. You can resort to massage, therapy with pleasant aromas and music.

In each specific case, it is better to begin treatment of asthenic neurosis immediately; it is reversed, first of all, by changing the patient’s lifestyle with the elimination of all factors that provoke an exacerbation, be it intense intellectual stress or a morally suppressive boss.

In the case of an infectious nature of neurasthenia, it is worth starting with treatment of the underlying disease, and if the genesis is intoxication, it is necessary to exclude the effect of toxic substances on the body.

Regardless of the causes of the origin of asthenic neurosis, it is indicated Spa treatment, in which balneotherapy will be an advantage.

Drug therapy and psychotherapeutic assistance

As for psychotherapy, designed to help a sick person eliminate the cause of his condition, it is effective both as individual conversations with a specialist and as group and family therapy.

A psychiatrist, based on the clinical picture of a particular patient, may prescribe:

• benzodiazepine tranquilizers, which will have a sedative (calming) effect, including reducing excitability and anxiety;
• small doses of antipsychotics (in extreme cases);
• antidepressants (if depression develops as a result of the disease).

Of course, side effects may occur during psychotropic therapy, so choosing a suitable regimen may take some time. In severe cases, it is carried out in a hospital setting.

In addition to psychotropic drugs, it is advisable to take general strengthening vitamins and mineral complexes, and in case of apathy - activating herbal tinctures with psychoactive properties, for example, eleutherococcus or Chinese lemongrass.

Prognosis and prevention of the disorder

If all recommendations are followed, the prognosis for asthenic neurosis is positive and full recovery occurs with high probability. When provoking chronic factors continue to influence the patient and cause further crises, the disorder can last for decades and significantly affect the quality of life, therefore, when its first symptoms appear, it is worth taking the necessary measures immediately.

The best prevention is social and psychohygienic measures - the creation of favorable living and working conditions, rational career guidance, avoidance of emotional overload and occupational hazards.