Neuroses and obsessive states. Neuroses and neurotic conditions. Types of neuroses

A healthy psyche is characterized by a positive emotional state as a stable response to various events and facts. The predominant emotional state (joy, anxiety, sadness, etc.) is the mood, the emotional background against which a person’s life takes place with all its components. It is the emotional state that has a powerful influence on and is a reliable indicator of it, therefore a negative emotional state is an indicator of deterioration mental health and health in general. The consequence of such negative emotions(especially suppressed ones) are neuroses.

Neurosis, according to I. II. Pavlov, - this is a breakdown of the highest nervous activity. Neurosis can be considered as a functional nervous disease, not confirmed structural changes. That is, with neurosis there are no organic disorders, but brain processes associated with information processing, emotions, and control of nervous processes are disrupted. Consequently, neurosis can be eliminated with appropriate therapy (mainly through normalization of lifestyle).

There are three basic forms of neurosis. Hysteria more often occurs in people close to the artistic type of GND, and manifests itself in motor-support and autonomic disorders.Psychasthenia, or obsessive-compulsive neurosis, most often develops in people of the thinking type and manifests itself in obsessions or fears. In people of the intermediate type, neuroses of the type arise neurasthenia, which manifests itself in decreased performance, sleep disturbances, irritability, etc.

In addition to the classification of neuroses given above, others are used in practice. Thus, neuroses are divided into general and systemic. TO general include asthenic and hysterical neuroses, neuroses of fear, obsessive states, etc. systemic The most common types are neurotic urinary incontinence (enuresis), stuttering (logoneurosis) and tics. These often include diseases in which it is difficult to identify any one leading syndrome; these are the so-called undifferentiated neuroses.

Each type of neurosis has its own characteristic features: symptoms, frequency of occurrence, preferential development in individuals with certain psychophysiological characteristics, etc. For example, asthenic neurosis- a combination of increased excitability and irritability with rapid depletion of active attention, fatigue and low mood; hysterical neurosis - an unconscious desire to maintain a painful state, etc.

With regard to neuroses, two important circumstances should be highlighted:

1. Manifestations of neurosis are predominantly determined by the individual psychophysiological characteristics of a person, i.e. due to hereditary conditions.

2. Ultimately, the immediate cause of any neurosis is the discrepancy between the work performed by the brain (the degree of its tension) and the conditions that ensure the restoration of its condition and performance. The fact is that in the process of hard work, the brain seems to use its existing reserves, works “on credit”, and if in recovery period this debt is fully repaid, then there are no problems. But if the brain works in conditions DC voltage, and adequate conditions for restoring reserves do not occur, then in this case neurosis occurs. For example, this happens among students during an exam session, when instead of rhythmically alternating brain load and rest, a student limits sleep time and deprives himself fresh air, movement and positive emotions.

Thus, the likelihood of a breakdown in higher nervous activity is primarily determined by a person’s lifestyle and the characteristics of his psychophysiological organization. Therefore, neurosis affects not only people who are poorly adaptive, weak, and unsure of themselves, but also those who do not know how to properly organize their lifestyle and live “peddling”: as a rule, they know about the need for rest in such a stressful work regime, but right now, how It seems to them that this is not the time to rest.

Neuroses are a widespread disorder. Thus, among schoolchildren, no more than a third are free from any mental disorders; at least 33% of conscripts into the Armed Forces are annually exempted from conscription due to neuropsychiatric disorders, up to 80% of teachers suffer from various forms.

Long-lasting neuroses often provoke various chronic diseases. This is due to the fact that when functional disorders arise in the brain various violations in the organ system associated with the corresponding part of the brain. These disorders appear in different people in different ways and primarily in the weakest system (due to genetic predisposition, or violations healthy image life, or both together). More often neurotic conditions manifest themselves in sharp decline performance, deterioration of sleep, memory, loss of appetite; the stability of blood flow and blood pressure may be disrupted, pain in the different organs and headaches. And if at first a person’s complaints are not supported by data objective research, then with insufficient or unqualified medical care may develop organic diseases. Therefore, it is not surprising that every second patient with vegetative symptoms needs first and foremost the help of a psychotherapist, and after receiving qualified assistance Often there is no need to visit another specialist doctor at all.

Neurotic conditions

Neuroses- nervous breakdowns mental activity: hysterical neurosis, neurasthenia and obsessive states.

Hysterical neurosis

Hysterical neurosis occurs in psychotraumatic circumstances, mainly in persons with pathological, artistic types of higher nervous activity. Increased inhibition of the cortex in these individuals causes increased excitability of subcortical formations - centers of emotional-instinctive reactions. Hysterical neurosis is common in persons with increased suggestibility and self-hypnosis. It is expressed in excessive affectation, loud and prolonged, uncontrollable laughter, theatricality, and demonstrative behavior.

Neurasthenia

Neurasthenia manifests itself in weakening of nervous activity, irritable weakness, increased fatigue, exhaustion. The individual’s behavior is characterized by lack of restraint, emotional instability, and impatience. The level of anxiety, restlessness, and constant expectation of unfavorable developments of events increases sharply. The environment is subjectively reflected by the individual as a threat factor. Experiencing anxiety and lack of self-confidence, the individual seeks inadequate means of overcompensation.

Weakness, exhaustion nervous system with neuroses it affects the weakening of its integrating function, some disintegration mental formations , individual manifestations of the psyche acquire relative independence; this leads to obsessive states.

Obsessive states

Obsessive-compulsive disorder is expressed in obsessive feelings, attractions, ideas and obsessive philosophies.

Obsessive feelings of fear are called phobias(grsch. phobos - fear). Phobias are accompanied by autonomic dysfunction (sweating, increased heart rate) and behavioral inadequacy. at the same time, he realizes the obsession of his fears, but cannot free himself from them. Phobias are diverse. Let's list just a few of them:

nosophobia- fear various diseases(cancerophobia, cardiophobia, etc.)
claustrophobia - fear of closed spaces, agoraphobia - fear of open spaces
aichmophobia - fear of sharp objects
xenophobia - fear of strangers
social phobia - fear of communication, public expressions
logophobia - fear speech activity in the presence of other people, etc.

Obsessive ideas - perseverations(Latin pcrsevcratio - perseverance) - cyclical involuntary reproduction of motor and sensory-perceptual images (this is what, in addition to our desire, “gets into our head”).

Obsessive urges - involuntary inappropriate aspirations (counting the sum of numbers, reading words backwards, etc.).

Obsessive philosophizing - obsessive thoughts about minor issues, meaningless problems (“Which hand would be right if a person had four arms?”).

For neurosis obsessive movements the individual loses control over his manners, commits inappropriate actions (sniffs, scratches the back of his head, makes inappropriate antics, grimaces, etc.).

The most common type of obsessive disorder is obsessive doubts(“Is the iron turned off?”, “Is the address written correctly?”). In a number of acutely critical situations, when there is dominance in a certain danger, obsessive urges to engage in contrasting actions, opposite to those dictated by the situation (the desire to move forward, standing on the edge of an abyss, to jump out of the Ferris wheel cabin).

Obsessive states arise mainly in people with a weak type of nervous system, in conditions of weakening of their psyche. Some obsessive states can be extremely persistent and criminogenic.

In addition to the above, there are other types of obsessive states that cause inappropriate behavior. Yes, when obsessive fear failures a person turns out to be unable to perform certain actions (according to this pattern, some forms of stuttering, sexual impotence, etc. develop). At neuroses of anticipation of danger a person who experiences a fright in a certain situation begins to become panicky in fear of all similar situations. (The young woman was frightened by her rival’s threats to pour sulfuric acid on her, and she was especially afraid of the possibility of losing her sight. One morning, hearing a knock on the door and opening it, she suddenly felt something wet on her face. The woman thought with horror that she had been doused with sulfur acid, and she suffered sudden blindness. In fact, only pure snow fell on the woman’s face, which had accumulated above the door and collapsed when it was opened.) There are also neurotic life scenarios, in which long-past events are acutely experienced.

Many people believe that neurosis is not a very serious mental illness because most of our population suffers from different types neuroses. But this is a fallacy, and neurosis may be the beginning of the worst mental illness, such as psychosis or schizophrenia.

Types of neuroses

The classification of neuroses is in a chaotic state. Many patients showed a mixture of several neurotic syndromes. Pure syndromes, however, can also be found, and this helps to clearly form the core of the diagnostic categories into which they are divided. In the second edition of the manual on diagnostics and statistics mental disorders(DSM-II) lists nine neurotic syndromes. We will only look at the six main ones.

Anxiety

Anxiety in neuroses is characterized by signs of restlessness.

Anxiety is painful internal state nervousness and tension. This is a premonition of fear, which is accompanied by a variety of unpleasant bodily sensations, such as rapid heartbeat, sweating, trembling, shortness of breath and chest pain.

Anxiety occurs in both acute and chronic form. IN acute form, at sudden attacks violent symptoms grip the patient, causing a state of panic.

Chronic anxiety is characterized lingering symptoms less intensity.

Both forms can be painful and debilitating and often force the patient to seek medical help.

Conversion hysteria

Hysterical neurosis is more common in women than in men and is accompanied by wide range somatic symptoms. Patients become paralyzed, experience abnormal movements, feelings, blindness or deafness; or autonomic functions, loss of appetite and vomiting.

The bodily symptoms of hysteria are different from those associated with organic reasons; Thus, in hysterics, dysfunction is not associated with neural pathways, but rather in the general concept of a specific body part.

Hysterical patients typically show no concern or concern for the fact that they have very serious and painful disturbances - this phenomenon is often called "indifference."

Dissociative type hysteria

Difficulty of this type hysterical neurosis consists of altered states of consciousness varying degrees gravity. The simplest and most common is amnesia, in which the patient loses memory of events in his life, which ranges from a few hours to a lifetime.

Repeated periods of amnesia may alternate with periods of normal memory.

In double or multiple personality two or more separate persons exist in one body. Two (or more) people alternately appear and exhibit personality and behavioral characteristics that are often completely opposite to each other.

Phobia

The basis of phobic neurosis is irrational anxiety in the form of some object (subway, elevator, crowd) or situation (loneliness, open space), in which there is not sufficient real danger to justify manifestations of fear. The patient is able to control his anxiety by avoiding the phobic object or situation. If phobias are sufficiently extensive, they affect vital activity, can limit the life of an individual, and cause serious disability.

Obsessive-compulsive neurosis

This type of neurosis is characterized by obsession or obsessive thoughts. An obsession is usually a thought that some harm or damage is about to happen. Uncontrolled thoughts go against the will of a person. The patient feels obligated and, as a rule, fights unsuccessfully against obsessive thoughts. Although he knows that the thought is irrational and will most likely not be realized, he nevertheless reacts emotionally with significant anxiety.

Depression

At depressive neurosis arises painful feeling sadness and depressed mood. It may be accompanied by fatigue, difficulty concentrating, loss of appetite, and feeling anxious, restless sleep. In addition, the patient may experience an unpleasant loss of self-esteem and self-confidence.

Unlike patients with psychotic depression, patients with nervous depression rarely commit suicide.

Among mental pathologies, neuroses are one of the most common diseases. Their treatment is complicated by the fact that there is no single generally accepted system by which the types of manifestations of the disorder can be effectively structured. Most often, medical specialists use the classification of neuroses according to ICD-10.

General description of neuroses

Systematization of neuroses is impossible without determining the main parameters of the disease, including the concept, symptoms, causes, etc.

Concept

Neurosis is a group of functional mental disorders that arise as a result of strong experiences and stress, which are reversible and tend to be protracted.

The concept was first introduced into scientific circulation at the end of the 18th century by the Scottish physician William Cullen. Since the beginning of the study, the content of the term has been revised several times. IN modern science There is no generally accepted interpretation of the concept of neurosis. With the advent of new works and research, the content of the phenomenon is adjusted and changed. In biology and medicine, neuroses can be understood as radically different disorders of higher nervous activity.

Symptoms

The key parameter for characterizing the pathology in question is clinical picture. It can be asthenic, obsessive or hysterical in nature. An additional aspect of the course of the disorder is a temporary decrease in mental and physical activity.

The nature of the development of the disease is influenced by age (children suffer from the disease differently than adults), gender, and other personal characteristics.

Differences between neuroses and other nervous pathologies:

the primary role of experiences, stress (psychogenic nature);
painful manifestations are secondary, additive in nature to psychogenic manifestations;
reversibility;
absence of signs of dementia, progressive personality changes;
a person is aware of the presence of certain psychological characteristics I have a hard time experiencing this.

Symptomatic manifestations are expressed in the psychological and physical spheres.

What are the psychological forms of the disorder:

Emotional depression, mood swings.
Behavioral defects manifested in indecisiveness.
Communication problems.
Problems with self-esteem.
The presence of anxieties, fears, phobias, panic attacks. High sensitivity to stressful influences.
Vagueness, inconsistency and variability of the system of values, desires, aspirations, expectations from life, attitudes towards oneself and others.
Irritability, touchiness, tearfulness, anxiety, sensitivity to external stimuli (noise, light).
Obsession with the situation that led to psychological trauma.
High level of fatigue, problems sleeping.

Which ones are highlighted? physical forms illness:

Pain in the head, stomach, heart area.
Decrease in physical and mental capabilities body.
Dizziness and darkening of the eyes.
Panic attacks.
Disruption of the digestive system.
Sleep disorders.
Increased psychological sensitivity to physical pain, excessive concern for health.
sweating, frequent urination, differences blood pressure, cough.

Reasons for development

Factors that encourage the emergence and development of neurotic disorders:

External conflicts.
Internal (deep psychological) conflicts.
Circumstances that influenced the occurrence of traumatic factors.
Nervous and mental tension.
Excessive emotional and intellectual stress.
Personal characteristics of a person, the conditions for their formation and maturation.
Character social role person, its relationship with internal claims.
Disturbances in the functioning of nervous system systems.

Preventive and therapeutic measures

The disease is reversible, so it can be completely cured and the condition of the patient’s body can be restored.

Literate people also play an important role preventive measures. They are able to prevent the occurrence and development of pathology. Used as a means of prevention and elimination various methods and means:

drug treatment;
various types of psychotherapy (cognitive-behavioral, psychodynamic, etc.);
hypnosis;
muscle relaxation, self-hypnosis;
light therapy, walks in the fresh air;
breathing exercises techniques.

Classifications and typologies

There is no generally accepted classification of psychoneuroses. The most authoritative typologies are the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the system adopted in clinical psychology.

Classification according to ICD-10

ICD-10 is a document used throughout the world as a statistical and classification framework for healthcare. The document is periodically updated and adjusted in accordance with the latest discoveries in the field of disease research. The number "10" indicates that this document was created as a result of the tenth revision.

Classification and brief description neuroses according to ICD-10:

Neurosis of obsessive states (thoughts) is a disorder, the causes of which are conflicts of needs and morality.
Anxiety-phobic disorder is a disease caused by fears and phobias.
Hysterical neurosis is a disorder of unstable emotional state caused by a defensive reaction to an “unsolvable” situation.
Neurasthenia is a disorder, the causes of which lie in the internal conflict of demands on oneself and the inability to meet them.

Clinical classification

As a result scientific research And practical treatment A clinical classification of patients has been created.

What types of neuroses are there?:

Neurasthenia is irritable weakness.
Obsessiveness.
Neurotic depression.
Phobias and fears.
Obsessive behavior and thoughts.
Refusal of food.
Pathological feeling of hunger.
Exhaustion.
Defective manifestations in the activity of the stomach are various forms of disturbances in the activity of the digestive system.
Panic attacks.
Nervous pathologies of cardiac activity.
Self-forming neuroses - unreasonable pain, disturbances in the functioning of organs.
Laryngo- and pharyngospasms.
Disorders of success or guilt.
Neurosis of sexual activity.

Differences in classifications in domestic science and abroad

The classification of the disease in question does not have generally accepted world standards. Domestic psychologists prefer to divide the phenomenon into three types: neurasthenia, obsessive-compulsive neurosis and hysteria.

In foreign scientific circles the situation is radically different. Thus, in the USA, neurosis as a concept has been completely phased out since 1980. Disorders of this type are divided into the following types:

Dysthymic disorder (the term replaced the concept of depressive neurosis).
Obsessive-compulsive disorder (instead of obsessive-compulsive neurosis).
Hypochondria (instead of hypochondriacal neurosis).

The lack of a unified classification of the pathology in question is due to the lack of common opinion regarding the definition and characteristics of the disease. The division into types is determined by the criteria that are the basis of the created structure. Further study of the disorder will clarify the formulation of the characteristics, types and types of neurosis.

Neuroses are disorders or breakdowns in mental activity that arise as a result of suppression (frustration) of negative emotions. At the same time, the patient’s criticality towards the disease remains, and the perception of the world is not distorted.

Currently, the incidence of neuroses has increased. Researchers on this issue refer to the frantic pace of life modern man, whose body is not able to adapt so quickly to changes in environment. And this affected not only people living in the city, but also those living in rural areas. However, it is not only lifestyle that influences mental disorders of this type. The list of causes of neuroses also includes heredity, characteristics of a person’s temperament, still unresolved problems from childhood, and, in general, psychogenic factors of a different nature.

The modern pace of life contributes to an increase in the number of neuroses

Somatic manifestations of neuroses include:

Headaches that occur without any reason and completely suddenly, tremors of the limbs, pain in the area of the heart and abdominal cavity, in the muscles, frequent bowel movements.
Increased fatigue, lack of sufficient energy, apathy.
Dizziness and poor orientation, general disorders work vestibular apparatus. Fainting is possible.
Increased sweating, independent of environmental conditions.
Disorders of the genital system.
Sleep and digestive disorders.

Sleep disorder is one of the symptoms of neurosis

IN mental manifestations neuroses include:

Constant tension, a person is constantly in a state of compressed spring.
The patient is constantly tormented by negative, obsessive thoughts.
Memory deteriorates, the person becomes absent-minded.
Irritability increases, the patient is constantly in a state of uncertainty and inconsistency.

Types of neuroses and their characteristics

According to the Austrian psychiatrist, the founding father of psychoanalysis, Sigmund Freud, all neuroses can be divided into two types:

Hysteria;
Current neuroses.

According to International classification diseases of the 10th revision to category “F 4: Other anxiety disorders» refer neurotic disorders psychiatry, somatophoric and stress-related disorders.

Hysteria is a type of neurosis

This article will consider only the traditional classification.

Universal classification of neuroses in at the moment does not exist, but traditionally there are three largest groups of them:

Obsessive-compulsive disorder. The form of its manifestation is an uncontrollable flow of negative thoughts, alarming thoughts, ideas, desires, feelings. The cause of obsessive states may be an unfavorable life situation, a person’s internal conflict with your own desires or some specific situation, mistakes made by parents when raising a child.

Obsessive fears and phobias are a fairly large group of neuroses.

This type of neurosis also has several ramifications due to the fact that obsession can manifest itself in various forms activities:

Obsessive fears or phobias. When a person meets the object of his fear (not necessarily personal), the body reacts accordingly to the situation that has arisen - the heart rate increases, the process of sweating intensifies, disorientation and loss of sense of reality occur. There are many types of phobias, here are just a few of them: claustrophobia - fear of being in a confined space; arachnophobia – fear of spiders; social phobia – fear of being the center of attention; Nosophobia is the fear of contracting any disease.
Obsessive ideas– uncontrollably emerging images in the head that tend to repeat themselves many times.
Obsessive movements– uncontrolled performance of certain movements, a certain ritual. If for some reason the action was not completed, the person begins to experience anxiety, panics and cannot find a place for himself.
Obsessive urges– the desire to perform certain operations regardless of surrounding circumstances (count objects that catch the eye).
Obsessive doubts– constant concerns about supposedly imperfect actions.

Neurasthenia(or fatigue syndrome) is a disorder that arises from a person’s desire for the ideals he has created and the inability to achieve them. Because of this conflict, exhaustion of the body occurs and subsequent overexertion occurs. Manifests itself in the form of disorders of the functioning of the body’s autonomic systems ( increased sweating, rapid heartbeat, shortness of breath, etc.), decreased general endurance of a person, absent-mindedness, constantly changing mood, sleep disturbances, increased irritability. A person begins to perceive the world around us as hostile.
Hysteria– accompanied by somatophoric disorders of the body simulating illnesses in patients. That is, a person is confident that he has serious problems with health, although in fact he is absolutely healthy. In this type of neurosis, the patient’s demonstrativeness and desire to attract attention predominate. This happens because the patient’s demands on himself are too high, and he does not set the bar for himself according to objective criteria. Most often, hysteria occurs in females. An outbreak of hysteria can occur for any reason, such as defensive reaction to the current situation.

Sometimes a hysterical attack can begin for no apparent reason

It is not uncommon for a woman to fall into hysteria for no particular reason, just to achieve what she wanted or to have her opponent agree with her.

Symptoms include inappropriate behavior, increased suggestibility, forgetfulness, sudden mood swings, demonstrativeness, disturbances in work autonomic system the body, paresis and paralysis, disorders of the motor and sensory apparatus are possible.

27.07.2017 26.01.2019 Alexander Firtsev

Every day we are faced with many different kinds of failures, disappointments and conflicts, which, as we know, negatively affect our health. Interpersonal clashes and a person’s negative emotional state, caused by real or perceived failure, unfulfilled hopes, can lead to the emergence of neurotic disorders.

To the most common purchased functional diseases neurosis belongs to the nervous system. The disease occurs not only against the background of various experiences, but can also serve as their cause.

According to statistics, neuroses are observed in more than 30% of the population developed countries, at the same time, this figure increases every year.

Causes of neurosis

Not a single disease known to date occurs on its own; there are always some reasons for this. Likewise, neurosis occurs against the background of various emotional shocks, for example:

a psychotraumatic situation based on severe emotional shock;
chronic stress;
frustration;
life circumstances do not correspond to deep subconscious attitudes received in childhood.

Depending on the causes of the disease, symptoms may appear various symptoms. It is worth noting that according to the symptoms, several directions of development of the disease can be distinguished.

Main types of neurosis

To date, scientists have determined three types of neurosis:

neurasthenia;
hysteria;
obsessive-compulsive neurosis.

According to research by scientists, various types of neurosis manifest themselves in people with a certain psychotype. So, for example, people belonging to the category of “creative personality” are more prone to such a disease as hysteria, people who “think” are at risk of obsessive-compulsive neurosis, but the category of people who are between “creative” and “thinking” are at risk of making money neurasthenia.

Neurasthenia

Translated from Latin, the term “neurasthenia” means nervous weakness, which is often the result of the inability to overcome interpersonal and intrapersonal conflicts. Neurasthenia can be determined by initial stages when a person begins to experience symptoms such as:

manifestation of irritability for various minor reasons;
absent-mindedness;
rapid fatigue;
headaches and heart pain;
disruption of the gastrointestinal tract;
sleep disturbance;
decreased sexual activity.

In order to determine the occurrence of such a serious mental disorder, it is necessary to monitor the stability of your body and, at the first signs, immediately seek professional help, which will allow you to avoid more severe mental disorders and a depressive state.

More detailed description such a condition as neurasthenia, as well as a detailed description of its causes and treatment features, you can find in the article - « « .

Hysteria

A disease such as hysteria is observed mainly among the fair half of humanity. The disease arises against the background of the manifestation of pity for one’s own person, and the habituation of “living in an imaginary depressive world.”

Symptoms of hysteria include:

uncontrollable tears;
loss of consciousness;
dizziness;
nausea and vomiting;
disappearance of voice.

Psychological disturbance occurs against the background of a person’s belief in moral suffering. Pampering, capriciousness, excessively high self-esteem and other personality traits can lead to hysteria.

Obsessive-compulsive disorder

Obsessive-compulsive disorder, also called psychasthenia or obsessive-compulsive disorder (OCD), manifests itself in a more severe form than other types of neurosis. Mental disorder is accompanied by fears various types, For example:

fear of accidentally becoming infected with a dangerous disease;
fear of losing control of oneself or going crazy;
fear of losing a loved one;
various types;
panic attacks;
intrusive thoughts (usually frightening);
obsessive actions (visiting doctors, constantly measuring blood pressure or pulse, frequent washing hands, various checks);
perfectionism.

The important point is that a person is aware of his thoughts and understands that all fears are extremely illogical, but his own beliefs do not help him get rid of negative experiences.

If symptoms similar to signs of neurosis occur, it is best to immediately consult a psychotherapist. This will protect the body from serious disorders and prevent the development of deep mental disorders.