Neurotic disorder (neurosis) – types, causes, treatment

Neurotic disorder is considered the most common of all mental illnesses. According to World Health Organization statistics, at least 10% of the population of every developed country is susceptible to neurosis. Unfortunately, these numbers are only increasing from year to year due to the increasing dynamics of our lives.

What is a neurotic disorder?

Neurosis (or mental neurosis) is a generalized name for a group of neuropsychiatric disorders, psychogenic in nature, resulting from prolonged or excessive intense emotional stress.

This disorder is always acquired, and acts both as a consequence and cause of failures, interpersonal clashes and frustrations.

During neurosis, there is a decrease in performance and a sense of joy in life. A person becomes anxious, aggressive, and his ability to communicate is impaired.

Neurotic mental disorders are characterized by agitation, tearfulness, and a generally inadequate reaction to stimuli. Many psychotherapists agree that the disorder is caused by mental trauma.

Speaking of the neurotic disorder syndrome, it is necessary to emphasize two points:

1. The neurosis is always a consequence of some negatively colored situation. It is the catalyst for triggering the disorder. In other words, only a person who has not been exposed to a stressful situation does not have a neurotic disorder.
2. The disorder is reversible. Unlike psychopathic disorders, in which there is complete destabilization of the nervous system and social maladjustment, neurosis does not instill in its wearer a critical self-perception. At the same time, the neurotic condition can last for quite a long time – in some cases, several years.

In other words, neurotic personality disorder is a condition that is caused by stress and causes exhaustion of the nervous system. It can often be a combination of fatigue and irritability. It is accompanied by vegetative disorders – palpitations, increased sweating.

This disorder has long been recognized by the world community of psychiatrists and is included in the ICD-10 under the heading “neurotic, stress-related and somatoform disorders”. All disorders related to neurosis are coded F40 to F48.

Symptoms of neurosis

A neurotic disorder can be found in anyone. Signs of it are also extensive and quite difficult to classify. However, it is always necessary to remember that the disease was preceded by some significant stress. In general, the symptoms of mental neurosis are as follows:

• decreased concentration, impaired memory, confusion of thought;
• gastrointestinal disorders – cramps in the stomach, loss of appetite;
• the skin begins to itch, redness may appear;
• disorders of sexual character;
• restless sleep or insomnia. Some people may remain drowsy throughout the day;
• frequent urge to go to the toilet;
• muscle soreness, headaches;
• blood pressure abnormalities; restlessness of the heart rhythm;
• the person may be short of breath during the attack.

Symptoms of neurosis in women are no different from those in men, although the disorder is much more common among the former. The difficulty is that these signs can accompany any other disease. The picture is further aggravated by the fact that neurotic women often feel pain in various organs, and often a rise in temperature. Malaise is written off on a cold or vegetative vascular dystonia due to high blood pressure and heart pain. Childhood neurosis is accompanied by bedwetting, and nervous tics may occur. Also, as in adults, sleep disturbances accompanied by nightmares are observed.

Neurotic disorders occur in people with a weak nervous system, but this is not a necessary rule, since stress can provoke a disorder in anyone.

The disorder can affect not only adults, it is often diagnosed in a child. The clinical picture in this case in children is peculiar:

• The symptomatology is incomplete;
• A child is less likely than an adult to have processed traumatic experiences in the psyche and the neurotic symptoms themselves;
• In children’s neurosis, there is a significant expression of somatic and motor disorders.

Why neurosis occurs

At the moment, it is believed that the disorder occurs due to a complex of reasons: social, psychological and biological. Each of them almost equally can provoke this condition. Although some experts still believe that neurosis is inherited, this opinion is groundless.

Among the main causes of neurosis are:

• Weak nervous system;
• Prolonged mental fatigue;
• Tension in relationships with loved ones;
• Overwork as a result of excessive work;
• Exposure to strong external stimuli.

In general, all factors, as already mentioned, can be divided into three groups:

1. Social: causes that are generated by social interaction. These include education, career, relationships with parents, friends and peers.
2. Biological: factors that arise from physiological attitudes. Neuroses can be triggered by pregnancy. There is a correlation with gender and age, and physique traits.
3. Psychological: the occurrence of neurotic disorders is connected with traumatic situations, the state on the verge of life and death, childhood psychological traumas.

Pathogenesis of neuroses

Neurosis is the effect of various stressful situations on a person’s mental equilibrium. Such situations include quarrels, conflicts, misunderstandings and enmity between people.

As soon as the brain receives a signal of stress, it turns on its protective functions and tries to protect the body as a whole from damage. To do this, it restructures the activity of the higher nervous system (HNS). Thus, all attention is concentrated on fighting back the conflict situation or trying to ignore it.

The pathogenesis of neurosis is built entirely on the GND, because it acts on all of our organs. And these organs can react in completely different ways. That’s why the manifestation of neurotic disorder can differ from person to person – someone is more irritated, and someone, on the contrary, has an inhibited reaction.

Stages of the disorder

Each person with symptoms of the disorder can go through three stages, each of which will aggravate the previous condition.

Stages of neurosis:

1. Neurasthenia. This manifests itself as demands on oneself – the person sets an insurmountable bar for oneself, he strives for success, to achieve which he spares no effort. This does not take into consideration the real situation. Often the reason for this may be the upbringing of parents, their transfer of expectations onto the child. At this stage, agitation, sleep disorders, and problems in one’s personal and sexual life appear.
2. Hysterical neurosis. The neurasthenic person is torn by feelings of contradiction – between the necessity to do something and the impossibility of doing it, and any unfulfilled business causes panic. At this stage, life’s system of values collapses. Material values are placed on a pedestal – one strives to earn more money or, on the contrary, to stray into spirituality and blindly follow spiritual goods. Vegetatively, forgetfulness and intense worrying appear, and the person imagines himself or herself to be the center of the universe.
3. Obsessive-compulsive neurosis. This stage in the development of the neurosis is marked by fear, a manic desire to become better, to achieve more. It appears in people who were brought up in an atmosphere of strict tutelage, due to which they have formed a sense of inferiority. Fear develops into a phobia, presenting itself in an obsessive form.

Each of these stages suggests a different approach to treatment.

Classification of neuroses

In psychiatry, it is customary to divide the disorder into several syndromes, each of which has certain features:

1. Obsessive syndrome. Associated with the manifestation of an obsessive state. A person with this type is like an obsessive who follows some thought or idea that has matured in his head. Examples of this disorder: obsession with numbers and the desire to count everything, unconscious or deliberate repetition of the same actions. The person suffers from incompleteness of actions, and his anxiety about them takes on a manic character.
2. Hypochondria. Exaggeration of one’s own painful condition, when the patient notes the slightest changes in his or her health, and often fancies them, tries to have a complete examination, constantly going to the doctor. This syndrome is one of the most obvious signs of a neurotic condition, which helps in the diagnosis of neurosis.
3. Asthenia. With this syndrome, the person feels depressed, has no desire to do anything, the condition resembles apathy, and there is weakness in the body. Asthenic syndrome in turn is presented in three forms:
   
   Neurotic – this is weakness, decreased concentration, restless sleep, possible dermatic reactions – redness, itching;
   Psychotic – weakness and depressed state bordering on depression. All emotions take on a negative coloring, any strain has a bad effect on the physical condition. This depressive neurotic disorder is fraught with difficulties in extricating the person from it;
   Organic. In this case, organs and systems are involved. Most often, the condition is accompanied by instability in the cardiovascular system. This type of asthenia usually occurs with disorders of brain function.
   
4. Phobias. This form of neurotic disorders is characterized by an intrusive feeling of fear. This person is clearly aware that nothing poses a threat to his life, but he cannot recognize the nature of his fear. The variety of phobias is very wide. The most common among them are fear of confined spaces, fear of performance and fear of various diseases.

All forms of neurotic disorders must be recognized at the initial stages, otherwise there is a high probability of hypochondria, when all of human existence will revolve around a painful condition.

In order to avoid this, it is necessary to contact a specialist in a timely manner. Otherwise, treatment will be delayed and the involvement of specialists of various profiles will be required.

The disorder also differs in degrees of manifestation – some of them are accompanied by weak manifestations of symptoms, while others are characterized by a pronounced severity:

1. Compulsive neurosis (CNS) is also called obsessive-compulsive neurosis. It is characterized by the predominance in the clinical picture of a variety of obsessive phenomena, such as movements, actions, fears (phobias), misgivings, ideas of thoughts that arise relentlessly against the wishes of the patient, who is aware of their unreasonably painful nature, unsuccessfully seeks to overcome them. NNS has psychogenic character and manifests itself as intolerance of external stimuli. Compulsive neurosis in children manifests itself in the form of compulsive movements and phobias. Depending on the prevalence of one or the other, an obsessive neurosis (compulsive movements) and phobias (compulsive fears) are conditionally allocated. Mixed forms are often encountered in both children and adults. Examples of compulsive movements: snapping fingers, biting lips or nails, jerking the head or leg, smacking, twisting buttons, circling an object only on the right or only on the left.
2. Another degree of manifestation is anxiety neurosis. It is connected with a feeling of fear; a person feels a sudden attack of anxiety, he or she can even anticipate it in some way. A fear that this condition will come back again develops. Therefore, a sense of avoidance phobia emerges. For example, a person who is afraid of confined spaces stops riding in the elevator. In this manifestation of the disorder, a combination of different states – aggression and anxiety, fear and obsessions – is also possible.
3. When the force of the influence of stress is too great, for example, many responsibilities in different areas appear at once, or an unexpected traumatic event occurs, acute mental neurosis can develop. Its difference from other forms and conditions is that this one arises quite unpredictably, that is, it is not preceded by a mild neurotic stage. Symptoms in this case are aggravated, the person is at the peak of emotional distress, his behavior may combine many manifestations – obsessions, depression, phobias, sleep disorders. Often only medication can help to relieve this condition.
4. At bright pathological sensations (“lump” in the throat, “needle in the heart” or “nail” in the head) it is possible to speak about panic neurosis. These sensations have a distinct subject character. And they are combined with the patient’s hysteriform behavior – excessive dramatization, theatricality in gestures, excessive demonstrativeness. Simultaneous or consecutive involvement of body systems – skin sensitivity, impaired coordination, cardiac failures – is observed.

Complications of neurosis

The disorder may affect not only the patient himself, but also people close to him. Communicating with a neurotic is uncomfortable.

Complications of neurosis can be various:

• disorganizes the activity of the person, can entail various psycho-emotional disorders – depression, memory disorders, obsessive-compulsive disorder;
• negative effect on the physical condition – heart and blood vessels suffer (hence, heart attacks, angina pectoris, hypertension), gastrointestinal tract (ulcers, gastritis appear), immunity is reduced;
• dizziness, fainting spells.

Consequences of neurosis can lead to severe health problems, so it is important to see a doctor and not try to get rid of this condition on your own.

When to see a doctor

Neurosis is in the field of study of psychotherapists. In neglected cases, other specialists – a neurologist, psychologist, therapist – may also be involved in the treatment process. When the first signs of neurosis appear, you need to make an appointment with a doctor right away. Only a specialist can correctly diagnose the disease and prescribe the necessary treatment.

If a person has at least 3 of the symptoms described above, you should take control of your condition. It is also important to listen to the people closest to you – disturbing signals of altered behavior and problems in your personal life may be a consequence of neurosis.

A patient with persistent neurosis should definitely be seen by a doctor.

It is better to choose proven clinics and certified specialists, since neurotic disorder can progress to a neglected stage and lead to other disorders.

Disease diagnosis

To make a diagnosis, the doctor conducts an interview. He asks questions, the answers to which can reveal the patient’s disorder.

The following criteria for the diagnosis of neurotic disorders are generally accepted among psychotherapists:

• The presence of a psychotraumatic situation in the person’s life;
• Presence of obvious neurotic features in the patient’s behavior – nail biting, itching, distracted attention, obsessive state when it comes to some achievements;
• Identifying the characteristic type of neurotic conflict and determining the stage of the disorder;
• Identification of neurotic symptoms.

Diagnosis also includes examining the patient and reviewing the patient’s medical history. One of the most popular techniques for diagnosing neuroses is considered to be color diagnosis – patients are asked to choose from a spectrum the color that they prefer at the moment. If a person chooses gray, purple, brown or black, it indicates that the patient is very likely to have a neurotic disorder.

With the help of psychological personality tests, the doctor can draw conclusions about the patient’s condition and his susceptibility to neurosis. A behavioral characteristics test is also often used.

Diagnosis of neurosis in women is better not to be carried out during the critical days – they can cause an anxious state and have an impact on behavior. It is also considered that the disorder in women is more severe than in men due to the greater natural emotionality of the former. In addition, the weaker sex is prone to hormonal outbursts. Menopause affects the outburst of emotions, and pregnancy and childbirth radically change the habitual way of life and cause elevated hormones.

In the case of neurosis in men, a heavy profession, way of life and worldview can provoke a disorder. It is worth taking into account that most men are trying to hide their emotions, so the visit to the doctor may postpone until the last moment. It is also difficult to recognize the diagnosis in men because of this – they don’t recognize the disorder to the last, they don’t go into contact with a professional.

Treatment of a neurotic disorder

First of all, it should begin with a visit to the doctor and strictly following his recommendations.

When treating a neurosis, the doctor can choose one of two methods – pharmacotherapy or psychotherapy. This is usually influenced by the stage of the disorder and its type.

A psychotherapist may be an advocate of one method of getting rid of the disorder, or a combination of the two in their practice. But medications are usually prescribed if psychotherapy is not effective.

The psychotherapeutic method is based on ways of communicating to the patient the abnormality of their condition. The therapist teaches how to monitor neurotic states and look for ways out of them. Identification of markers helps to correct situations that provoke stress. The person develops an attitude toward stressful events on the basis of learned practices (e.g. correct breathing, relaxing local massage).

As psychotherapy for neurotic disorders, psychoanalysis and suggestive therapy (which is based on the technique of self-involvement) can be used. Neurolinguistic programming, metaphorical maps, and body-oriented therapy have recently become popular. Many psychotherapists do not consider these methods, but nevertheless they are effective in some cases.

When the doctor decides to prescribe medications, the main ones will be tranquilizers – they improve sleep quality, relieve neurotic symptoms, negate irritability and reduce nervous irritability.

Also in the treatment of neurotic disorders are used nootropic drugs, antidepressants, psychostimulants and neuroleptics. The choice again depends on the patient’s condition and the stage of the disease: Elivel (Amitriptyline).
Vitamins and general reinforcing agents are often prescribed to strengthen the result.

Prevention of neurosis

Every year neurosis is only gaining momentum – there are more and more people with neurotic disorders. This is primarily due to the dynamism of modern life, which forces people to be mobile and multitasking.

As a preventive measure against neurosis, above all, it is worth recommending control of the quality of sleep – it should be calm and sufficient. Improving the immune system – hardening, taking vitamins, proper diet, can also play a role in preventing disorders. It is important to observe the alternation of work and rest.

Recommendations for children include the direct involvement of parents. There is no need to snap at the child and set expectations on him or her. Despotic parenting can ruin a child’s psyche in the future. Prevention of childhood neuroses is also based on general hygiene of the spirit – proper sleep, a balanced diet and spending time outdoors.