Disorders of adaptation
Contents:
Description:
Degree of manifestation of reaction to a stress of the same force can be various and depends on many factors: sex, age, structure of the personality, level of social support, any circumstance. At some persons with extremely low resistance to stress in response to a stressful event, not beyond usual or daily mental stress, disease state can develop. Stressorny events, more or less obvious to the patient, cause the painful symptoms breaking usual functioning of the patient (professional activity, social functions can be broken). These painful fortune were come into by names of disorder of adaptation.
Symptoms of Disorders of adaptation:
The disease develops, as a rule, within three months after influence of a psychosocial stress factor or multiple stresses. Clinical manifestations of adaptive frustration are extremely variable. Nevertheless it is usually possible to allocate psychopathological symptoms and the vegetative frustration interfaced to them. Vegetative symptoms force the patient to look for the help at the doctor.
The feeling of heat or cold, tachycardia, nausea, abyodoyominalny pain, diarrhea and lock can be a poyosledyostviye of the vegetative answer to a stress. The vegetative answer inadequate to an incentive (stress) – basis for many psychosomatic frustration. Knowledge of a pattern of the vegetative answer to a psychological stress allows to understand a stress – dependent diseases. The vegetative answer to a stress can be the somatopathy trigger (psychosomatic boyolezyon). For example, the cardiovascular answer to a stress increases consumption by a myocardium of oxygen and can cause stenocardia in persons with a coronary disease.
Most of patients show exclusively organ complaints, proceeding from own or cultural ideas of the importance of this or that body in an organism. Vegetative disturbances can preferential be shown in one system (more often in cardiovascular), but in most cases active inquiry of the patient allows to reveal less expressed symptoms from other systems. With the course of a disease vegetative disturbances gain clear polysystem character. For vegetative dysfunction replacement of one symptoms by others is natural. At patients, in addition to vegetative dysfunction, sleep disorders (difficulties of backfilling, a light superficial sleep, night awakenings), an asthenic symptom complex, irritability, neuroendocrinal disturbances are quite often noted.
Mental disturbances obligatno accompany vegetative dysfunction. However the type of a mental rasyostroystvo and degree of its expressiveness widely vary at various patients. Mental symptoms often are behind "facade" of massive vegetative dysfunction, are ignored by the patient and surrounding his faces. Ability of the doctor "to see" at the patient, in addition to vegetative dysfunction, psychopathological symptoms is decisive in diagnosis of disorders of adaptation.
Most often disadaptation is characterized by alarming mood, feeling of inability to cope with a situation and even decline in the ability to function in everyday life. Uneasiness is shown by diffusion, extremely unpleasant, often uncertain feeling of fear something, feeling of threat, feeling of tension, an acrimony, tearfulness. Disorder of adaptation with depressive nayostroyoeyoniy is characterized by the lowered nayostroyeniye background sometimes reaching melancholy level, restriction of usual interests, desires.
Reasons of Disorders of adaptation:
Disorder of adaptation arises in response to a stress. The stress is a condition of tension of adaptable mechanisms. Causes critical situations дистресс which is endured as a grief, misfortune, an isyotoshcheniye of forces and is followed by disturbance of adaptation, control, interferes with self-updating of the personality. All critical situations, from rather easy to sayomy difficult (a stress, frustration, the conflict and crisis), demand from the person of various internal work, certain abilities on their overcoming and adaptation to them.
Treatment of Disorders of adaptation:
Despite an obligatnost of vegetative dysfunction and often masked nature of emotional frustration, a basic method of treatment of disorders of adaptation is psychopharmacological treatment. Therapeutic strategy needs to be built depending on type of the dominating frustration and degree of its expressiveness. The choice of drug depends on degree of manifestation of level of alarm and duration of a disease.
If painful symptoms exist short time (up to two months) and slightly break functioning of the patient, then can isyopolyyozovatsya both medicinal (anxiolytic therapy), and not medicinal methods. Nelekaryostvenyony therapy is first of all a possibility of a vyyorayozheniye patients of the fears in the conditions of psychological support which the doctor can render. Of course, the professional help of the psychologist can activate the ways of adaptation characteristic of the patient.
Medicinal methods of treatment include first of all tranquilizing drugs. Benzodiazepiyonoyovy anxiolytics are used for stopping of acute symptoms of alarm and more than 4 weeks because of threat of formation of a syndrome of dependence should not be applied. At short-term subsyndromal or soft alarming disorder of adaptation the vegetable calming collecting or drugs on their basis, antihistaminic drugs (Hydroxyzinum) are used. The valerian for many years is used in traditional medicine thanks to hypnotic and sedative effects and so far remains very demanded medicine. Especially successful were drugs containing the valerian and additional phyto-extracts strengthening anxiolytic effect of a valerian. Shiroyoky application was found by the drug Persen which contains, in addition to a valerian, extract of a melissa and mint that strengthens anxiolytic effect of a valerian and adds spasmolytic action. Osoyobenyono well proved in treatment of subsyndromal alarming and soft alarming frustration of Persen-Forte, soyoderyozhashchy 125 mg of extract of a valerian in the capsule against 50 mg in the tableted form thanks to what Peryosen-Forte provides high and bystry anksioyolitichesky effect. The range of use of Peryosena-Foryote in practice of the clinical physician is extremely wide – from use in monotherapy for treatment of subsyndromal and soft alarming disturbances to a combination with antidepressants for leveling of alarm at alarming and depressive frustration. There are no accurate recommendations about duration of therapy of soft and subsyndromal alarming syndromes. Nevertheless the majority of researches proved advantage of long courses of therapy. It is considered that after a reduction of all symptoms has to pass not less than 4 weeks of medicinal remission then the drug withdrawal attempt becomes. Treatment by sedative rasyotitelny collecting averages 2–4 months.
Drugs of the first stage of the choice for treatment of chronic alarming frustration are the selective serotonin reuptake inhibitors (SSRI). At disorders of adaptation the question of a nayoznayocheyoniya of SIOZS rises in case of risk of synchronization of frustration (progressing of symptoms more than three months) and/or risk of transition of adaptive frustration to clinical forms of psychopathology. Besides, the indication for prescription of antidepressants is disorder of adaptation with alarming and depressive mood or domination of depressive mood.
The set of the medicines used for treatment of frustration of mood, alarm and sleep disorders can badly be transferred by patients because of side effects that finally levels their efficiency. The officinal preparations of a plant origin having significantly less than side effects can be considered as alternative therapy or be used for strengthening of efficiency of prescription medicines (in particular, at intolerance of tranquilizers and antidepressants).
