Who treats neurosis – a neurologist or a psychotherapist?

Neurosis is a collective name for a whole group of mental disorders that have a wide variety of manifestations. Their symptoms are individual in each clinical case, although they have common features: a depressed emotional state, irritability, dissatisfaction with oneself and one’s life, anxious expectations of bad things.

Often, psychological discomfort is accompanied by complaints of physical distress: insomnia, headaches, rapid heartbeat, etc. Therefore, patients are faced with the question: who treats neuroses: a neurologist or a psychotherapist?

Treats neuroses preferably by a doctor

Cause of neuroses

To understand which doctor treats neurosis, you need to understand how this disorder arises. The question of why some people develop psychological disorders that cause neuroses has long been the subject of research in medicine.

I. P. Pavlov, a famous Russian scientist, believed that the reason lay in disturbances in the functioning of the nervous system. In his opinion, they are caused by excessive tension in the processes occurring in the cerebral cortex. Moreover, this happens not only in humans, but also in animals. This load is caused by exposure to strong and long-lasting external stimuli.

Supporters of psychoanalytic theories have a different opinion on this matter, the most prominent adherent of which is the famous Sigmund Freud. They called the cause of neurosis a psychological conflict caused by dissatisfaction with human needs. And Karen Horney believed that this disorder is formed as a defense mechanism against unfavorable conditions in the social environment.

Today medicine names two main groups of factors leading to neurosis, based on the theories put forward and research conducted:

1. Psychological : individual personality characteristics, social environment, stress and psychological trauma.
2. Biological : abnormalities in the functioning of the nervous system that cause a predisposition to mental disorders due to psychogenic influences.

There is no universal “formula” for the appearance of such disorders. Therefore, treatment is individual for each person.

A tense social environment can cause neurosis

Autonomic neurosis: symptoms of vegetative-vascular neurosis of the skin of the body, treatment

Autonomic neurosis (vegetoneurosis) is not a disease.
It is a syndrome - a combination of symptoms indicating disturbances in the functioning of the autonomic nervous system. This neurosis is also called vegetative-vascular dystonia, dysfunction of internal organs, and organ neurosis.

The autonomic nervous system has a regulatory effect on the activity of all organs and systems that function autonomously - such as the heart, blood vessels, intestines, and sweat glands. It is not subject to human thinking.

With vegetative neurosis, the patient may complain of pain and disruption of the functioning of internal organs. However, upon examination, pathological changes are not detected in them. Neurosis only imitates diseases, and does not indicate that they actually exist. However, due to prolonged disruption of the functioning of the nervous system, structural changes may occur.

With vegetative neurosis, a person seems to have pain in different organs

Causes of vegetative neurosis

The main causes of this syndrome are:

1. Traumatic brain injury, in which the functioning of the higher autonomic centers of the brain occurs.
2. Constant mental and emotional stress, stress.

1. Unbalanced type of higher nervous activity.

1. Infectious diseases that inhibit the functioning of the nervous system or debilitate the entire body for a long time.
2. Psychopathology.
3. Unhealthy lifestyle: regular lack of sleep, alcohol, smoking, unbalanced diet.

Symptoms and signs of autonomic neurosis

With autonomic neurosis, various symptoms (subjective sensations of the patient) and signs (objective manifestations) are observed, which is associated with certain disruptions in the activity of the autonomic nervous system. Doctors group them into the following syndromes:

1. Vegetative-visceral neurosis. Accompanied by stool disorder, dysfunction of the bladder, swallowing process, and metabolic disorders. The patient may feel a rapid heartbeat, which is not detected during the study.
2. Vegetative-vascular neurosis (or vasomotor). Vegetative-vascular neurosis is accompanied by symptoms such as frequent surges in blood pressure, nausea and vomiting, persistent headache, sudden dizziness, arrhythmia, and rapid heartbeat. With vascular neurosis, patients also feel pain in the stomach, joints and muscles.
3. Vegetative-allergic. Accompanied by different types of allergies - food, skin, and also in the form of a runny nose.
4. Vegetative-cutaneous. Body skin neurosis is accompanied by the following symptoms: the sensitivity of the skin increases, it acquires a bluish or marbled tint, and humidity increases or decreases. With skin neurosis, itching also appears.
5. Vegetative-trophic. It causes ulcers and erosions to appear. The nutrition of nails, hair, and muscles, which can atrophy, deteriorates.
6. Phobic. Characterized by unreasonable fears. The patient may understand this, but he is not able to get rid of fear.
7. Hypochondriacal. With it, patients are exaggeratedly worried about their health and may suspect they have serious illnesses, although there is no reason for this.

Vegetative-vascular neurosis is accompanied by pressure surges

Features of the emergence and development of neurosis

According to its occurrence and development, vegetative neurosis is divided into several groups:

• The second group is vegetative neuroses that arose in connection with the pathology of the subcortical vegetative centers, which is functional and dynamic in nature. The consequence of this is disruption of the activity of certain body systems. If the vascular system is affected, vascular neurosis occurs, leading to an increase in pressure (hypertension) or a decrease (primary hypotension). When the respiratory system is damaged, bronchial asthma develops. Disturbances in the gastrointestinal tract lead to peptic ulcers of the stomach and duodenum. Disturbances in the functioning of other body systems lead to the occurrence of corresponding diseases. In patients with neurosis of the second group, the synergistic activity of different parts of the autonomic nervous system is also impaired.
• In the first group, the development of vegetative neurosis occurs against the background of general neurosis, manifested in the form of neurasthenia, hysteria or psychasthenia. Autonomic disorders are manifested by such disorders as changes in heart rate, arrhythmia, disorders of the gastrointestinal tract, and shortness of breath. Vegetative neuroses belonging to the first group develop as a result of impaired functioning of the cortical-hypothalamic structures of the brain (the hypothalamus is the highest vegetative center). In addition, the development of vegetative neurosis is facilitated by the patient’s personality traits, as well as infections and vitamin deficiency, which weaken the nervous system.
• The third group includes vegetative neuroses, which are a consequence of a pathological process that has arisen in the periphery. The cause of these processes is local traumatic injuries, damage to one or another organ.

A necessary condition for the occurrence of these vegetative neuroses is increased excitability and lability of the autonomic nervous system. At the same time, there are no organic lesions - this is precisely what indicates that this disease is a vegetoneurosis.

Diagnostics

First of all, the doctor excludes the possibility of organic pathology. Various forms of manifestation, unstable symptoms, together with dependence on psychogenic factors indicate vegetative neurosis.

Worth seeing: Bladder neurosis

The doctor determines which organ reacts most to disturbances in the nervous system. The functions of this organ are also impaired. Therefore, it is necessary to exclude the presence of visceral pathology such as diseases of the stomach and gall bladder.

To confirm the diagnosis of vegetative neurosis and determine its nature, a reflex study is carried out. With vegetative neurosis, there are often asymmetrical reactions.

Dermographism is also being studied (translated from Greek this means writing, image on the skin). Its cause is the reaction of skin vessels in response to passing a blunt object across it. With vegetoneurosis, skin vascular reactions are pronounced and can manifest themselves in the form of urticaria.

The pilomotor reflex, which is characterized by the appearance of “goose bumps,” is also checked. With vegetative neurosis, its intensification is typical.

The study of reflexes is one of the options for diagnosing vegetoneurosis

The solar plexus reflex is also determined by applying pressure to the epigastric region (located behind the stomach). If pain appears, this may indicate increased excitability of the nervous system, which is observed with vegetative neuroses.

Treatment

Autonomic neurosis is accompanied by symptoms that reduce the quality of life, in addition, it can lead to serious complications, so it is very important to start its treatment in a timely manner.

If the cause of neurosis is a traumatic brain injury, as well as certain diseases, then treatment should be carried out by a neurologist or other specialist.

Therapy for vegetative neurosis should be comprehensive and include the following components:

1. In order to recover, the patient must lead a healthy lifestyle, including a daily routine, good sleep, a balanced diet, time for daytime rest, and walks in the fresh air. This is very important, because a healthy lifestyle reduces the painful manifestations of vegetative neurosis.
2. During treatment, the doctor identifies factors that could contribute to the development of vegetative neurosis. They may be bad habits that weaken the nervous system. In this case, the patient must refuse them.
3. With vegetative neurosis, psychotherapy sessions help to reduce the patient’s emotional arousal and calm him down. They will also help the patient understand the cause of the development of neurosis associated with stress, and will help overcome overload in the emotional sphere.
4. Massage has a healing effect in case of neurosis; reflexology, that is, influence on biologically active points of the body; special breathing exercises by Strelnikova.
5. For autonomic neurosis, drug treatment is also used to eliminate neurological symptoms, which is prescribed by a doctor.

Psychotherapy sessions will help cure vegetative neurosis

Prevention of autonomic neurosis and elimination of its initial symptoms

To prevent the development of vegetative neurosis, you need to follow simple recommendations aimed at maintaining the health of the nervous system and strengthening it (if disorders begin to appear):

1. Mandatory adherence to the daily routine.
2. Get adequate sleep of at least 8 or 10 hours.
3. Physical education classes.
4. Daily walks.
5. Limited stress, both physical and mental.
6. Avoiding chronic overexertion.
7. Take herbal remedies if you need to calm down.
8. Mastering relaxation techniques. Relaxation keeps stress levels at an acceptable level without allowing them to rise.
9. Correction or complete elimination of factors that can lead to emotional instability and stress. These include life goals, professional activities, and family relationships.
10. Familiarization with methods of preventing neuroses can really help.

Adequate sleep is important for psychological health - at least 8-10 hours

The prognosis for autonomic neurosis depends mainly on which group it belongs to.

For vegetative neuroses belonging to the second group, the prognosis is cautious, since treatment often gives only temporary improvement, followed by deterioration.

In forms such as hypertension, the disease process progresses, which often leads to complete disability and death.

Worth seeing: Hypochondriacal neurosis

The prognosis for autonomic neuroses belonging to the first and third groups is favorable.

Source: https://psycholekar.ru/nevroz/vidyi-nevroz/vegetativnyiy-nevroz.html

What problems does a psychotherapist solve?

A psychotherapist is a specialist with a higher medical education who deals with problems caused by mild to moderate mental disorders.

Worth seeing: Post-schizophrenic depression

Trusting relationships play an important role in the success of treatment, because the point of psychotherapy is to search for traumatic situations that happened to the patient. He must be sincere with the doctor and talk about his past, without being embarrassed by ugly details and personal emotions. In short, during the sessions you need to find in the consciousness and subconscious what a person most does not want to remember.

Treatment of neuroses is the competence of a psychotherapist. But if there are biological factors that provoke the disorder, you will need the help of specialists in other fields. This doctor will help you cope with manifestations of psychological disorders, including aggression or depression, anxiety, apathy and depression.

When working with patients, an experienced psychotherapist uses a guide for doctors for neuroses. Typically, interaction takes place in three key directions:

1. Psychoanalysis , which allows you to look into a person’s subconscious and consider his needs. Based on the information received, the doctor determines the characteristics of the patient’s psyche and consciousness, studies traumatic factors and situations that occurred in the past. This is how the psychotherapist finds the root of the problem, thanks to which the disorder can be successfully cured.
2. Existential psychology is based on the study of human life as a holistic picture. This allows us to determine the patient’s social connections with his loved ones, friends, colleagues and the world around him in general. Relationships with yourself also play an important role.
3. Gestalt therapy works with the self-regulation of the patient’s psyche, his ability to control his consciousness and take responsibility for his life.

Methods of work in psychotherapy are varied. The most common of these is conversation. Group classes and hypnosis can also be used.

Treatment of neuroses is the competence of a psychotherapist

Drug therapy (mainly using antidepressants) is aimed at eliminating the symptoms of neurosis. It is not required for patients with a mild form of the disorder.

Taking psychotropic drugs only temporarily eliminates the manifestations of the disease, while successful psychotherapy allows you to determine the original cause, work through it and return the person to a full life.

How to recognize facial nerve neurosis

Symptoms of facial nerve inflammation often appear slowly. Initially, there is the appearance of pain behind the ear, the so-called neuralgia of the nerve, and after a couple of days facial asymmetry is observed.

The affected side is characterized by the appearance of smoothness of the nasolabial fold, the corner of the mouth drops slightly, thereby the face takes on a skewed appearance. In most cases, the eyelids do not have the opportunity to close; each attempt is accompanied by the eye pointing upward.

Facial weakness is manifested by a violation of facial expressions; a person cannot smile, raise an eyebrow or express surprise. The side with neuritis has the “hare’s eye” symptom, which is characterized by the presence of a constantly wide-open eyelid - lagophthalmos. Visually, it is represented by a white edging of the sclera between the iris and the lower edge of the eyelid.

The tip of the tongue, innervated by the trigeminal nerve, partially loses sensitivity and salivation increases. Sometimes there is dryness or the release of a large volume of tear fluid from the eye, or even both processes at the same time. On the affected side, the ear becomes more sensitive to sounds, so everything seems loud.

What does a neurologist do?

A neurologist helps in cases where neurosis has biological causes . These can be various diseases of the nervous system: the human brain and spinal cord, individual nerves that penetrate the body. She controls all organs.

Worth seeing: Neurosis according to ICD 10

Very often, patients with neurosis turn first to a neurologist because they are worried about insomnia, headaches, panic attacks and even fainting. Some may complain of very real discomfort in the chest, reminiscent of a heart attack. Such vegetative symptoms are also characteristic of neurosis.

Insomnia problems are usually addressed to a neurologist.

The neurologist conducts the necessary studies and, if necessary, prescribes treatment and preventive procedures. This could be massage, gymnastics and yoga, manual therapy. In some cases, medication and other treatments are indicated. But medical practice shows that 50% of clinical cases when contacting a neurologist require the help of a psychotherapist

Symptoms of a malfunction of nervous regulation

A manifestation of a malfunction of the ANS can be a feeling of cramping in the abdomen.
The autonomic nervous system controls the functioning of all internal organs and glands, therefore the manifestations of vegetative-vascular neurosis are not specific and are very diverse. Each patient has a variety of pathological symptoms from different body systems. In addition to physiological signs, the pathology is characterized by disturbances in the emotional and mental state. The main manifestations of autonomic neurosis:

• sudden changes in blood pressure;
• headaches and dizziness;
• sudden disruptions in heart rhythm;
• pain in the chest area on the left;
• failures of thermoregulation, as a result of increased sweating;
• difficulty breathing and shortness of breath;
• abdominal cramps and loss of appetite;
• weight loss;
• nausea and vomiting with stool disturbances;
• trembling in the body and muscle weakness;
• numbness and loss of sensation in the limbs;
• sleep problems;
• poor coordination of movements;
• anxiety, panic attacks;
• deterioration of memory and concentration;
• depression, isolation, aggressiveness, touchiness.

Choosing a doctor for neurosis

If a person suspects he has a neurosis, which doctor should he go to? First you need to go to a psychotherapist. He will assess the person’s condition and, if necessary, refer to specialists of another profile.

In cases where the physiological symptoms of disorders clearly manifest themselves and are repeated regularly, a general examination of the body will be required in order to identify possible diseases in time.

In case of neurosis, first of all, you need to consult a psychotherapist

When a diagnosis of “neurosis” is established, the doctor will prescribe treatment that will help the patient get rid of the disease as soon as possible. But you shouldn’t count on a quick recovery: several sessions of psychotherapy, which is the main way to treat psychological disorders, will be needed. Their number is determined individually: depending on the degree of development of neurosis and the personal characteristics of the patient.

Physiotherapy

Physiotherapy is recommended for faster recovery. During this procedure, a medicinal drug is applied to electrodes, which are then pressed against the patient’s skin, and an electric current of low voltage and strength is passed through them.

This causes the drug molecules to penetrate the intercellular space of the skin and enter directly into the blood.

The drugs used in this situation are Trental, Hydrocortisone, Aminophyllin, Proserin.

Physiotherapeutic treatments sometimes include acupuncture. But this method refers more to the placebo effect - if a person believes in its effectiveness, then it will definitely help him. And vice versa, if a person is skeptical about this method, then there will be no effect from such treatment.

Is taking medication justified?

But if tranquilizers and various antidepressants, which neurologists so often prescribe, cannot cure neurosis, then what is the point of their use? Isn’t it easier to immediately refer the patient to psychotherapy sessions and not waste time on pharmacology? Indeed, there are reasons for prescribing antidepressants for neurosis, and significant ones. The fact is that in an advanced, acute or chronic form of neurosis, the patient may be in a state where it is extremely difficult for him to carry out the simplest everyday tasks at home and at work. In such cases, medications provide the necessary emergency assistance to the patient, improving his condition until the moment when psychotherapy can be started to gradually remove him from neurosis.

It is also important to remember one of the symptoms of neurosis - severe fatigue, which the patient cannot control. A constant lack of energy, even with regular sleep and moderate physical activity, also prevents the patient from leading a full life. Psychotherapy does not have the desired effect on a person in such a state, and the treatment process itself may drag on for an indefinite period.

The patient simply does not have the physical resources to begin to change his life and finally get out of the stressful situation that is aggravating his health.

But there is also a downside to taking tranquilizers and antidepressants. In cases where the symptoms of the disease are not so pronounced that they have a negative impact on the person’s condition, taking medications is more likely to interfere with recovery. The doctor will not be able to determine whether the positive trend of improvement in the patient’s well-being is due to medications or as a result of effective psychotherapy. In this way, therapy can go the wrong way, and as a result, the patient will temporarily get rid of only symptoms, which, after completing the course of drug treatment, may return with renewed vigor.

Which doctor treats depression?

Several specialists treat the disease. To get a good result, you should contact not one, but 2-3 doctors from different fields. This is a psychiatrist, neurologist and psychotherapist. What type of assistance do they provide?

1. Psychiatrist. His help is based on the fact that the cause of depression is global mental damage. The task of a psychiatrist is to normalize the functioning of the brain and psyche as a whole. To do this, he prescribes medication. As a rule, these are antidepressants, but other drugs can be used as a supplement.
2. Neurologist. This specialist will help you cope with depression if it is caused by disorders in the nervous system. The doctor prescribes medications that will remove them.
3. Psychotherapist. The specialist’s main focus is conducting conversations and hypnotic sessions. Thanks to this, a person’s attitudes, behavior and personality change.

Everything is clear about which doctor treats depression. Now you need to find a competent specialist.

Should I go to a therapist?

The main problem with “cataloging” neurosis as a disease is the frequent failure by doctors to recognize the psychological causes of physical problems. Therapists, to whom patients decide to turn with itching or pain in the extremities, last of all ask the patient a question about stressful situations experienced recently, because this is often where the whole problem lies. In official medicine there is no diagnosis “due to nervousness,” especially when it comes to itchy skin or hypertension. First of all, therapists consider causes that are related to human physiology: tests and diagnostic procedures are carried out. Accordingly, the therapist treats the consequences of the disease, but the causes remain untouched. Because of this, the effectiveness of the treatment course may be several times lower than required. As a result, the duration of the course also increases, during which the patient, without seeing any improvement in his health, may experience new stress, thereby aggravating his situation and well-being.

And yet, often an experienced therapist gives the patient a referral to see a psychotherapist. But this is only possible if the doctor receives confirmation from the patient of a recent nervous disorder or stressful situation. Neurologists, endocrinologists and doctors of other fields follow the same principle when people with a pronounced physical problem caused by a psychological factor turn to them for help.

Ericksonian hypnosis in the treatment of depression

Depression is a complex mental illness that prevents a person from living peacefully and enjoying the world. Therefore, it needs to be corrected as quickly as possible. Which doctor treats depression? Today, different specialists are engaged in this, so to achieve a good result it is worth contacting several of them.

More than 300 million people in the world today live with depression. It is therefore not surprising that the theme of World Health Day, celebrated on April 7, is depression.

According to the World Health Organization (WHO), depression is a leading cause of ill health and disability worldwide. In the 10 years from 2005 to 2020, the number of people with depression increased by more than 18%. “Due to a lack of support, many people with mental health conditions do not seek the treatment they need to live healthy and productive lives,” the organization states. WHO calls on countries to increase investment in mental health, recalling that even in high-income countries, about 50% of people with depression do not receive treatment.

Meanwhile, most depression is treated on an outpatient basis if the patient consults a psychiatrist for help in time. TASS was told about this by the chief freelance specialist of the Russian Ministry of Health in psychiatry, director of the State Scientific Institute of Forensic and Social Psychiatry named after. V.P. Serbian Zurab Kekelidze. “Of course, there are chronic, resistant severe conditions when it is necessary to take serious measures,” the expert added.

Kekelidze notes that according to statistics, there are more women with diagnosed depression. However, this may be partly due not to a predisposition to depression, but to the fact that women are more attentive to their health. “They notice abnormalities more quickly, see a doctor more often and are treated more carefully,” he said.