Mental asthenia. Asthenic state Lack of rest as a cause of psychological fatigue

Asthenic syndrome- a feeling of temporary or chronic fatigue, loss of mental and physical energy. From Latin" asthenia "translated as weakness. Asthenic - a person characterized by a lack of strength, depression, and suspiciousness. In psychology, asthenics include people who are dependent, alarming - fearful and avoidant type.

Asthenia, what it looks like you're tired, actually this is what it is a disease that can put an end to a person’s effectiveness and have a negative impact on his self-esteem and standard of living. Asthenia does not go away without treatment, which is the main difference from episodes of fatigue caused by objective reasons - the need to rest after intense exercise.

Characteristic manifestations and possible causes

Asthenic conditioncan be a consequence of both serious diseases of the body and lifestyle (frequent changes in time zones, emotional and physical overload, lack of sleep, etc.). A sthenia - a reason to think about going to the hospital, the main causes its appearance is either a disease of the body or a mental problem.

Objective (organic, caused by health problems):

1. Asthenia often occurs as a consequence of diseases of internal organs, infection, and intoxication.
2. Fatigue and asthenia are sometimes associated with diabetes and in general metabolic disorders.
3. Lack of food or its poor composition (minimal content of vitamins and minerals) logically leads to asthenia, since the body simply does not have energy, it does not receive it in sufficient quantities. Therefore, asthenia is often a companion to anorexia and other eating disorders.
4. Age, senile astheniaallocated to a separate branch of research in gerontology. The percentage of patients with asthenia increases in proportion to age. However, some factors, such as a high level of education, marriage and others, reduce the likelihood of being in the group of people with the disease, which also speaks about the psychological side of the development of asthenia in old age.

Subjective-objective (depending on the conditions and perception of a person):

1. Emotional, mental or physical stress leads to acute forms of asthenia.
2. Nervous and mental illnesses (especially schizophrenia).

What is hidden behind asthenia?Only a doctor can determine for sure, so at the first symptoms that do not go away within two to three weeks, you should seek the advice of a specialist.

Signs of asthenia:

• Shortness of breath, rapid heartbeat.
• Muscle spasms, cramps, fever.
• Fast fatiguability , loss or decrease in energy, fainting.
• Disorientation.
• Irritability, hot temper, suspiciousness.
• Depressed state, anxiety.
• Sexual asthenia.

Symptoms of astheniadepend on the cause that caused it. Thus, heart problems are usually associated with headaches and a feeling of pressure in the chest. And weakness and weakness are most often observed with any source of asthenia.

Psyche and weakness

A distinction is made between real asthenia, when the body really mobilizes forces to fight the disease and the source of the problem is clearly defined. And functional, in which the body works like a clock, but for some reason the person still cannot finish a single task, everything literally falls out of hand, while he experiences characteristicasthenic emotions(sadness, depression). Thisasthenic conditioncan be very acute, although a person has every chance of quickly getting back on his feet.

In psychology are engaged in the analysis of mental factors leading to asthenia. What does working with people with disabilities include? psychotype asthenics, and treatment of neurasthenia, which may be complicated by other pathologies. INasthenic disorderincludes asthenic psychopathy or dependent personality disorder, which most often affects asthenic psychotype . Let's first consider what's happened asthenic psychopathy, and then neurasthenia, which is described in three phases.

Socio-mental weakness

Dependentpersonality disorder, included in ICD-10, is one of the serious diseases that significantly worsens a person’s quality of life. Asthenia literally does not provide him with the opportunity to take life into his own hands. The disorder corresponds toasthenic typepersonality, who appears in the works of Konstorum, Leonhard, Kaplan and Sadok, although under different names.

A person with an asthenic personality type has the following symptoms of a dependent disorder (in accordance with ICD-10):

• The tendency to transfer responsibility, to throw it off oneself.
• Submission to other people, passive fulfillment of their desires.
• Extreme undemandingness towards those from whom asthenic depending.
• Anxiety and feelings of helplessness when alone (fear of independence), feelings of helplessness and incompetence.
• Desire for approval and advice from others, inability to make decisions without them.

Asthenics This type has a special mental constitution; when they encounter problems, they prefer to avoid them hide . There is even a specialasthenic form of fear, which consists of numbness and inappropriate actions when aware of danger. This psychotype associated with such qualities and features as:

• Conscientiousness, pride, vulnerability, irritable weakness (in a close circle, there is no aggression in it, this irritability is a response to the asthenic’s suspicions that he is being treated poorly), a sense of personal inferiority, hence uncertainty and shyness.
• Frequent headaches, hand tremors, problems with stool, increased heart rate, pressure surges.
• Fatigue, intellectual and emotional.

In general, the asthenic type is not characterized struggle , they easily give in and retreat into the background, just to avoid the aggressiveness of others.Asthenic personalityobsessed with what people think of her, she places high demands on herself and suffers from inadequacy.

Here for the disease one can accept both the personality constitution of an asthenic person and its pathological manifestations.Psychologicalthe portrait practically corresponds to chronic asthenia. Asthenics can and need therapeutic treatment - help in setting boundaries, transferring the locus of control inside and getting rid of fear.

Fatigue and irritability

Neurasthenia (a sthenic neurosis) first entered the vocabulary of doctors in the 19th century, and was considered a disease of intellectuals. Thisasthenic disordercharacterized by:

• Weakness.
• Fatigue quickly.
• Difficulty concentrating.
• Worry.
• Decreased efficiency.

With neurasthenia, the following are often observed:

• Inability to relax.
• Chest pain.
• Accelerated heartbeat.
• Sweaty hands and feet.
• Hyperventilation.
• Sleep disorders.

The exact causes of neurasthenia have not been established, but, as a rule, it is observed before the disease mental trauma combined with severe stress. Thisasthenic disordermay be associated with burnout and chronic fatigue syndrome. It goes through three stages:

1. The beginning of the development of neurasthenia - irritability, slight excitability, poor sleep, problems with concentration. R reaction does not correspond to the stimulus - minor noises can infuriate a neurasthenic person. As a result of lack of sleep and overwork, there are girdling headaches, which are called neurasthenic headaches.

2. The second stage of neurasthenia - the neurasthenic is easily irritated, but quickly cools down, exhausted to the limit, is often impatient and fussy, sleeps poorly at night.

3. The third stage of neurasthenia is apathy, depression and drowsiness. A person becomes isolated on himself, his feelings.

It would be optimal for people suffering from this disease to refrain from intensive activities and work during treatment. If this is not possible, any sources of stress should be minimized.

How to improve your condition?

Although asthenia is not life-threatening unless caused by a serious illness, it significantly reduces its quality. A person often becomes unable to perform the simplest tasks. May prevent the development of asthenia or alleviate its symptoms:

1. Time control. Alternating rest and activity, switching between forms of activity.
2. Eating foods rich in vitamins and minerals.
3. Refusal of diets and intense sports, although light physical activity is definitely necessary.
4. Normalization of sleep/wake patterns.

If you deviate from a healthy lifestyle after treatment, there is a risk of again get sick. A sthenic manifestationswill stretch over time and may develop into a chronic disease.

Asthenic syndrome, which is not caused by infection, disease or other organic causes, can be alleviated through relaxation and concentration exercises.

Asthenic conditionscharacterized by increased excitability, inability to tolerate stress and make significant emotional or intellectual efforts. Meditation and attention training, as well as reducing the number of irritants at home and at work (turning off devices that make sounds, distracting devices) will help you stay focused longer and reduce anxiety levels.

The most unexpected answer to the question "how to deal with asthenia“came from the University of Michigan, however, asthenics were not studied there, but the data from their experiment allows us to extend it to people with asthenia. Asthenic will increase concentration, reduce anxiety and reduce impulsivity with just an hour of sleep. Trying by force of will to continue to work or engage in some useful work, a person risks further aggravating his mental state.

Asthenic depressionrequires more complex treatment, including antidepressants and psychostimulants. A specialist will determine which drugs are suitable and in what case. If hints of a disorder are detected, then a comprehensive analysis of the body is required. Oftenasthenia in schizophreniahides the latter, and it, being the cause of fatigue and irritability, will grow, remaining unnoticed.

At the first sign asthenia can be usedtreatment with folk remedies- honey, relaxing herbs - chamomile, valerian, linden, yarrow, tincture of eleutherococcus, aromatherapy with essential oils of lavender and eucalyptus. However, when using them, you need to remember that some people are individually intolerant to the components of herbs or extracts, and also, if the condition does not change or worsens, consult a doctor.

Asthenia is the starting point of many psychopathological processes. Timely treatment will not only improve a person’s quality of life, but also protect against more serious problems.

Have you ever felt like you just can't do it anymore? If so, you are experiencing the effects of mental fatigue. These symptoms of brain fatigue sound familiar when you are experiencing the effects of stress and hectic environment.

We've all experienced physical fatigue, so these signs are quite familiar to us. Compared to how your brain controls the processes occurring in the body, mental fatigue is quite a serious phenomenon. In this article, we'll look at the signs of mental fatigue, as well as several ways to help combat it.

1. You know there's too much going on at once.

Are you overwhelmed with emotions? You are probably literally on sensory overload. Sounds, smells, sights, mental activity, changes on the physical level. Sometimes all this happens in a busy environment and can cause too much mental clutter.

When there is too much input from all your senses, your brain begins to show signs of stress and mental fatigue. You may find that you have to ask people to repeat themselves to you. In addition, in this state you may make spelling mistakes.

Try turning off any noisy devices that you can control, such as fans, music, TV, buzzing lights, etc. Turn to the source of information and observe him to bring him into full understanding. Limit yourself from performing a huge number of tasks as much as possible.

2. You don't have free time

Don't remember the last time you went on vacation? A study in the journal Environment and Human Behavior found that there are two strategies that can help you manage your mental fatigue more effectively. To do this, you should avoid those things that cause mental fatigue and tension.

One strategy is to avoid unnecessary costs in terms of attention management. In other words, you should limit your thought processes. If you can, assign some tasks to trusted individuals or delay making decisions unless they are urgent.

In another case, we are talking about increasing the efficiency of restoration processes. They include restorative environments, reflective spas - all of which will help refresh your mind so you can think clearly again. Indeed, even short exposure to the sun is what you need to be able to continue moving.

3. You have some kind of mental block

A mental block is when you are so exhausted that you cannot continue to think. You simply stop thinking until you can calm down enough to regain your strength and continue again.

Researchers from the Journal of Psychology studying mental fatigue found that mental blocking acts "as an automatic defense that prevents a person from working continuously." In other words, you can't use your brain because it will simply stop working the moment you are truly tired.

4. You feel more emotional lately.

Depression or anxiety can be symptoms of mental fatigue because a person may feel hopeless about how they will be understood by others. Being mentally tired can feel a lot like a type of depression because your mental energy levels are quite low. For example, you may feel anxious that the situation will not improve.

If the situation that is causing you mental fatigue is the cause of your lack of control, you may feel angry emotions towards the person you see as the cause of all your suffering.

5. Physical symptoms

Headaches, stomach discomfort, intestinal problems, loss of appetite, insomnia and nervousness are some of the physical symptoms that you may experience and which in turn are signs of mental fatigue. Of course, you can consult your doctor if they worry you. The therapist can provide you with helpful advice.

6. You forget little things that are quite important to you.

Forgetfulness and memory lapses are a sign of mental fatigue. Your brain processes a lot of information at once, but memories don't work in the same way. At a later time, when you rest, your brain remembers.

You will find it difficult to remember as well as concentrate on anything for a long period of time. If you can avoid anything that could cause harm to people when using your mental powers (like driving a car), that would be better. Avoid such activities until you have rested from your mental fatigue.

7. One question can make you explode.

After answering questions and making decisions all day long, you become exhausted and unable to answer anymore. People will need to do without you because you avoid answering due to mental fatigue.

Let other people take charge of making the small decisions you need to make in one day. By letting go of small decisions like not knowing what to make for dinner, you can make another decision in your favor that can prevent mental fatigue.

In our Library you can read. The author's simple but effective advice will help you restore energy and forget about fatigue. Research shows that Dr. Teitelbaum's techniques increase energy levels by 91%.

For quotation: Lebedev M.A., Palatov S.Yu., Kovrov G.V. Fatigue and its manifestations // Breast cancer. Medical Review. 2014. No. 4. P. 282

Fatigue is a symptom complex characterized by a feeling of weakness, lethargy, powerlessness, a feeling of physical and mental discomfort, which is combined with a decrease in performance, loss of interest in work and a deterioration in the quality of life in general. The relevance of studying the problems of asthenic disorders is determined by their significant prevalence, reaching up to 20% (depending on assessment approaches) in the population and occurring in most mental, somatic and psychosomatic diseases. According to World Health Organization forecasts, by 2020, asthenic disorders and depression will take second place in incidence after cardiovascular diseases.

There is a lack of awareness among doctors about this mental disorder, the least specific of all, and there is no general understanding of the reasons for its occurrence. A variety of symptoms that are strictly specific to each case of the development of one or another form of fatigue are not monitored.

Manifestations of fatigue in each individual case can be defined as basic or initial in relation to any other disorders, sometimes preceding or determining and almost always completing the course of any illness - somatic or mental, which also increases the significance of this problem.

The polymorphism of symptoms leads to the identification of various syndromes and diseases, such as asthenic syndrome, chronic fatigue syndrome, vegetative-vascular dystonia, nervous weakness, asthenic condition, neurotic syndrome, neurasthenic reaction, neurotic condition, pseudoneurasthenia, functional disease of the nervous system, neurasthenia, etc. .

The symptoms of the disorder are varied and vary greatly depending on the reasons that caused fatigue or the disease against which it developed. But as already mentioned, there are a number of clinical manifestations and characteristic groups of symptoms that are present in all cases of the development of fatigue to a greater or lesser extent:

1. Weakness:

• a feeling of physical and mental fatigue, fatigue, which limits performance and often occurs before work (should be distinguished from physiological fatigue and tiredness);
• inability to exert stress for a long time and rapid exhaustion, leading to a deterioration in the quality of work;
• a feeling of powerlessness, adynamia, inability to remember, creativity, which is accompanied by tears and despair;
• feeling of lethargy, weakness, difficulty thinking, loss of associations, lack of thoughts, feeling of emptiness in the head, decreased activity and interest in others;
• drowsiness combined with constant mental and physical fatigue;
• increased mental and physical exhaustion with sudden sweating, tremors after a conflict or excitement.

2. Irritability:

• anger;
• explosiveness;
• increased excitability;
• grumpy touchiness;
• pickiness;
• grumpiness;
• vulnerability for no reason;
• internal anxiety;
• restless activity;
• inability to rest;
• sensitivity with tears;
• dissatisfaction for any reason and without an obvious reason.

3. Sleep disorders:

• difficulty falling asleep;
• manifestations of unusually persistent insomnia or sleep “without the feeling of sleep,” when the patient resolutely denies reports from staff that he was sleeping;
• sensitive, restless sleep, lack of performance after sleep;
• waking up early with a feeling of unaccountable anxiety, internal restlessness and impending unhappiness;
• perversion of the “sleep formula”: drowsiness during the day, insomnia at night;
• constant desire for sleep and drowsiness.

4. Autonomic disorders:

• various types of vascular disorders: fluctuations in blood pressure, pulse and slight paleness or redness of the skin during excitement; vascular asymmetry (different pressure on the arms); discomfort in the heart area; stabbing pain and palpitations; changes in vascular reflexes; asymmetry of body temperature; sweating of various parts of the body;
• headache, most often occurring with fatigue, excitement, at the end of the working day, often of a tightening nature, characterized by patients as “a neurasthenic helmet”, “as if a hoop was put on the head”;
• Severe headaches are not uncommon, occurring more often at night and in the morning, the patient may wake up because of them; the pain is bursting in nature;
• dizziness and heaviness in the head;
• changes in muscle tone;
• impaired potency, dysmenorrhea in women;
• gastrointestinal disorders;
• allergic reactions;
• cognitive dysfunction.

Physiological fatigue can develop against the background of ordinary fatigue from physical or psychological stress. As a rule, doctors are not consulted about this - unlike the situation when it comes to the development of a psychopathological symptom complex against the background of a neurological, somatic or mental disorder, in particular asthenia or chronic fatigue syndrome.

Asthenia (Greek astheneia - weakness, impotence) is a psychopathological disorder, the picture of which is determined by the phenomena of increased physical and/or mental fatigue with a decrease in the level of activity (lack of vigor, energy, motivation), entailing clinically and socially significant consequences: the need for additional rest, reduction in the volume and efficiency of activities (even habitual ones).

There are a number of clinical forms of asthenia. The most common forms are:

1. Hypersthenic form.

It is characterized by a weakening of the processes of internal inhibition, as a result, irritative symptoms come to the fore: phenomena of irritability, increased excitability, anger, incontinence, impatience. Patients complain of a constant feeling of internal tension, anxiety, inability to restrain themselves, to wait. The feeling of fatigue, especially noticeable during failures, is sharply replaced by an increase in performance with successful results. Fatigue itself has a peculiar character; they say about it: “fatigue that knows no rest.” Despite the feeling of fatigue, the patient is restless and is constantly doing something.

Sleep is characterized by nightmares, inability to fall asleep, lack of a refreshing effect and the presence of feelings of anxiety and irritability.

Autonomic disorders: increased sweating, tachycardia, increased blood pressure.

2. Hyposthenic form (often called wasting syndrome).

It is characterized by the development of protective inhibition and a decrease in cortical excitability. In this regard, the phenomena of general weakness, exhaustion and fatigue come to the fore. Habitual activities cause great stress in such patients. By the middle of the day they are unable to work normally, and after work they feel completely unable to do anything, have fun or read. Characterized by constant drowsiness. The mood is low and has a hint of apathy. Sometimes, against the background of this nervous and physical impotence, short-term irritation arises about one’s own unproductivity and clashes with others, after which even greater fatigue and adynamia are noted, accompanied by tears.

There are special forms: the first is intermediate between the above, the second is the result of the development of asthenia.

3. Irritable weakness syndrome.

The phenomena of increased irritability, excitability with fatigue, weakness, and exhaustion come to the fore. These are those patients in whom short outbursts of anger are followed by tears and weakness; after a rapid start to activity there is a rapid decline in performance; behind the quickly flared up interest - lethargy and apathy; behind the impatient desire to say or do something is a subsequent feeling of fatigue and powerlessness.

4. Astheno-vegetative and astheno-hypochondriacal form.

It is characterized by a predominance of vegetative disorders. In patients, from the very beginning or, more often, after a relatively short debut of general asthenic disorders, objective and subjective symptoms of various disorders characterized by polymorphism, variability, and turnover appear quite clearly. Patients describe their condition as follows: “everything hurts: my heart is pounding and beating, I’m sweating, I’m losing weight, I have no appetite, there’s heaviness in my stomach, belching of food, diarrhea is replaced by constipation, hives on the skin.”

Hypochondria is characterized by anxious fears. Cancer phobia, fear of missing a disease, fear of a heart attack, etc. arise. The patient retains a critical attitude towards these fears, he tries to fight them, and can be persuaded. Often occurs or intensifies after the occurrence of a real somato-vegetative disorder.

In the International Classification of Diseases, 10th revision, conditions, the main manifestation of which is asthenia, are considered under the headings:

1. Neurasthenia F48.0.

2. Organic emotionally labile (asthenic) disorder F06.6.

3. Fatigue syndrome after viral infection G93.3.

4. Asthenia NOS (R53) (unspecified).

5. Overwork (Z73.0) (burnout syndrome).

6. Other specified neurotic disorders (F48.8), which includes psychasthenia.

Currently, in practice it is customary to distinguish the following clinical and etiological forms of the disease:

1. Exogenous-organic:

• functional (somatogenic) asthenia;
• organic (cerebrogenic) asthenia.

2. Psychogenic-reactive asthenia:

• overload syndrome;
• neurasthenia.

3. Constitutional asthenia.

4. Asthenic depression.

5. Endogenous asthenia (schizophrenic asthenia).

6. Asthenia due to non-medical use of psychoactive substances.

Functional asthenia (somatogenic) is an independent clinical unit not associated with specific organic diseases. It is characterized primarily by clinical reversibility, since it arises as a result of or as a component of time-limited or curable pathological conditions. These include:

1) acute asthenia, which occurs as a reaction to acute stress or significant overload at work (mental or physical (overexertion asthenia);

2) chronic asthenia, appearing after childbirth (postpartum asthenia), infections (post-infectious asthenia) or noted in the structure of withdrawal syndrome, cachexia, etc.;

3) separately, due to the extreme significance of the problem, psychiatric asthenia is distinguished, in which an asthenic symptom complex is identified in the structure of functional borderline mental disorders (anxiety, depression, insomnia, etc.).

Organic asthenia (symptomatic, neurosis-like) is a condition characterized by severe and persistent emotional incontinence or lability, fatigue, or a variety of unpleasant physical sensations (for example, dizziness) and pain, presumably arising from an organic disorder. The disorder is thought to be more often associated with cerebrovascular disease or hypertension than with other causes. It also occurs as a result of various somatic diseases, being their manifestation.

Neurasthenia is one of the psychogenic diseases that occurs after acute or long-term psychogenic stress.

Neurasthenia is characterized by:

• decreased physical activity: unusual fatigue during the day with weakening or loss of the ability to exercise for more or less prolonged periods, combined with an increased need for rest and lack of a feeling of full recovery after rest;
• phenomena of irritable weakness in the form of increased excitability and exhaustion quickly following it;
• intolerance to psycho-emotional stress (lability of mood with the inability to restrain reactions of resentment, outbursts of irritability and discontent, followed by violent remorse);
• cognitive disorders: increased fatigue even under normal intellectual stress with decreased concentration and executive functions (absent-mindedness, difficulty in concentrating for long periods of time, decreased volume and efficiency of activity);
• disturbance of the sleep-wake cycle: episodes of drowsiness during the day or fluctuating drowsiness throughout the day combined with deterioration in sleep quality (insomnia is manifested by shallow intermittent sleep with unpleasant, often anxious, dreams or drowsy states).

Overload syndrome is characterized by clinical manifestations very similar to neurasthenia (fatigue, decreased physical activity, fatigue, emotional instability, irritability, sleep disorders).

Constitutional asthenia is manifested by hyposthenia. Symptomatic lability characteristic of patients is due to congenital inferiority of vegetative functions (vascular crises, dizziness, orthostatic fainting, palpitations, hyperhidrosis, etc.) and hypersenesthesia in the sphere of bodily perception (hyperpathy, algia, pseudomigraine).

Constitutional asthenics are characterized by an elegant physique with a predominance of longitudinal dimensions over transverse ones (“Gothic” body type), hypoplasticity of the cardiovascular system (teardrop-shaped heart, narrowing of the aorta, tendency to syncope), infantilism of the genital area. They are timid, passive, cannot tolerate even minor emotional stress, get tired quickly, get upset over any trifle and, losing self-control, become unrestrained. Increased impressionability and suspiciousness are often combined with a consciousness of their own inferiority. Their character and behavior bear the imprint of weakness and instability.

Asthenic depression. The course of such depression is slow, with an imperceptible onset, or persistent wave-like (like dysthymia). Less commonly observed is a recurrent course with deterioration of the condition due to increased asthenic and autonomic disorders. The clinical picture includes depressed mood, but hypothymia is not accompanied by feelings of melancholy and hopelessness characteristic of endogenous depression. The peak of poor health in the morning is also not associated with vital symptoms of depression, and ideas of low value and guilt are not typical. Disorders of the sleep-wake cycle appear less pronounced than in somatogenic asthenia, in which manifestations of hypersomnia predominate; in these cases, pre-, intra- and post-somnic disorders (disturbances in the depth of sleep) are most pronounced. Sadness and heaviness in the soul are interpreted as a consequence of poor physical health or unfavorable life events, and fluctuations in depressive affect are associated with changes in the situation. Weakness with decreased activity and initiative, and increased tearfulness (“tears flow by themselves”) predominate. The picture of full-blown asthenic depression is determined by signs of negative affectivity and includes increased exhaustion, complaints of physical impotence, loss of energy, “wear and tear,” and disproportion of sensations accompanying physiological processes.

Endogenous asthenia (schizophrenic, asthenic-like). Asthenic manifestations in such cases are realized in accordance with the stage of the endogenous process and can, in some cases, determine the structure of psychopathological disorders at each of these stages separately, ending with a complete change in the syndrome (residual conditions, in the picture of which negative disorders dominate, are an exception). In all other cases, a different evolution of the syndrome is characteristic. In sluggish schizophrenia with a predominance of asthenic disorders, asthenia prevails throughout the entire course of the disease:

1. At the prodromal stage, the phenomena of hyperesthetic asthenia predominate: a painful feeling of fatigue, signs of sensitization to normally neutral stimuli, hyperpathia, sleep disturbances.

2. At the onset of the disease process (as a rule, it occurs in adolescence), the clinical picture is determined by the phenomena of juvenile asthenic failure, often overlapping with affective (depressive) disorders. Among the manifestations of the disease is a progressive decline in academic performance, most clearly evident during exam sessions: severe mental fatigue, absent-mindedness, decreased concentration. In this case, complaints of nervous exhaustion, weakness, poor memory, absent-mindedness and difficulties in comprehending the material predominate.

3. In the active period of the disease (manifest stage), the symptoms of asthenia, not associated with mental or physical overload, prevail and occur with the alienation of self-awareness of activity. Asthenia acquires a total character, the feeling of a decrease in activity covers both the ideational and somatopsychic spheres (vital asthenia syndrome). In some cases, the phenomena of physical impotence take the form of a violation of the general sense of the body. The clinical picture is dominated by weakness, weakness, a feeling of loss of muscle tone, unusual physical heaviness, and “wooliness” throughout the body. The course of schizoasthenia, as a rule, takes on a continuous character. In this case, exacerbations are possible in the form of affective phases, occurring with increased mental and physical asthenia, depressed, gloomy mood, anhedonia and alienation phenomena (a feeling of indifference, detachment from the environment, inability to experience joy, pleasure and interest in life). The picture of remissions is dominated by the symptomatology of the same name, associated with hypochondriacal introspection and fear of exacerbations - dyspsychophobia.

4. At the final stages of the process (stabilization period, residual conditions), a persistent asthenic defect is formed. In the clinical picture, the phenomena of asthenia again come to the fore, but in the form of negative changes. The latter are manifested both by disorders of the cognitive sphere (persistent mental fatigue associated with difficulties in comprehending what has been read and memory disorders) and changes in the general feeling of the body (feelings of unusual physical heaviness, loss of muscle tone, general impotence).

Asthenic disorders that deepen within a series of negative changes take the form of somatopsychic fragility. Even minor physical stress or psycho-emotional stress (watching a movie, communicating with relatives) is accompanied by an increase in the intensity of asthenic disorders: weakness, lethargy, a feeling of exhaustion, heaviness in the head, a feeling of tightness in the back of the head, heightened sensitivity to the slightest changes in the established life pattern. The formation of negative disorders is accompanied by a steady decline in performance. Due to fears of worsening well-being (increased lethargy, headaches, insomnia), patients minimize work duties and household chores, shifting most of the household chores to loved ones, and refuse to communicate.

Asthenia due to non-medical substance use occurs in adolescents and adults with all forms of substance dependence. The most severe conditions are observed when using psychostimulants (so-called “disco drugs”). In this case, the typical asthenic symptoms are accompanied by a feeling of exhaustion with aching pain in different parts of the body. The need for sleep is combined with the inability to fall asleep, and drowsiness is combined with restless sleep. Characteristic emotional disturbances: dysphoria, anger, suspicion. With continued abuse of psychoactive drugs, serious, prolonged depression develops.

The term "chronic fatigue syndrome" appeared in 1984 in the USA. Whether this syndrome is independent in relation to asthenia or a separate manifestation of asthenic disorders is a debatable issue to date. Chronic fatigue syndrome is considered to affect patients who experience debilitating fatigue (or get tired quickly) for at least six months, and whose performance has decreased by at least half. In this case, any mental illnesses should be excluded (with the help of doctors), such as depression, which has similar symptoms, various infectious diseases, hormonal disorders, for example those associated with dysfunction of the thyroid gland, drug abuse, exposure to toxic substances. To make a diagnosis, a combination of 2 major and 8 of 11 minor symptoms is required, constantly or recurring over 6 months. or longer. Today, about 17 million people worldwide suffer from chronic fatigue. Thus, in the United States there are from 400 thousand to 9 million adults with this disease. This disorder is recorded in environmentally unfavorable regions where there is a high level of environmental pollution with chemically harmful substances or increased levels of radiation.

Currently, there are several theories about the development of chronic fatigue syndrome. The most common belief is that chronic fatigue is caused by a deficiency of the immune system or a chronic viral infection. This is due to the fact that patients with this pathology show signs of decreased immunity.

To summarize, it must be said that ordinary fatigue, with insufficient attention to it, can turn into overwork, and then into asthenia as a significant but nonspecific syndrome for the patient. In all cases, the doctor must respond to this by prescribing certain schemes for correcting the patient’s condition.

Treatment

Non-drug treatment is aimed at activating the metabolism and restorative functions of the body, normalizing the work and rest regime. Physical therapy, physiotherapeutic procedures, and sanatorium-resort treatment are often used. The most effective approach is psychotherapy. This is, first of all, the rational conviction of the patient in the absence of serious diseases, the formation of a positive attitude, auto-training - reducing the intensity of existing manifestations of neurotic symptoms, person-oriented (reconstructive) psychotherapy - the formation of a healthy lifestyle.

Herbal preparations (otherwise known as galenic preparations) are a group of pharmaceuticals and dosage forms obtained, as a rule, from plant materials by extraction. It is known that herbal medicines (ginseng, Aralia Manchurian, golden root, Chinese magnolia vine, Sterculia platanofolia, Eleutherococcus senticosus, etc.) restore neurohormonal regulatory mechanisms and optimize recovery processes in severe, recurrent chronic diseases, reduce the risk and rate of development of degenerative-dystrophic diseases. and precancerous diseases, have a number of advantages regarding safety, namely their non-toxicity and compatibility with other drugs, and can be used by weakened patients. In some cases, hypersensitivity reactions (allergic skin reactions) may occur, as well as cases of allergic reactions due to individual sensitivity to the components of the drugs (phenol, quinine), increased blood pressure (hypertension), tachycardia, conditions that are accompanied by overexcitation and hyperkinetic syndrome.

An equally interesting drug from the point of view of treating asthenia is the extract of red deer antlers. This extract is highly effective due to the high concentration of a complex of biologically active substances. It contains more than 80 different elements: peptides, amino acids, lipids, carbohydrates, nucleotides, minerals, glucosides, vitamins. The extract is a valuable source of essential amino acids, which must enter the human body with food, and contains protein with collagen. Amino acids are the most important components of proteins, enzymes and other biological substances; they also have an independent preventive value. Glutamic acid takes part in the biological processes of the brain, in protein and carbohydrate metabolism, and improves the nutrition of brain cells. Aspartic acid is used in the prevention and treatment of diseases of the cardiovascular system, promotes the penetration of potassium and magnesium ions into the intracellular space. A mixture of methionine, cysteine, glutathione and adenosine triphosphate (ATP) improves the biosynthesis of protein and nucleic acids by providing energy for these processes. The extract can be used in patients with fatigue, asthenic conditions of various natures, and also for preventive purposes as a tonic and stimulant during increased physical and mental stress.

You can use preparations of St. John's wort, which has a mild anxiolytic (eliminates feelings of fear and tension) and antidepressant (eliminates depression and apathy) effect, increases mental and physical activity, and normalizes sleep. Valerian root has a multifaceted effect on the body, depresses the central nervous system (CNS), reduces its excitability, and facilitates the onset of natural sleep.

Nootropics (Greek noos - thinking, mind; tropos - direction) are drugs that have a specific positive effect on the higher integrative functions of the brain. They improve mental activity, stimulate cognitive functions, learning and memory, and increase the brain’s resistance to various damaging factors, including extreme stress and hypoxia. In addition, nootropics have the ability to reduce neurological deficits and improve cortico-subcortical connections.

Currently, the main mechanisms of action of nootropic drugs are considered to be the influence on metabolic and bioenergetic processes in the nerve cell and interaction with the neurotransmitter systems of the brain. Neurometabolic stimulants improve the metabolism of nucleic acids, activate the synthesis of ATP, protein and ribonucleic acid (RNA). The effect of a number of nootropics is mediated through the neurotransmitter systems of the brain, among which the most important are monoaminergic (piracetam causes an increase in the content of dopamine and norepinephrine in the brain, some other nootropics - serotonin), cholinergic (piracetam and meclofenoxate increase the content of acetylcholine in synaptic endings and the density of cholinergic receptors , choline alfoscerate, pyridoxine and pyrrolidine derivatives improve cholinergic transmission in the central nervous system), glutamatergic (memantine and glycine act through N-methyl-D-aspartate (NMDA) receptor subtype).

There is a group of antiasthenic drugs - deanol aceglumate, salbutiamine, etc.

Deanol aceglumate has a structural similarity to γ-aminobutyric and glutamic acids, is a neurometabolic stimulant, has cerebroprotective, nootropic, psychostimulating and psychoharmonizing effects, facilitates the processes of fixation, consolidation and reproduction of information, improves learning ability. Deanol aceglumate is successfully used in the treatment of asthenic disorders (borderline conditions, psychoorganic syndrome, schizophrenia, alcoholism), neuroleptic syndrome (mild and moderate manifestations), alcohol withdrawal syndrome with a predominance of somatovegetative and asthenic disorders, intellectual-mnestic disorders, neurotic and neurosis-like disorders against the background of residual organic inferiority of the central nervous system, psychosomatic disorders.

Another drug, salbutiamine, has a stimulating metabolism in the central nervous system and antiasthenic effects, regulates metabolic processes in the central nervous system, accumulates in the cells of the reticular formation, hippocampus and dentate gyrus, Purkinje cells and glomeruli of the granular layer of the cerebellar cortex (according to immunofluorescence histological study). Placebo-controlled clinical trials using psychometric tests and rating scales have shown its high effectiveness in the symptomatic treatment of functional asthenic conditions.

Among the drugs with an antidepressant effect, selective serotonin reuptake blockers and selective serotonin reuptake stimulants are often used. Tranquilizers are also used in the correction of asthenic conditions; their calming effect is often necessary for patients with asthenic conditions.

Thus, when correcting a condition such as fatigue, a nonspecific manifestation of somatic and mental ill-being, it is necessary to use a variety of approaches - both non-medicinal and medicinal.

Literature

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In psychology, asthenics include people of the dependent, anxious-fearful and avoidant types.

Asthenia, which looks like fatigue, is actually a disease that can put an end to a person’s effectiveness and have a negative impact on his self-esteem and standard of living. Asthenia does not go away without treatment, which is the main difference from episodes of fatigue caused by objective reasons - the need to rest after intense exercise.

Characteristic manifestations and possible causes

An asthenic state can be a consequence of both serious diseases of the body and lifestyle (frequent changes in time zones, emotional and physical overload, lack of sleep, etc.). And sthenia is a reason to think about going to the hospital; the main reasons for its appearance are either a disease of the body or a mental problem.

Objective (organic, caused by health problems):

1. Asthenia often occurs as a consequence of diseases of internal organs, infection, and intoxication.
2. Fatigue and asthenia are sometimes associated with diabetes and metabolic disorders in general.
3. Lack of food or its poor composition (minimal content of vitamins and minerals) logically leads to asthenia, since the body simply does not have energy, it does not receive it in sufficient quantities. Therefore, asthenia is often a companion to anorexia and other eating disorders.
4. Age and senile asthenia are identified as a separate branch of research in gerontology. The percentage of patients with asthenia increases in proportion to age. However, some factors, such as a high level of education, marriage and others, reduce the likelihood of being in the group of people with the disease, which also speaks about the psychological side of the development of asthenia in old age.

Subjective-objective (depending on the conditions and perception of a person):

1. Emotional, mental or physical stress leads to acute forms of asthenia.
2. Nervous and mental illnesses (especially schizophrenia).

Only a doctor can determine for sure what is hidden behind asthenia, so at the first symptoms that do not go away within two to three weeks, you should seek the advice of a specialist.

• Shortness of breath, rapid heartbeat.
• Muscle spasms, cramps, fever.
• Fatigue, loss or decrease in energy, fainting.
• Disorientation.
• Irritability, hot temper, suspiciousness.
• Depressed state, anxiety.
• Sexual asthenia.

Symptoms of asthenia depend on the cause that caused it. Thus, heart problems are usually associated with headaches and a feeling of pressure in the chest. And weakness and weakness are most often observed with any source of asthenia.

Psyche and weakness

A distinction is made between real asthenia, when the body really mobilizes forces to fight the disease and the source of the problem is clearly defined. And functional, in which the body works like a clock, but for some reason the person still cannot finish a single task, everything literally falls out of hand, while he experiences characteristic asthenic emotions (sadness, depression). This asthenic condition can be very acute, although the person has every chance of quickly getting back on his feet.

In psychology, they analyze the mental factors leading to asthenia. This includes working with people who have the asthenic psychotype and treating neurasthenia, which may be complicated by other pathologies. Asthenic disorder includes asthenic psychopathy or dependent personality disorder, which most often affects the asthenic psychotype. First, let's look at what asthenic psychopathy is, and then neurasthenia, which is described in three phases.

Socio-mental weakness

Dependent personality disorder, included in the ICD-10, is one of the serious diseases that significantly impairs a person’s quality of life. Asthenia literally does not provide him with the opportunity to take life into his own hands. The disorder corresponds to the asthenic personality type, which appears in the works of Gannushkin, Konstorum, Leonhard, Kaplan and Sadok, although under different names.

A person with an asthenic personality type has the following symptoms of a dependent disorder (in accordance with ICD-10):

• The tendency to transfer responsibility, to throw it off oneself.
• Submission to other people, passive fulfillment of their desires.
• Extreme undemandingness towards those on whom the asthenic is dependent.
• Anxiety and feelings of helplessness when alone (fear of independence), feelings of helplessness and incompetence.
• Desire for approval and advice from others, inability to make decisions without them.

Asthenics of this type have a special mental constitution; when they encounter problems, they prefer to hide from them. There is even a special asthenic form of fear, which consists of numbness and inappropriate actions when aware of danger. This psychotype is associated with such qualities and characteristics as:

• Conscientiousness, pride, vulnerability, irritable weakness (in a close circle, there is no aggression in it, this irritability is a response to the asthenic’s suspicions that he is being treated poorly), a sense of personal inferiority, hence uncertainty and shyness.
• Frequent headaches, hand tremors, problems with stool, increased heart rate, pressure surges.
• Fatigue, intellectual and emotional.

In general, the asthenic type is not characterized by fighting; they easily give in and fade into the background, just to avoid the aggressiveness of others. An asthenic person is fixated on what people think about her, she places high demands on herself and suffers from inconsistency.

Here, both the personality constitution of the asthenic person and its pathological manifestations can be taken as a disease. The psychological portrait practically corresponds to chronic asthenia. Asthenics can and need therapeutic treatment - help in setting boundaries, transferring the locus of control inside and getting rid of fear.

Fatigue and irritability

Neurasthenia (and sthenic neurosis) first entered the vocabulary of doctors in the 19th century, and was considered a disease of intellectuals. This asthenic disorder is characterized by:

• Weakness.
• Fatigue quickly.
• Difficulty concentrating.
• Worry.
• Decreased efficiency.

With neurasthenia, the following are often observed:

• Inability to relax.
• Chest pain.
• Accelerated heartbeat.
• Sweaty hands and feet.
• Hyperventilation.
• Sleep disorders.

The exact causes of neurasthenia have not been established, but, as a rule, mental trauma in combination with severe stress is observed before the disease. This asthenic disorder may be associated with burnout and chronic fatigue syndrome. It goes through three stages:

1. The beginning of the development of neurasthenia - irritability, slight excitability, poor sleep, problems with concentration. The reaction does not correspond to the stimulus - minor noises can infuriate a neurasthenic. As a result of lack of sleep and overwork, there are girdling headaches, which are called neurasthenic headaches.

2. The second stage of neurasthenia - the neurasthenic is easily irritated, but quickly cools down, exhausted to the limit, is often impatient and fussy, sleeps poorly at night.

3. The third stage of neurasthenia is apathy, depression and drowsiness. A person becomes isolated on himself, his feelings.

It would be optimal for people suffering from this disease to refrain from intensive activities and work during treatment. If this is not possible, any sources of stress should be minimized.

How to improve your condition?

Although asthenia is not life-threatening unless caused by a serious illness, it significantly reduces its quality. A person often becomes unable to perform the simplest tasks. May prevent the development of asthenia or alleviate its symptoms:

1. Time control. Alternating rest and activity, switching between forms of activity.
2. Eating foods rich in vitamins and minerals.
3. Refusal of diets and intense sports, although light physical activity is definitely necessary.
4. Normalization of sleep/wake patterns.

If you deviate from a healthy lifestyle after recovery, there is a risk of getting sick again. And sthenic manifestations will stretch over time and can develop into a chronic disease.

Asthenic syndrome, which is not caused by infections, diseases or other organic causes, can be alleviated with relaxation and concentration exercises.

Asthenic conditions are characterized by increased excitability, inability to tolerate stress and make significant emotional or intellectual efforts. Meditation and attention training, as well as reducing the number of irritants at home and at work (turning off devices that make sounds, distracting devices) will help you stay focused longer and reduce anxiety levels.

The most unexpected answer to the question “how to deal with asthenia” came from the University of Michigan; however, asthenics were not studied there, but the data from their experiment allows us to extend it to people with asthenia. An asthenic will increase concentration, reduce anxiety and reduce impulsiveness with just an hour of sleep. Trying by force of will to continue to work or engage in some useful work, a person risks further aggravating his mental state.

Asthenic depression requires more complex treatment, including antidepressants and psychostimulants. A specialist will determine which drugs are suitable and in what case. If hints of a disorder are detected, then a comprehensive analysis of the body is required. Often, asthenia in schizophrenia hides the latter, and it, being the cause of fatigue and irritability, will grow, remaining unnoticed.

At the first signs of asthenia, you can use folk remedies - honey, relaxing herbs - chamomile, valerian, linden, yarrow, tincture of eleutherococcus, aromatherapy with essential oils of lavender and eucalyptus. However, when using them, you need to remember that some people are individually intolerant to the components of herbs or extracts, and also, if the condition does not change or worsens, consult a doctor.

Asthenia is the starting point of many psychopathological processes. Timely treatment will not only improve a person’s quality of life, but also protect against more serious problems.

And the most important advice

Asthenia (asthenic syndrome) is a gradually developing psychopathological disorder that accompanies many diseases of the body. Asthenia is manifested by fatigue, decreased mental and physical performance, sleep disturbances, increased irritability or, conversely, lethargy, emotional instability, and autonomic disorders.

Asthenia can be identified through a thorough survey of the patient and a study of his psycho-emotional and mnestic sphere. A complete diagnostic examination is also necessary to identify the underlying disease that caused the asthenia. Asthenia is treated by selecting an optimal work regimen and a rational diet, using adaptogens, neuroprotectors and psychotropic drugs (neuroleptics, antidepressants).

Asthenia

Asthenia is undoubtedly the most common syndrome in medicine. It accompanies many infections (ARVI, influenza, foodborne illnesses, viral hepatitis, tuberculosis, etc.), somatic diseases (acute and chronic gastritis, peptic ulcer of the 12th intestine, enterocolitis, pneumonia, arrhythmia, hypertension, glomerulonephritis, neurocirculatory dystonia, etc. .), psychopathological conditions, postpartum, post-traumatic and postoperative periods. For this reason, specialists in almost any field encounter asthenia: gastroenterology, cardiology, neurology, surgery, traumatology, psychiatry. Asthenia may be the first sign of an incipient disease, accompany its peak, or be observed during the period of convalescence.

Asthenia should be distinguished from ordinary fatigue, which occurs after excessive physical or mental stress, change in time zones or climate, or non-compliance with the work and rest regime. Unlike physiological fatigue, asthenia develops gradually, persists for a long time (months and years), does not go away after proper rest and requires medical intervention.

Reasons for the development of asthenia

According to many authors, asthenia is based on overstrain and exhaustion of higher nervous activity. The direct cause of asthenia may be insufficient intake of nutrients, excessive energy expenditure or metabolic disorders. Any factors that lead to exhaustion of the body can potentiate the development of asthenia: acute and chronic diseases, intoxication, poor nutrition, mental disorders, mental and physical overload, chronic stress, etc.

Classification of asthenia

Due to its occurrence in clinical practice, organic and functional asthenia are distinguished. Organic asthenia occurs in 45% of cases and is associated with the patient’s existing chronic somatic diseases or progressive organic pathology. In neurology, organic asthenia accompanies infectious-organic brain lesions (encephalitis, abscess, tumor), severe traumatic brain injury, demyelinating diseases (multiple encephalomyelitis, multiple sclerosis), vascular disorders (chronic cerebral ischemia, hemorrhagic and ischemic stroke), degenerative processes (Alzheimer's disease, Parkinson's disease, senile chorea). Functional asthenia accounts for 55% of cases and is a temporary reversible condition. Functional asthenia is also called reactive, since it is essentially the body’s reaction to a stressful situation, physical fatigue, or an acute illness.

According to the etiological factor, somatogenic, post-traumatic, postpartum, and post-infectious asthenia are also distinguished.

According to the characteristics of clinical manifestations, asthenia is divided into hyper- and hyposthenic forms. Hypersthenic asthenia is accompanied by increased sensory excitability, as a result of which the patient is irritable and does not tolerate loud sounds, noise, or bright light. Hyposthenic asthenia, on the contrary, is characterized by a decrease in susceptibility to external stimuli, which leads to lethargy and drowsiness of the patient. Hypersthenic asthenia is a milder form and, with an increase in asthenic syndrome, can turn into hyposthenic asthenia.

Depending on the duration of existence of asthenic syndrome, asthenia is classified into acute and chronic. Acute asthenia is usually functional in nature. It develops after severe stress, acute illness (bronchitis, pneumonia, pyelonephritis, gastritis) or infection (measles, influenza, rubella, infectious mononucleosis, dysentery). Chronic asthenia has a long course and is often organic. Chronic functional asthenia includes chronic fatigue syndrome.

A separate category is asthenia associated with depletion of higher nervous activity - neurasthenia.

Clinical manifestations of asthenia

The symptom complex characteristic of asthenia includes 3 components: own clinical manifestations of asthenia; disorders associated with an underlying pathological condition; disorders caused by the patient's psychological reaction to the disease. Manifestations of asthenic syndrome itself are often absent or mildly expressed in the morning, appearing and increasing during the day. In the evening, asthenia reaches its maximum manifestation, which forces patients to take rest before continuing work or moving on to household chores.

Fatigue. The main complaint with asthenia is fatigue. Patients note that they get tired faster than before, and the feeling of fatigue does not disappear even after a long rest. If we are talking about physical labor, then there is a general weakness and reluctance to do one’s usual work. In the case of intellectual work, the situation is much more complicated. Patients complain of difficulty concentrating, memory deterioration, decreased attentiveness and intelligence. They note difficulties in formulating their own thoughts and expressing them verbally. Patients with asthenia often cannot concentrate on thinking about one specific problem, have difficulty finding words to express any idea, and are absent-minded and somewhat retarded when making decisions. In order to do previously feasible work, they are forced to take breaks; in order to solve the task at hand, they try to think about it not as a whole, but by breaking it down into parts. However, this does not bring the desired results, increases the feeling of fatigue, increases anxiety and causes confidence in one’s own intellectual inadequacy.

Psycho-emotional disorders. A decrease in productivity in professional activities causes the emergence of negative psycho-emotional states associated with the patient’s attitude to the problem that has arisen. At the same time, patients with asthenia become hot-tempered, tense, picky and irritable, and quickly lose self-control. They experience sudden mood swings, states of depression or anxiety, extremes in their assessment of what is happening (unreasonable pessimism or optimism). The aggravation of psycho-emotional disorders characteristic of asthenia can lead to the development of neurasthenia, depressive or hypochondriacal neurosis.

Autonomic disorders. Asthenia is almost always accompanied by disorders of the autonomic nervous system. These include tachycardia, pulse lability, changes in blood pressure, chilliness or a feeling of heat in the body, generalized or local (palms, armpits or feet) hyperhidrosis, decreased appetite, constipation, pain along the intestines. With asthenia, headaches and a “heavy” head are possible. Men often experience a decrease in potency.

Sleep disorders. Depending on the form, asthenia may be accompanied by sleep disturbances of various natures. Hypersthenic asthenia is characterized by difficulty falling asleep, restless and intense dreams, night awakenings, early awakening and a feeling of weakness after sleep. Some patients have the feeling that they hardly sleep at night, although in reality this is not the case. Hyposthenic asthenia is characterized by the occurrence of daytime sleepiness. At the same time, problems with falling asleep and poor quality of night sleep persist.

Diagnosis of asthenia

Asthenia itself usually does not cause diagnostic difficulties for a doctor of any profile. In cases where asthenia is a consequence of stress, trauma, illness, or acts as a harbinger of pathological changes beginning in the body, its symptoms are pronounced. If asthenia occurs against the background of an existing disease, then its manifestations may fade into the background and not be so noticeable behind the symptoms of the underlying disease. In such cases, signs of asthenia can be identified by interviewing the patient and detailing his complaints. Particular attention should be paid to questions about the patient's mood, his sleep state, his attitude towards work and other responsibilities, as well as his own condition. Not every patient with asthenia will be able to tell the doctor about his problems in the field of intellectual activity. Some patients tend to exaggerate existing disorders. To get an objective picture, the neurologist, along with a neurological examination, needs to conduct a study of the patient’s mnestic sphere, assess his emotional state and response to various external signals. In some cases, it is necessary to differentiate asthenia from hypochondriacal neurosis, hypersomnia, and depressive neurosis.

Diagnosis of asthenic syndrome requires mandatory examination of the patient for the underlying disease that caused the development of asthenia. For this purpose, additional consultations with a gastroenterologist, cardiologist, gynecologist, pulmonologist, nephrologist, oncologist, traumatologist, endocrinologist, infectious disease specialist and other specialized specialists can be carried out. Clinical tests are required: blood and urine tests, coprograms, blood sugar determination, biochemical blood and urine tests. Diagnosis of infectious diseases is carried out through bacteriological studies and PCR diagnostics. According to indications, instrumental research methods are prescribed: ultrasound of the abdominal organs, gastroscopy, duodenal intubation, ECG, ultrasound of the heart, fluorography or radiography of the lungs, ultrasound of the kidneys, MRI of the brain, ultrasound of the pelvic organs, etc.

Treatment of asthenia

General recommendations for asthenia boil down to selecting the optimal work and rest regime; refusal of contact with various harmful influences, including alcohol consumption; introduction of health-improving physical activity into the daily routine; following a diet that is fortified and corresponds to the underlying disease. The best option is a long rest and a change of scenery: vacation, sanatorium treatment, tourist trip, etc.

Patients with asthenia benefit from foods rich in tryptophan (bananas, turkey meat, cheese, wholemeal bread), vitamin B (liver, eggs) and other vitamins (rose hips, black currants, sea buckthorn, kiwi, strawberries, citrus fruits, apples, raw vegetable salads and fresh fruit juices). A calm work environment and psychological comfort at home are important for patients with asthenia.

Drug treatment of asthenia in general medical practice comes down to the prescription of adaptogens: ginseng, Rhodiola rosea, Chinese schisandra, Eleutherococcus, pantocrine. In the USA, the practice of treating asthenia with large doses of B vitamins has been adopted. However, this method of therapy is limited in the use of a high percentage of adverse allergic reactions. A number of authors believe that complex vitamin therapy is optimal, including not only B vitamins, but also C, PP, as well as microelements involved in their metabolism (zinc, magnesium, calcium). Often, nootropics and neuroprotectors are used in the treatment of asthenia (ginkgo biloba, piracetam, gamma-aminobutyric acid, cinnarizine + piracetam, picamelon, hopantenic acid). However, their effectiveness in asthenia has not been definitively proven due to the lack of large studies in this area.

In many cases, asthenia requires symptomatic psychotropic treatment, which can only be selected by a specialist: a neurologist, psychiatrist or psychotherapist. So, on an individual basis, for asthenia, antidepressants are prescribed - serotonin and dopamine reuptake inhibitors, neuroleptics (antipsychotics), procholinergic drugs (salbutiamine).

The success of treating asthenia resulting from any disease largely depends on the effectiveness of treatment of the latter. If the underlying disease can be cured, the symptoms of asthenia usually go away or are significantly reduced. With long-term remission of a chronic disease, the manifestations of asthenia accompanying it are also minimized.

Asthenia: causes and signs

Asthenic syndrome is a feeling of temporary or chronic fatigue, loss of mental and physical energy. From Latin “asthenia” is translated as weakness. Asthenic is a person characterized by a lack of strength, depression, and suspiciousness. In psychology, asthenics include people of the dependent, anxious-fearful and avoidant types.

Asthenia, which looks like fatigue, is actually a disease that can put an end to a person’s effectiveness and have a negative impact on his self-esteem and standard of living. Asthenia does not go away without treatment, which is the main difference from episodes of fatigue caused by objective reasons - the need to rest after intense exercise.

Characteristic manifestations and possible causes

An asthenic state can be a consequence of both serious diseases of the body and lifestyle (frequent changes in time zones, emotional and physical overload, lack of sleep, etc.). And sthenia is a reason to think about going to the hospital; the main reasons for its appearance are either a disease of the body or a mental problem.

Objective (organic, caused by health problems):

1. Asthenia often occurs as a consequence of diseases of internal organs, infection, and intoxication.
2. Fatigue and asthenia are sometimes associated with diabetes and metabolic disorders in general.
3. Lack of food or its poor composition (minimal content of vitamins and minerals) logically leads to asthenia, since the body simply does not have energy, it does not receive it in sufficient quantities. Therefore, asthenia is often a companion to anorexia and other eating disorders.
4. Age and senile asthenia are identified as a separate branch of research in gerontology. The percentage of patients with asthenia increases in proportion to age. However, some factors, such as a high level of education, marriage and others, reduce the likelihood of being in the group of people with the disease, which also speaks about the psychological side of the development of asthenia in old age.

Subjective-objective (depending on the conditions and perception of a person):

1. Emotional, mental or physical stress leads to acute forms of asthenia.
2. Nervous and mental illnesses (especially schizophrenia).

Only a doctor can determine for sure what is hidden behind asthenia, so at the first symptoms that do not go away within two to three weeks, you should seek the advice of a specialist.

• Shortness of breath, rapid heartbeat.
• Muscle spasms, cramps, fever.
• Fatigue, loss or decrease in energy, fainting.
• Disorientation.
• Irritability, hot temper, suspiciousness.
• Depressed state, anxiety.
• Sexual asthenia.

Symptoms of asthenia depend on the cause that caused it. Thus, heart problems are usually associated with headaches and a feeling of pressure in the chest. And weakness and weakness are most often observed with any source of asthenia.

Psyche and weakness

A distinction is made between real asthenia, when the body really mobilizes forces to fight the disease and the source of the problem is clearly defined. And functional, in which the body works like a clock, but for some reason the person still cannot finish a single task, everything literally falls out of hand, while he experiences characteristic asthenic emotions (sadness, depression). This asthenic condition can be very acute, although the person has every chance of quickly getting back on his feet.

In psychology, they analyze the mental factors leading to asthenia. This includes working with people who have the asthenic psychotype and treating neurasthenia, which may be complicated by other pathologies. Asthenic disorder includes asthenic psychopathy or dependent personality disorder, which most often affects the asthenic psychotype. First, let's look at what asthenic psychopathy is, and then neurasthenia, which is described in three phases.

Socio-mental weakness

Dependent personality disorder, included in the ICD-10, is one of the serious diseases that significantly impairs a person’s quality of life. Asthenia literally does not provide him with the opportunity to take life into his own hands. The disorder corresponds to the asthenic personality type, which appears in the works of Gannushkin, Konstorum, Leonhard, Kaplan and Sadok, although under different names.

A person with an asthenic personality type has the following symptoms of a dependent disorder (in accordance with ICD-10):

• The tendency to transfer responsibility, to throw it off oneself.
• Submission to other people, passive fulfillment of their desires.
• Extreme undemandingness towards those on whom the asthenic is dependent.
• Anxiety and feelings of helplessness when alone (fear of independence), feelings of helplessness and incompetence.
• Desire for approval and advice from others, inability to make decisions without them.

Asthenics of this type have a special mental constitution; when they encounter problems, they prefer to hide from them. There is even a special asthenic form of fear, which consists of numbness and inappropriate actions when aware of danger. This psychotype is associated with such qualities and characteristics as:

• Conscientiousness, pride, vulnerability, irritable weakness (in a close circle, there is no aggression in it, this irritability is a response to the asthenic’s suspicions that he is being treated poorly), a sense of personal inferiority, hence uncertainty and shyness.
• Frequent headaches, hand tremors, problems with stool, increased heart rate, pressure surges.
• Fatigue, intellectual and emotional.

In general, the asthenic type is not characterized by fighting; they easily give in and fade into the background, just to avoid the aggressiveness of others. An asthenic person is fixated on what people think about her, she places high demands on herself and suffers from inconsistency.

Here, both the personality constitution of the asthenic person and its pathological manifestations can be taken as a disease. The psychological portrait practically corresponds to chronic asthenia. Asthenics can and need therapeutic treatment - help in setting boundaries, transferring the locus of control inside and getting rid of fear.

Fatigue and irritability

Neurasthenia (and sthenic neurosis) first entered the vocabulary of doctors in the 19th century, and was considered a disease of intellectuals. This asthenic disorder is characterized by:

• Weakness.
• Fatigue quickly.
• Difficulty concentrating.
• Worry.
• Decreased efficiency.

With neurasthenia, the following are often observed:

• Inability to relax.
• Chest pain.
• Accelerated heartbeat.
• Sweaty hands and feet.
• Hyperventilation.
• Sleep disorders.

The exact causes of neurasthenia have not been established, but, as a rule, mental trauma in combination with severe stress is observed before the disease. This asthenic disorder may be associated with burnout and chronic fatigue syndrome. It goes through three stages:

1. The beginning of the development of neurasthenia - irritability, slight excitability, poor sleep, problems with concentration. The reaction does not correspond to the stimulus - minor noises can infuriate a neurasthenic. As a result of lack of sleep and overwork, there are girdling headaches, which are called neurasthenic headaches.

2. The second stage of neurasthenia - the neurasthenic is easily irritated, but quickly cools down, exhausted to the limit, is often impatient and fussy, sleeps poorly at night.

3. The third stage of neurasthenia is apathy, depression and drowsiness. A person becomes isolated on himself, his feelings.

It would be optimal for people suffering from this disease to refrain from intensive activities and work during treatment. If this is not possible, any sources of stress should be minimized.

How to improve your condition?

Although asthenia is not life-threatening unless caused by a serious illness, it significantly reduces its quality. A person often becomes unable to perform the simplest tasks. May prevent the development of asthenia or alleviate its symptoms:

1. Time control. Alternating rest and activity, switching between forms of activity.
2. Eating foods rich in vitamins and minerals.
3. Refusal of diets and intense sports, although light physical activity is definitely necessary.
4. Normalization of sleep/wake patterns.

If you deviate from a healthy lifestyle after recovery, there is a risk of getting sick again. And sthenic manifestations will stretch over time and can develop into a chronic disease.

Asthenic syndrome, which is not caused by infections, diseases or other organic causes, can be alleviated with relaxation and concentration exercises.

Asthenic conditions are characterized by increased excitability, inability to tolerate stress and make significant emotional or intellectual efforts. Meditation and attention training, as well as reducing the number of irritants at home and at work (turning off devices that make sounds, distracting devices) will help you stay focused longer and reduce anxiety levels.

The most unexpected answer to the question “how to deal with asthenia” came from the University of Michigan; however, asthenics were not studied there, but the data from their experiment allows us to extend it to people with asthenia. An asthenic will increase concentration, reduce anxiety and reduce impulsiveness with just an hour of sleep. Trying by force of will to continue to work or engage in some useful work, a person risks further aggravating his mental state.

Asthenic depression requires more complex treatment, including antidepressants and psychostimulants. A specialist will determine which drugs are suitable and in what case. If hints of a disorder are detected, then a comprehensive analysis of the body is required. Often, asthenia in schizophrenia hides the latter, and it, being the cause of fatigue and irritability, will grow, remaining unnoticed.

At the first signs of asthenia, you can use folk remedies - honey, relaxing herbs - chamomile, valerian, linden, yarrow, tincture of eleutherococcus, aromatherapy with essential oils of lavender and eucalyptus. However, when using them, you need to remember that some people are individually intolerant to the components of herbs or extracts, and also, if the condition does not change or worsens, consult a doctor.

Asthenia is the starting point of many psychopathological processes. Timely treatment will not only improve a person’s quality of life, but also protect against more serious problems.

Asthenia: how to overcome painful impotence?

Almost all of us are familiar with the state of “no strength for action”: rapid fatigue, fatigue that does not disappear after leisure, muscle weakness. However, many interpret their painful condition as a slight malaise, hoping that the loss of strength will go away on its own. However, overwhelming impotence, a significant decrease in performance, rapid fatigue from habitual stress are symptoms of an abnormal state of the body called asthenia.

Signs of asthenic syndrome observed for more than one month and not associated with viral or bacterial diseases require comprehensive therapeutic measures. It is worth noting that asthenia not only does not allow an individual to live a full and rich life, it can act as a symptom of more serious problems in the body or transform into an affective disorder - depression.

The term "asthenia" is borrowed from Latin (Asthenia) and means "weakness". Asthenic status implies that the human central nervous system is in an exhausted state, all systems are working at the limit of their capabilities. Manifestations of asthenia are severe neuropsychic weakness, immediate depletion of nervous system resources, decreased tolerance to standard mental and physical stress, and a noticeable decline in a person’s ability to work.

In addition to the overwhelming feeling of weakness, weakness, exhaustion, a person’s emotional state undergoes changes, and defects in cognitive functions arise. A person suffering from asthenia often experiences mood changes with a predominance of despondency and apathy, which outwardly manifest as tearfulness. A person becomes nervous and irritable, which causes conflicts in his environment.

Symptoms of asthenia: restlessness, fussiness, desire to complete all tasks at the same time and quickly. However, due to the rapid exhaustion of nervous processes and the inability to concentrate, the person cannot complete the work she has started. The constant companions of asthenia are a variety of pain sensations of a psychogenic nature: headache, “aches” in the joints and muscles, discomfort and cramps in the abdominal area.

Causes

Asthenic syndrome is caused by the presence of certain congenital and acquired factors, which, under unfavorable circumstances, provoke the onset of the disorder. The reasons for the development of asthenia are the following:

• inherited predisposition to asthenic and depressive states;
• innate properties of the nervous system, causing its weakness and rapid exhaustion;
• asthenic personality type.

Probable causes of asthenia:

• acquired defects of the central nervous system due to traumatic brain injury or vascular diseases;
• acute infectious diseases affecting the brain;
• endocrine pathologies;
• oncological diseases.

A separate group of causes of asthenia includes addictions and their consequences:

• uncontrolled use of psychotropic drugs, drug dependence, abrupt withdrawal of psychostimulants;
• drug use, withdrawal syndrome;
• alcoholism, withdrawal symptoms.

Among the “social” causes of asthenia, psychologists highlight the excessive demands of modernity, forcing a person to exist in “emergency mode.” The most harmful factors in this group are:

• political and economic instability in the country;
• high unemployment;
• poor financial situation of many citizens;
• excessive information overload;
• high demands on the performance and activity of an individual striving to build a successful career;
• serious competition in the labor market.

The following reasons contribute to the development of asthenia:

• low level of medical care;
• availability of narcotic substances to the average person;
• global alcoholization of the population of the post-Soviet space;
• lack of physical activity among office workers;
• lack of relaxation and relaxation skills;
• improper or meager diet due to lack of financial resources among people.

Clinical signs of asthenia

The development of asthenia can be assumed based on the patient’s complaints: his sensations are focused on the very process of painful experiences of his condition. A person really suffers a lot, because he cannot understand the reasons and in any way eliminate the all-consuming weakness, insurmountable fatigue, and complete powerlessness. The individual describes that he has lost “vital energy” and is unable to perform either professional duties or everyday activities. A patient with asthenia indicates that he lacks the “tone and strength” to qualitatively perform a stereotyped intellectual task.

An important sign of asthenia is a lack of vigor after a full night’s sleep. The person indicates that his condition is: “as if he didn’t go to bed at all, but worked all night long.”

Often the patient complains that he has become indifferent to current events. However, questioning the patient establishes that he retains an interest in life and is capable of enjoying himself, but he simply does not have the strength to begin and complete any enjoyable activities.

Objective clinical signs of asthenia are the phenomena of hyperesthesia: an inadequately high response to the action of stimuli of minor strength. Symptoms of asthenic status: excessive sensitivity of the patient not only to external stimuli, but also to internal stimuli.

A person loses calm and becomes agitated by normally inconspicuous external signals: people talking, the speech of a television announcer, birdsong, the sounds of dripping water, creaking doors. In addition to sound stimuli, the individual is disturbed by the visual signals received: flashes of bright light, flashing pictures on the monitor, natural movements, gestures and facial expressions of people. High tactile reactions are noted: some individuals cannot tolerate the process of combing, others suffer from touching the body of underwear. A tightly tied tie, tight-fitting clothes, and tight shoes get on the nerves of an asthenic person.

A subject with asthenia reacts violently to the normal processes of his body: he is unsettled by the sensation of heartbeat, sounds when inhaling and exhaling, rumbling in the digestive tract.

He intensely experiences the resulting pain syndromes, often describing that the headache is simply “driving him crazy”: “his head is cracking, splitting, seething like a cauldron.” At the same time, the appearance of cephalgia is cyclical: the headache is minimal in the morning and feels like a heaviness in the head, and intensifies in the afternoon as fatigue sets in. Many patients with asthenia are characterized by increased meteosensitivity: the malaise intensifies when weather conditions change, or when flying to areas with different climatic conditions.

Symptoms of asthenia also appear at the vegetative level, up to sympathoadrenal crises. During the period of vegetative failures, the subject is determined to have:

• increased heart rate;
• blood pressure surges;
• instability of body position, unsteadiness of gait;
• tremor of the limbs.

The person describes that a “dark veil” or “flies are flying” appeared before his eyes. He finds it difficult to breathe and feels like “the ground is disappearing from under his feet.” He is overcome by hot flashes, which are replaced by internal chills.

Asthenia and depression almost always make changes in sleep and wakefulness. During the day, the asthenic person is lethargic and drowsy, and at night he is deprived of sleep. He can't fall asleep on time. Plunging into sleep, he is overcome by nightmares. With asthenia, frequent awakenings at night are noted. Rising time is pushed back to later morning hours. At the same time, getting out of bed, he feels as if half asleep.

With asthenia, the psychological characteristics of the individual, behavior patterns, and cognitive abilities undergo changes. A unique portrait of the patient will help demonstrate a typical asthenic person.

Portrait of an asthenic

Such a personality can be characterized by its inseparable trait - defensiveness (defensive position). A defensive person is not ready to show the required degree of aggressiveness and assertiveness when faced with the difficulties of life. His credo is to silently protest, withdraw into himself, run away and hide from problems.

To discharge the accumulated indignation, short outbursts of rage are observed in the immediate environment, but such an outburst of irritation quickly ends due to the rapid onset of depletion of mental resources. Such an attack is caused by accumulated grievances and suspicions that all people hate him. A flash of hysteria is replaced by apologies, regrets, and tears of repentance.

An asthenic is a conscientious and compassionate nature, completely devoid of indifference and insensitivity. A conflict that greatly disturbs him is burning in his soul, in which two principles are combined: the experience of a fairly exaggerated inferiority complex and painful pride. With asthenia, the subject often attributes imaginary shortcomings to himself and is very ashamed of them. He always gives in when faced with human arrogance and rudeness.

The external manifestation of low self-esteem is indecisiveness, lack of confidence in one’s abilities, constant doubts, and shyness. In an unusual situation, when the gaze of others is directed at the asthenic person, he tries to move away to a decent distance, blushes, lowers his shoulders, tries not to look into the eyes of his opponent, and shifts from foot to foot.

A distinctive feature of an asthenic is increased impressionability, sensitivity, and “mimosa-likeness.” He cannot recover for a long time after an unpleasant event, and the sight of violence can cause him to faint. The subject is sensitive to offensive and rude words, for this reason he becomes uncommunicative, meticulously choosing his circle of acquaintances.

A feature of a person with asthenia is alarming suspiciousness, implying a significant exaggeration of the existing risk. The asthenic person “manages” to predict danger even in situations where there is no minimal threat. Instead of painstakingly analyzing the situation and inventing ways to protect himself, he simply refuses to take action.

Asthenia significantly complicates the performance of the usual work process. Absent-mindedness and rapid fatigue lead to the fact that a person performs duties poorly or does not have time to complete the work in full. At the same time, the subject is deprived of strength not only by physically or intellectually complex tasks, but also by a normal conversation with an interlocutor, performing routine actions. Due to the dispersion of attention, a person cannot connect together a long chain of tasks, which often creates an erroneous opinion about the intellectual insufficiency of an asthenic person.

Treatment options

Since asthenia is not only an independent anomaly, but is also associated with a variety of neurological diseases, somatic ailments, and mental disorders, the choice of treatment method requires a comprehensive examination of the patient. If the underlying disease is diagnosed, treatment is aimed at eliminating the factors that provoked it and minimizing the manifestation of signs of asthenia.

What to do if asthenia is not associated with other diseases? The basis for the treatment of asthenic syndrome is general strengthening measures that help normalize the functioning of the central nervous system. A patient diagnosed with asthenic status is prescribed physiotherapeutic procedures, a course of massage, acupuncture, and a complex of physical therapy. Properly selected water procedures are of great importance for stabilizing the well-coordinated functioning of the body: a contrast shower in the morning, swimming in a pool or open pond during the day and a relaxing warm bath with essential oils in the evening.

For asthenia, the statement “movement is life” is true. Therefore, a special place in the treatment of the abnormal condition is given to daily walks in the fresh air and active sports. The patient is recommended to arrange his weekly schedule in such a way that he can devote his entire weekend to active entertainment: hiking in the mountains, cycling, walking in the forest. For gardening lovers, working in a personal plot is a natural healer, restoring a depleted nervous system in a natural way.

However, when starting the “rehabilitation” of your body, you should remember: in the initial stages, excessive physical activity is unacceptable. The intensity and duration of exercise should be increased gradually, without expecting instant results.

Treatment of asthenia is impossible without a review of the diet and proper planning of the daily menu. Persons with asthenic status should eat at least four times a day at equal intervals. The main “fueling” should occur at breakfast and lunch; after lunch, preference should be given to light, low-calorie foods. The daily diet must include porridge from cereals, vegetables and fruits of local origin, lean meats, sea fish and seafood, nuts, and dairy products.

Many people who suffer from fatigue mistakenly believe that coffee and energy drinks can “get them back on track.” This is a rather dangerous misconception: all products containing caffeine actually activate the nervous system for a short period of time, but such stimulation occurs due to the intensive consumption of mental energy, so vigor is soon replaced by debilitating fatigue. How to overcome asthenia? The rule for asthenics: drink a sufficient amount of clean still water (at least two liters per day).

Among the irreplaceable measures, without which it is impossible to overcome asthenia, is changing the daily work schedule. Asthenics should forget about a ten-hour or more working day, perform professional duties for no more than eight hours with a mandatory rest break at lunchtime. At the same time, the daytime break should be reserved not only for eating and discussing problems at the dinner table. This hour should be devoted to breathing exercises, relaxation techniques, and methods for relieving emotional stress.

How to get rid of asthenia once and for all? Eliminate stressful situations, minimize the expenditure of nervous energy on conflicts, quarrels, and showdowns. Without normalizing the atmosphere at home and at work, it will not be possible to restore the resources of the nervous system. Therefore, in difficult situations, all patients with asthenia are recommended to seek the help of a psychologist or psychotherapist to select the most adequate methods to eliminate stressors. Since asthenia is often a manifestation of the personal constitution, the doctor will suggest ways to “neutralize” unfavorable individual traits and help with choosing measures to transform the characterological portrait.

How to deal with asthenia without resorting to the “chemical” arsenal of the pharmaceutical industry? In simple situations, it is advisable to carry out a long course of treatment with natural stimulants and tonics. As a rule, vitamin C, E, group B and mineral complexes are prescribed. It will not be superfluous to use tinctures:

For asthenia of various origins, treatment often includes amino acids that promote the formation of energy at the molecular level. The following drugs have a good effect: Stimol and L-arginine. A fairly common companion of asthenic syndrome is minor defects in the cognitive and mnestic sphere, the functions of which can be restored by nootropic drugs, for example: Phezam or Cortexinum. .

If asthenia has developed against the background of impaired cerebral blood supply or is associated with alcoholism, the effective drug Mildronate should be included in the treatment. In the treatment of severe asthenic forms, it is appropriate to use psychostimulants, for example: Meridil (Meridiltim) or Sydnocarbum.

In case of protracted and persistent asthenia, additional diagnostic measures should be carried out. If asthenic depression is confirmed, treatment with antidepressants is carried out.

Instead of an afterword

Although asthenia is a common phenomenon of our time, and many people exist in an asthenic status for years, this condition is not the norm. Timely medical assistance, establishment of the true cause of the anomaly, changes in the usual lifestyle, psychotherapeutic work will allow you to feel like a completely different person: energetic and cheerful, and will give you a chance to feel the fullness of life.

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Psychasthenia

Psychasthenia is a neurotic disorder that has no resemblance to classical concepts of pathology and is so vague in its scope that it is classified in completely different ways.

Psychasthenics are very special people who manifest themselves as anxious or more suspicious. And although this pathology is consonant with asthenia, it has a completely different framework with components that are relevant today. Psychasthenia as a diagnosis can very rarely be noticed, since the diagnosis of this kind of illness rarely requires inpatient treatment; this is rather a problem for psychotherapists.

What is psychasthenia?

Modern society is exposed to stressors every day, and if for some it is a minor annoyance, then for psychasthenics it is a big test. Psychasthenics, showing self-criticism, are capable of causing a lot of trouble to those around them. Most often, without realizing it, they expect the unknown from people due to low self-esteem and excessive severity.

Psychasthenia, as a term, is of Greek origin and stands for weakness or impotence of the soul. At this stage, psychasthenia according to ICD 10 is classified as neurosis under number F 48.8. This pathology has already appeared in the international classifier. Before this, such neurosis had not been identified in Soviet psychiatry, but psychasthenic psychopathy was distinguished according to Gannushkin, who developed an excellent and current classification of psychopathy. But the modern classification does not distinguish such psychopathy, which complicates the separation of psychasthenia, as a pathology, and the psychasthenic personality type. Anxious personality disorder can be considered a certain similarity to a personality type, a similar equivalent. This is mainly due to the character of psychasthenics, which is known as anxious and suspicious.

Psychasthenia, as a psychiatric term, was introduced by Janet at the end of the 19th century. Then the scope of this term was much wider and the reasons were more extensive, but in general some consonance remains, confirming the inviolability of psychiatry. Many learned psychiatrists subsequently worked to protect psychasthenia from the circle of alien symptoms “attached” to it. All works describing psychasthenia fall at the beginning of the 20th century, including Raymond, Sukhanov, and Yudin. An important discovery was the separation of psychasthenia from asthenia and neurasthenia, as well as its exclusion from schizophrenic and anancastic states.

Pathology of this type, similar to psychopathy, is most often detected in childhood. And yet, more mature people consult doctors; in children, this is simply attributed to personality traits. Thus, the disease is most common in older people, that is, at the peak of working capacity and love of life. Psychasthenia bothers individuals much less after the age of forty. According to statistics, psychasthenia in women is more rare compared to men, and the predominance of men with this pathology is twice that of women.

Causes of psychasthenia

Psychasthenia is one of the modern diseases, and this should not be surprising, because previously there was simply no time to chew the same mental cud, thinking through some little thing. Previously, life was shorter and harder, and instead of groundless thoughts, the individual had to think about food and the preservation of his family. The obvious causes of the disorder, and even more so its progression, have not yet been studied; there are only speculative factors.

The factors that provoke psychasthenia include many influences and individuals of all age groups are exposed to this. Stress has its impact with negative consequences, of which psychasthenia is quite common. The stress of our society is a broad concept; it includes many events:

Stress at a personal level, such as school exams or work certification;

Family-level stress, for example, dismissal, divorce, problems with a child;

Large-scale stressors, for example, a difficult military situation, defaults, mass bankruptcies, instability, polar changes in society.

The most common thing, of course, that can lead to psychasthenia is great personal responsibility, which pushes the individual to great overexertion.

Even without a high level of stressors, excessive reboots of both the mental and physical spectrum can provoke psychasthenia. Particularly dangerous is the lack of quality rest and its replacement with bad habits and parties. Sleep deprivation is also very dangerous and is a provocateur for many bad habits and pathologies, including psychasthenia. The nervous system is exhausted too quickly and ceases to withstand loads even of the usual volume.

The danger of overload has already been indicated above, but physical inactivity - the scourge of office plankton - is also no less dangerous. Physical inactivity is a decrease in the overall level of physical activity. It is harmful not only due to metabolic and weight consequences, but also due to the deterioration of the nervous system. Physical activity is simply necessary for the normal functioning of an individual. Bad habits fill the nervous system with toxins, thereby reducing its resistance to the daily challenges that befall the individual. Endocrinological health is also very important, since a lack or overdose of certain hormones greatly destabilizes the nervous system, leading to various disorders of the psychasthenic spectrum. Pathology of the thyroid and adrenal glands in line with psychasthenia, as well as disturbances in the regulatory properties of the pituitary gland or hypothalamus, are dangerous. Psychasthenia in women can occur due to hormonal imbalances.

A poor environmental situation is also not conducive to the healthy development of an individual. Particularly unfavorable are various types of radiation, incorrect and unhealthy nutrition with a disrupted daily routine. Anyone who reads this carefully can say that there is no person in the world who would not be influenced by such factors, but the frequency and strength of these factors, as well as the personal characteristics of the individual, still matter.

A special nervous and mental characteristic of an individual can become the basis for psychasthenia, which, after exposure to negative factors, will progress, developing into this disorder. Personal organization is influenced by upbringing and its pathological manifestations can provoke this disease.

Symptoms of psychasthenia

The clinical picture of psychasthenia does not have classical symptoms; it is more appropriate to describe the personality rather than talk about pathology in terms of symptoms. Individuals with psychasthenia are overly focused on defeat during work. This keeps them from the slightest risky actions and does not give them the opportunity to go wrong. Psychasthenics are overly indecisive and overly pedantic, which is reflected in all areas of life, leading to difficulties. Psychasthenics think through the plan to the smallest detail, but if even one nuance is not taken into account, they will deviate from the plan and will not do it. Often the slightest inconsistencies can lead an individual to complete inaction.

Intellectually, psychasthenics are very highly educated. Basically, the level of intelligence of a psychasthenic is above average, but due to the frequent fixation on trifles and some strange “importances”, psychasthenics do not achieve high results in school or work. Individuals of this type rarely become public people: all their intellectual efforts are often hidden by shyness and excessive isolation. Such people depend on external assessments and consult with others, which often prevents them from remaining themselves and making decisions that are acceptable to them. It’s easy to put pressure on a psychasthenic person, knowing his weak points.

Psychasthenia in women greatly influences the choice of men, partners and girlfriends, but in men the selectivity of choice is also increased. Such individuals are said to have too high expectations. Psychasthenics are punctual and pedantic, while also being very hardworking. Such individuals are completely reliable, which is due to their fear of offending and long thoughts about it. Once they find themselves in bad company, they find it difficult to get out of it.

Psychasthenics are usually subject to hypochondriacal thoughts and experiences; they spare no expense on their health, and sometimes go too far with treatment. They say about psychasthenics that they are people of doubt. Their thought processes are so logical that sometimes it is unnecessary, since they are forced to logically comprehend each of their actions, completely excluding the possibility of spontaneity.

Psychasthenia pushes individuals into constant dependence on society; this pushes the individual toward even greater complexities and isolation. Psychasthenics can reveal the fullness of their personality only to people they have proven over the years.

Personal characteristics are also characterized by constant development, which does not bring satisfaction to the psychasthenic at all. That is why such individuals are very difficult partners and parents, because they are not able to stop and enjoy what they have done.

Janet himself said that psychasthenia affects several areas. In the field of intellect, that is, thought processes, psychasthenia is expressed by obsessive excessive thoughts and debilitating doubts and thoughts. In the emotional sphere, the most unpleasant thing is a constant decrease in mood, often turning into reactive depression. In the area of ​​the volitional sphere, indecision is noticeable. In addition, many people experience organ discomfort, hence hypochondria.

Treatment of psychasthenia

Psychasthenia cannot be cured, since it is more like a specific personality type than a disease. But still, in case of severe manifestations that take away the possibility of normal functioning, it is simply necessary to prescribe relief therapy. The difficulties of psychasthenics mainly manifest themselves in communication, which isolates them from the team.

Treatment should be selected as needed, based on the need to relieve bothersome symptoms. Obsessions can be considered the most unpleasant for an individual, then treatment is selected to relieve them as much as possible. Excessive anxiety and paranoia can also be considered no less painful. These symptoms also have the possibility of relief, which already facilitates the stay of an individual with psychasthenic tendencies in society and allows him to be involved in all areas of activity. Naturally, psychopharmacology will not correct the personality type itself, but it will definitely contribute to the relief of affective states and the improvement of personal life.

Psychopharmacotherapy includes anti-anxiety drugs, including tranquilizers and sedatives.

How to treat psychasthenia using tranquilizers? They are used depending on the severity of symptoms and tension, which is taken into account objectively during examination and subjectively by the patient himself. The drugs of choice include Phenazepam, Tofizolam, Diazepam, Cloxazolam, Chlordiazepoxide, Clotiazepam, Persen, Medazepam, Valerian, Etizolam, Oxazepam, Ethilloflazepate, Hydroxin, Meprobamate.

How to treat psychasthenia using sedatives? There are many sedatives, but they have their negative effects, so you need to weigh the risks and benefits. The most applicable: Gidazepam, Lorazepam, Ketazolam. In some cases, obsessions can only be corrected by antipsychotics, as well as feelings of anxiety. Neuroleptics of different groups are used; when using classic ones, the use of Cyclodol is sometimes required. The most common: Aminazine, Eglonil, Azaleptol, Clopixol, Haloperildol, Rispaxol.

Stabilizing mood is very important, especially when there is a risk of developing depressive symptoms. Thymostabilizers are used in long courses and thoroughly eliminate mood swings: Valproate, Valprocom, Valpronate, Valpromax, Lithium salts, Litosan, Lithium carbonate, Depakin, Depakin chrono, Carbamazepine. If depressive inclusions are obvious and it was not possible to prevent their manifestations, then antidepressants are used, these include: Fluoxetine, Fevarin, Prozac, Miaser, Mianserin, Anafranil, Maprotiline, Tritico, Melipramine, Nardil, Amitriptyline, Protiaden, Dosulepin, Fluanxol, Sertraline, Serdolect.

How to treat psychasthenia with psychotherapy? To change psychasthenic personal behavior, psychotherapy aimed at developing socialization skills is most effective. It is very important to socialize a psychasthenic. Both group and personal methods are used. For effectiveness, it makes sense to combine psychoanalysis and cognitive-behavioral techniques.

Test for psychasthenia

Tests for psychasthenia are most often based on psychological techniques. There are also various additional questionnaires for individual home use. It is worth noting that the identification of a tendency to psychasthenia in such a survey does not indicate anything. If an individual has no complaints and is adapted to society, then we can assume that this is only a psychasthenic tendency that does not affect the general life needs of the individual.

The most relevant for psychological determination is the Leonhard questionnaire. It includes a large number of scales, which include psychasthenia. This is the definition of accentuation of character, that is, the extreme degree of the norm. The anxious or psychasthenic type of this scale is described as an individual who worries about himself and his family. These experiences gradually turn into fears, often annoying relatives, while the mood is lowered. Behavioral characteristics are dominated by excessive timidity and shyness, which interferes with normal existence. Indecision manifests itself in its extreme form, there is a long, continuous experience of failure, as well as continuous groundless doubts. All this is calculated with the help of a pollster in the necessary questions.

Depending on the subtype of psychasthenia, different questionnaires are used. For the anancaste, it is most important to identify obsessions, and for the anxious, the length of decision-making and excessive doubts. It is important to distinguish the psychasthenic type from the pedantic and other accentuations. That is why independent tests only approximately correlate with the true identification of psychasthenics, and the final diagnosis can only be made with the help of a full psychological examination.