Types of neuroses, how neurosis differs from depression

Causes of neurosis

The phenomenon of neurosis is caused by many different factors of an endogenous and exogenous nature. Each type of neurosis develops against the background of psychogenic disorders resulting from conflicts and psychoneurological stress. At the same time, the social and individual significance of the person who has succumbed to the experience is important, that is, the individual experiences a neurological reaction only if there is a stimulus that passes individually. Also, one of the key factors influencing the development of neurosis is the phenotypic personality trait, determined by heredity and upbringing.

According to the results of some studies, it is known that most often the formation of a hypersthenic neurasthenic is caused by neglect and poor upbringing, and a hyposthenic neurasthenic is formed if the personality is subject to oppression in the process of its development. With excessive attention from loved ones, there is a high risk of developing hysteria. If a person does not have any neurotic tendencies, then psycho-emotional overloads can provoke neurotic states, vegetoneurosis or reactive states; however, without a constitutional predisposition of the person, such types of neuroses as obsessional neurosis or hysteria usually do not develop.

Risk factors for the development of neuroses include:

• somatic diseases;
• physical stress;
• injuries;
• professional dissatisfaction;
• uncontrolled use of sleeping pills and tranquilizers;
• alcohol abuse;
• trouble in the family.

A special place in the clinic of neuroses is given to changes in the vegetative-endocrine system and homeostasis that arose as a result of close connections between the higher vegetative centers and the psycho-emotional sphere.

Pathogenetic aspects of neuroses

Today, most scientists believe that the basic role in the pathogenesis of neurosis is assigned to dysfunction of the limbic-reticular complex, in particular, the hypothalamic part of the diencephalon. Failure in the functioning of the limbic-reticular complex in neuroses is often combined with neurotransmitter disorders. This is evidenced by the insufficiency of the noradrenergic systems of the brain, which is one of the links in the mechanism of anxiety development.

There is also an opinion that pathological anxiety is associated with the abnormal development of GABAergic and benzodiazepine receptors or a decrease in the amount of neurotransmitters that affect them. This hypothesis is confirmed by the positive dynamics in the treatment of anxiety with benzodiazepine tranquilizers. The pathogenetic connection of neurosis with a disorder of serotonin metabolism in brain structures is evidenced by the positive effect of antidepressant therapy.

Classification of neuroses

The fact that neuroses are represented by diseases in which the absence of visible pathomorphological changes in the nervous system is combined with neuropsychic dysfunction does not at all exclude the material substrate of neuroses, since they develop subtle transient changes in nerve cells and metabolic processes at various levels of the nervous system. In the medical literature there are a large number of different classifications of neuroses. Most often in clinical practice, neuroses are divided according to their form and the nature of their course. Depending on the form, the following neuroses are distinguished:

• hysteria (hysterical neurosis);
• neurasthenia;
• motor and autonomic neuroses;
• obsessive-compulsive neurosis;
• neurosis syndrome (neurosis-like conditions).

Based on the nature of their course, the following types of neuroses are known:

• acute neurosis;
• reactive state (neurotic reactions);
• neurotic development.

General neuroses

General neuroses are divided into the following types:

• neurasthenia or asthenic neurosis;
• obsessive-compulsive neurosis;
• hysterical neurosis;
• phobic neurosis;
• depressive neurosis;
• hypochondriacal neurosis;
• psychasthenia.

Neurasthenia, or asthenic neurosis. Symptoms of neurasthenia include increased irritability, fatigue, and loss of ability for prolonged mental or physical stress.

Neurasthenia goes through three phases. The first phase is called “hydrosthenic neurasthenia.” Its symptoms are mainly irritability, excitability, inability to concentrate on anything, absent-mindedness, and weakness of active attention. At this stage, a person is irritated by any extraneous sounds, he is distracted by everything and strives to quit one thing without finishing it and grab onto another. At this stage, he is not yet showing symptoms of weakness.

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The second phase is called “irritable weakness.” The name of this phase speaks for itself. Irritability associated with weakness, turning into exhaustion and leading to gloom, lethargy, and indifference.

The third phase is “hyposthenic neurasthenia.” At this phase, exhaustion of the nervous system is already clearly manifested, and as a result, a state of apathy, lethargy, increased drowsiness, and depression begins.

Obsessive-compulsive neurosis is a mental disorder in which a person is bothered by obsessive thoughts, ideas and actions that arise beyond reason and will. This disease may also be called “obsessive-compulsive disorder.” This disease is diagnosed in 2-5% of the world's population. In this condition, a person is haunted by thoughts that he cannot control, as well as actions of which he is not aware.

Hysterical neurosis is a mental disorder, the development of which is accompanied by autonomic disorders and destructive behavior. This problem is more often diagnosed in women. With hysteria, symptoms manifest themselves in the form of an individual’s desire to attract the attention of others. Hysteria often occurs in mentally unstable people as a result of a stressful situation. Often this is facilitated by character traits such as excessive sensitivity, infantilism, and selfishness. External causes are the consumption of alcohol-containing drinks and drugs.

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Phobic neurosis, where obsessive fears and phobias are key. This disease is expressed in the form of an uncontrollable feeling of fear and anxiety as a result of a reaction to a specific object or person. This feeling can be so strong that a person ceases to control his actions and begins to behave according to instincts. In most cases, phobias originate from childhood, when the child was frightened by something.

Depressive neurosis is a type of neurotic disorder, the characteristic features of which are a sad mood, physical inactivity and general lethargy. With depressive neurosis, sleep disturbances can also be observed. Symptoms of neurosis can include dwelling on negative memories, depressed mood, and loss of ability to work. Only a specialist can make a diagnosis of depressive neurosis. Usually this is a neurologist or psychotherapist. Treatment may include periodic meetings with the attending physician to identify the causes of depressive neurosis, as well as the use of medications (antidepressants, antipsychotics, psychostimulants, sedatives) and physical therapy (hydrotherapy, reflexology, electrosleep, massage).

Hypochondriacal neurosis is a functional disorder of the nervous system, characterized by increased attention to one’s health. When diagnosing hypochondria, it is important to distinguish fictitious symptoms from real ones, because a hypochondriac may have real diseases. Sometimes it is quite difficult for a doctor to understand the symptoms voiced by the patient. Therefore, a psychotherapist should be involved in the diagnosis and treatment of hypochondriacal neurosis. Hypochondriacal neurosis often develops in older people.

Psychasthenia partially coincides with obsessive-compulsive neurosis, because it is also manifested by increased anxiety, anxious fears, and doubts. This is a mental illness characterized by self-doubt, suspiciousness, constant fears, and obsessive thoughts. This disease is characterized by excessive introspection. People exposed to it place high demands on themselves. They are very self-critical and may have low self-esteem.

Hysteria

Hysterical neurosis (hysteria) is a rather complex disease; it is based on behavioral characteristics that depend on the increased suggestibility and emotionality of the individual. The risk group for hysteria includes women aged 20-40 years, although this disease also occurs in men. One of the behavioral features of patients with hysterical neurosis is their desire to be the center of attention of others, to evoke admiration, surprise, envy, etc. The increased emotionality of patients affects all assessments and judgments, as a result of which they become extremely unstable and changeable.

Obsessive-compulsive disorder, or obsessive-compulsive disorder (OCD).

Accompanied by various fears:

• fear of accidentally contracting a dangerous disease, fear of getting sick;
• fear of losing control of oneself or going crazy;
• fear of losing a loved one, fear of death;
• various phobias;
• panic attacks;
• intrusive thoughts (usually frightening);
• obsessive actions (going to doctors, constantly measuring blood pressure or pulse, constantly washing hands, various examinations).

But with “milder” forms and without physical manifestations, a neurotic person will necessarily exhibit dependence on the approval of others, perfectionism and procrastination. Such people, regardless of real circumstances, are filled with all sorts of fears, are very suspicious and touchy. They try more than is appropriate to please others, while almost always focusing on themselves. And yes, these are infantile people who are stuck in their psychological development at approximately the age when they were most mentally traumatized. That is why they choose manipulative ways of interacting with others, avoid responsibility, blame others and external circumstances.

Neurasthenia

Neurasthenia is overwork, nervous exhaustion. It is expressed by a combination of fatigue and increased irritability. With this form of neurosis, patients are characterized by inadequate reactions to minimal stimuli, as well as the inability to suppress them. Neurosthenics may be irritated by too loud a conversation, bright light, etc.; they often complain of bursting headaches and heaviness in the head. In addition, somatic symptoms are added: loss of appetite, sweating, bloating, tachycardia, polyuria, sleep disorders (difficulty falling asleep). Neurasthenia can be hyposthenic (depressive) and hypersthenic (irritable).

Obsessive-compulsive disorder

Patients with obsessive-compulsive disorder have general neurological symptoms and obsessive-phobic manifestations. Often the clinical picture of this form of neurosis is expressed by cardiophobia (obsessive fear of cardiac pathologies), cancerophobia (fear of cancer pathologies), claustrophobia (fear of enclosed spaces), etc. General neurological signs of this disease include poor sleep, deterioration of mood, irritability.

Neurosis-like conditions develop against the background of general somatic pathologies, intoxication, trauma, infection, while neurasthenic disorders are less pronounced in nature compared to the symptoms of other forms of neurosis.

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 characteristics of neuroses according to ICD-10:

1. Neurosis of obsessive states (thoughts) is a disorder, the causes of which are conflicts of needs and morality.
2. Anxiety-phobic disorder is a disease caused by fears and phobias.
3. Hysterical neurosis is a disorder of an unstable emotional state caused by a defensive reaction to an “unsolvable” situation.
4. 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 of scientific research and practical treatment of patients, a clinical classification was created.

What types of neuroses are there?:

1. Neurasthenia is irritable weakness.
2. Obsessiveness.
3. Neurotic depression.
4. Phobias and fears.
5. Obsessive behavior and thoughts.
6. Refusal of food.
7. Pathological feeling of hunger.
8. Exhaustion.
9. Defective manifestations in the activity of the stomach are various forms of disturbances in the activity of the digestive system.
10. Panic attacks.
11. Nervous pathologies of cardiac activity.
12. Self-forming neuroses - unreasonable pain, disturbances in the functioning of organs.
13. Laryngo- and pharyngospasms.
14. Disorders of success or guilt.
15. 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:

1. Dysthymic disorder (the term replaced the concept of depressive neurosis).
2. Obsessive-compulsive disorder (instead of obsessive-compulsive neurosis).
3. 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 make it possible to clarify the formulation of the characteristics, types and types of neurosis.

Stages of development of neurosis

There are three main stages in the development of neurosis. The main distinguishing feature of the first two stages from the third is the high probability of complete elimination of the disease in the conditions of appropriate treatment tactics. In the absence of quality medical care and prolonged exposure to a traumatic stimulus, the third stage of neurosis develops. At the third stage of neurosis, changes in personality structure become persistent and even with a competent approach to treatment, these personality disorders persist.

At the first stage of the development of neurosis, neurotic dysfunction occurs as a result of acute psychotrauma and is short-term in nature (no more than one month). Most often, the first stage of neurosis manifests itself in childhood. In some cases, neurotic disorders can also occur in mentally healthy people.

The long course of a neurotic disorder develops into a neurotic state, which is represented by neurosis itself. At the same time, personal characteristics undergo significant changes.

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 the 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 realizes the presence of certain psychological characteristics in himself, and experiences this with difficulty.

Symptomatic manifestations are expressed in the psychological and physical spheres.

What are the psychological forms of the disorder?

1. Emotional depression, mood swings.
2. Behavioral defects manifested in indecisiveness.
3. Communication problems.
4. Self-esteem problems.
5. The presence of anxiety, fears, phobias, panic attacks. High sensitivity to stress.
6. Vagueness, inconsistency and variability of the system of values, desires, aspirations, expectations from life, attitudes towards oneself and others.
7. Irritability, touchiness, tearfulness, anxiety, sensitivity to external stimuli (noise, light).
8. Obsession with the situation that led to psychological trauma.
9. High level of fatigue, problems sleeping.

What are the physical forms of the disease:

1. Pain in the head, stomach, heart area.
2. Decreased physical and mental capabilities of the body.
3. Dizziness and darkening of the eyes.
4. Panic attacks.
5. Disruption of the digestive system.
6. Sleep disorders.
7. Increased psychological sensitivity to physical pain, excessive concern for health.
8. Sweating, frequent urination, changes in blood pressure, cough.

Reasons for development

Factors that encourage the emergence and development of neurotic disorders:

1. External conflicts.
2. Internal (deep psychological) conflicts.
3. Circumstances that influenced the occurrence of traumatic factors.
4. Nervous and mental tension.
5. Excessive emotional and intellectual stress.
6. Personal characteristics of a person, the conditions for their formation and maturation.
7. The nature of a person’s social role, its relationship with internal aspirations.
8. 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.

Competent preventive measures also play an important role. They are able to prevent the occurrence and development of pathology. Various methods and means are used as means of prevention and elimination:

• 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.

General symptoms of neuroses

Common signs of neuroses can be various neurological dysfunctions, most often they are represented by tension headaches, dizziness, hyperesthesia, a feeling of instability while walking, tremors of the limbs, muscle twitching and paresthesia. Also, patients with neurosis often experience sleep disturbances in the form of hypersomnia or insomnia. Permanent or paroxysmal disorders may develop on the part of the autonomic nervous system.

In case of damage to the cardiovascular system due to neurosis, patients complain of a feeling of discomfort or pain in the heart area. Objectively, such patients have a heart rhythm disturbance in the form of tachycardia or extrasystole, arterial hypotension or hypertension, Raynaud's syndrome, pseudocoronary insufficiency syndrome. Respiratory disorders are expressed by a feeling of suffocation or a lump in the throat, lack of air, yawning and hiccups, as well as fear of suffocation.

Disorders of the digestive system against the background of neuroses include heartburn, vomiting, nausea, loss of appetite, constipation, diarrhea, flatulence and abdominal pain of unknown origin. Genitourinary disorders manifest themselves in the form of enuresis, cystalgia, itching in the genital area, pollakiuria, decreased libido, as well as erectile dysfunction in men. Often one of the symptoms of neurosis may be chills, low-grade fever and hyperhidrosis. The skin of neurotic patients may become covered with a rash such as psoriasis, urticaria, or atopic dermatitis.

One of the typical symptoms of neurosis is asthenia, which is expressed not only by mental, but also by physical fatigue. Patients may be bothered by various phobias and constant anxiety, and some of them are susceptible to dystomia (decline in mood, with feelings of melancholy, grief, sadness, despondency).

Neuroses are often associated with mental disorders in the form of forgetfulness, inattention, deterioration of memory and inability to concentrate.

Interpretations of neurosis

The concept of neurosis (from the Greek neuron, nerve) was introduced by the Scottish physician William Cullen in paragraph 1091 of his work “First Lines in the Practice of Physics”, 1776-1784. It denoted sensory affects or movements for which bodily causes could not be fixed.

Over time, it has undergone repeated transformations. 3. Freud

, on whose teaching about neurosis the psychoanalytic direction is still based, distinguished four of its varieties: fear neurosis, fear hysteria (phobia), obsessive-compulsive neurosis (anancasm) and hysteria.

Neuroses, from the point of view of psychoanalysis, are the return of desire that was repressed in the early genital phase - when ambivalence (the simultaneity of conflicting feelings) was hidden from parents.

Symptoms of neurosis are compromise formations between repressed ideas and ideas that are repressed. Condensation and displacement return, as in a dream, previously rejected pleasure in a perverted form.

When analyzing clients’ resistance and interpreting dreams, transference regularly occurs (a shift in attitude towards the parents towards the therapist), which develops into transference neurosis

, which does not allow access to the therapist’s identity.

K. Jung

did not object to the emergence of neurosis in childhood, as Freud insisted, but attached greater importance to the actual situations of neuroses: if the critical phases of development are not overcome, their content is avoided and repressed.

K. Horney

rejects the Freudian interpretation of neurosis and calls the cause of its occurrence the pressure of human culture on the individual, which occurs from early childhood and gives rise to global fear and competition. She connects the progress of civilization with the growth of neuroses. The latter are the price that humanity pays for its cultural development.

Also in the etiology (origin) of neurosis the following were indicated as its causes:

• acquired maladaptive behavior (behavioral therapy);
• repressed conflict of drives, which turns into a form of disorder (psychoanalysis);
• false “I-concept” (verbal psychotherapy);
• incorrect conflict resolution (existential analysis);
• arrangements as an overcompensatory life strategy (individual psychology);
• consequences of mental imbalance between high expectations and passivity (neopsychoanalysis);
• interruptions and denial of life needs (gestalt therapy);
• delays and losses in individual development (complex psychology);
• bad decisions and loss of meaning (logotherapy);
• and many more etc.

Among the characteristics of neurosis were:

• psychogenic nature of occurrence (due to mental trauma or emotional shock);
• manifestation in the form of emotional and somatovegetative disorders;
• functionality and reversibility (possibility of cure);
• the patient's awareness of the fact of his illness;
• absence of disturbances in the reflection of the real world;
• and etc.

The symptoms of neurosis were:

• mental restlessness, anxiety, feeling of fear;
• obsessive thoughts, phobias and actions;
• frequent recall and rumination of traumatic episodes;
• increased fatigue, weakness, decreased performance;
• irritability, tearfulness;
• nervous tension;
• insomnia or shallow sleep;
• general deterioration in health and well-being;
• decreased memory, reaction and concentration during cognitive functions;
• general weakness, asthenia;
• pain in the heart, headaches and gastrointestinal disorders;
• exacerbation of negative character traits (indecisiveness, excessive conscientiousness, stubbornness, stinginess, perfectionism, straightforwardness, aggressiveness, conflict, embitterment, emotional arousal, constant vigilance, suspicion);
• the tendency to take to heart what happens around you;
• tendency to pour out all your negativity on family and friends;
• excessive consumption of alcohol, psychotropic, potent and narcotic substances in order to mitigate their neurotic symptoms.

Despite its vague definitions and multifaceted explanations, neurosis covers a clear group of distressing mental states that cannot be fully described by other terms.

Diagnosis of neurosis

Diagnosis of neuroses consists of several stages. The first is taking an anamnesis. In the process of interviewing the patient, information is found out about hereditary predisposition to this group of diseases, previous events in the patient’s life that could have caused the disease.

In addition, during the diagnostic process, psychological testing of the patient, pathopsychological examination, and personality structure studies are carried out.

The neurological status of a patient with neurosis implies the absence of focal symptoms. During the examination, tremor of the upper extremities may be visualized when they are pulled forward, hyperhidrosis of the palms and a general revival of reflex reactions. In order to exclude cerebropathologies of vascular or organic origin, a number of additional studies are performed (ultrasound of the vessels of the head, MRI of the brain, EEG, REG). In case of severe sleep disorders, a consultation with a somnologist is recommended, who will decide on the advisability of polysomniography.

The complex of diagnostic measures necessarily includes differential diagnosis, the main task of which is to exclude diseases with a similar clinical picture (bipolar disorder, schizophrenia, psychopathy); similar manifestations occur not only in psychoneurological disorders, but also in somatic diseases (cardiomyopathy, angina pectoris, chronic gastritis, glomerulonephritis, etc.), which also need to be excluded in the process of differential diagnosis. The main difference between patients with neurosis and psychiatric patients is their awareness of the disease, an accurate description of the symptoms and the desire to eliminate these pathological phenomena. Sometimes a psychiatrist may be brought in to clarify the diagnosis. In some cases, you need the help of specialists from other categories of medicine (gynecologists, urologists, gastroenterologists, cardiologists, etc.), as well as ultrasound of the abdominal organs, bladder, ECG, FGDS, etc.

Treatment of neurosis

Today, a large number of methods for treating neuroses are used in clinical practice. They apply an individual approach to treatment, depending on the characteristics of the patient’s personality and the form of neurosis; they may prescribe group psychotherapy, psychotropic and restorative drug therapy. It is very important to get enough rest. For a positive effect from treatment measures, it is necessary to exclude the cause of the disease, which requires changing the environment that provoked it. If it is not possible to completely eliminate the cause of neurosis, all efforts are aimed at reducing its significance, this is achieved through the use of various psychotherapy techniques.

In the case of vegetative neurosis, obsessive-compulsive neurosis, neurosis-like reactions and neurasthenia, the optimal treatment method will be persuasion psychotherapy (rational psychotherapy). To eliminate motor neuroses and hysteria, it is advisable to use the method of suggestion, both in the patient’s state of hypnotic sleep and during waking moments. Quite often, auto-training is used for various forms of neurosis. During autogenic training, the doctor selects the necessary phrases, which in the future the patient independently repeats for 15-20 minutes. It is recommended to perform auto-training twice a day, in the morning and evening; at this time it is better to be in a separate room. The patient should be in a lying or sitting position and completely relaxed. An auto-training session most often begins with phrases like these: “I’m calm, I’m relaxed, I’m resting, I’m completely calm. I feel warmth and heaviness in my limbs. My nervous system is resting,” etc. This is followed by verbal formulas aimed at various disorders - irritability, poor sleep, headache, shortness of breath, etc. The session ends with an expanded formula of calm, which instills an understanding that the patient is becoming calmer, more self-confident and this state is becoming stable. Self-hypnosis can be used at home and it is not necessary to place the patient in a hospital. After such treatment, a good rest is recommended; for this, the patient may be sent to a sanatorium resort.

In the case of severe forms of hysteria and motor neuroses, hospital treatment is mandatory.

Drug treatment of neurosis is based on the neurotransmitter aspects of its origin. Medications help the patient to make it easier to work on himself during psychotherapy and record the results achieved. In addition to medications, the mechanism of action of which is aimed at eliminating disorders of the nervous system, general restorative therapy is also provided, which includes multivitamins, glycine, adaptogens, as well as reflexology and physiotherapy.

World of Psychology

Neurosis is a psychogenic, functional, personality disorder that manifests itself primarily in emotional disturbances, behavioral disorders and disturbances in the neurovegetative regulation of internal organs.

Neurosis is a consequence of an insoluble intrapersonal motivational conflict with insufficient effectiveness of psychological defense mechanisms.

Neurosis is an acquired functional disease of the nervous system, in which a “disruption” of brain activity occurs without any signs of its anatomical damage. Neurosis is a consequence of failures, frustrations and interpersonal clashes and at the same time often serves as their cause. So a vicious circle results: conflicts lead to neuroticism, and this, in turn, provokes new conflicts. Short-term neurotic states that go away on their own over time, without treatment, are observed at one time or another in almost any person’s life.

The causes of neuroses lie in a wide variety of traumatic situations, in acute or chronic emotional stress. And depending on the predisposing background, the disease can manifest itself with various symptoms.

Types of neuroses:

1. Neurasthenia (Latin – “nervous weakness”). Reason: prolonged emotional stress, leading to exhaustion of the nervous system. Conflicts at work, family troubles, unsettled personal life. Psychological defense mechanisms such as “denial”, “rationalization”, “repression”. A patient with neurasthenia is bothered by irritability for the most significant reasons. It is difficult for them to concentrate their attention, they quickly get tired, they develop headaches, heart pain, stomach functions are disrupted, insomnia appears, sexual function is upset, and the intensity of sexual relations decreases. Sleep disturbance.

2. Hysteria – observed more often in women. They sometimes imagine themselves as seriously ill, unhappy, “misunderstood people” and become deeply accustomed to the image they have created. Sometimes an occasional unpleasant minor family quarrel or minor work conflict is enough for the Patient to begin to sob bitterly, curse everything and everyone, and threaten to commit suicide. A hysterical reaction usually begins when the Patient needs to achieve something from others, or, conversely, to get rid of their allegedly unfair or simply unwanted demands. These reactions can manifest themselves as uncontrollable tears, fainting, complaints of dizziness and nausea, vomiting, convulsive curling of the fingers, and in general - symptoms of almost any disease known to a given person; imaginary paralysis, deafness, and loss of voice may occur. But with all this, a hysterical attack cannot be considered a simulation; it most often occurs against a person’s desire and causes him to suffer greatly physically and mentally.

3. Obsessive-compulsive neurosis (psychasthenia) – persistent anxious thoughts and fears appear, for example, “getting sick,” losing a loved one, blushing during a conversation, being left alone in a room, etc. At the same time, the person understands well the illogicality of his fears, but cannot get rid of them.

Each of them occurs in people with a certain type of GNI, with specific mistakes in their upbringing and typical unfavorable life situations.

Problems and approaches to study

In Pavlov's teaching, the essence of neurosis is reduced to a chronic deviation of the GNI from the norm, which occurred as a result of overstrain of nervous processes and changes in their mobility. According to Pavlov and his students, neuroses depend on the initial type of nervous system. Thus, people of the “artistic type”, who perceive reality very emotionally, are more prone to hysteria; “mental type” - to obsessive-compulsive neurosis, and the mean between them - to neurasthenia.

The first definition of the concept “neurosis” belongs to Gullen . Neuroses are “disorders of sensations and movements that are not accompanied by fever and do not depend on local damage to any organ, but are caused by general suffering, on which movements and thought specifically depend.” In the second half of the twentieth century. Two main directions have emerged in the study of the origin of neuroses: anatomical and psychological.

It should be noted that the search for the pathoanatomical substrate of neuroses has not yet brought significant results, although supporters of the anatomical direction believe that advances in the field of molecular biology and genetics make it possible to confidently deny the existence of functional diseases and find morphological substrates that are adequate to any dysfunction.

Supporters of the psychological direction are the most numerous. Already in the second half of the 19th century. The basis for the emergence of neuroses in humans, in particular hysteria, was considered to be increased suggestibility and self-hypnosis. Therefore, hypnosis was proposed as the main method of treating neurotic conditions.

According to S. Freud , who headed the psychoanalytic school, neuroses are explained by the action of “infringed” affects, repressed into the unconscious of various drives. Freud divided all psychogenic disorders that have somatic correlates into 2 main groups: conversion neuroses (hysteria) and actual neuroses. The latter included anxiety neurosis, hypochondria and neurasthenia. From the standpoint of various psychological trends associated with Freudianism, the essence of the conflict in neuroses is the contradiction between instincts in the sphere of the unconscious and social norms.

All representatives of the psychological movement recognize that psychological factors are leading in the etiopathogenesis of neuroses.