Neurasthenia

Introduction to neurasthenia Neurasthenia is a neurosis characterized by weak brain and somatic function. It is characterized by easy excitement and fatigue. It is often accompanied by emotional symptoms such as nervousness, trouble, irritability, muscle tension, and other physiological functions such as sleep disorders. Disorder symptoms. These symptoms are not secondary to physical illnesses and brain organic lesions, nor are they part of any other mental disorder, but there may be persistent emotional stress and stress during the patient's illness. basic knowledge The proportion of illness: 80% Susceptible people: no specific population Mode of infection: non-infectious Complications: autonomic dysfunction, sleep disorders, headache

Cause of neurasthenia

Disease troubles (15%):

Suffering from infectious diseases, chronic poisoning, craniocerebral injury or dystrophic diseases, decreased resistance, cautious tension, or mental burden, often in trouble and anxiety, causing the nervous system to be in tension for a long time and become the cause of neurasthenia .

Excessive brain use (20%):

Mental labor time is too long, work tasks are too long, work tasks are too heavy, attention is highly concentrated, brain cells are over-consumption of energy, loss of normal regulation and susceptibility to neurasthenia, is the most common neurasthenia induced by mental workers. the reason.

Trauma (15%):

Some events in life, and sad emotions such as sorrow, anxiety, panic, etc., if sustained or too strong, become a bad stimulus of the brain, called "mental trauma." Such as the death of loved ones, loss of love, college entrance examinations, work accidents and other hidden bad emotions, is the most common cause of neurasthenia.

Excessive tension (25%):

Strong mental stimulation, heavy mental burden, persistent environmental stress, inappropriate working methods, such as family disputes, intense competition in study and work, and interpersonal tensions make the brain over-stressed and exceed the tolerance of the nervous system. Subject to boundaries, it may also be the cause of neurasthenia.

Poor environment (15%):

Long-term in a noisy environment, lack of peace of mind and body, rest and sleep can not be guaranteed, long-term exposure to noise, glare of light, pungent smell, or polluted air, will be damaged by the nervous system, will become induced in the long run The cause of neurasthenia.

Pathogenesis

1. Physiological quality and personality characteristics: Pavlov believes that the types of high-level neurological activities belong to weak and intermediate type, and their personality characteristics are characterized by loneliness, timidity, sensitivity, suspiciousness, impatience, and easy to suffer from this disease. The Luo Luofu school believes that the main pathophysiological basis of this disease is the weakening of the inhibition process in the cerebral cortex. When the internal inhibition process is weakened, the excitability of nerve cells is relatively increased, and the external stimulus can produce a strong and rapid response, thus making the nerve cells The energy is consumed in large quantities. Clinically, such patients often exhibit excitement and are prone to fatigue. On the other hand, the cerebral cortex is weakened, and its function of regulating and controlling the subcortical autonomic nervous system is also weakened, resulting in various autonomic nerves. Symptoms of hyperfunction.

2. Infection, poisoning, malnutrition, endocrine disorders, etc. have adverse effects on the nervous system. Beard envisions the onset of neurasthenia caused by dephosphorization of central nervous cells.

3. People without personality defects can also develop disease under the influence of strong and lasting mental factors. Dejerine and Gauckler (1913) think that it is caused by psychological factors, excessive tension, especially the unpleasant emotion caused by excessive tension, is nerve The cause of weakness, Laughlin (1967) argues that neurasthenia is a state of fatigue caused by excessive psychological conflicts. Psychoanalytic schools believe that neurasthenia is caused by frustration of sexual instinct, inhibition of aggression, and need for unconsciousness ( Strike needs) to reinforce and strengthen other infancy conflicts that have not been resolved.

Neurasthenia prevention

The causes of neurasthenia are environmental factors and internal factors. Therefore, prevention should be taken from these two aspects.

First, you must know yourself correctly: you must have self-knowledge about your physical fitness, knowledge, social adaptability, etc. Try to avoid doing things that you can't do, or avoid engaging in physical and mental activities that are not suitable for you. Its not good to worry about the fame and fortune.

Second, cultivate open-minded and cheerful personality: Your own temper, once the character is formed, it will be difficult to change overnight. There is no difficulty in the world, I am afraid that there are people, as long as you are interested in cultivating a good personality, a good personality will naturally affect you. Righteousness.

Third, advocate the overall situation: to think about things from big things, to distinguish between right and wrong, such as dealing with interpersonal relationships, advocating strict self-discipline, treating others with kindness, understanding each other, understanding, is one of the effective ways to prevent interpersonal tension, dealing with family relationships This is especially true when you have a colleague relationship, a neighborhood relationship, or a subordinate relationship.

4. Being good at self-regulation, there is Zhang Youchi: For those who are too nervous, too busy, or who are overburdened by students and have a lot of stress in life, it is necessary to self-regulate and reasonably arrange the relationship between work, study and life. To achieve a relaxation, work and rest, this can also improve work efficiency.

5. Rescuing to medical staff: If self-regulation is not good, and there are some psychological problems or signs of illness that cannot be solved, you should seek medical advice immediately, conduct psychological counseling, psychotherapy or drug treatment, and do not suffer from illness, but you should not be confused. Go to the doctor.

Nervous complication Complications autonomic dysfunction sleep disorder headache

Patients often experience muscle tension pain, autonomic dysfunction, such as headache or unclear muscle pain with a slight tension, accompanied by palpitation, sweating, poor appetite, indigestion, diarrhea or constipation; female patients also Irregular menstruation can occur, male patients have impotence, nocturnal emission, premature ejaculation, etc. In terms of sleep, various sleep disorders are also very common.

Symptoms of neurasthenia Common symptoms Multiple dreams, muscle tension, pain, tightness, head, tightness, urinary frequency, amnesia, anxiety, forgetfulness, weakness, nails, linear tension, headache

The original meaning of neurasthenia is: "An excessively weak and excessively excitable state of the central nervous system with secondary symptoms" (Muller's Handbook of Nervous Depression, 1893), and now basically agrees with this view, many The textbooks only describe the symptoms in more detail. For example, Kind believes that the main symptoms of neurasthenia are decreased ability in various aspects and increased response to various stimuli, psychological fatigue, sleep disorders, inattention, and memory loss. Anxious with horrific nature, susceptibility to sound, light or various parts of the body, such as heart weakness and various sexual dysfunctions. The definition of neurasthenia determined in the symposium of neurosis in China in 1985 pointed out that the mentality of patients with this disease It is easy to be excited and the brain is easy to be tired, often accompanied by emotional troubles and some psychophysiological symptoms. Some scholars believe that the fatigue of the neurasthenia is selective, that is, the emotional experience of interest is not easy to be tired, but there is no interest or subconsciousness. Those who resist emotions are prone to fatigue, which is characteristic. The main clinical manifestations can be roughly classified into the following categories.

Debilitating symptoms

This is a common symptom of this disease. Patients often feel lack of energy, lack of energy, can not use the brain, or mental retardation, limb weakness, drowsiness and sleepiness; especially when working for a long time, that is, the concentration can not concentrate, thinking hard, Work efficiency has significantly diminished, and even a full rest is not enough to restore fatigue. Many patients complain that things are lost, and they often say mistakes and can't remember what they have just experienced.

2. Excitement symptoms

Patients are prone to excitement when reading books or watching TV, and involuntarily recall and associate; patients are struggling with directional thinking, while lack of pointing thinking is active and uncontrollable; this phenomenon is especially before going to sleep. Obviously, the patient is deeply distressed, and some patients are also sensitive to sound and light.

3. Emotional symptoms

Mainly manifested as easy troubles and easy to provoke, the content of trouble often involves various contradictions in real life, feeling difficult and unable to solve, on the other hand, self-control is weakened, things are easy to be excited; or irritability, irritability, at home People lose their temper and feel regret afterwards; or they are prone to sadness, tears, about a quarter of patients have anxiety, have doubts about the disease, worry and nervousness; for example, patients can be heartbroken, pulse fast and doubt I have suffered from heart disease; I am worried about suffering from stomach cancer due to bloating and anorexia; or I think that I am suffering from an incurable disease because of poor therapeutic effect. This kind of suspicion can aggravate anxiety and nervousness and form a vicious circle. Another 40% of patients have a transient, mildly depressed mood during the course of the disease. They are scored on the Hamilton Depression Scale, often under 10 points. They may have self-blame, but generally have no suicidal ideation or attempt. Some patients There is resentment and the cause of the disease is blamed on others.

4. Tension pain

Often caused by nervousness, tension headaches are most common, patients feel head weight, head swelling, head pressure, or neck stiffness; others complain of back pain or muscle pain in the limbs.

5. Sleep disorders

The most common is that it is difficult to fall asleep, sleepless, so that the mood is irritating, it is more difficult to fall asleep, followed by telling more dreams, easy to wake up, or feeling that sleep is very shallow, it seems that they have not fallen asleep all night, and some patients feel tired after waking up. Do not understand, still sleepy; or feel sleepy during the day, go to bed and feel the brain excited, difficult to sleep, manifested as a disorder of sleep rhythm, some patients have fallen asleep, screaming, but awake firmly denied that they have slept, lack The true sense of sleep, these patients are worried about insomnia, and the distress often exceeds the pain caused by the sleep disorder itself, reflecting the patient's anxiety about sleep.

6. Other psychophysiological disorders

More common such as: dizziness, vertigo, tinnitus, palpitations, palpitation, shortness of breath, chest tightness, bloating, indigestion, frequent urination, excessive sweating, impotence, premature ejaculation or menstrual disorders, etc. These symptoms are not specific, but also common in anxiety Obstacles, depression or somatization disorders, but can become the main complaint of patients with this disease, concealing the basic symptoms of neurasthenia.

Neurasthenic examination

In order to eliminate these concepts and eliminate possible organic lesions, ECG, EEG, EEG topography, transcranial Doppler, CT head scan, etc. are required.

Electroencephalogram: Electroencephalogram (EEG) is the spontaneous and rhythmic electrical activity of brain cell populations recorded by electrodes.

Transcranial Doppler: Transcranial Doppler (TCD) is a new technique for studying hemodynamics in intracranial large blood vessels using the Doppler effect of ultrasound.

Diagnosis of neurasthenia

Diagnostic identification and diagnosis basis:

1. There are psychosocial factors that cause excessive brain activity.

2. Has a susceptibility or character.

3. Clinical symptoms are easy to be excited, mental fatigue is easy, headache, sleep disorders, secondary anxiety.

4. The course of disease is at least 3 months, with repeated fluctuations or prolonged characteristics. Each time the disease fluctuates more than the mental factors.

5. Comprehensive physical examination, including neuropsychiatric examinations or other necessary examinations, can indeed exclude other physical illnesses or early mental illness.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.