This feeling is so strong that a person is unable to control himself, even if he realizes that the fear is groundless and his life and health are not in danger.

When does a phobia develop?

A person can develop a phobia in two cases:

• if a person directly had a bad experience in the past regarding some thing, action, place and other similar objects. For example, after accidental painful contact with a hot iron, fear of hot objects may develop in the future;
• if the object is associated with thoughts and memories of a negative nature. For example, in the past, while talking on the phone, there was a fire or someone got hurt.

The development and occurrence of phobic neuroses are influenced by:

• heredity;
• human character: increased anxiety, constant state of worry, excessive responsibility, suspiciousness;
• emotional stress and physical exhaustion;
• disturbances in the functioning of the body's endocrine system;
• sleep disturbance and poor diet;
• infections and bad habits that cause significant harm to the body.

Often these disorders occur against the background of another disease: schizophrenia, obsessive-compulsive disorder, psychasthenia, obsessional neurosis.

The risk of phobic neurosis increases during certain periods of a person’s life: during puberty, early adulthood and immediately before menopause.

Types of phobic neuroses

The most common phobia in this moment is a fear of open spaces - agrophobia. A person suffering from this disorder, depending on the severity of the disease, either tries not to leave the house unnecessarily, or is unable to force himself to even leave his own room.

The opposite of this phobia is claustrophobia. A person is seized with fear at the moment when he is in a closed space. This is especially true for elevators.

According to the severity of manifestation, phobic neuroses are divided into three groups:

• mild degree - fear arises from direct contact with the object of fear;
• medium degree - fear arises in anticipation of contact with the object of fear;
• severe degree - the mere thought of the object of fear seizes a person into panic.

Most often, phobias arise in adolescence against the background of hormonal changes in the body, and then can develop into obsessive fears or, conversely, disappear. The beginning of such disorders is always direct or indirect contact with a future object of fear, which is negative in nature. Patients are critical of their illness and may realize the groundlessness of their own fears, but at the same time they are not able to get rid of them.

Signs of phobic nephrosis

Common symptoms of phobic neuroses include:

• panic attacks;
• irregularities in work autonomic system organs ( the cardiovascular system, respiratory, etc.);
• headache;
• general weakness;
• sleep disorders;
• depression;
• emotional tension.

All these signs are easy to detect when the patient comes into contact with the subject of the phobia.

In medicine, all symptoms are divided into 4 groups:

1. Panic attacks– severe fear and a feeling of imminent death, accompanied by increased sweating, heart rhythm disturbances, dizziness, nausea, difficulty breathing and a feeling of the unreality of what is happening.
2. Agrophobia is a fear of open spaces, large crowds of people, and in severe cases, fear of leaving one’s own home or room.
3. Hypohodrical phobias are the fear of contracting some disease or the feeling that a person is already terminally ill.
4. Social phobias are the fear of being the center of attention, being criticized or ridiculed.

Treatment of phobic neuroses

If you have a question about the consequences and treatment of phobic neurosis, you need to consult a doctor, and not self-medicate and rely on Internet resources for everything. Ill-informed treatment can only worsen the situation.

For mild forms of phobias, you can limit yourself to attending sessions with a professional psychoanalyst.

For more advanced cases, cognitive behavioral therapy is considered the most effective method. Its main task is to teach the patient to manage his own emotions and fears through a detailed examination of the situations in which an attack occurs, identifying the causes and ways to get rid of such reactions.

Drug therapy is used in combination with any psychotherapy. It is impossible to overcome a phobia with medications alone.

In addition to basic treatment methods, doctors usually recommend relaxing massage, yoga or meditation, herbal medicine, short regular rest in sanatoriums, and acupuncture.

What is anxiety neurosis?

Fear neurosis, or phobia, is neuropsychiatric disorder, which is characterized by an obsessive fear of something. Examples include such forms of phobic neurosis as:

• agoraphobia - fear of open spaces;
• claustrophobia - fear of enclosed spaces;
• aquaphobia - fear of water, and other similar disorders.

Fear neurosis as an independent form of psychasthenia was isolated from neurasthenia at the beginning of the 20th century. At the same time, the main symptoms of this were described. pathological condition. In addition to neuropsychic problems, anxiety neurosis can be one of the symptoms of a somatic disease, for example, angina pectoris.

Doctors describe a wide variety of symptoms of phobic neurosis, but nevertheless, all these signs have a common component that makes it possible to distinguish them into a separate disease.

Causes and symptoms of fear neurosis

Fear neurosis can arise either suddenly or slowly, extended over time, but gradually intensifying. The feeling of fear does not leave the sick person all day long, and does not allow him to fall asleep at night. Anxiety arises at the slightest, even insignificant, reason. The intensity of this state can vary from mild anxiety to panic horror.

What are the causes of this neuropsychiatric disorder?

Psychotherapists and psychiatrists identify the following reasons that provoke anxiety neurosis:

1. Internal conflicts repressed into the subconscious.
2. Mental and physical stress that exceeds the physiologically determined compensatory mechanisms of the body and leads to their failure.
3. Reaction to severe stress.
4. Adaptive reaction of the psyche to a recurring negative situation.

It is important to understand that all external manifestations of fear neurosis are determined by its internal component, which is firmly entrenched in the subconscious. The symptoms of this condition are closely related to the listed reasons. Manifestations of phobic neurosis may include the following somatic symptoms:

1. Nausea and/or vomiting.
2. Urinary urgency or diarrhea.
3. Increased sweating.
4. Dry throat, shortness of breath, or even difficulty breathing.
5. Tachycardia and increased blood pressure.

From the psyche and nervous system, fear neurosis causes the following symptoms:

1. Worry, fear and/or worry.
2. Violation of perception of surrounding reality.
3. Confusion or loss of consciousness.
4. Thinking disorders.
5. Panic and strong excitement.
6. Feeling of insecurity.

It should be noted that a neurotic reaction in each specific case may have some individual characteristics. However, in general they can be attributed to the manifestation of fear neurosis.

If any of the listed symptoms occur, and even more so when several of them occur and fear neurosis has been observed for a long time, it is recommended to seek medical help from a specialized doctor.

Medical care and treatment of phobic neuroses

It is worth saying right away that if treatment for this disorder is not started in time, then anxiety will only increase. In the most extreme manifestations and severe cases, this can even make you go crazy. In order to get rid of this neuropsychiatric disorder, you need to make independent attempts to improve your condition.

Here we mean self-hypnosis, regular and long walks in the fresh air, the complete exclusion of traumatic information (which can provoke anxiety) coming from the patient’s environment: television, films with relevant content, and so on. In the case when the fear neurosis is not running, you can overcome it yourself.

In such situations, the doctor prescribes behavioral psychotherapy, taking medications such as multivitamins, sedatives. In severe cases, medications such as fluoxetine and other drugs for the treatment of obsessive-compulsive mental disorders may be prescribed.

Any drug treatment must be prescribed by a doctor and carried out under his strict supervision.

In milder cases, taking medications at home is allowed, but with regular visits attending physician to monitor the patient's condition. Treatment should always be completed and not stopped at the first signs of improvement.

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Neurosis - symptoms in adults, causes, first signs and treatment

Neuroses are functional disorders of higher nervous activity psychogenic origin. The clinical picture of neuroses is very diverse and may include somatic neurotic disorders, autonomic disorders, various phobias, dysthymia, obsessions, compulsions, and emotional and mental problems.

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

What is neurosis?

Neurosis is a set of psychogenic, functional, reversible disorders that tend to last 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 vary among different social groups.

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

The term neurosis was introduced into medical terminology in 1776 by a doctor from Scotland, William Cullen.

Causes

Neuroses and neurotic conditions are considered a multifactorial pathology. Their occurrence is caused by a large number of reasons that act together and trigger a large complex of pathogenetic reactions leading to pathology of the central and peripheral nervous system.

The cause of neuroses is the action of a psychotraumatic factor or a psychotraumatic 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, we talk about the long-term, chronic impact of a negative factor, for example, a family conflict situation. Speaking about the causes of neurosis, it is psychotraumatic situations and, above all, family conflicts that are of great importance.

Today 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 aspirations and relationships with society;
• biological factors, which are understood as functional insufficiency of certain neurophysiological as well as neurotransmitter systems that make patients susceptible to psychogenic influences

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

• death or loss of a loved one;
• serious 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 exposes his nervous system to injury.

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

A variety of neuroses

Neuroses are a group of diseases that arise in humans due to exposure to trauma. mental nature. As a rule, they are accompanied by a deterioration in a person’s well-being, mood swings and manifestations of somato-vegetative manifestations.

Neurasthenia

Neurasthenia (nervous weakness or fatigue syndrome) is the most common form of neuroses. Occurs during prolonged nervous overstrain, chronic stress and other similar conditions that cause fatigue and “breakdown” defense mechanisms nervous system.

Neurasthenia is characterized by the following symptoms:

Hysterical neurosis

Vegetative manifestations of hysteria manifest themselves in the form of spasms, persistent nausea, vomiting, fainting states. Characteristic movement disorders are tremors, tremor in the limbs, blepharospasm. Sensory disorders are expressed by disturbances in sensitivity in various parts bodies, painful sensations, hysterical deafness and blindness may develop.

Patients strive to attract the attention of loved ones and doctors to their condition; they have extremely unstable emotions, their mood changes sharply, they easily move from sobbing to wild laughter.

There are a specific type of patients with a tendency to hysterical neurosis:

• Impressionable and sensitive;
• Self-hypnosis and suggestibility;
• With mood instability;
• With a tendency to attract external attention.

Hysterical neurosis must be distinguished from somatic and mental illnesses. Similar symptoms occur in schizophrenia, central nervous system tumors, endocrinopathy, and encephalopathy due to trauma.

Obsessive-compulsive disorder

A disease characterized by the occurrence of obsessive ideas and thoughts. A person is overcome by fears that he cannot get rid of. In this condition, the patient often exhibits phobias (this form is also called phobic neurosis).

Symptoms of neurosis of this form manifest themselves as follows: a person feels fear, which manifests itself with repeated unpleasant incidents.

For example, if a patient faints on 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 deterioration in sleep quality, loss of the ability to rejoice, and chronic low mood. The disease is accompanied by:

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

Symptoms of neurosis in adults

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

Patients experience memory impairment, low concentration, and 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:

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

People suffering from neuroses often experience:

• mood instability;
• a feeling of self-doubt and the correctness of the actions taken;
• overly expressed emotional reaction to minor stress (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 changes in the value system;
• excessive fixation on the problem;
• increased mental fatigue;
• decreased ability to remember and concentrate;
• 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 that are worth mentioning. First of all, women are characterized by asthenic neurosis (neurasthenia), which is caused by irritability, loss of mental and physical ability, and also leads to problems in sexual life.

The following types are typical for men:

• 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 sudden changes in life, both personal and social.
• Male neurasthenia. It usually occurs against the background of overstrain, both physical and nervous, and most often it affects workaholics.

Signs of menopausal neurosis, which develops in both men and women, are increased emotional sensitivity and irritability, decreased stamina, sleep disturbances, and general problems with the functioning of internal organs, beginning between the ages of 45 and 55 years.

Stages

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

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 decreased mood, drowsiness, lethargy and apathy due to the strong severity of inhibition processes in the nervous system.

A longer course of a neurotic disorder, changes in behavioral reactions and the emergence of an assessment of one’s illness indicate the development of a neurotic state, i.e., neurosis itself. An uncontrollable neurotic state for 6 months - 2 years leads to the formation of neurotic personality development.

Diagnostics

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

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

Diagnosing neurosis is not an easy task, which only an experienced specialist can do. As mentioned above, the symptoms of neurosis manifest themselves differently 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 make a diagnosis.

The disease is diagnosed using a 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 99% indicates the patient’s low self-esteem.

To identify signs psychopathic character They conduct a special test - it allows you to identify the presence of chronic fatigue, anxiety, indecision, and lack of self-confidence. People with neuroses rarely set long-term goals for themselves, do not believe in success, they often have complexes about their own appearance, and it is difficult for them to communicate with people.

Treatment of neuroses

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

In the absence of somatic pathologies, patients are necessarily recommended to change their lifestyle, normalize their work and rest schedule, 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 and change something. Therefore, medications are widely used. They do not solve problems, but are intended only 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’s worth looking at the conflict (within yourself, with others or with life) from a different angle and finally resolving it.

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

For neuroses, the following groups of drugs are usually used:

• tranquilizers – alprazolam, phenazepam.
• antidepressants – fluoxetine, sertraline.
• sleeping pills – 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 a complete picture of his personality, to establish cause-and-effect relationships that gave impetus to the emergence of neurotic reactions.

Treatment methods for neuroses include color therapy. The right color for the brain is beneficial, just like vitamins are for the body.

• To extinguish anger and irritation, avoid the color red.
• At the moment of onset bad mood Eliminate black and dark blue tones from your wardrobe, surround yourself with light and warm tones.
• To relieve tension, look at blue, greenish tones. Replace the wallpaper at home, choose the appropriate decor.

Folk remedies

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

1. For restless sleep, general weakness, or those suffering from neurasthenia, pour a teaspoon of verbena herb into a glass of boiling water, then leave for an hour, take small sips throughout the day.
2. Tea with lemon balm - mix 10 g of tea leaves and herbal leaves, pour 1 liter of boiling water, drink tea in the evening and before 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 decoction in the morning on an empty stomach and in the evening before bed.
4. Bath with valerian. Take 60 grams of root and boil for 15 minutes, leave to brew for 1 hour, strain and pour into a bath with hot water. Take 15 minutes.

Forecast

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

The long-term existence of neurosis is dangerous due to irreversible personality changes and the risk of suicide.

Prevention

Despite the fact that neurosis is treatable, it is still better to prevent than to treat.

Prevention methods for adults:

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

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Symptoms and treatment of anxiety neurosis

Anxiety neurosis is a psychiatric and neurological disorder, which is based on a constant feeling of fear, anxiety, sometimes almost panic, which is difficult to explain. The developed disease begins to significantly limit the person, interfering with full functioning and ability to work. It is worth knowing about the main symptoms and treatment of anxiety neurosis.

Features of the disease

Anxiety neurosis sometimes causes difficulties in diagnosis; often people pay attention to their condition only when vegetative and somatic symptoms, ignoring the depressed emotional state, the constant feeling of anxiety. Therefore, they often begin to look for the cause of the malaise in the field of cardiology or other neurological disorders, only over time moving towards psychiatry.

Causes and types

Towards the emergence of this disease cite various factors. Experts find it difficult to determine the specific causes of this disease. Usually, constant stress, severe emotional and physical stress, and an unhealthy lifestyle lead to anxiety and other symptoms.

Also, some experts highlight a genetic factor; some people are more predisposed to depression and anxiety than others. Some people's nervous systems are not as strong as others. Severe systemic diseases that exhaust the body can also provoke attacks of anxiety neurosis.

Anxious-phobic neurosis can be called the most common form of the disease, which is mainly haunted by unreasonable anxieties and fears. They can vary in intensity and worsen periodically, but there is no pronounced depression.

Anxiety-depressive neurosis is sometimes called a mixed disorder, in which anxiety and fears manifest themselves as strongly as depressive symptoms. With a mixed disorder, the patient feels more depressed and tired.

Often people go to the doctor when chronic anxiety neurosis. Anxiety and other symptoms become constant with periodic worsening of the condition. At the very beginning of the disease, on the contrary, anxiety episodes are rare, provoked by physical and emotional fatigue, otherwise the patient feels quite well.

Important! If you suspect anxiety neurosis, you should contact a neurologist or psychotherapist.

Symptoms

There are several groups of signs of the disorder; you should pay attention to their appearance first:

1. Emotional signs of anxiety. These include constant anxious thoughts associated with various events and fears about the future. Such thoughts often have no basis and seem irrational from the outside.
2. Physical manifestations of anxiety. Usually they manifest themselves in the inability to relax, constant muscle tension, and a feeling of physical fatigue that does not go away after rest.
3. Motor manifestations of anxiety. People often call them nervous tics; the patient may constantly adjust his clothes, things, fuss, and tremble. Sometimes it is impossible to literally sit still; a person needs to constantly walk or do something.

This is the main symptom of this disease. Also, over time, various vegetative symptoms may develop, these include heartbeat disturbances, the appearance of pain in the area of ​​the heart muscle, shortness of breath, headaches and dizziness.

Some patients develop severe sleep disturbances, insomnia may occur, and constant drowsiness. Some people with this disease become more fearful and become more afraid of even ordinary everyday situations. In rare cases, urinary problems occur.

Advanced neurosis leads to serious limitations in performance. This disorder usually does not lead to disability, but it has been noticed that patients in the later stages of the disease begin to cope worse with the usual volumes of work, and everything begins to be more difficult.

Important! Similar symptoms may indicate other psychiatric and neurological disorders; a comprehensive diagnosis is required.

Treatment at home

This disease usually does not require hospitalization or inpatient treatment, so you can start therapy at home under the supervision of a specialist. It is worth preparing for the fact that treatment for an anxiety disorder can be quite lengthy, sometimes taking years. However, with the right treatment regimen, relief will become noticeable very soon.

Treatment on your own, without the help of a neurologist or psychotherapist, is unacceptable; it is impossible to get out of a depressed state and constant fear on your own. In addition, often starting full-fledged psychotherapy is one of the main steps on the path to getting rid of neurosis.

Tablets and other drugs often only help relieve symptoms; treatment is based on sessions with a psychotherapist, anti-stress therapy, normalization of work and rest schedules, transition to healthy eating and an appropriate lifestyle in general. Only in this case will it be possible to achieve a stable result.

In case of severe anxiety, constant fear that interferes with normal life activities, tranquilizers may be prescribed. Treatment with Atarax and its analogues is common; Grandaxin and other drugs of this group can be prescribed.

Antidepressants are prescribed less frequently and are usually required if depression is the most prominent symptom of the disorder. Only in this case will taking medications be most effective. It is worth remembering that such drugs can only be prescribed by the attending physician; taking them independently is dangerous to health.

Various physiotherapeutic and manual techniques can also be used. They use massage, warm baths, electrophoresis and other methods of combating anxiety. They may also recommend doing sports.

Treatment with homeopathy and other non-standard methods can only be carried out simultaneously with official therapy; it is also advised to treat them with caution; improper treatment can seriously harm a patient with neurosis. Homeopathy is best used to strengthen the immune system.

Treatment with traditional methods

For neurosis, herbal treatment with a sedative effect is most effective. They will help ease severe anxiety, fears, and cope with sleep problems that arise with this disease.

It is recommended to use dried mint, sage, lemon balm, chamomile, and other medicinal herbs with a sedative effect. They are added to tea or an infusion based on them is brewed. For one glass of hot water, take one tablespoon of dried herb, brew for 15 - 30 minutes, the finished infusion can be diluted. One glass before bed is enough, you can add milk to the infusion. Instead of sugar, it is recommended to take the infusion as a bite.

© 2017 Treatment with folk remedies - the best recipes

The information is provided for informational purposes.

This neurosis includes a number of neurotic conditions in which patients experience obsessive fears, thoughts, actions, memories, which they themselves perceive as alien and unpleasant, painful; at the same time, patients cannot free themselves from their obsessions.

Constitutional and personal predisposition plays an important role in the origin of the disease. Among the patients, people who are prone to reflection (self-analysis), as well as anxious and suspicious ones, predominate.

Most often, the leading symptoms of neurosis are fears (phobias). There is a predominant fear of contracting severe somatic or infectious diseases(cardiophobia, cancerophobia, syphilophobia, speedophobia, etc.). For many patients, a feeling of fear is caused by staying in confined spaces, transport (claustrophobia); they are afraid to go outside or be in a crowded place (); in some cases, fear arises when patients only imagine this difficult situation for them. Neurotics, in the presence of phobic disorders, try in any way to get rid of those situations in which they have fears. Many of them constantly turn to various doctors to make sure there are no heart diseases (cardiophobia), cancer(cancerophobia). Close attention to the work of your internal organs contributes to the formation.

Sometimes neuroses develop in connection with a disruption of any habitual activity, while patients are in a state of anticipation of failure in its implementation. A typical example may be the occurrence of a psychogenic weakening of adequate erections in men, which subsequently leads to a fixation of attention on a possible “failure” when it is necessary to get closer to a woman and the formation of “expectation neurosis” (E. Kraepelin, 1910).

In more rare cases, the characteristics of neurosis are characterized by a predominance of obsessive thoughts. In addition to their desire, patients experience, for example, intrusive memories that they cannot get rid of; some patients senselessly count the steps on the stairs, the number of passing cars of any one color, ask themselves various questions many times and try to answer them (why are there four letters in the word “chair”, and five letters in the word “lamp”; why is a chair - it is a chair, not a table, although both words have four letters, etc.). In this case, the phenomenon of “mental chewing gum” is formed. Patients understand the meaninglessness of such thoughts, but cannot get rid of them. Particularly difficult for them are obsessive thoughts about the need to commit some shameful actions, for example, swearing obscenely in public, killing their child (contrasting thoughts, “blasphemous” thoughts). Although patients never realize such tendencies, they have a hard time experiencing them.

In addition to such disorders, obsessive actions (compulsions) may occur, for example, compulsive washing of hands to achieve ideal cleanliness (up to 100 times or more per day), returning home to check whether the door is closed, whether the gas or iron is turned off. In some cases, obsessive actions (rituals) arise in order to eliminate obsession. For example, a patient must jump 6 times and only after that he can leave the house, because he is calm and knows that nothing bad will happen to him today, etc.

In the dynamics of neurosis obsessive states(N.M. Asatiani) there are three stages. At the first stage, obsessive fear arises only in a situation where the patient is afraid of something, at the second - at the thought of being in a similar situation, at the third - a conditionally pathogenic stimulus is a word that is somehow connected with the phobia (for example, in cardiophobia such words can be “heart”, “vessels”, “heart attack”; for cancerophobia - “tumour”, “cancer”, etc.).

Some patients experience "" - repeated attacks of severe fear, most often fear of death, or loss of consciousness, which are accompanied by palpitations, shortness of breath, and pain. These conditions can last quite a long time, patients subsequently fear their recurrence, do not go out alone or move with accompanying persons. Most of these autonomic paroxysmal attacks with palpitations and shortness of breath are closely related to chronic stress and occur against the background of overwork. In Russian psychiatry, such conditions were described as sympathoadrenal crises or designated as diencephalic syndrome.

Phobic neurosis is also called anxious-phobic neurosis, which is one of the forms of neuroses and is manifested by fear, constant anxiety, panic in relation to events, people, and various objects. “Phobia” in translation means fear, therefore all types of pathological fears are classified as phobic neuroses.

Types of phobic neurosis

A phobia is a variety of fears that are associated with an action, object, people or memories of them. Typically, all phobias develop in two ways:

Primary reflex- when fear appears when trying to brew tea, for example, after an unsuccessful attempt to do so and getting a burn.

Secondary reflex- when there is a fear of talking on the phone, because the last time while talking on the phone there was an accident or a fire, for example.

Particularly common is agoraphobia or fear of open space, which leads to voluntary self-confinement at home. In contrast to this condition, a fear of closed spaces or claustrophobia may occur.

Fear of heights in medicine is called acrophobia and also refers to a type of phobic neurosis, and fear of animals is called zoophobia. The fear of being the center of negative attention from strangers is called social phobia. All these types of phobic neurosis are connected by one thing - mental disorders and signs of the disease.

In medical practice, there are three types of severity of phobias, and each subsequent form is more severe in relation to the previous forms:

When a person touches objects that intuitively cause him fear.

When a person is waiting to touch an object that causes fear.

When a person just imagines the possibility of touching that object that once caused fear.

Signs of phobic neurosis

Most often, the disease manifests itself in adolescence and young adulthood, when hormonal changes in the body occur. In childhood, children exhibit character traits such as shyness, timidity, suspiciousness, and reticence, which, if not given proper attention, can easily go into a state of panic.

At first, fear in patients arises for some reason, and then it can manifest itself at the mere mention of the current situation, turning into obsessive fear. Despite understanding the situations, patients cannot do anything about the nature of fear. Many patients throughout their lives, realizing this, try to avoid situations that can provoke panic and fear in them.

Phobic neurosis is characterized, in addition to fears, by periodic depression, headaches, weakness, irregular heart rhythm, breathing and other symptoms characteristic of the group of neuroses. Moreover, all the signs of neurosis appear in those minutes when the patient sees a threat to himself and is afraid of panic. Patients in these situations complain of persistent emotional stress and the inability to relax.

The behavior of patients with such a painful condition is typical - most of them try to consciously run away from the causes that cause them fear and switch their attention to other objects. This is especially pronounced in childhood - for example, a child who is afraid of his father tries to switch his attention to animals.

There are cases when stable situations that cause fear are well recognized and avoided by patients, and in this case the person may develop a phobic character. This behavior will continue until the patient’s panic situations get out of control, causing the person to have attacks of exacerbation of the disease. There are cases of so-called hypochondriacal neurosis, when the patient is haunted by thoughts about the presence of a disease (for example, cancer).

Treatment of phobic neurosis

Treatment of phobic neurosis must be carried out after consulting with a specialist. It is not recommended to treat with home remedies, self-medicate, or take medication. This can aggravate the patient's condition and cause complications of the disease.

If the patient’s condition is not advanced (especially in childhood), then anxiety-phobic neurosis can be easily cured with the help of a competent psychoanalyst, who is able to find the cause of this condition and cure the patient in several sessions of psychotherapy.

Traditionally, in the treatment of phobic neurosis, there are several methods that can be used either individually or in combination:

Cognitive-behavioral therapy, which is the gold standard in psychotherapy, and without which it is impossible to imagine the treatment of neuroses. This therapy helps to identify, remember, sort out those situations that cause fear, and also find means to eliminate them. With the help of psychotherapy, you can teach the patient to control their emotions and anxiety.

Drug treatment - beta blockers, antidepressants, antipsychotics, and drugs that calm the nervous system are used in treatment. But you need to know that phobic neurosis cannot be cured with medications alone (without psychotherapy).

Additional therapies, which include herbal medicine, acupuncture, relaxation massage, Spa treatment, the use of meditation techniques and yoga exercises.

Diagnosis of phobic neurosis is made on the basis of examination and medical history of the patient. In practice, phobic neurosis often accompanies schizophrenia, manic-depressive psychoses and other diseases with mental disorders.

Phobic neurosis symptoms

Phobic neurosis is a mental illness characterized by obsessive fears, thoughts, and memories. These obsessions are unpleasant for patients because they arise without their knowledge and are uncontrollable or difficult to control. Due to its negative connotation, an obsessive phobia is perceived by the patient as foreign, thus increasing his fear according to the “snowball” principle. Gradually, obsessive fear takes over the patient’s entire life, and he loses the ability to think about anything other than the phobia.

The occurrence of phobic neurosis may be due to:

Hereditary factors. We are talking about certain character traits, such as timidity, shyness, suspiciousness. A person who has such a set of qualities experiences his own failures more strongly than others and is prone to excessive introspection and a heightened sense of guilt.

Situational factors. These phobic neuroses are divided into primary and secondary reflexes. The first arise as a response to an external stimulus. For example, a person with this condition becomes afraid of heights after nearly falling from a roof. In the case of a secondary phobic disorder, the person does not connect events directly and begins to experience fear of indirect events related to fear. Thus, the patient will be afraid of cockroaches, because he observed them during stressful situation(for example, when a fire started).

Physical factors. Chronic fatigue, bad dream, poor diet, and constant stress can lead to the development of the disease.

What symptoms indicate phobic neurosis?

1. Patients try to avoid phenomena, objects, conversations that directly or indirectly remind them of their fear.
2. Phobic neurosis can manifest itself in various forms. So, with agoraphobia, the patient will be afraid to be in crowded places, in open spaces. Other forms of the disease are also possible. The most common:
   • acrophobia - fear of heights;
   • claustrophobia - fear of closed spaces;
   • nosophobia - fear of contracting a fatal disease;
   • social phobia - fear of social contacts;
   • thanatophobia - fear of death.
3. With various forms of phobic neurosis, a person tries to compensate for the influence of obsessions. Then compulsions (rituals) appear, designed to alleviate negative thoughts. A person with this form of phobic neurosis can check many times whether he closed the front door before leaving, whether he turned off the light. Almost always the ritual is accompanied by counting the number of actions performed. In severe forms, a person may spend hours washing their hands or closing/opening a cabinet door and eventually not even leaving the house. It is worth noting that compulsions can manifest themselves not only as actions, but also as compensatory thoughts aimed at combating obsessive fear.
4. Panic attacks are sudden attacks of severe anxiety. Accompanied by lack of air, rapid heartbeat, and fear of dying. The patient's seizures are not controlled.

It is impossible to cure this disease on your own. The fact is that the fight against obsessions only increases anxiety, closing a vicious circle for the patient. Not thinking about it is an impossible task. The patient would be happy to get rid of the obsessive fear, but is not able to. Not because he doesn’t have an iron will and doesn’t know how to control himself. Phobic neurosis is a disease, and, like bronchitis, you cannot get rid of it by willpower.

What should I do?

We recommend contacting a good psychiatrist. We know that deciding to make an appointment is not easy - fear, fear of misunderstanding gets in the way. But you should understand that it is impossible to do without the help of a doctor, and you cannot solve the problem on your own.

Treatment of phobic neurosis is carried out comprehensively. Medications and cognitive behavioral therapy can relieve the patient of obsessive fears, thoughts, and memories. Also, the love and support of loved ones will be a good help on the path to recovery.

5. Allow fear to exist freely. As soon as you stop opposing him, he will immediately weaken. Remember that most of our fears are irrational, meaning there is no real reason to worry.
6. If you are tormented by obsessive ideas, vivid images of fear, fixate on this mental image. Regular analysis of your phobia will allow you to slightly reduce your level of anxiety.
7. The disease greatly depletes the psyche. Relaxing baths will help you cope with this. essential oils: ylang-ylang or clary sage. Drinking mint tea and other soothing herbs can also help.
8. A walk in the fresh air and regular sports activities can distract the patient from unpleasant thoughts and fears.

To get help from a psychotherapist, just make an appointment by phone.



To reach your goal, you must first of all. go.

Phobic neurosis most often occurs in people with a pronounced anxious-suspicious component in their character structure and a tendency to delay affect (retention). It means that various situations, coinciding in time with a feeling of fear, as a rule, cause this fear when these situations reoccur.

The development of a phobia can occur in two ways:

9. Primary conditioning (for example, the emergence of a fear of boarding a plane after experiencing an unsuccessful landing once)
10. Secondary conditioning (for example, the emergence of a fear of suffocation during a ringing telephone or fire truck siren, if a previous, severe asthma attack occurred at the same time as these events.

Typically, phobic neurosis is distinguished by the presence of independent fears that arise in certain situations. The foundation of phobic neurosis is the “attachment” of anxiety to a characteristic situation or characteristic object, after which a phobia arises. So, a phobia is fears associated with a characteristic object, action, memory or fantasizing about them.

The difference between phobias and other fears (for example, with anxiety neurosis) is that phobias are always associated with a characteristic object.

There are a great many phobias, but, usually, phobias related to health and phobias characterizing the position of the physical body somewhere arise more often than others. The first category includes: fear of death (thanatophobia), fear of getting cancer (oncophobia), AIDS, or any other dangerous disease(nosophobia). The second category is agoraphobia (fear of open space), claustrophobia (fear of enclosed spaces), fear of heights or depths, etc.

Fears are formed, usually not associated with a past state of affect, and are perceived by patients as alien to their inner feeling and self-awareness.

There are three types of severity of phobias. The first type of phobia is felt by directly touching an object. The second type is when a person expects this objective touch, and the third type is only when imagining the likelihood of touching the object of the phobia.

Patients realize the absurdity of their phobias, but cannot cope with them.

It happens that, along with the primary phobia, second-order fears arise, linked to the original object. In addition to the fear of heights, there may be a fear of being on the roof, going out onto the balcony, driving over a bridge, or living on high floors.

It is obvious that despite the groundlessness and absurdity of phobias that are recognized by patients, these phobias, as a rule, affect their lifestyle and behavior.

The presence and improvement of rituals—characteristic patterns of behavior, the implementation of which “should ward off misfortune” or “attract good luck”—changes the way of life even more. Rituals may be linked to the primary phobia; (for example, mandatory taking 7 tablets of nitroglycerin in the morning, with cardiophobia), or completely independent of it (spit five times through left shoulder, before bedtime). Over time, rituals tend to become more complex, further changing the patient's life.

Phobic neurosis is characterized by somatic manifestations, which usually appear at the same time as the phobia. These manifestations are very diverse: disruption of activity gastrointestinal tract, convulsive states, palpitations, feeling of shortness of breath, dizziness, weakness in the legs, etc.

As a rule, the peculiarity of somatic manifestations is associated with the nature of the phobia. Typically, this can be seen in cardiophobia, when a feeling of fear is accompanied by pain in the heart, heaviness in the chest, palpitations, and sensations in cardiac activity.

It is necessary to distinguish between true phobia and phobic syndrome, differential diagnosis which can be very difficult and complex.

Phobic syndrome can accompany schizophrenia, manic-depressive psychosis, organic brain damage and other mental illnesses. The diagnosis is made by identifying the symptoms of the underlying disease.

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Phobic anxiety disorder

Recently, the concept of “panic attack” has become firmly established in our lives. This is an attack of panic, or uncontrollable fear, that occurs in certain situations. Main feature A panic attack is its irrationality, that is, the reason that caused the fear is not actually threatening to the person. Most people have experienced an irrational panic attack at least once. If panic attacks are repeated and negatively affect the quality of life, we are talking about an anxiety disorder.

Phobic anxiety disorder or anxiety-phobic neurosis is a disease in which a person reacts to harmless stimuli with an attack of fear.

There may be one reason for a panic attack, or less often - several. This disease is also called a phobia, with a prefix in Greek denoting a reason for fear:

• claustrophobia (fear of closed spaces),
• agoraphobia (fear of open space),
• aquaphobia (fear of water, fear of swimming),
• anthropophobia (fear of people, communication), etc.

Anxious personality disorder significantly impairs a person's quality of life. Often those around him do not understand him, even to the point of ridicule. But the fact that others do not consider the “irritant” dangerous and are trying to convince a person with phobic neurosis of this does not in any way affect the strength of fear, but, on the contrary, can aggravate the situation. This can lead to withdrawal from communication and familiar circles, which also increases the strength and frequency of attacks, because it is very difficult for people with phobias to be alone.

If you or someone you know is having seizures irrational fear, rejection of any situation, accompanied by a panic attack - the help of a specialist is needed, because self-medication, as well as avoiding the situation, are unacceptable here.

Anxiety-phobic disorder: symptoms

In phobic anxiety personality disorder, symptoms typically include:

• uncontrollable fear that occurs in a specific situation or when interacting with a specific object;
• irrationality of fear (in fact, the cause of fear is not dangerous);
• avoiding a situation or object that causes panic attacks;
• fear of anticipation (with this neurosis, a phobia may begin at the thought of an upcoming situation);
• vegetative reaction - symptoms that occur during phobic neurosis (palpitations, dizziness, nausea, sweating, weakness), characteristic of any attack of fear and provided by the hormonal reaction of the body.

The reasons that caused the development of phobic neurosis can be either primarily organic (increased work of the body's sympathetic-adrenal system and deterioration in the functions of its antagonists) or psychological (an unpleasant situation in the past, especially in childhood). One way or another, with phobic neurosis there is always a so-called constitutional background - a special type of personality (after all, not everyone has unpleasant situations from childhood that cause a subsequent phobia). There is also a certain hereditary predisposition to the development of anxiety disorders.

Phobic anxiety disorders: treatment

If you or your loved ones are diagnosed with phobic neurosis, this disease should be treated exclusively by a specialist - a psychotherapist. Treatment of phobic anxiety disorders is complex - includes both medications and psychotherapy (individual and in groups).

It is important to note that phobic neurosis is not only a disease of adults. If phobic anxiety disorder is identified in childhood, treatment is carried out by a child psychotherapist.

You should not delay contacting a specialist and let the situation take its course - it is difficult to cope with the disorder on your own, but with the support of a specialist this will happen quickly and comfortably.

We have many years of successful experience working with people suffering from anxiety-phobic disorders. Modern medicines with a mild effect, psychotherapy in groups and individually, creative and movement techniques are a guarantee of getting rid of the disease and the path to a new, fulfilling life without fears and restrictions.

Phobic neurosis

Phobic (or anxiety-phobic) neurosis is one of the many types of neuroses. The main manifestation of this disorder is an uncontrollable feeling of fear and anxiety as a reaction to a specific object (object, action, memory, etc.). This feeling is so strong that a person is unable to control himself, even if he realizes that the fear is groundless and his life and health are not in danger.

When does a phobia develop?

A person can develop a phobia in two cases:

if a person directly had a bad experience in the past regarding some thing, action, place and other similar objects. For example, after accidental painful contact with a hot iron, fear of hot objects may develop in the future;

if the object is associated with thoughts and memories of a negative nature. For example, in the past, while talking on the phone, there was a fire or someone got hurt.

The development and occurrence of phobic neuroses are influenced by:

• heredity;
• human character: increased anxiety, constant state of worry, excessive responsibility, suspiciousness;
• emotional stress and physical exhaustion;
• disturbances in the functioning of the body's endocrine system;
• sleep disturbance and poor diet;
• infections and bad habits that cause significant harm to the body.

Often these disorders occur against the background of another disease: schizophrenia, obsessive-compulsive disorder, psychasthenia, obsessional neurosis.

The risk of phobic neurosis increases during certain periods of a person’s life: during puberty, early adulthood and immediately before menopause.

Types of phobic neuroses

The most common phobia at the moment is the fear of open spaces - agrophobia. A person suffering from this disorder, depending on the severity of the disease, either tries not to leave the house unnecessarily, or is unable to force himself to even leave his own room.



The opposite of this phobia is claustrophobia. A person is seized with fear at the moment when he is in a closed space. This is especially true for elevators.

According to the severity of manifestation, phobic neuroses are divided into three groups:

• mild degree– fear arises from direct contact with the object of fear;
• average degree– fear arises in anticipation of contact with the object of fear;
• severe– just the thought of the object of fear seizes a person into panic.

Most often, phobias arise in adolescence against the background of hormonal changes in the body, and then they can develop into obsessive fears or, conversely, disappear. The beginning of such disorders is always direct or indirect contact with a future object of fear, which is negative in nature. Patients are critical of their illness and may realize the groundlessness of their own fears, but at the same time they are not able to get rid of them.

Signs of phobic nephrosis

Common symptoms of phobic neuroses include:

• panic attacks;
• disturbances in the functioning of the autonomic organ system (cardiovascular system, respiratory system, etc.);
• headache;
• general weakness;
• sleep disorders;
• depression;
• emotional tension.

All these signs are easy to detect when the patient comes into contact with the subject of the phobia.



In medicine, all symptoms are divided into 4 groups:



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lethargic, apathetic, frozen facial expressions, scanty speech, often of absurd content. In bed they take pretentious poses, cover their heads, grimace, make stereotypical movements, imitate animals, eat with their mouths.

Course of hysterical disorders:

Hysteroneurotic psychogenic reactions may be short-term, episodic and disappear spontaneously, without treatment. Long-term recording of hysterical manifestations over several years is also possible. After their attenuation, there may remain a tendency to the occurrence of individual hysterical stigmas (paresthesia, unsteadiness of gait, fainting) in situations that cause affective stress. Patients with functional hysteroneurotic disorders require a thorough somatic and neurological examination to exclude organic pathology.

II. Anxiety-phobic neurosis

The problem of phobias and obsessions attracted the attention of clinicians even in the prenosological period of psychiatry. Mentions of obsessions are found in the works of Ph. Pinel (1829). I. Balinsky proposed the term “obsessive ideas”, which has taken root in Russian psychiatric literature. In 1871, C. Westphal introduced the term “agoraphobia,” which denoted the fear of being in public places. However, only at the turn of the XIX-XX centuries. (1895-1903), thanks to the research of Z. Freud and P. Janet, attempts were made to combine anxiety-phobic disorders into an independent disease - anxiety neurosis (Z. Freud). Somewhat later, P. Janet (1911) combined agoraphobia, claustrophobia, and transport phobias with the term “position phobias” [Tiganov A.S., 1999].

In accordance with ICD-10, psychopathological manifestations of anxiety disorders include the following symptom complexes: panic disorder

disorder without agoraphobia, panic disorder with agoraphobia, hypochondriacal phobias, social and isolated phobias, obsessive-compulsive disorder.

Clinical manifestations:

Anxiety-phobic syndrome develops predominantly in cases where pronounced vegetative-vascular paroxysms were observed in the initial period of the disease. The affect of anxiety and fear, which initially arose in connection with vegetative-vascular paroxysms, becomes more and more constant as the syndrome develops. Against the background of vague anxiety, obsessive fears develop related to the possibility of a repetition of the paroxysm and its tragic consequences. Intensity obsessive fears is not measured by previous experience, which testifies to their groundlessness. Phobic phenomena also intensify under conditions that place increased demands on the vestibular apparatus: when using various types of

transport, industrial vibrations, rhythmic visual stimuli (for example, when a stream of people flashes before the eyes). During periods of exacerbation of the condition, other psychopathological symptoms characteristic of the disease also arise or intensify: senestopathies, psychosensory disorders, derealization disorders.

Anxiety states appear in two main forms. At generalized anxiety disorder anxiety is persistent and not limited to any specific circumstances. The most common complaints are a feeling of constant nervousness, restlessness, trembling, muscle tension, sweating, palpitations, dizziness, discomfort in the epigastric region, accompanied by fears and concerns for their health and the health of their loved ones, as well as other various worries and apprehensions. This disorder is more common in women and is often associated with chronic stress.

At panic disorder(episodic paroxysmal anxiety) anxiety manifests itself in the form of severe panic attacks, which are also not limited to a specific situation and are therefore unpredictable. Dominant symptoms: sudden palpitations, chest pain, a feeling of suffocation, dizziness, a feeling of unreality, often accompanied by fears of death, loss of self-control or madness. Subsequently, the person tends to avoid the situation in which the first panic attack occurred. In addition, he may develop a persistent fear of the attack being repeated. Panic disorder most often determines the onset of the disease. In this case, three dynamics options can be distinguished psychopathological disorders alarming series, manifested by panic attacks.

1st option: the clinical picture of anxiety-phobic disorders is represented only by panic attacks. Panic attacks manifest themselves as an isolated symptom complex with a combination of signs of cognitive and somatic anxiety and are not accompanied by the formation of persistent mental disorders. The clinical picture of panic attacks expands only due to transient hypochondriacal phobias and agoraphobia phenomena, which are of a secondary nature. Once the acute period has passed and panic attacks have been reduced, concomitant psychopathological disorders also develop in reverse.

2nd option: anxiety disorders include panic attacks and persistent agoraphobia. Panic attacks occur suddenly, without any precursors, and are characterized by vital fear, generalized cognitive anxiety with a feeling of sudden, life-threatening bodily catastrophe with minimal severity of autonomic disorders and the rapid (sometimes after the first attack) formation of agoraphobia, phobophobia and avoidant behavior. As panic attacks reverse, a complete reduction of psychopathological disorders does not occur.

3rd option: anxiety-phobic disorders with panic attacks developing as a vegetative crisis (Da Costa syndrome) and culminating in hypochondriacal phobias. Distinctive features panicky

attacks: subclinical manifestations of anxiety, combined with algia and conversion symptoms; psychogenic provocation of seizures; predominance of somatic anxiety with dominance of symptoms from the cardiovascular and respiratory systems without vital fear (“alexithymic panic”); expansion of the picture due to hypochondriacal phobias with minimal severity of phobic avoidance and agoraphobia. After full-blown panic attacks have passed ( acute period) a complete reduction of psychopathological anxiety disorders does not occur. Hypochondriacal phobias (cardio-, stroke-, thanatophobia) come to the fore, determining the clinical picture for months and even years.

Phobic disorders- These are disorders characterized by the occurrence of anxiety primarily in relation to certain situations or external objects. As a result, these situations are avoided or endured with a feeling of fear. The experience of fear is usually accompanied by a variety of autonomic symptoms - palpitations, difficulty breathing, a feeling of lightheadedness, dizziness, weakness in the legs, as well as secondary fears of death or loss of self-control. At the same time, anxiety is not reduced by the knowledge that other people do not consider this situation dangerous or threatening. Subsequently, the mere idea of ​​getting into a phobic situation in advance causes anticipation anxiety.

There are several types of phobias:

– fear of open spaces (being in a crowd or public places, moving outside the home, traveling alone);

– fear of individual animals;

– fear of heights;

– fear of closed spaces (travelling on airplanes, elevators, subways);

– fear of blood or injury;

– fear of getting a certain disease (myocardial infarction, cancer, venereal disease, HIV, etc.);

– fear of the dark;

– fear of exams, etc.

It is worth noting that anxiety and phobic disorders are very often accompanied by various sleep disorders (difficulty falling asleep, superficial night sleep, early awakening), depression (low mood, decreased self-esteem and self-confidence, poor appetite, loss of interests and the ability to enjoy activities that previously brought such pleasure, a pessimistic vision of the future), neurasthenic symptoms(fatigue, irritability) [Karvasarsky B.D., 1990].

Among psychopathological manifestations anxiety-phobic disorders, first of all, it is necessary to consider panic attacks, agoraphobia, hypochondriacal phobias, social phobia and mysophobia, since in the dynamics of these symptom complexes the greatest comorbid connections are found.

Panic attacks- an unexpected and quickly, within a few minutes, growing symptom complex of vegetative disorders (vegetative crisis - palpitations, tightness in the chest, a feeling of suffocation, lack of air, sweating, dizziness), combined with a feeling of impending death, fear of loss of consciousness or loss of control over oneself , madness. The duration of manifest panic attacks usually does not exceed 20-30 minutes.

Agoraphobia, contrary to the original meaning of the term, includes not only the fear of open spaces, but also a whole series of similar phobias (claustrophobia, phobia of transport, crowds, etc.), defined by P. Janet (1918) as phobias of position. Agoraphobia typically occurs in conjunction with (or following) panic attacks and is essentially the fear of being in a situation that could lead to a panic attack. Typical situations that provoke the occurrence of agoraphobia are traveling on the subway, being in a store, among a large crowd of people, etc.

Hypochondriacal phobias (nosophobias)) - obsessive fear of some kind of

yellow disease. The most commonly observed are cardio-, cancer- and stroke-phobias, lissophobia (fear of getting a mental illness), as well as syphilo- and AIDS-phobias. At the height of anxiety (phobic raptus), patients sometimes lose their critical attitude towards their condition - they turn to doctors of the appropriate profile and require examination.

Social phobias– fear of being the center of attention, accompanied by fears of negative evaluation by others and avoidance of social situations. Data on the prevalence of social phobias in the population vary from 3 to 5% [Kaplan G.I., Sadok B.J.., 1994]. These patients come to the attention of psychiatrists relatively rarely. Among those not covered by treatment measures, people with subthreshold social phobias that do not significantly affect daily activities predominate. Most often, those suffering from this disorder, when visiting a doctor, focus on comorbid (mainly affective) psychopathological symptom complexes. Social phobias usually manifest during puberty and adolescence. Often their appearance coincides with unfavorable psychogenic or social influences. In this case, only special situations act as provoking situations (answering at the blackboard, passing exams - school phobias, appearing on stage) or contact with a certain group of people (teachers, educators, representatives of the opposite sex). Communication with family and close friends, as a rule, does not cause fear. Social phobias can occur transiently or have a tendency to develop chronically. Patients suffering from social phobias are more likely than healthy ones to live alone and have a lower level of education.

Social phobias have a high level of comorbidity with other mental disorders. In most cases, they are combined with simple phobias, agoraphobia, panic disorder, affective

pathology, alcoholism, disorders eating behavior, which worsens the prognosis of the disease and increases the risk of suicide attempts. There are two groups of states - isolated and generalized social phobia.

The first of these includes monophobia, which is the fear of not performing habitual actions in public associated with anxious expectations of failure (fear of public speaking, communicating with superiors, eating in public places), and as a result - avoidance of specific life situations. At the same time, there are no difficulties in communication outside such key situations. This group of phobias includes ereytophobia - the fear of blushing, showing awkwardness or embarrassment in society. Accordingly, shyness and embarrassment appear in public, accompanied by internal stiffness, muscle tension, trembling, palpitations, sweating, and dry mouth.

Generalized social phobia is a more complex psychopathological phenomenon, which, along with phobias, includes ideas of low value and sensitive ideas of relationship. Disorders in this group most often appear within the framework of scoptophobia syndrome. Scoptophobia (Greek scopto - joke, mock; phobos - fear) - fear of appearing funny, of discovering signs of imaginary inferiority in people. In these cases, in the foreground there is an affect of shame, which does not correspond to reality, but determines behavior (avoidance of communication, contact with people). The fear of being embarrassed may be associated with ideas about people’s hostile assessment of the “flaw” attributed to themselves by the sick, and corresponding interpretations of the behavior of others (disdainful smiles, ridicule, etc.).

Mysophobia (fear of pollution) . This group of obsessions includes not only the fear of pollution (earth, dust, urine, feces and other impurities), but also the phobia of penetration into the body of harmful and toxic substances, small objects, microorganisms, i.e. phobias of extracorporeal threat. In some cases, the fear of contamination may be limited in nature, remaining for many years at a subclinical level, manifesting itself only in some features of personal hygiene (frequent change of linen, repeated hand washing) or in housekeeping (careful handling of food, daily washing of floors). , "taboo" on pets). This kind of monophobia does not significantly affect the quality of life and is assessed by others as habits [Tiganov A.S., 1999].

Clinically completed variants of mysophobia belong to the group of severe obsessions, in which a tendency to complication and generalization is often found. In these cases, gradually becoming more complex protective rituals come to the fore in the clinical picture: avoiding sources of pollution, touching “unclean” objects, handling things that might have gotten dirty. Staying outside the apartment is also accompanied by a series of protective measures: going outside in special clothing that covers the body as much as possible, special treatment of personal items upon returning home. On later stages disease patients, avoiding co-

touching dirt or any harmful substances, not only do not go outside, but do not even leave the confines of your own room.

Mysophobia is also associated with the fear of contracting any disease, which does not belong to the categories of hypochondriacal phobias, since it is not determined by fears of having a particular disease. In the foreground is the fear of a threat from the outside - the fear of pathogenic bacteria entering the body. Fear of infection in these cases sometimes arises in an unusual way: for example, as a result of fleeting contact with old things that once belonged to a sick person.

III. Obsessive-compulsive disorders Clinical manifestations:

The manifestation of clinically defined manifestations of obsessive-compulsive disorders occurs in the age interval of 10 years – 24 years. Obsessions are expressed in the form of obsessive thoughts and compulsive actions, perceived by the patient as something psychologically alien to him, absurd and irrational [Asatiani N.M., 1985]. Obsessive thoughts- painful ideas, images or desires that arise against one’s will, which in a stereotypical form come to the patient’s mind again and again and which he tries to resist. Compulsive actions– repeated stereotypical actions, sometimes acquiring the character of protective rituals. The latter are aimed at preventing any objectively unlikely events that are dangerous for the patient or his loved ones.

Despite the diversity of clinical manifestations, among obsessive-compulsive disorders, delineated symptom complexes stand out: obsessive ideas, thoughts, fears, actions [Svyadoshch A.M., 1982].

1) Obsessive ideas often have the character of vivid intrusive memories. This includes some melodies, words or phrases from sound images which the patient cannot free himself from, as well as visual perceptions. Sometimes they have a bright sensual coloring, characteristic of sensations, and approach obsessive or psychogenic hallucinations. Obsessive images very often arise in the form of extremely vivid intrusive memories that reflect the traumatic impact that caused them.

2) Intrusive thoughts can be expressed in the form of obsessive doubts, fears, blasphemous or “blasphemous” thoughts and wisdom.

* With obsessive doubts, there is usually a painful uncertainty about the correctness or completeness of an action, with the desire to check its implementation again and again. Obsessive doubts can sometimes force the patient to spend hours checking the correctness of the action performed until exhaustion. Compulsions in these cases stop only after the internal feeling of completeness of the completeness of the motor act is restored.

* With obsessive fears, patients are painfully afraid that they will not be able to perform this or that action when required, for example, play a musical instrument in front of an audience or remember vocabulary roles, answer without blushing (ereitophobia), fall asleep, start walking, getting out of bed after an illness , swallow squeaks. d.

* Contrasting obsessions (“aggressive obsessions”, according to S.Rasmussen, J.L.Eisen, 1991) – blasphemous, blasphemous thoughts, fear of harming oneself and others. They are distinguished by a feeling of alienation, unmotivated content, as well as a close combination with obsessive drives and actions, which represent a complex system of protective rituals. Patients with contrasting obsessions complain of an irresistible desire to add certain endings to the remarks they have just heard, giving what was said an unpleasant or threatening meaning, to shout out cynical words that contradict their own attitudes and generally accepted morality; They may experience fear of losing control over themselves and possibly committing dangerous or ridiculous actions, auto-aggression, or injuring their own children. In the latter cases, obsessions are often combined with object phobias (fear of sharp objects). The contrast group also partially includes obsessions with sexual content (obsessions like forbidden ideas about perverted sexual acts, the objects of which are children, representatives of the same sex, animals).

* With obsessive philosophizing (“mental chewing gum”), patients are forced to endlessly think about certain things that have no meaning or interest for them, for example, thinking about what will happen if a state of weightlessness occurs on earth, or if humanity were to lose their clothes and everyone had to walk around naked.

3) Obsessive fears (phobias) are the most diverse and occur most often. These include: fear of death (thanatophobia) from various causes: heart disease (cardiophobia), the possibility of committing suicide, etc., fear of contracting syphilis (syphilophobia), cancer (cancerophobia), myocardial infarction (infarction phobia), mental illness (lyssophobia ) and other diseases, fear of pollution (mysophobia), phobia of penetration of harmful and toxic substances, small objects, microorganisms into the body, fear of open space (agarophobia), closed spaces (claustrophobia) and the like. Many patients, trying to make it easier to overcome obsessive fear, commit protective actions(rituals) that are supposed to "prevent" what they fear.

4) Obsessive actions relatively rarely appear in isolation, not combined with verbal obsessions. A special place in this regard is occupied by obsessive actions in the form of isolated, monosymptomatic movement disorders. Tics predominate among them, especially often in childhood. Tics give the impression of exaggerated physiological movements. This is a kind of caricature of certain motor acts, natural gestures. Patients suffering from tics may shake their heads (as if checking whether a hat fits well), make movements with their hands (as if

Phobic neurosis is a mental illness characterized by obsessive fears, thoughts, and memories. These obsessions are unpleasant for patients because they arise without their knowledge and are uncontrollable or difficult to control. Due to its negative connotation, an obsessive phobia is perceived by the patient as foreign, thus increasing his fear according to the “snowball” principle. Gradually, obsessive fear takes over the patient’s entire life, and he loses the ability to think about anything other than the phobia.

The occurrence of phobic neurosis may be due to:

1. Hereditary factors. We are talking about certain character traits, such as timidity, shyness, suspiciousness. A person who has such a set of qualities experiences his own failures more strongly than others and is prone to excessive introspection and a heightened sense of guilt.
2. Situational factors. These phobic neuroses are divided into primary and secondary reflexes. The first arise as a response to an external stimulus. For example, a person with this condition becomes afraid of heights after nearly falling from a roof. In the case of a secondary phobic disorder, the person does not connect events directly and begins to experience fear of indirect events related to fear. Thus, the patient will be afraid of cockroaches because he observed them during a stressful situation (for example, when a fire started).
3. Physical factors. Chronic fatigue, poor sleep, poor diet, and constant stress can lead to the development of the disease.

What symptoms indicate phobic neurosis?

1. Patients try to avoid phenomena, objects, conversations that directly or indirectly remind them of their fear.
2. Phobic neurosis can manifest itself in various forms. So, with agoraphobia, the patient will be afraid to be in crowded places, in open spaces. Other forms of the disease are also possible. The most common:
   • acrophobia - fear of heights;
   • claustrophobia - fear of closed spaces;
   • nosophobia - fear of contracting a fatal disease;
   • social phobia - fear of social contacts;
   • thanatophobia - fear of death.
3. With various forms of phobic neurosis, a person tries to compensate for the influence of obsessions. Then compulsions (rituals) appear, designed to alleviate negative thoughts. A person with this form of phobic neurosis can check many times whether he closed the front door before leaving, whether he turned off the light. Almost always the ritual is accompanied by counting the number of actions performed. In severe forms, a person may spend hours washing their hands or closing/opening a cabinet door and eventually not even leaving the house. It is worth noting that compulsions can manifest themselves not only as actions, but also as compensatory thoughts aimed at combating obsessive fear.
4. Panic attacks are sudden attacks of severe anxiety. Accompanied by lack of air, rapid heartbeat, and fear of dying. The patient's seizures are not controlled.

Treatment of phobic neurosis

It is impossible to cure this disease on your own. The fact is that the fight against obsessions only increases anxiety, closing a vicious circle for the patient. Not thinking about it is an impossible task. The patient would be happy to get rid of the obsessive fear, but is not able to. Not because he doesn’t have an iron will and doesn’t know how to control himself. Phobic neurosis is a disease, and, like bronchitis, you cannot get rid of it by willpower.

What should I do?

We recommend contacting a good psychiatrist. We know that deciding to make an appointment is not easy - fear, fear of misunderstanding gets in the way. But you should understand that it is impossible to do without the help of a doctor, and you cannot solve the problem on your own.

Treatment of phobic neurosis is carried out comprehensively. Medications and cognitive behavioral therapy can relieve the patient of obsessive fears, thoughts, and memories. Also, the love and support of loved ones will be a good help on the path to recovery.

• Allow fear to exist freely. As soon as you stop opposing him, he will immediately weaken. Remember that most of our fears are irrational, meaning there is no real reason to worry.
• If you are tormented by obsessive ideas, vivid images of fear, fixate on this mental image. Regular analysis of your phobia will allow you to slightly reduce your level of anxiety.
• The disease greatly depletes the psyche. Relaxing baths and soothing essential oils: ylang-ylang or clary sage will help you cope with this. Drinking mint tea and other soothing herbs can also help.
• A walk in the fresh air and regular sports activities can distract the patient from unpleasant thoughts and fears.

To get help from a psychotherapist, just make an appointment by phone.