Hyperactivity and increased excitability are a common problem

Almost every modern parent has heard about the concept of a hyperactive child, and many even use it in relation to their children. But not everyone really understands that hyperactivity syndrome is not a fancy name for increased childhood activity, but a kind of disease that is caused by impaired functioning of the brain and can seriously affect, first of all, the life of a child and his relationships with peers. At the same time, we must not forget that sooner or later children grow up and become adults, and hyperactivity syndrome may continue to haunt them.

What is hyperactivity

Hyperactivity is a condition in which there is increased excitability of the child, which is manifested by excessive speech and motor activity. This is often combined with attention deficits and impulsivity, which in medical terms is called attention deficit hyperactivity disorder (ADHD). Very often this is accompanied by behavioral disorders and emotional instability. As a result, the child is constantly in a state of nervous tension, which he tries to relieve through physical activity. In general, he simply cannot behave differently, much less consciously correct his own behavior.

But the child’s increased excitability causes a lot of problems, both for his parents and teachers, and for himself. Disruption of the nervous system leaves an imprint on his relationships with peers and adults, which ultimately often becomes the cause of psychological problems and complexes.

At the same time, there may be a lack of attention, which most often forces parents to seek help from specialists. Problems with concentration and perseverance cause negative feedback about the child’s work in classes in kindergarten, other preschool institutions, and then at school.

According to medical statistics, hyperactivity syndrome is diagnosed in 6% of school-age children and 3% of adolescents, while boys suffer from it 5-6 times more often.

A neurobehavioral disorder should not be confused with hyperactivity. The vast majority of children cannot sit still for a long time and strive for active games. But with hyperactivity, there is a truly pathological inability of the child to behave calmly, which creates problems even for himself. This term means not just a diagnosis, but a whole complex of disorders, united by the presence of individual signs that do not correspond to a specific age, which explains the versatility of the manifestations of the syndrome.

Thus, ADHD can manifest itself in different children in different ways, on the basis of which its varieties are distinguished. Some children may have both excessive mobility and attention disorder at the same time, while others may have only hyperactivity or problems with concentration. In the latter case, the child is impulsive; he constantly receives complaints from caregivers and teachers due to bad behavior, which, it must be admitted, he is not able to control on his own. But at the same time, such a child can successfully cope with solving problems that require concentration and attention. There are also situations when only attention disorder is present, but the child is not hyperactive, or mixed types are observed.

Therefore, reasons to consult a doctor if you suspect hyperactivity are:

• constant high activity and problems with concentration;
• the occurrence of difficulties when communicating with other people due to behavioral characteristics, in particular other children on playgrounds;
• persistent poor behavior in preschool settings;
• poor school performance and bad behavior;
• a complete lack of desire or even the ability to do homework independently;
• aggressiveness towards other people and animals.

Disturbances in the sphere of emotional reactions

They manifest themselves as disproportionate in intensity or inadequate in quality emotional reactions in response to changes in situations that are essential for patients.

Emotional explosiveness or explosiveness . It manifests itself as an increased readiness for emotional reactions in the form of affects or disorders close to such, in response to various emotiogenic stimuli. From the outside, one may get the impression that violent emotional reactions arise over completely trivial matters (a rude word, an ironic remark, etc.). But these are usually “trifles” that greatly hurt the individual’s wounded pride. Reactions of expressed dissatisfaction, anger with verbal, and often physical aggression predominate. It happens that in such an impulse the victim is seriously injured, sometimes incompatible with life. Sometimes such patients exhibit “free-floating aggressiveness,” so that external aggression can immediately transform into auto-aggression. Such aggressors do not value their own lives or those of others. Most often they are psychopaths. During the reaction, self-control is significantly reduced, patients mostly act impulsively.

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Explosiveness is often found in patients with psychopathic-like disorders of various origins (TBI, schizophrenia, etc.). E. Bleuler about and attacks of despair with attempted suicide, as well as “fear or even stuporous states.” Let us remember that we are not talking here about acute reactions to stress or reactions to repeated stress, when the first, as it were, prepared the ground for a reaction to the latter (“mental anaphylaxis”, “mental allergy”). Sometimes hysterical patients can “work themselves up” to the point of passion, especially if they have developed such a defensive reaction somewhere in the zone.

Defensiveness is emotional viscosity. It manifests itself as a persistent fixation of predominantly negative emotional reactions that arose in a situation of frustration. Typical in this case are rancor, vindictiveness, and aggressive fantasies. The patient, for example, talks about a long-standing conflict with his colleague and at the same time plays with his nodules, clenching his fists as if we were talking about a very recent skirmish. He does not forget to add that if he came across this man now, “I would settle accounts with him in full.” Another patient, 15 years later, brutally beat a classmate because he “made fun of me at school in front of everyone.” Such patients overcome mental trauma for a long time and with difficulty, unable to switch to something else. They seem to be invariant and strictly adhere to previous habits and patterns of behavior. Defensiveness can also manifest itself in relation to positive emotions and attachments. Patients say that they are “monogamous” and cannot start a second family if their husband or wife dies, they prefer to live in one place, it is very difficult for them to change their occupation, hobbies, entertainment, they keep old things for a long time, but they cannot get used to new ones. quite difficult, they listen to the same music and watch old films they once loved many times, do not include new people in their circle of friends, etc. Emotional viscosity is characteristic of epileptoid psychopaths, epilepsy, individuals with age-related personality changes, and has been described in parkinsonism and postencephalitic mental disorders.

Emotive lability is a slight, capricious changeability of mood under the influence of the most insignificant reasons, sometimes not noticed by the patient himself, much less by those around him - tachythymia. The wind rose, the sun set, rain splashed, a heel broke, the pen stopped writing, a stain appeared on the blouse - all this can significantly ruin the mood. But it easily rises if pleasant little things happen right away: the seller didn’t shortchange, someone said a compliment, smiled, gave up his seat on the bus - and the mood is good again, life makes you happy again, you like all the people, and rainbow mirages appear ahead again. In some cases, emotional lability reaches the level of emotional hyperesthesia, when the mood becomes dependent on an infinite number of random details of what is happening.

These are mimosa-type people, impressionists who cringe at a random glance, the intonation of a voice, the smell of sweat, the sight of a wilting flower. Such painful fragility makes it difficult to live, maintain smooth relationships with people, think about something serious, and generally creates a feeling of ephemeral, airy existence, in which everything is so conditional and changeable. Emotive lability is a sign of corresponding psychopathy, foreshadowing the possibility of more serious affective pathology.

Emotional incontinence is the inability to control not only your emotions, but also their external manifestations. The disorder was described by E. Bleuler in mental retardation, as well as in mentally ill people. Characterizes a significant decrease in the ability of self-control and dysfunction of higher integrative authorities.

Weakness - compassionate tearfulness, excessive sentimentality, manifested when perceiving or remembering touching events. One of the early signs of cerebral atherosclerosis. Weakness is often associated with traumatic events of the past and in such cases reminds us of the approaching symptom of “living in the past.” Weakness also occurs in states of neuropsychic asthenia, when a rational attitude to what is happening is replaced by a sterile emotional one. Excessive tearfulness often occurs with mild depression and hysteria. Sometimes tears characterize impotent anger, self-pity and resentment towards someone, a state of tenderness, a release of emotional stress, and the ability to share the suffering of someone. There are also tears of joy. The latter things do not relate to weak-willedness itself.

Weakness should not be confused with forced crying, which, like forced laughter, occurs with pseudobulbar disorders. “Hysterics” with sometimes uncontrollable sobs are associated with the fact that patients fall into the corresponding role, needing consolation, but cannot immediately get out of it on their own. Tearfulness in patients with painful insensibility does not relate to weakness: here the tears flow as if on their own, mechanically, not accompanied by the experience of corresponding emotions. There are also “made tears” - someone “forces the patient to cry or he feels that it is not he who is crying, but someone else instead of him.” Tears, like laughter, have many meanings.

Emotional dullness is the underdevelopment or loss of higher feelings while maintaining or even reviving simpler emotions. Patients lack such feelings as compassion, tenderness, a sense of justice, remorse, a sense of beauty, a religious feeling, intellectual feelings, etc. Emotionally stupid individuals are callous, cruel, not prone to repentance, many of them do not even know the feeling of shame. They do not care at all what feelings they form as parents and teachers. Many parents today teach their children to be selfish, to love only themselves, not to stand on ceremony with those who are weaker, to refuse help and to learn to say a firm “no” when asked for something, and if they hit, even when they are down. The leitmotif of such teachings is the conviction that “now you can’t live as a good person and you must win your place in the sun by force.”

Here is an example of the emotional dullness of a school teacher who, due to illness, was transferred to disability. The patient is a teacher-mathematician by profession; she taught physics and mathematics in high school. She said that she had developed a new system for teaching her disciplines and that after six months her class was unrecognizable: the eternal C students began to show miracles in solving problems. That is why - out of envy - she was suspended from lessons. Her method was to create problems of the type that would be interesting to schoolchildren. Over the course of a year, she came up with four hundred such problems and was extremely proud of it. Here are some of them. “A brick is sliding on the roof of a five-story building. The length of the sliding path is 5 m. The height of the house is H, the sliding speed is X. An old man is approaching the house at speed Y. From the place where the brick is supposed to fall, it is located at a distance B. The question is: will the brick fall on the head of this bald old man?” Or: “A climber fell from a cliff 250 m high. The question is: how long will it take him to reach the gorge and at what speed will he crash on its bottom?” The saddest thing about this story about emotional stupidity was that all the children liked the problems, and none of their parents protested.

A somewhat lesser degree of emotional dullness is designated as emotional impoverishment or impoverishment. The attachments, altruistic feelings, and empathy of such patients are significantly weakened, fragile and quickly dry up. Thus, a 30-year-old patient reports that he is still not married and does not intend to get married, that he has never been interested in anyone before, has never been in love and has never liked anyone.

“Love,” he explains, “is animal magnetism, the relationship between a male and a female. Why marry - to mate? And then, even if you get married, you have to adapt to society, and tedious legal procedures will follow.” He doesn’t think about becoming a father at all. “What is this, what is the point of having children, I don’t love them, and caring for them disgusts me.” I got a job several times, even for good pay. After 1–2 months, he quit his job, but did not formalize his dismissal, without notifying him in advance of his intention. Questions about duties, responsibilities, and the fact that he had let someone down were ignored. His motivation to leave work was: “The work is boring, monotonous, I would like bright impressions, but everything gets boring quickly.” He does not visit his parents, does not write letters to them. I had only one friend at school. He is not interested in anything at the moment, does not communicate with anyone, and practically does not leave the house. Lives on the help of his parents. At home he sometimes plays computer games, sometimes watches TV, and occasionally reads anything he can get his hands on.

“Of course, I would have to work, but there is nothing that I would like.”

The degree of emotional impoverishment varies, of course, but usually it concerns higher feelings: affection, love, friendship, gratitude, cordiality, respect, compassion. Even minor emotional changes play, according to E. Bleuler, “an outstanding role” and “especially because in any disorder it is the affective mechanisms that first reveal symptoms.”

Emotional paradox is a disproportion between the intensity of affective reactions and the objective significance of emerging situations and developing circumstances. Thus, a 31-year-old patient, a prosector at a children's hospital, is satisfied with his work, it does not depress him, does not darken his mood. Explains: “At the cellular level, the corpse is not visible.” A good photographer, he especially likes to photograph children. Loves nature, serious music, “pop music disgusts me.” Very vulnerable - “one word is enough to ruin your mood for the whole day.” Not married, never been in a close relationship: “This is pure physiology; love was invented so as not to feel like beasts.”

He tolerates the environment of the psychiatric ward (located in the general ward) calmly, is not burdened by being here, communicates with patients on equal terms, goes with them to lunch and to work. He accepted the offer to undergo treatment without resistance. Informed by the doctor that he is ill, and quite seriously. He listened to this calmly and did not ask why he was sick. He didn’t ask about the threat of this disease or how it would affect his life. I calmly accepted the offer to register for disability. For some reason I remembered that I once spent the night in the morgue for a whole month. “The only bad thing there is that it’s hot.” Another patient reports: “I’m not afraid of fights, men fight bloody, with knives, and I try to separate them. Lately, one has broken up seven fights. “More than anything else, I’m afraid of mysticism and watching thrillers.”

Another patient stoically endures the atmosphere of the department, the noise, quarrels, fights between patients, he is not traumatized by the fact of the disease (he knows what he is sick with), and the not very bright prospects of remaining virtually thrown out of life. And yet one day he suddenly became very indignant, shouted, and was agitated - the reason was that he was moved to another bed in the ward.

Irritability is a tendency to frequent and relatively shallow reactions of dissatisfaction for various, usually minor reasons, which often have no direct relationship to the true causes of the disorder. One of the most common causes of irritability is the egocentrism of patients - many of them are dissatisfied only because “everything is not done as it should be,” that is, “not my way.” An egocentric person gets irritated when people don’t listen to him: how can you not listen to me, others are capable of talking nonsense, but not me. It infuriates him when he is interrupted, although he himself does not allow anyone to open their mouth: “he also interrupts, boorish, it would be better for him to keep quiet, listen to what smart people say.” An egocentric person constantly reproaches someone, lectures, instructs, gives very impartial assessments, he is generally irritated by everything that, in his opinion, is unfair, that is, it hurts his exorbitant pride. They are irritable to the point of scandals and hysterics: they are offended that they are not appreciated, not understood, not thanked at every step, they need their path to be strewn with roses of admiration.

Often, irritability is a way of releasing accumulated resentment on someone. Resentment and tension spill out onto household members, children, animals; goes to objects too. Dishes are shattered, clothes are torn to shreds, pens and pencils are broken. One patient smashed his car with a hammer because it would not start. The transfer of emotions from one object to another is sometimes called the transportation of emotions. Patients, irritated, often want at all costs to maintain the illusion of their control over what is happening by demonstrating aggression, the strength of their ego. Irritability can be a consequence of dissatisfaction with themselves: few are able to understand themselves in order to understand what is wrong with them . The easiest way is to find the culprit in order to distract your attention from yourself with a flash of irritation, as if to crowd out dissatisfaction with yourself, and at the same time restore self-esteem. Sometimes irritation is a mild form of expressing indignation, that is, dissatisfaction with the essence of the matter, which does not affect the dignity of another; such people are often dissatisfied with themselves, or rather, with the fact that they did something wrong, at the wrong time, let someone down, and generally did something unworthy of themselves.

Usually they are immediately ready to apologize and correct the situation as soon as possible. Finally, irritability is a constant companion to asthenia - irritable weakness or “failure of the brakes” - hypersthenia. Such patients are at first indignant, then they think, and then they realize that they “got excited” and were wrong. Emotions are generally difficult to bring under control, but losing control over them is much easier. And when this happens, they always have the first word. If irritability is combined with other manifestations of increased emotional sensitivity, it may be a sign of excessive impressionability in depressed patients. So, irritability can be characteristic of patients with various disorders; we think we have identified some of its main causes.

Emotional coarsening is the loss of subtle, differentiated emotional reactions associated with a mild decrease in intelligence with organic brain damage in persons who are disharmonious in terms of premorbid personality. Due to an overly simplified, incomplete, fragmentary or one-sided understanding of what is happening, patients become quite inadequate: tactless, naked, familiar, boastful or even dishonest, since deception and cunning are in the order of things for them. Their sense of proportion, delicacy, courtesy, tolerance often betrays them; in polite society they resemble a bull in a china shop. They cannot understand that their inappropriate behavior will shock someone, may injure someone with an obscene phrase, offend or cause self-loathing. They also love to joke. But their jokes are vulgar, obscene and often repeated to the accompaniment of their own laughter.

Because of their importunity, they shamelessly barge into someone else’s conversation and try to lead him in their direction, where they wash someone’s bones. They speak loudly, a lot, as if they are trying to shout someone down. Their phraseology is very far from subtlety, the statements of prostitutes, the beginning and end of the latter are rarely on the same line of reasoning. Patients easily cross the boundaries of subordination, interfere with personal relationships with employees, and do not take into account the self-respect and ethical position of the interlocutor. And if the interlocutor is also a subordinate, he finds himself in the position of a “fool” who should not be taken into account at all. Patients are often very cheeky, they can be rude and even mock people who are dependent on them. They are incapable of dialogue: they interrupt the interlocutor, do not allow him to complete his thought, do not try to understand him, impose their opinion, and then draw dubious conclusions from the conversation, relating not so much to the problem being discussed, but to interpersonal relationships.

Subordinates rarely leave the office of such a boss with a light heart, unless they use flattery or something else to appease the “deity.” Such dialogue is somewhat reminiscent of the communication disorder in the form of double dialogue described in families of patients with schizophrenia (J. Batesson, 1956). For example, a son, rejoicing at his mother’s visit, puts his hand on her shoulder. The mother responds with a grimace of disapproval. The patient withdraws his hand, to which the mother reproaches him for not loving her. The patient blushes, but the mother reprimands him, saying that he shouldn’t be so embarrassed. In other circumstances, emotionally hardened patients may behave completely differently: they ingratiate themselves, please, humiliate themselves, agree with everything and eat with the eyes of their boss, trying to speak less so as not to inadvertently anger him. Someone rightly said: silence is a shield for a fool, a fool is smart as long as he remains silent. The essence of the matter does not change from this change of dishes. The coarsening of emotions and feelings occurs quite often and usually comes to the fore, while intellectual decline remains, as it were, in the shadows, and gross violations are often not detected.

Anniversary reactions are the appearance or intensification of feelings of grief on the date of the tragic event. This happens, for example, on Parents' Day, on days of remembrance of victims of war or terrorist attacks, disasters, etc. For example, participants in battles in hot spots get together from time to time to remember their fallen combat friends. Usually reserved in talking about mourning events with outsiders, here they indulge in detailed memories, reviving in their memory the smallest details of what happened. At the same time, it cannot be done without a feast. They drink to remember the dead, to soften the severity of the loss and to suppress the guilt of the survivors. In hindsight, it often seems that the disaster could have been prevented.

Parathymia is an inversion of emotional reactions, the replacement of adequate emotions with the exact opposite. So, a mother congratulates her daughter on her birthday as follows: “Galina! I don't wish you a happy birthday. I don't wish you happiness. I curse you, your mother’s curse is the worst!” The girl was raped in a group; her friends held her legs. In shock, she returned home, did not say anything to her loved ones, went into the bathroom, lay down in the water with her clothes on and burst out laughing. Another patient recalled that at the age of seven she fell into the water, got scared, and began to drown. She was saved by a woman passing by. Instead of the joy of salvation and gratitude to the woman, “I scolded the savior in all sorts of ways, told her that she was a fool and ugly.”

Idiosyncrasy to emotions - intolerance of various emotions: “I perceive my emotions too acutely. And good ones too. After them there is palpitation, discomfort, I feel very bad. I try not to worry or be happy at all.” This symptom seems to be the opposite of painful insensibility. In the latter case, patients suffer from the fact that they have ceased to be aware of their emotions. In the second case, on the contrary, the patient is too acutely aware of her emotions and suffers for this reason.

Emotional ambivalence is the coexistence of polar feelings in relation to the same object or phenomenon: “I seem to have two selves: one loves my mother, the other hates her... I am attached to my husband, I am tender with him and at the same time he infuriates me, I’m ready to kill him”... The patient wants his wife to die, but when he sees her dead in hallucinations, he falls into despair. The disorder indicates a splitting of the ego.

Escalation of affectivity - excessive expressiveness (in gestures, facial expressions, postures, voice intonations) in hysterics as a means of suppressing others, self-affirmation and as a mechanism for discharging excess motivation (teaching a lesson, punishing someone, moderating libido, etc.). Patients start small: they raise their voices, cry, nervously walk around the room. Then, gradually and as if involuntarily, they inflate themselves to such an extent that they can no longer get out of the role on their own unless they are saved by fainting.

Emotional burnout is a symptom complex that includes emotional and (or) physical exhaustion, depersonalization and decreased performance (Pelmann, Hartman, 1982). Emotional exhaustion is experienced as internal emptiness, depletion of affective resources, and emotional overstrain. Interest in work is lost, the patient goes there as if “to hard labor”, without inspiration and enthusiasm, but rather with disgust. Depersonalization is expressed by a feeling of depersonalization of people; they all seem equally unpleasant.

Relations with them become purely formal; employees often cause irritation, hostility, dissatisfaction and indignation. Conflicts with them are quite likely if colleagues do not realize that they are dealing with a person whose mental strength has left them. The decline in performance is associated with such reasons as the emergence of a negative assessment of oneself as a professional, self-doubt, feelings of uselessness, doubts about one’s competence, dissatisfaction with oneself, and decreased motivation to work.

Emotional burnout occurs in individuals who are in intensive and close communication with clients, patients, students, students and colleagues when providing professional assistance. Characteristic of emotional people who do not know how to protect themselves from excessive affective reactions to work situations. The surgeon should not die with every patient, the psychiatrist should not go crazy with the patient, accepting his grief as his own; The teacher should not worry about the failures of his students as if he himself received ones and twos. Work should not exceed the optimal level of tension, otherwise it will lead to fatigue and many mistakes in simple situations. The amount of workload should be rational and in no case go beyond the scope of mental hygiene. Managers do not know anything like this or do not want to know, overloading their subordinates; Usually, unfortunately, they care more about themselves and their prestige in the eyes of their superiors.

The disorder develops at the age of 30–40 years, more often in women with these professions, as well as in scientists and managers. It is sometimes called compassion fatigue. It is necessary to timely identify patients and provide rehabilitation assistance using psychotherapy and psychopharmacotherapy (small doses of antidepressants, nootropics, sleep normalization, physiotherapy, etc.).

Learned helplessness is a condition caused by “being caught in harmful, unpleasant situations” that “can neither be avoided nor prevented” (Seligman). In experiments on animals, the helplessness of the latter becomes such that even the emerging opportunity to get out of the situation is not used. Some authors see in this disorder a factor contributing to the emergence or intensification of depression. V. Frankl observed the complete loss of the ability to resist in the Nazi death camps; For some reason such prisoners were called Muslims, perhaps because they pinned their hopes only on the Almighty.

Dyshomophilia - tension, anxiety during homoerotic fantasies. It is observed in homo-, heterosexuals and even asexual people. It is recommended not to confuse the disorder with “egodystonic homosexuality.”

Emotional paralysis of Beltz (1901), or affective anesthesia. Described as a variant of psychogenic stupor without impairment of consciousness with complete shutdown of emotions without subsequent amnesia. Derealization is also observed, the patient perceives what is happening detachedly, from the outside, as something apparent to him. At the same time, he can move and behave outwardly quite adequately.

The loss of syntony manifests itself in the fact that the patient does not feel the emotional context in someone’s conversation with him, and thus cannot discover the meaning of the speech addressed to him. Thus, the patient perceives the doctor’s usual sympathetic questions about his well-being as an “interrogation” and says that “they are getting into his soul.” When asked to clarify what he means, he states that they are pestering him and showing inappropriate curiosity. He considers the advice to get medical treatment as pressure on him, and is indignant at being “dictated” or “imposed” on him. He is offended by a joke, believing that he is being “mocked”; he regards a friendly attitude towards himself as an attempt to “manipulate” him, etc. It is more often observed in patients with schizophrenia.

Vicarious pleasure is the replacement of one’s own dissatisfaction with joy or pleasure for other people. A father is happy, for example, that his son gets an A in math at school, but no matter how hard he tried, he couldn’t do this at one time. The voyeur gets vicarious pleasure by spying on the intimate relationships of other people.

Phobic reactions are excessive fears of something, observed in timid, timid natures. It is important that such patients do not know how to assess the true extent of the danger and do not have sufficient personal experience in dealing with dangerous situations. They are not able to adequately control their fears. The best form of fear control is coping skills in threatening situations. For example, a person sees someone drowning. He runs along the shore in fear and calls for help. Another person silently rushes into the water and saves the drowning man, without feeling any fear. Phobic reactions are not obsessive, although the patient fruitlessly struggles with them, is burdened by them, would like to get rid of them, while understanding that they are something not entirely normal. In addition, he is also ashamed of his fears and tries not to tell anyone about them. V.V. Kovalev defines such fears as overvalued and exaggerated.

Hypophobia is a lack of feeling of fear, leading to an underestimation of the degree of danger or threat of any situations. Described in patients with schizophrenia, in alcoholic intoxication, and with neuroses - “thenic sting of a psychasthenic.” There are cases of complete absence of fear - anaphobia. A 30-year-old patient claims that she does not know what fear is and has never experienced it under any circumstances. She says that during her school years she went to the cemetery alone at midnight, even before school she visited the anatomy class, visited the morgue, and even took her friends there out of curiosity. She never had fears in her dreams, no matter what she dreamed. From the very beginning, she watched horror films completely calmly and said: “I don’t understand what people find scary in them.” She jumped from a parachute and “wasn’t afraid at all, even the instructor was surprised,” she drowned and “wasn’t scared at all: if I drown, I’ll drown, so that’s how it’s supposed to be.” “I wasn’t afraid of the psychiatric hospital, I came myself, what’s there to be scared of.”

Without fear, she walked at night along the unlit streets of the city, where “I know they killed, robbed, and raped.” “I’m not brave, no, I just don’t have developed fear. Well, there are people without legs, I have something similar to this.” There is also a known phenomenon called contophobia - the desire to get into dangerous situations for the sake of acute impressions that are not accompanied by fear.

Satomura syndrome (1979) is a peculiar fear of superiors or other high-ranking officials. This is the fear of appearing funny or unpleasant in their eyes. It is considered as a neurosis characteristic of the Japanese. Apparently, it occurs not only among them.

Disorders of the sense of humor are the inability to see something worthy of compassion behind the comical, playful form. First of all, the sense of humor changes when perceiving real life situations of a humorous nature. At the same time, the sense of humor in relation to oneself suffers. The perception of humor in corresponding images (cartoons, etc.) seems to be preserved to a greater extent (Bleicher, Kruk, 1986).

According to our preliminary impressions, the loss of a sense of humor first manifests itself, apparently, in the fact that when an individual meets an object of humor, he becomes very happy, his mood rises, so that he himself is not averse to making someone laugh, and then having a pleasant time the rest of time. The second, hidden level of humor is not distinguished, light sadness and in-depth reflections about human nature, and about oneself usually do not exist. The next stage of a sense of humor deficit occurs when an individual becomes funny, very funny, when he encounters manifestations of humor. He is sometimes filled with Homeric laughter, and he does not think about anything serious.

Once he starts laughing, he will do it all evening (for example, at a laughter concert) and at very dubious jokes. As soon as you provoke some “decoy duck” to laugh, the rest of the humor lovers begin to laugh together, as if on command. A funny person resembles a stoned drug addict who laughs at everything you show him. A. Maslow, meanwhile, noticed that people with a genuine sense of humor usually do not have fun and laugh, only a sad smile runs across their face. Statistics say there are only 1–3 such people per hundred. The continuing degradation of the sense of humor is expressed in the fact that the individual will laugh with pleasure when someone is laughed at. But he does not accept jokes directed at himself; moreover, he may be offended by this or, worse, get angry. Finally, humor dies when it is taken “seriously,” that is, not taken at all.

The lack of a sense of humor is especially acute in patients with schizophrenia, who are educated, intelligent, knowledgeable, but who take jokes and allegories very literally. The best sense of humor, as is well known, is developed among pessimists, who see the weaknesses and shortcomings of people better than others and, nevertheless, treat them with particular delicacy and care. However, in depressed patients, their sense of humor, like other high feelings, is blocked, which makes it extremely difficult for them to survive depression - they are deprived of the internal support that only helps people in misfortune. Patients with epilepsy are deprived of a sense of humor once and for all.

With their rigidity, getting bogged down in trifles, they do not have time to notice how this spark of God flashes over them - a moment of humor. With alcoholism, the sense of humor degrades to banality, vulgarity, cynicism with an indispensable element of greasiness - mentions of betrayal, meetings with passionate beauties and something else like that. One would like to call such humor genital. “Black humor” has only one similarity with genuine humor - the use of a comic configuration. In its depths lies not compassion, not high sadness, but merciless cynicism, ready to strike all the saints and everything that is called the existential, enduring and eternal values ​​of human existence.

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Causes

There are many assumptions about what exactly can provoke the development of hyperactivity syndrome in children, but not a single neurologist will be able to accurately name a complete list of them and trace a clear connection between any events and factors with the manifestation of hyperactivity. Today it is believed that it develops against the background of a combination of a complex of various disorders and external influences. Therefore, biological, genetic and psychosocial factors are identified, the presence of which contributes to the occurrence of hyperactivity and/or attention disorder.

Conducted studies confirm that the effect of a hereditary factor is found in 50% of children with this diagnosis. As for biological disorders, the main causes of the development of ADHD are considered to be cerebral-organic changes, that is, those that are accompanied by disturbances in the functioning of the nervous system, namely:

• premature or complicated birth, which affected the development of the nervous system or caused hypoxia (oxygen starvation);
• occupational hazards that a woman encountered during pregnancy, as well as smoking, drinking alcohol, and a number of medications;
• intrauterine infections;
• a pregnant woman experiencing stress or frequent physical fatigue;
• far from healthy diet during pregnancy;
• premature birth or “post-term” pregnancy;
• birth of a child before 20 years of age or after 40 years of age;
• metabolic disorders, especially those that tend to be inherited.

It is believed that a deficiency of high-quality protein foods, vitamins and minerals in the daily diet against the background of an excess of simple carbohydrates, especially consumed in large quantities in the morning (bread, rolls, sweets), creates favorable conditions for the occurrence of ADHD.

Psychosocial factors play an important role in the development of the disease, among which the most significant are considered to be:

• alcoholism and serious disagreements between parents;
• violence in family;
• the child's experience of psychological trauma;
• low social status of the family, lack of means of subsistence, which can be aggravated by ridicule from peers.

Inflated demands of parents on them, constant dissatisfaction with achievements, etc. contribute to the development of hyperactivity in children.

How does hyperactivity syndrome manifest?

The disease can first appear at any age, starting in infancy. It may be accompanied by:

• anxiety;
• restlessness;
• irritability, tearfulness;
• sleep disorders;
• decreased level of attention, constant distractibility;
• impulsiveness;
• stubbornness;
• delayed speech development.

For each age, separate standards have been developed, non-compliance with which makes one think about the occurrence of disturbances in the functioning of the nervous system. For example, very quickly switching to other surrounding objects, voicing random thoughts and memories is called distractibility, which is one of the most striking signs of attention deficit.

Another term often heard when diagnosing ADHD is “impulsivity.” This means that when a child receives a task, he does not listen to the end of the recommendation or instruction and begins to complete it prematurely. As a result, he usually underestimates the complexity of the task or handles it incorrectly because he ignored the requirements. At the same time, impulsive children are not able to think about the consequences of their actions, so they often get injured, become victims of accidents of varying severity and find themselves in unpleasant situations.

Hyperactivity or not

As already mentioned, very often healthy children's activity and spontaneity are confused with such a disorder of the functioning of the nervous system as attention deficit hyperactivity disorder. Parents may suspect the presence of ADHD by the presence of the following signs:

• the child is much more active than his peers (sometimes parents say that he is “running on the ceiling”);
• increased excitability, which is manifested by the presence of unnecessary movements (the child constantly twirls, dangles his legs, swings on a chair, plays with his hands, etc.) or speech incontinence (the child talks without stopping);
• absent-mindedness - with ADHD, children constantly lose and forget personal belongings, do not listen to instructions received from adults, even short ones, and are distracted;
• rapid onset of fatigue when it is necessary to complete tasks that require perseverance and concentration on the process - parents of schoolchildren are sometimes forced to constantly sit next to the child while doing homework and control them;
• increased emotionality, manifested by absolute incontinence and splashing out any emotions on others;
• the inability to bring the work started to its logical conclusion - the child loses interest in the activity and quickly moves on to another type of activity;
• lack of self-control, manifested by constant interruption of other people, difficulties when it is necessary to wait for one’s turn or where, a tendency to quarrels and fights;
• lack of coordination, as a result of which the child can often be injured.

Signs of ADHD always appear before the age of 7, but they most often begin to attract attention in the late preschool and school periods of a child’s life.

In addition, with ADHD in children over 4 years of age, parents may lose control over their behavior. Such children often not only do not listen to adults, but are incapable of negotiating and seeking compromise and generally following established rules. But such “symptoms” can appear together or separately in healthy children during a difficult psychological period, experiencing a crisis of 3, 6-7 years, etc. Therefore, parents should sound the alarm only if the child has several of the above-described violations, moreover, for longer than six months, and they prevent him from adapting to society.

Hyperactivity is a permanent condition. Therefore, children with this syndrome behave the same everywhere: at home, in kindergarten, at school, on a walk.

Characteristic manifestations

Insomnia is a possible sign of increased nervous excitability

Nervous excitability can be described:

• difficulty moving the eyeballs;
• asymmetrical nature of the muscular component of the face;
• lack of organization;
• absent-mindedness;
• difficulty expressing your thoughts;
• complaints of pain in the head;
• mental problems;
• the occurrence of insomnia;
• the appearance of excessive irritability;
• excessive conflict;
• acute reaction to minor irritants;
• the appearance of nightmares;
• self-pity, increased tearfulness, feeling of loneliness;
• difficulty falling asleep.

Diagnosis of ADHD

No matter what kindergarten teachers, teachers, other parents or acquaintances say, only a doctor can accurately assess the child’s condition, and only a neurologist or child psychologist can diagnose hyperactivity syndrome with or without attention impairment. Teachers or other people communicating with the child can only draw the parents’ attention to certain personality traits of the child, the existing difficulties when working with him, and suggest the need to obtain specialist advice.

When diagnosing ADHD, the doctor must exclude other pathologies of the nervous system and developmental disorders. Therefore, consultations with both specialists – a neurologist and a psychologist – are often required. This will allow you to accurately differentiate ADHD from:

• consequences of psychological trauma, anxiety disorders;
• autism spectrum disorders (may be combined with hyperactivity);
• certain types of schizophrenia, epilepsy;
• endocrine pathologies.

Therefore, the diagnosis cannot be made at the first consultation with a doctor. To do this, in addition to a detailed conversation with the child and his parents, it is necessary to observe his behavior, as well as conduct neuropsychological testing. To exclude other pathologies, the following are prescribed:

• general and biochemical blood test;
• EEG;
• MRI of the brain;
• ECG and other studies.

Treatment of hyperactivity

Attention deficit hyperactivity disorder necessarily requires complex treatment. Today you can often hear that over time the child will outgrow his increased excitability and his condition will return to normal, so there is no need to do anything. Grandparents are especially often guilty of such statements. In reality, in the absence of competent correction, the problem will not go away, but will only transform.

As the child grows older, without treatment, one can only count on the elimination of excessive mobility. But since the disturbance in the functioning of the nervous system persists, it will be replaced by fussiness and constant internal restlessness. Adults with ADHD who are unaware of their diagnosis are characterized by irresponsibility, conflict, and a tendency to take unnecessary risks. It is also difficult for them to independently organize and plan their activities, as well as follow the developed plan.

Therefore, when receiving a diagnosis of attention deficit hyperactivity disorder, you should not panic, but strictly follow the recommendations of a neurologist and psychologist in order to properly organize the rehabilitation process. This will significantly improve the child’s condition and help him avoid many problems.

Since ADHD is a multifactorial disorder and can manifest itself in different ways, treatment for each child is selected strictly individually. This may include:

• drug therapy;
• lifestyle correction;
• change in diet;
• manual therapy with elements of osteopathy.

To effectively treat increased excitability, parents and their children are recommended to work with a psychologist. This will help create a favorable atmosphere in the family and improve interpersonal relationships. Working with a psychologist will help create compensatory mechanisms that will help the child better control his own behavior, teach him to get along with peers and learn better. It is also recommended to obtain consultations from a defectologist who will help build the right program for correcting existing disorders.

Conflicts between parents aggravate ADHD.

Parents of children with officially diagnosed hyperactivity should talk with their kindergarten teacher, school teachers, and others who work with them. The purpose of this conversation is to convey information about the child’s characteristics and how best to organize the educational process so that it is as comfortable as possible for him and the teacher, and does not provoke difficulties in communication.

Drug therapy

Medicines are not always prescribed to children. Most often, the need for them arises when lifestyle corrections are ineffective. Drug therapy is mainly aimed at eliminating the symptoms of ADHD and alleviating the child's condition. This may include:

• sedatives;
• nootropics;
• mild sleeping pills;
• psychostimulants;
• neuroleptics;
• antidepressants (in severe cases).

Lifestyle correction

Children with increased excitability just need to be loved. They need to be praised for the slightest successes and encouraged to continue. Parents should focus on the positive aspects of the child’s personality and talk with him in a calm, friendly tone about accepted norms and rules of behavior in society.

Hyperactive children need a clear daily routine more than others. Therefore, if there is none, it should be developed. The child should wake up, walk, eat, and go to bed at the same time. This will allow you to better control the course of ADHD.

It is important to try to allocate personal space for the child. If it is not possible to give him a separate room, you need to arrange at least his own corner where he can isolate himself from adults. But since it is difficult for children with increased excitability to clean up and maintain order on their own, you need to be prepared for a mess and a long process of instilling the skill of cleaning up after yourself.

As mentioned earlier, children with ADHD can be forgetful. Therefore, parents, together with them, can create special temporary or permanent checklists, which should help the child not to forget anything important. It would be a good idea to leave stickers and various reminders as needed.

Sports activities have a very good effect on the condition of hyperactive children. But these should not be team sports, but martial arts, swimming, equestrian sports, etc.

Changing food

If there is increased excitability, it is recommended to reduce the amount of sweets in the child’s diet and other sources of simple carbohydrates. At the same time, nutrition should fully cover the body’s needs for proteins, vitamins and minerals.

Manual therapy with elements of osteopathy

Manual therapy can work real miracles with children who are highly excitable. Using special, absolutely safe manual techniques, the doctor can effectively influence the consequences of hypoxia and other biological disorders, creating conditions for normalizing the activity of the nervous system. Manual therapy sessions allow you to influence the cause of ADHD, which no other treatment method can do. As a result, the child becomes significantly calmer, his ability to perceive and process information improves, as well as his success in school.

Thus, hyperactivity cannot be called a dangerous disease. But such a condition can significantly reduce the quality of life of the child and his loved ones, and subsequently move with him into adulthood. But there is no need to panic when receiving such a diagnosis. Today, ADHD can and should be fought, but in order for the fight to be effective, the help of qualified specialists is required. ADHD symptoms may worsen with changing seasons, illness and other factors, but this does not mean giving up, but is an inevitable phenomenon that must be accepted and continued treatment. As a result, your adult child will be able to live a full life, not experience difficulties in communication, and achieve any goal.

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Precautionary measures

Physical activity helps counteract increased nervous excitability

1. Devote your time to sports. You can do exercises every day in the morning, the main thing is that there is at least minimal physical activity in your life. Ideal if you can, for example, run in the fresh air.
2. Try to be outside as much as possible, especially in areas with vegetation (parks, forests).
3. Train yourself not to sit at the computer for long periods of time, get rid of Internet or gaming addiction, if you have one.
4. Lead a healthy lifestyle, eliminate any bad habits, in particular alcohol and smoking.
5. Clearly allocate time for work and rest, do not be a workaholic.
6. Filter incoming information, protect yourself from negativity. In particular, you can refuse to watch news programs.
7. Decide on a daily routine. It is mandatory to have adequate sleep (eight hours a day), and go to bed on time (no later than 23:00).
8. Maintain communication with relatives and friends, go for a walk with them, visit a cinema, a museum, travel.
9. Protect yourself from communicating with toxic people.

Now you know what increased excitability of the nervous system is. Having become familiar with the reasons that can provoke it, you can take certain actions to prevent the development of this condition. If you cannot cope with nervous excitability on your own, you should seek help from a specialist and follow his recommendations.