Asthenic (neurotic) syndrome
Asthenic syndrome is a psychopathological disorder that is characterized by progressive development and accompanies most diseases of the body. The main manifestations of asthenic syndrome are fatigue, sleep disturbance, decreased performance, both physical and mental, irritability, lethargy, autonomic disorders.
Asthenia is the most common syndrome in medicine. It accompanies infectious and somatic diseases, disorders of the mental and nervous system, occurs in the postpartum, postoperative, post-traumatic period.
Asthenic syndrome should not be confused with ordinary fatigue, which is a natural state of the body of any person after pronounced mental or physical stress, after a change of time zones, etc. Asthenia does not occur suddenly, it develops gradually and remains with a person for many years. Asthenic syndrome cannot be dealt with simply by getting enough sleep at night. His therapy is within the competence of the physician.
Most often people of working age from 20 to 40 suffer from asthenic syndrome. People who do hard physical work, those who rarely rest, are exposed to regular stress, conflicts in the family and at work can fall into a risk group. Doctors recognize asthenia as a disaster of our time, since it imperceptibly affects the intellectual abilities of a person, his physical condition, and reduces the quality of life. In the clinical practice of any doctor, the share of complaints of asthenia symptoms is up to 60%
- Asthenic syndrome symptoms
- Causes of asthenic syndrome
- Diagnostics of the asthenic syndrome
- Treatment of asthenic syndrome
Asthenic syndrome symptoms
The symptoms of asthenic syndrome are three basic manifestations:
- Symptoms of asthenia itself;
- Symptoms of the pathology that led to asthenia;
- Symptoms of a person's psychological reaction to the existing syndrome.
Symptoms of asthenia are most often subtle in the morning hours. They tend to build up throughout the day. The clinical signs of asthenia reach their peak in the evening, which forces a person to interrupt his work and rest.
So, the main symptoms of asthenic syndrome are:
Fatigue. It is fatigue that all patients complain about. They note that they are starting to get tired more than in previous years, and this feeling does not go away even after a long rest. In the context of physical labor, this is manifested in the lack of desire to do their job, in the growth of general weakness. As for intellectual activity, there are difficulties with concentration, memory, attentiveness and intelligence. Patients prone to asthenic syndrome indicate that it has become more difficult for them to express their own thoughts, to formulate them into sentences. It is difficult for a person to find the words to express any idea; the decision is made with some inhibition. To cope with the previously feasible work, he has to take a time-out to get some rest. At the same time, work interruptions do not bring results,the feeling of fatigue does not recede, which provokes anxiety, forms self-doubt, causes internal discomfort due to his own intellectual failure.
Vegetative disorders. The autonomic nervous system always suffers from asthenic syndrome. Such disorders are reflected in tachycardia, in blood pressure drops, in hyperhidrosis and pulse lability. It is possible that a sensation of heat appears in the body, or, on the contrary, a person experiences a feeling of chilliness. Appetite suffers, disorders of the stool appear, which is expressed in the occurrence of constipation. Pains in the intestines are frequent. Patients often complain of headaches, heaviness in the head, males suffer from decreased potency. (read also: Vegeto vascular dystonia - causes and symptoms)
Psycho-emotional disorders. Decreased performance, difficulties in terms of professional activity cause the appearance of negative emotions. This is a completely natural human reaction to a problem that has arisen. At the same time, people become quick-tempered, picky, unbalanced, constantly in tension, unable to control their own emotions and quickly leave themselves. Many patients with asthenic syndrome have a tendency to increased anxiety, assess what is happening with obviously unfounded pessimism, or, on the contrary, with inadequate optimism. If a person does not receive qualified assistance, then disorders of the psycho-emotional sphere are aggravated and can lead to depression, neurosis, neurasthenia.
Problems with night rest. Sleep disorders depend on what form of asthenic syndrome a person suffers from. With hypersthenic syndrome, it is difficult for a person to fall asleep, when he succeeds in seeing vivid saturated dreams, he can wake up several times at night, gets up early in the morning and does not feel fully rested. Hyposthenic asthenic syndrome is expressed in drowsiness, which follows the patient in the daytime, and at night it is difficult for him to fall asleep. Sleep quality also suffers. Sometimes people think that they practically do not sleep at night, although in fact sleep is present, but it is severely disturbed. On the subject: how to fall asleep quickly in 2 minutes?
Patients are characterized by increased sensitivity. So, a weak light seems to them too bright, a quiet sound is very loud.
The development of phobias is often inherent in people with asthenic syndrome.
Often, patients find in themselves symptoms of various diseases, which in fact they do not have. These can be both minor illnesses and fatal pathologies. Therefore, such people are frequent visitors to doctors of various specialties.
It is also possible to consider the symptoms of asthenic syndrome in the context of two forms of the disease - this is a hypersthenic and hyposthenic type of the disease. The hypersthenic form of the disease is characterized by increased excitability of a person, as a result of which it is difficult for him to endure loud noises, screams of children, bright light, etc. This irritates the patient, forcing him to avoid such situations. A person is haunted by frequent headaches and other vegetative-vascular disorders.
The hyposthenic form of the disease is expressed in low sensitivity to any external stimuli. The patient is depressed all the time. He is lethargic and drowsy, passive. Often people with this type of asthenic syndrome experience apathy, unmotivated anxiety, sadness.
Causes of asthenic syndrome
Most scientists are of the opinion that the causes of asthenic syndrome lie in overstrain and depletion of higher nervous activity. The syndrome can occur in absolutely healthy people who have been exposed to certain factors.
A number of scientists compare asthenic syndrome with an emergency brake, which does not allow the potential of working capacity inherent in a person to be completely lost. Symptoms of asthenia signal to a person about overload, that the body is struggling to cope with the resources it has. It is an alarming condition indicating that mental and physical activity should be suspended. Thus, the causes of asthenic syndrome, depending on its form, can vary.
Causes of functional asthenic syndrome
Acute functional asthenia occurs due to exposure to stress factors on the body, overload at work, as a result of a change in the time zone or climatic conditions of residence.
- Chronic functional asthenia occurs after infections, after labor, after surgery and weight loss. The impetus can be transferred ARVI, influenza, tuberculosis, hepatitis, etc. Dangerous somatic diseases such as pneumonia, gastrointestinal diseases, glomerulonephritis, etc.
- Psychiatric functional asthenia develops against the background of depressive disorders, with increased anxiety and as a result of insomnia.
Functional asthenia is a reversible process, it is temporary and affects 55% of patients with asthenic syndrome. Functional asthenia is also called reactive, since it is the body's reaction to one or another effect.
The causes of organic asthenic syndrome. Separately, it is worth noting organic asthenia, which occurs in 45% of cases. This type of asthenia is provoked by either a chronic organic disease or a somatic disorder.
In this regard, the following reasons are distinguished leading to the development of asthenic syndrome:
- Brain lesions of infectious organic origin are various neoplasms, encephalitis and abscess.
- Severe traumatic brain injury.
- Demyelinating pathologies are disseminated encephalomyelitis, multiple sclerosis.
- Degenerative diseases are Parkinson's disease, Alzheimer's disease, and senile chorea.
- Vascular pathologies - chronic cerebral ischemia, strokes (ischemic and hemorrhagic).
Provocative factors that have a potential effect on the development of asthenic syndrome:
- Monotonous sedentary work;
- Chronic sleep deprivation;
- Regular conflict situations in the family and at work;
- Prolonged mental or physical work that does not alternate with subsequent rest.
Diagnostics of the asthenic syndrome
Diagnosis of asthenic syndrome does not cause difficulties for doctors of any specialty. If the syndrome is a consequence of an injury, or develops against the background of a stressful situation or after an illness, then the clinical picture is quite pronounced.
If the cause of asthenic syndrome is any disease, then its symptoms can be veiled by the symptoms of the underlying pathology. Therefore, it is important to interview the patient and clarify his complaints.
It is important to pay maximum attention to the mood of the person who came to the reception, to find out the features of his night's rest, to clarify his attitude to work duties, etc. This should be done, since not every patient can independently describe all his problems and formulate his complaints.
When interviewing, it is important to take into account that many patients tend to exaggerate their intellectual and other impairments. Therefore, not only neurological examination is very important, but also the study of the intellectual and mnestic sphere of a person, for which there are special questionnaire tests. It is equally important to assess the patient's emotional background and his reaction to some external stimuli.
Asthenic syndrome has a similar clinical picture with neurosis of the depressive type and hypochondriacal type, and with hypersomnia. Therefore, it is important to make differential diagnosis with these types of disorders.
It is necessary to identify the main pathology that could provoke asthenic syndrome, for which the patient should be referred for consultations to specialists of various profiles. The decision is made on the basis of the patient's complaints and after his examination by a neurologist.
Treatment of asthenic syndrome
It is important to begin treatment of asthenic syndrome of any etiology with the performance of psycho-hygienic procedures.
Medication is reduced to taking the following drugs:
Antiasthenic drugs: Salbutiamine (Enerion), Adamantylphenylamine (Ladasten).
- Nootropic drugs with the effect of psychostimulation and antiasthenic properties. They give strength, have a stimulating effect. These drugs include: Piracetam, Pyritinol, Gliatilin, Pantogam, Cerebrolysin, Kogitum, Noben, Neuromet, Nooclerin, Phenotropil.
- Vitamin and mineral complexes. In the United States, it is customary to treat asthenic syndrome by prescribing high doses of B vitamins, such as neuromultivitis.
Herbal adaptogens: ginseng, lemongrass, rhodiola rosea, ashwagandha, pantocrine, etc. On the topic: soothing medicinal herbs
- Antidepressants, neuroleptics, procholinergic drugs can be prescribed by neurologists, psychiatrists, psychotherapists. In this case, a comprehensive examination of the patient is important. With mild asthenia, the following can be prescribed: Gelarium, Azafen, Trazodon. With severe asthenic syndrome: Clomipramine, Imipramine, Amitriptyline, Fluoxetine.
- Depending on the degree of disturbance in the night rest, hypnotics and sedatives may be recommended to relieve unnecessary anxiety. These drugs include persen and novo-passit.
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To improve overall emotional and physical well-being, the drug Valemidin shows itself well. It is a herbal sedative. Release form in the form of drops of 25, 50, 100 ml in a bottle, dispensed without a doctor's prescription. It contains: tincture of hawthorn, valerian, motherwort, mint, the interaction of which is enhanced by a small dosage of diphenhydramine. With severe stress, nervousness and insomnia, it works effectively, after its use, a general improvement in the emotional state is noticeable. The quality of sleep also improves, the sleep becomes deeper. Valemidin acts on the central nervous system gently, without toxic effects and without forming dependence on the drug.
Some physiotherapy procedures, such as electrosleep, massage, aromatherapy, reflexology, give a good effect.
The general recommendations given by experts are as follows:
- The mode of work and rest should be optimized, that is, it makes sense to revise your own habits and, possibly, change jobs.
- You should start doing tonic physical exercises.
- It is important to exclude the effects of any toxic substances on the body.
- You should stop drinking alcohol, smoking and other bad habits.
- Tryptophan-fortified foods are useful - bananas, turkey, and wholemeal bread.
- It is important to include foods such as meat, soy, and legumes in your diet. They are excellent sources of protein.
- Do not forget about vitamins, which are also desirable to obtain from food. These are a variety of berries, fruits and vegetables. Separately, it is worth highlighting seeds and brewer's yeast, as a source of B vitamins in large quantities.
The best option for a patient with asthenic syndrome is long rest. It is advisable to change the environment and go on vacation, or to a spa treatment. It is important that relatives and friends are sympathetic to the condition of a member of their family, since the psychological comfort at home is important in terms of therapy.
The success of treatment often depends on the accuracy of identifying the cause that led to the development of asthenic syndrome. As a rule, if it is possible to get rid of the underlying pathology, then the symptoms of asthenic syndrome either completely disappear or become less pronounced.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".