Neurasthenia

Description:

Neurasthenia — the mental disorder from group of neurosises which is shown in an acrimony, fatigue, loss of ability to long intellectual and physical tension. It is for the first time described by the American doctor George Beard in 1869.
The neurasthenia literally designates "weakness of nerves" (Greek asthenos – "weak").

Neurasthenia symptoms:

3 stages (form) of a neurasthenia are allocated:
1. Hypersthenic
The initial stage with which debuts a disease is shown by the increased mental excitability expressed by irritability. Patients are irritated by the slightest noise, a talk of people around, any sounds, bystry movement of people, just crowd of people around, populous concourses. They are easily irritated, shout at relatives, employees, interlocutors, are capable to offend, that is easily lose self-control, differ in big impatience. Along with it efficiency of patients is reduced, but not only at the expense of exhaustion, and at this stage of a disease, mainly, due to their mental not concentration, absent-mindedness, inability to concentrate on the necessary circle of representations and to begin necessary business, that is in connection with primary weakness of active attention. Having begun occupation, the patient long does not maintain the mental tension necessary here, besides — tension of active attention. Rises because of a table, leaves a workplace, is distracted by foreign irritants, then again "the difficult beginning" of occupation and so repeatedly, owing to big losses of time, labor productivity is insignificant. Sleep disorders are always expressed: the patient hardly falls asleep, often wakes up, again falls asleep, enduring the plentiful dreams cast by day cares. As a result rises with lateness and hardly, not the holidaymaker, with the heavy "not clear" head, bad mood in the morning, with feeling of fatigue and weakness which recedes a little only by the evening. Complaints to a headache, the general weakness, bad memory, unpleasant feelings in various parts of a body are frequent. Patients test weight in the head, pressure sense in temples, the surrounding headaches ("a neurotic helmet").
2. Irritable weakness - the second, intermediate, a disease stage.
It is characterized by so-called irritable weakness (the main clinical maintenance of the second form of a neurasthenia) — a combination of a hyperexcitability and irritability to fatigue and a bystry exhaustion. In accidental and insignificant occasions the patient has rough reactions of irritation or flash of excitement which are usually short, but are frequent. A hyperexcitability is quite often expressed in the tearfulness earlier not inherent to the patient, or in impatience, fussiness. The painful intolerance of loud sounds, noise, bright light, pungent smells is characteristic. Ability to control external manifestations of the emotions is lost. The active attention falls apart. There are complaints to absent-mindedness, bad storing. The mood is unstable, with tendency to depression. At severe forms of a neurasthenia the picture of a so-called depression of exhaustion can develop: patients are gloomy, sluggish, to everything are indifferent. Constant sign of a neurasthenia — a sleep disorder: backfilling difficulty, superficial or not grateful sleep, alarming dreams, drowsiness in the afternoon and sleeplessness at night. Decreases or completely appetite vanishes, the eructation, heartburn, locks, feeling of weight in a stomach appear. Complaints to headaches, heartbeat, feeling of sinking heart are frequent, disorders of sexual function etc. are possible.
Irritable weakness — the main clinical maintenance of the second form of a neurasthenia (or the second phase of a disease) which can be shown at subjects of impetuous, choleric temperament or at persons with strong and balanced type of a nervous system in cases when recovery at a hypersthenic stage did not follow, and a pathogenic situation remains.
3. Hyposthenic - the third stage. Weakness and an exhaustion prevail.
The main symptoms — slackness, apathy, the increased drowsiness, depression. Patients are not capable to mobilize themselves for working effort, they constantly have feeling of big fatigue, are suppressed by thoughts of the somatic feelings. At this stage of a disease the constant massive adynamy against the background of reduced mood is available. A mood background a little alarming, with a shade of grief and easing of interests. There are no affects of melancholy or alarm, the reduced mood has neurotic character, is penetrated by an adynamy and differs in tearfulness and emotional lability. Hypochiondrial complaints and fixing of patients on the internal feelings are frequent. Eventually (especially under the influence of treatment) at patients the dream improves what, in effect, and recovery process begins with. It should be noted that at repeated attacks of a neurasthenia (at any its form, in particular — the last) duration of attacks increases, and the depressive phenomena, going deep, more and more approach tsiklotimny level. In this regard still old authors (N. of Schule, R. Kraft-Ebing, S. S. Korsakov, A. V. Kannabikh) pointed to possibility of a periodic neurasthenia. The latest data of clinical experience on a possibility of development of such periodic displays of a neurotic depression into a cyclotymia also will be coordinated with it.

Neurasthenia reasons:

The neurasthenia arises usually at a combination of a mental injury to excessively hard work and physiological deprivations (a chronic sleep debt, lack of rest, etc.). Emergence of a neurasthenia is promoted by the infections weakening an organism and intoxications (alcohol, smoking), endocrine frustration, a hyponutrient, etc.

Treatment of the Neurasthenia:

Treatment of a neurasthenia in an initial stage is directed to streamlining of a work-rest schedule, elimination of the reason of an emotional overstrain, the general strengthening of an organism (regular food, vitamin therapy, fortifying treatment, psychotherapy). If necessary — work change. In hard cases (a hyposthenic neurasthenia) treatment in a hospital, use along with fortifying means of antidepressants and tranquilizers is shown. The forecast is favorable.