Psychoses and neuroses: causes, symptoms and differences between pathologies

Definition of neurosis and its symptoms

A group of disorders that arise in a person due to destructive psychological attitudes and stress is called neurosis. Situations conducive to the development of neurosis:

• hereditary tendency to nervous disorders;
• periodic conflicts at home or at work. Often occur in children and adolescents who grow up in dysfunctional families;
• excessive suspiciousness of the subject. The habit of reacting painfully to minor troubles exhausts the nervous system - a person with low self-esteem and a pessimistic attitude towards life is much more likely to develop neurosis than a positive-minded person;
• physical overload;
• chronic diseases that cause constant discomfort or acute pain (psoriasis, arthritis);
• a strong shock that the subject experienced in the recent past (death of a relative, fire, bankruptcy);
• long stay in a place where he was in danger.

Forms of neurosis:

• neurasthenia;
• fear;
• obsessive states;
• hysteria.

Manifestation of pathology

How the disease manifests itself: the patient’s mood changes sharply, the level of sensitivity increases. You can cry for half a day over a broken plate and be offended for a month at a colleague who did not invite you to his wedding. Self-esteem changes: some patients are overly critical of themselves. Inflated self-esteem is also not uncommon in neurosis.

A person suffers from constant fatigue, although the amount of daily exercise remains the same. A neurotic person is tormented by strong unreasonable fear. The patient experiences increased sweating. Trembling appears in the arms and legs.

The symptoms of a neurotic disorder are noticeable not only to you, but also to your friends and relatives. Can neurosis turn into psychosis: the likelihood of such a development of events is negligible, but an advanced neurotic disorder can undermine the nervous system and lead to insomnia and fainting.

Causes of neuroses

Most often, the onset of neurosis is provoked by events that cause enormous stress to the nervous system, or a prolonged state of tension. Less common are cases of hereditary predisposition, environmental influences or poor lifestyle choices. Loading himself with work up to his shoulders, which also brings emotional shocks, he accidentally leads himself to a nervous breakdown. Chronic diseases that debilitate the human body have an additional impact.

Causes and features of the manifestation of psychosis

Psychosis is a mental disorder that is expressed in the patient’s behavior that is strange and shocking to others. One of the differences between neurosis and psychosis: a neurotic disorder occurs due to traumatic situations, and psychosis develops unnoticed.

Causes of psychosis:

• congenital brain pathologies;
• alcoholism;
• taking narcotic drugs;
• traumatic brain damage;
• diseases of the endocrine system;
• infections affecting the nervous system;
• tumors in brain tissue;
• severe shock.

Psychosis has several varieties.

1. Endogenous. This form of the disease develops due to malfunctions of the endocrine and nervous systems.
2. Exogenous. The disease occurs due to external factors (inflammatory process, alcohol abuse).
3. Organic. This type of psychosis is characterized by impaired blood circulation in the brain.

It is difficult for a person far from medicine to understand whether neurosis or psychosis is debilitating his relative. The manifestation of psychosis differs from neurotic behavior; it has special signs.

1. Crazy ideas. The patient’s consciousness is taken over by a thought that is far from reality. A person may believe that his colleagues and neighbors are watching him. Some patients are obsessed with causeless jealousy. A psychotic person may imagine himself to be a prophet or an alien.
2. Auditory or visual hallucinations. The most common symptom is voices and sounds that a person allegedly hears. Some also experience olfactory and tactile hallucinations. The patient himself is sure that his visions are real.
3. Loss of appetite.
4. Incoherent speech. The subject may speak animatedly and then become silent or laugh. People whose mental health has been affected by psychosis often mimic their interlocutors.
5. Outbursts of aggression. The longer a person suffers from psychosis, the more often he becomes angry.
6. Loss of interest in work and household responsibilities. A psychotic has no desire to communicate with other people. The patient lacks the ability to empathize.
7. Forgetfulness.
8. Obsessive repetition of actions. For example, a psychotic may make and unroll his bed 5-10 times a day.
9. Suicidal thoughts.
10. Movement disorders. Psychotics are characterized by extremes in motor activity. The patient can sit in one position for a long time without reacting to stimuli (phone ringing, voices of relatives). Some patients experience excessive mobility and fussiness.

Personal characteristics that, under unfavorable conditions, facilitate the appearance of neurosis:

• emotionality
• impressionability
• pedantry
• tendency to control everything
• anxiety
• suspiciousness
• tendency to bottle up emotions within oneself
• tendency to get stuck in situations
• high intelligence
• dependence on the opinions of others
• desire to be good
• do everything perfectly
• the best
• ambition
• habit of success
• inflexibility
• tendency to view everything through an all-or-nothing or black-or-white lens

In addition to the above-mentioned personality traits, external unfavorable factors can contribute to neuroses. This includes everything that contributes to the accumulation of stress:

• Long periods of uncertainty and novelty (for example: will a deal pass/fail, will it be approved/not approved, will it be promoted/not promoted, will it be fired/not fired, how will some test end, what is the child’s illness, why can’t you get pregnant, and so on). What is typical (and very often) is that neurosis begins when the troubles end.
• Long-term dissatisfaction with any needs (for example, chronic lack of sleep, routine, inability to realize one’s interests, potential or ambitions, dissatisfaction with personal life, non-recognition of achievements, inability to control everything... It is worth noting that people differ in the expression of different needs, therefore, for one will cause stress, for others - not. For example, a person with a high degree of need for communication, recognition, dynamics around what is happening will be uncomfortable working as a programmer or an ordinary accountant. And for introverts and pedants, that’s just the thing.
• Some external factor provoked strong feelings and anxiety. For example, someone died, went crazy; unexpectedly and very sharply increased blood pressure; the person was subjected to ridicule/bullying; a person was involved in a serious accident.

Conclusions:

• Anyone can develop neurosis (anxiety disorder).
• Having neurosis is not weakness. Rather, it was an unfortunate coincidence of circumstances, or rather, unfavorable circumstances that were layered on the personality traits. (We often hear from our patients something like: “I never thought that this could happen to me,” “even if I heard about neuroses and depression, I always thought it wasn’t about me,” “I thought it was some kind of -weakness, a fool, with nothing to do, a person invents everything and simply doesn’t want to work.”)
• Reducing the causes of neurosis to childhood complexes, to a lack of love in childhood, to intrapersonal conflicts and hidden motives in the unconscious is literally a thing of the past.
• The main type of treatment for neurosis is psychotherapy, and medications are only a help.
• It is very important for complete liberation from neurosis to understand the characteristics and personalities that contribute to the anxiety disorder. It is believed that character cannot be changed. This is true in many ways, especially regarding temperament. But such a task is not set; it is only necessary to help the psyche master additional models of perception and behavior in order to make a person more stress-resistant and adaptive. It is also important to optimize your lifestyle.
• You can get rid of neurosis and stop giving it the opportunity to influence your life.

If anyone can get neurosis, then not everyone, or rather a very small group of people, has the “luck” to go crazy. For example, schizophrenia affects about 1% of the world's population. People don’t just fall into psychosis (that is, a state with hallucinations, delusions, pronounced emotional shifts, etc.) from external circumstances or from strong experiences. By the way, neurosis never turns into psychosis, that is, people don’t go crazy because of it. For psychosis to occur, there must be changes in the brain at the cellular and biochemical level. Anticipating the question “what if I have something similar,” I would like to say that a person in psychosis (in the acute phase of madness) will never think that he has suddenly gone crazy. One of the most important criteria for psychosis is the lack of criticism of the condition or disease. Therefore, if you are puzzled, then you are sane, despite the symptoms that may seem abnormal to you. Among the factors that can increase the chances of going crazy is a family history, for example, one of the relatives ended up in a psychiatric hospital. Of course, you can describe the sores that cause or manifest themselves as psychoses. However, it is better for non-specialists not to delve into this topic, so as not to start fantasizing and deceiving themselves. If something confuses you, it is better to find a good specialist on the topic you are interested in and consult.

Psychiatry sees its goal, first of all, to help a person in trouble. The most common pathologies are all kinds of neuroses and psychoses. Treatment of neuroses and psychoses may not be the most difficult task in psychiatry, but it comes to the fore because the prevalence of this kind of pathology is increasing every day.

Neurosis,

As a rule, it is diagnosed in practically mentally healthy people. Neurosis itself occurs against the background of psychological trauma, so to speak, of moderate severity. With neuroses, a person is aware of what caused his condition and tries to cope with it on his own.

The clinical picture of such disorders is characterized by asthenic, obsessive and/or hysterical manifestations, as well as a temporary decrease in mental and physical performance. The concept of “neurosis” was introduced into medicine in 1776 by Scottish physician William Cullen. The psychogenic factor in all cases is conflicts (external or internal), the action of circumstances causing psychological trauma, stress or prolonged overstrain of the emotional and/or intellectual spheres of the psyche.

I. P. Pavlov, within the framework of his physiological teaching, defined neurosis as a chronic long-term disorder of higher nervous activity (HNA), caused by overstrain of nervous processes in the cerebral cortex by the action of external stimuli that were inadequate in strength and duration. The use of the clinical term “neurosis” in relation not only to humans, but also to animals at the beginning of the 20th century caused a lot of controversy.

Psychoanalytic theories present neurosis and its symptoms mainly as a consequence of deep-seated psychological conflict. It is assumed that such a conflict is formed in the context of a social situation that has persisted for a long time, which prevents the satisfaction of a person’s basic needs or poses a threat to his future, which he tries, but cannot overcome.

Sigmund Freud saw this conflict in the basic contradiction between the instinctual drives of the id and the prohibitive pressure of the superego, which represents the morals and norms existing in society.

Karen Horney believed that the basic conflict of neurosis is the result of a contradiction between incompatible defensive tendencies of the personality. To protect against such unfavorable social factors as humiliation, social isolation, total controlling love of parents, dismissive and aggressive attitude, the child develops methods of defense based on movement “towards people”, “against people” and “from people”. The movement towards people mainly represents the need for submission, love, protection. The movement against people is the need for power over people, fame, recognition, success, to be strong and to cope with life. Movement from people represents the need for independence, freedom, care, isolation from people. A neurotic is subject to all three tendencies at once, but one of them dominates, and thus we can conditionally classify neurotics into “subordinate”, “aggressive” and “isolated”. Karen Horney has paid much attention to the problems created by contradictions between defensive tendencies.

In general, at present, as factors predisposing to the development of neurosis, both psychological (personality characteristics, conditions of its maturation and upbringing, the formation of relationships with society, level of aspirations) and biological factors (functional insufficiency of certain neurotransmitter or neurophysiological systems, making patients vulnerable to certain psychogenic influences).

The main criteria for distinguishing neurotic disorders from mental disorders in general are

: the leading role of psychogenic factors in the occurrence and decompensation of painful manifestations; functional (reversible) nature of mental disorders; absence of psychotic symptoms, dementia, or increasing personality changes; egodystonic (painful for the patient) nature of psychopathological manifestations, as well as the patient maintaining a critical attitude towards his condition.

Mental symptoms: Emotional distress (often for no apparent reason);

Indecisiveness; Communication problems; Inadequate self-esteem: underestimation or overestimation; Frequent experiences of anxiety, fear, “anxious expectation of something,” phobia; possible panic attacks, panic disorder; Uncertainty or inconsistency of the system of values, life desires and preferences, ideas about oneself, about others and about life. Cynicism is common; Instability of mood, its frequent and sharp variability;

Irritability; High sensitivity to stress - people react to a minor stressful event with despair or aggression; Tearfulness; Touchiness, vulnerability; Anxiety; Preoccupation with a traumatic situation; When trying to work, they quickly get tired - memory, attention, and thinking abilities decrease; Sensitivity to loud sounds, bright lights, temperature changes; sleep disorders: it is often difficult for a person to fall asleep due to overexcitation; superficial, disturbing sleep that does not bring relief; Drowsiness is often observed in the morning.

In the case of psychosis, the situation is somewhat different. Psychosis

is the body’s reaction to a sudden and very negative impact. If the cause of neurosis can be a long-term and serious illness of a loved one, hard work for a long time, constant financial difficulties, then psychosis can be caused by a momentary event, such as a major accident that occurred before our eyes, and possibly with the participation of the patient. Psychosis is characterized by the fact that a person cannot analyze either his internal state or the state of the environment.

Term Psychosis

refers mainly to more severe forms of mental illness, such as organic mental disorders, schizophrenia, affective disorders, etc.

Although Psychosis

Although not of particular value as a category in the classification of mental disorders, the term still finds use in everyday practice because it is useful for denoting disorders that, due to lack of data, cannot be more accurately diagnosed, e.g. when it is not yet clear whether the mental disorder is schizophrenia or mania. For similar purposes, it is useful to retain such terminological combinations as “psychotic disorders not elsewhere classified” (in DSM-IIIR), “acute and transient psychotic disorders” (in ICD-10). Finally, the adjective “psychotic”, derived from the word “psychosis”, is also quite widely used, in particular in the terminological combinations “psychotic symptom” (this expression is usually used to denote delusions, hallucinations and agitation) and “antipsychotic drug” (implying a pharmacological drug , controlling these symptoms).

Psychoses are classified according to their origin (etiology) and causes (pathogenetic mechanisms of development) into endogenous (endogenous psychoses include schizophrenia, schizoaffective disorder, psychotic forms of affective disorders), organic, somatogenic, psychogenic (reactive, situational), intoxication, withdrawal symptoms and post-withdrawal.

In addition, psychoses are classified according to the leading clinical picture, according to the predominant symptoms (syndromic classification) into paranoid, hypochondriacal, depressive, manic, etc., including combinations (depressive-paranoid, depressive-hypochondriacal, etc.).

Psychotic states are accompanied by productive psychopathological symptoms (signs of psychosis) - delusions (delusions of relationships, minor damage, jealousy, etc.), hallucinations (auditory, visual, tactile), depersonalization (impaired self-perception) and derealization (feeling of the unreality of what is happening around, alienation from surrounding world). Patients, as a rule, treat such phenomena uncritically. Meanwhile, these signs indicate the disease psychosis, the symptoms of which are associated with the fact that the clarity of consciousness is reduced, and orientation in one’s own personality, place and time may be difficult.

Neuroses and reactive psychoses, although they have similar aspects in their nature, differ in the degree of damage to the human nervous system. And if neurosis can be characterized as a disorder

, then psychosis is considered as
a disease
. It should be noted that even the great Sigmund Freud defined neurosis and psychosis not as brain damage, but as a consequence of the impact on the human nervous system.

Related information.

Among the numerous mental disorders, pathologies such as neurosis and psychosis are often observed. These violations have nothing in common with each other, but at first they can be confused. How does neurosis differ from psychosis?

The main differences between pathologies

A subject suffering from a neurotic disorder goes to work and takes care of his appearance. It is difficult for a person with psychosis to concentrate on anything. He is irritable and intolerant. Many patients whose perception of the world has been changed by psychosis exhibit sloppiness and indifference to hygiene measures.

An important detail in which psychosis differs from neurosis: a neurotic understands that he has a loss of strength and a gloomy mood, while a psychotic does not see a problem in his changed perception of the world. People with neurosis often seek help from a psychologist or psychotherapist. A patient debilitated by psychosis can only be persuaded to seek treatment by those he trusts (spouse, children, close friends).

Symptoms of psychosis

In reactive psychoses, the symptoms are slightly different. This disorder causes hallucinations and delusions. Patients’ perception of the surrounding world is also disrupted, sensations change, emotional instability and sudden mood swings are observed.

The movements of a person suffering from psychosis are chaotic, speech is incomprehensible and abrupt. His state is similar to human sleep. Signs of the disease do not appear immediately when the disorder occurs. The disease develops gradually.

Treatment of neurosis and psychosis

Psychotherapy sessions can free a person from neurosis. Sometimes, to eliminate increased anxiety and depressive conditions, the patient is prescribed medications from one of the following groups:

• tranquilizers;
• antidepressants;
• neuroleptics.

In addition to the main therapy, the neurologist may prescribe you vitamins. To combat a neurotic disorder you will need a lot of time. In order for the disease to leave you forever, you need to distance yourself from the painful circumstances that caused the development of the disease. The patient needs to give up alcohol and tobacco at least until medications and conversations with a psychotherapist help improve his emotional balance.

Even if neurotics do not seek treatment, their behavior does not pose a threat to others. Sad thoughts and constant worries only harm him. Psychotics are completely different from healthy people.

A significant difference between neurosis and psychosis: emotional disorder progresses without treatment. The subject becomes dangerous to himself, as well as to the people around him.

There are known cases where patients, overcome by delusional ideas of persecution, attacked passers-by. The patient may set fire to the apartment or injure himself. Psychotic disorders are often irreversible, but with timely consultation with a specialist, the patient has a high chance of regaining an adequate perception of life.

To reduce or eliminate the manifestations of a neurotic disorder, you just need to visit a psychologist and follow his recommendations. Treatment of psychosis is carried out in a hospital setting. The doctor prescribes medications to the patient.

What medications help get rid of psychosis:

• antipsychotics - fight thought disorders;
• mood stabilizers - stabilize mood;
• benzodiazepines - reduce anxiety.

Therapy takes an average of one and a half months. The patient's stay in the hospital increases to 5-8 months.

Yale-Brown scale

The Yale Brown Compulsive Scale is called the OCD Test. It was created in the field of application of mental illnesses.

The test determines the presence of obsessive-compulsive disorder and obsessive-compulsive disorder. This type of method also helps to determine the level of self-esteem of an individual. During the testing process, the doctor asks the patient 10 questions. Each answer is scored on a scale from 0-4 points. When calculated, an average is displayed that expresses symptoms over the past 7 days.

This test must be repeated after a course of therapy. Then the indicators will help determine the correctness of the drawn up scheme and the effectiveness of treatment. Criteria that allow diagnosing the presence of obsessive disorders according to the expressed symptoms:

• duration of manifestation of characteristic symptoms for 1 day;
• vital function value;
• the power of moral dysfunction;
• ability to resist symptoms;
• degree of control over obsession.