Neurotic disorders: causes, symptoms, treatment

What is a neurotic disorder

What is a neurotic disorder? It is a heterogeneous group of dysfunctions that arise as a result of acute or chronic psychological trauma. Symptoms are varied, but maladaptation, phobias, asthenia, obsessions and somatovegetative disturbances are always noted. A person's physical and mental abilities are temporarily weakened. Self-awareness and criticism persist. The diagnosis is made based on complaints, medical history and the person’s life history. To eliminate the problem, they resort to psychotherapy and medication.

Neurotic disorder is characterized

Doctors mean by neuroses a group of pathologies that arise due to the influence of mental trauma. A neurotic disorder is characterized by a deterioration in well-being, mood swings are noted, and somato-vegetative symptoms appear. In severe cases, suicidal thoughts are possible.

Treatment of asthenic neurosis at Neopsy

Methods for diagnosing asthenic neurosis at the Center include the clinical-psychopathological method - a conversation with the patient (with his consent - with relatives), studying the medical history at the first consultation during the collection of anamnesis. Usually this is enough for our experienced specialists to identify neurasthenia. But to make a more accurate diagnosis, in the presence or suspicion of the possibility of somatic diseases, additional laboratory and hardware examinations and consultations with related specialists are prescribed. After confirmation of the diagnosis, an individual treatment plan is developed, which includes psychotherapeutic methods of influence, physical and dietary therapy, and drug treatment.

The Center’s specialists are fluent in all modern methods of psychotherapeutic assistance for asthenic neurosis, including hypnotherapy, relaxation, resource trance, autogenic training, etc. Together with the patient, a psychiatrist or psychotherapist develops a way to reduce physical and intellectual stress (up to changing jobs, giving up part-time work). etc.), rest, sleep and nutrition regime. The high professionalism of the specialists at the Neopsi Center for Mental Health allows us to treat asthenic neurosis with high efficiency. Contact us for help through the website services or call the specified phone number.

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Causes of neurotic disorders

Doctors have different opinions regarding the catalyst for neuroses. Some believe that this condition develops due to a genetic predisposition, others – childhood psychological trauma. Children's psyche is weak, their memory is tenacious, any serious stress persists for a long time. Most of the complexes that a person suffers from in adulthood arose in childhood. Women are more susceptible to the disease.

Other causes of neurotic disorders:

• unfavorable environment, poor living conditions;
• prolonged physical overload in combination with stress;
• exhaustion of the nervous system;
• too busy work schedule;
• lack of proper rest;
• alcohol and drug abuse.

Neurotic dysfunctions occur when the body is exhausted.

Body strengthening

To restore your body and mind, you need to follow simple tips:

• Physical activity has a positive effect on the body. Constant movement, sports and other physical activity have a positive effect on the condition of the body, and, consequently, the nervous system improves;
• control your diet. The body must receive the required amount of vitamins, minerals and other beneficial substances found in food products every day;
• rejection of bad habits. Despite the fact that many are accustomed to starting the morning with coffee and a cigarette, this habit should be forgotten. It’s better to completely give up all bad habits, such as alcohol, cigarettes, stimulants. The excitement that occurs due to receiving a dose of nicotine is quickly replaced by an inhibitory reaction;
• sauna and bathhouse. Such methods help cleanse the body and soul. Elevated temperatures and hot steam together help cope with many diseases, the body and nerves relax;
• harden. Water has a positive effect on the nervous system. If you harden yourself, you can strengthen your immune system. It invigorates and strengthens the body. There is a more extreme way to harden yourself - winter swimming. It may seem strange, but the health and calmness of walruses can only be envied. If you go down into an ice hole, your body will be very grateful;
• drink as much water as possible. Many people know the 8 glasses method. This is how much water a person should drink per day. This cleanses the body well, removing toxic substances;
• massage. A great way to get rid of many ailments and relieve stress. The body gradually loses its flexibility, the joints become less mobile. A good massage will speed up blood circulation and trigger metabolic processes.

Classification of neurotic disorders

Disorders are divided into 3 groups:

• hysterical;
• obsessive states;
• asthenic.

This classification of neurotic disorders is not similar to practice. It does not contain approved certain and most common pathologies. The differences lead to different ways of systematizing disorders.

Types of neurotic disorders

When making a diagnosis, doctors take into account the following types of neurotic disorders.

1. Anxious-phobic. The main symptom is a sharp increase in anxiety and the appearance of obsessive fears. This group includes panic attacks, simple and complex phobias, and generalized anxiety disorder.
2. Obsessive-compulsive. The main symptom is the appearance of obsessive ideas and actions.
3. Asthenic disorders are characterized by asthenic syndrome.
4. Somatoform. Clinically, they are similar to somatic ones, but do not imply a physical basis.
5. Dissociative disorders imply disorders of motor function and sensations. Previously, this disease was classified as hysterical neuroses.

The sooner the patient seeks help, the more favorable the prognosis.

Forms of neurotic disorders

There are such forms of neurotic disorders.

1. The most common is neurasthenia; it is divided into 3 stages. The first phase is characterized by irritability. Mental and physical abilities are not affected. The second stage is characterized by a decrease in working capacity, a person understands this. The third phase is manifested by lethargy, reluctance to do anything, and asthenic syndrome.
2. Hysterical neurosis is the second form. The disease is caused by inappropriate behavior; the person is unpredictable and extremely irritable. There are signs such as seizures, paresis, vomiting, hypotension. The patient also complains of obsessive thoughts, a “lump” in the throat, and insomnia. During an attack, a person screams, lies on the floor, can get into a fight, or injure himself.
3. The third form is depressive neurosis. It is characterized by symptoms such as insomnia, bad mood, loss of the ability to feel joyful emotions, a feeling of burden, and tearfulness. There are also disturbances in heart rhythm, stomach function, slow reaction to events, sexual dysfunction, and hypotension. The patient complains of despondency, sadness appears, and a feeling of uselessness.
4. Obsessive states. With it, the patient is unable to control his thoughts and actions.
5. Hypochondriacal neurosis - there is a fear of a circumstance from which a person cannot find a way out, or a fear of falling ill with an incurable pathology. The condition is complemented by hysteria and obsessions.

Each form requires an individual approach to therapy.

Neurotic disorders in adults

Neurotic disorders in adults have a reversible, relatively mild course, unlike psychoses. According to statistics, the problem is detected in 20% of the population. The causes include a disorder of brain activity responsible for human adaptation. Somatic and mental disturbances appear. Patients are rarely admitted to the hospital; conservative methods are usually successful.

Neurotic disorders in children

In children, the catalyst for the development of neurosis is delays in personality development. Against the background of separation from parents, stress, loss of a loved one, psychological trauma is possible. A child who experiences these situations becomes infantile or acquires neurosis.

Neurotic disorders in children: features of occurrence and course.

1. The age of 7-11 years is considered the affective stage of personality formation. If at this time the child encounters a traumatic factor, his development as a person may be delayed. In adulthood, such people experience emotional instability; a person cannot adequately assess the situation or think about the consequences. The only and beloved children acquire hysterical traits.

2. At the age of 11-14, a teenager learns to independently assess the situation, analyze, and plan his actions. There is a subsequent development of the affective component of the personality. If at this age a stressful situation arises, neuroses are possible in the future. Such teenagers outwardly look older than their peers and are more reasonable, but subconsciously, the synchronicity of personality development is disrupted.

Attention! The most important role in the successful growth of a child is played by the relationship with parents. Those who felt overprotected in childhood and were not allowed to make their own decisions become timid and unsure of themselves. It is in this category of people that neurotic disorders arise.

How to overcome mental exhaustion

The most obvious and at the same time the most difficult decision is to take a break and rest. Put some things aside and delegate the rest, write a vacation application, get a good night’s sleep, change your surroundings at least for a couple of days. But this is not always possible. Therefore, psychologists recommend 4 Things to Do When Your Brain Is Tired a few more actions that can alleviate your condition a little.

“Turn off” some of your senses

Large sensory load: light, sound, conversations, tactile sensations - can be very exhausting. Try to exclude some irritants and spend at least a few minutes in silence and darkness. Buy blackout curtains for your room, turn off the TV when you're not watching it, don't leave music or the radio playing in the background, wear headphones when riding the subway.

This is not a radical solution to the problem, but this approach can at least slightly reduce overall fatigue and irritability.

Make fewer decisions

Put off life-changing decisions for at least a couple of weeks, try to reduce smaller ones: eat the same dish for lunch every day, order the same type of coffee, take the same route to work, prepare several sets of clothes in advance so that you can I didn't have to choose what to wear in the morning.

Having to make even such small decisions can be very draining, and taking a break will give you some strength.

Look at the plants

Researchers from the University of Melbourne conducted a small experiment. Participants were asked to look out the window at a nearby rooftop on which a small garden was laid out. Tests showed 40-second green roof views sustain attention: The role of micro-breaks in attention restoration that even after 40-second observations, participants became more focused and made fewer mistakes in their studies during the day. Keith Lee, the author of the experiment, believes that contemplating nature helps us focus and maintain a working mood.

Look out the window from time to time, especially if there is a picturesque view from there, go for a walk in the yard or in a nearby park.

Astheno-neurotic syndrome

Astheno-neurotic syndrome is manifested by chronic fatigue, apathy, increased fatigue and irritability. This disease is complemented by loss of appetite and insomnia. Physical signs are associated with apparent heart disease. It may seem to a person that he has a slow heartbeat, or vice versa – tachycardia. No changes are observed on the cardiogram. However, the patient feels pain in the heart muscle. Stomach problems and migraines are also possible. Diagnostics involves interviewing and examining a person. An examination is being carried out for a viral infection. The prognosis is favorable, especially if the person additionally attends art therapy sessions. Drawing has a relaxing effect on the psyche, negative thoughts dissipate, and the patient feels harmony.

Hypersthenic form

The first phase of asthenic neurosis is characterized by the dominance of excitability, irritability, and emotional instability. A neurasthenic person is not restrained in emotions, raises his voice in normal conversation, shouts during an argument or quarrel, and allows insults. The absent-minded attention of the sick person leads to a decrease in the productivity of any type of activity, since he is constantly distracted by irritants and has difficulty returning to the work process. The patient is haunted by dreams related to daytime events and problems. Having difficulty falling asleep, he often wakes up, and in the morning he feels exhausted and unrested.

Dysthymia – depressive neurotic disorder

The disease is characterized by a depressed state in the patient, which does not go away for more than 2 years. The pathology is characterized by decreased vital energy and increased fatigue. A person feels apathy and is unable to enjoy life. Self-esteem decreases and self-confidence is lost. Such people rarely share their emotions with others. The most severe consequence is suicide. The patient is referred to a psychotherapist. With timely treatment, dysthymia, or depressive neurotic disorder, is treatable.

Psychological causes of exhaustion

1. Constant experience of anxiety and despair.

The inability to cope with anxiety and despair leads to fatigue and indifference. This is how the body protects itself from unbearable experiences. Anxiety occurs when it is impossible to be sure about the future. Despair arises from the need to give up your goals or familiar things: a car, an apartment, a vacation abroad, or sausage for breakfast.

1. Insensitivity to your body.

There are people who were raised in such a way that they stopped listening to their body. They do not feel tired or pain. Some of them don't feel hungry. They just get very sick at some point. Sensitivity to your body can be restored through long-term psychotherapy.

1. All by myself, all by myself.

If you have a lot of responsibility, you may experience symptoms of burnout. Sometimes unbearable burdens are associated with objective necessity - for example, paying a mortgage in foreign currency and feeding children. But truly hopeless situations are extremely rare. In most cases, it is simply difficult to see the resources around you. Or it’s scary to share responsibility with other people. Or you lack the ability to ask for help. Or asking for help is humiliating for you, the same as admitting that you are a “weak”.

1. Unrealistic demands on yourself.

If the word “should” is more important to you than the word “want,” then this is a path to exhaustion.

"I must be successful." “I should buy a luxury car.” “I simply have to send my child to the best paid school.”

Constant demands on oneself may be a habit that appeared in the parental family. Or they can serve to maintain unstable self-esteem: if self-esteem depends solely on your successes and failures, then you are forced to waste a lot of energy.

1. The idea of ​​“everything depends only on me.”

Nowadays the idea is popular that we shape our reality, that everything depends on us. This is partly true, but it is also true that each person has his own limitations. If you “see the goal, believe in yourself and do not notice obstacles,” then reality can remind you of itself either as a lump on your forehead or as exhaustion.

1. Denial of the changed reality.

It happens that exhaustion is associated with an unwillingness to give up your goals and ambitions no matter what. Have you heard the phrase “The crisis is in your head”? Denial of reality is a defense mechanism of the psyche.

If you decide: “I will do everything possible to live as before, I will pay all the bills and go on vacation the same as before,” then you increase the likelihood of asthenia.

1. Refusal to mourn losses.

Some of the causes of exhaustion are related to the reluctance to grieve over fading opportunities. The experience of anger and sadness is so frightening that it is easier to drive yourself to exhaustion than to accept the new reality.

Symptoms of neurotic disorders

Neurotic dysfunctions are characterized by instability of mood and rash actions. Patients suffer from memory impairment, problems with concentration, and a number of other clinical manifestations:

1. causeless psychological stress;
2. increased fatigue;
3. sleep problems;
4. isolation;
5. fixation on problems in life;
6. memory impairment;
7. dizziness;
8. fainting;
9. migraine;
10. pain in the heart muscle and joints;
11. frequent urination;
12. excessive sweating;
13. decreased potency;
14. high or low self-esteem;
15. inconsistency, uncertainty;
16. tearfulness;
17. aggressiveness;
18. suspiciousness;
19. poor prioritization.

Symptoms of neurotic disorders are often complemented by increased sensitivity to light, sound, and reactions to minor temperature changes.

Signs of neurotic disorders

Signs of neurotic disorders vary by gender. In women, asthenic neurosis more often appears, characterized by aggressiveness, loss of mental and physical ability, and lack of sexual desire. During intimacy, it is impossible to relax. A woman suffering from asthenic neurosis quarrels with relatives and often loses her temper over trifles. Constant tension is fraught with the development of diseases of internal organs.

In men there are the following types:

• depressed – a person is not able to realize himself in the world of work, or adapt to sudden changes in any area of ​​life;
• male neurasthenia - usually appears after physical or moral overstrain; workaholics are susceptible to this type.

Men and women over 45 years of age are prone to these types of diseases. They may still have problems with the functioning of their internal organs.

Neurotic disorder syndrome

The syndrome of neurotic disorders is a reflection of a traumatic circumstance and is often combined with other neurotic manifestations. The patient's mood decreases, but there is no feeling of melancholy. Usually, a bad mood is combined with emotional lability, asthenia, mild anxiety, loss of appetite and insomnia. During the day, no special fluctuations are observed, or they are mild. Mental and motor retardation, self-flagellation, and suicidal thoughts are not typical.

1. Neurotic depression is distinguished from reactive depression, which is also caused by traumatic circumstances. In the second type, the symptoms reach the level of reactive psychosis - the patient is depressed, inhibited, consciousness is narrowed, and thoughts of suicide appear.
2. In the case of psychotic depression, the patient wishes to die, there is gross disorientation of the personality with separation from life, sudden anosognosia, delusional ideas of self-humiliation, manic episodes. The condition can be controlled with antidepressants and a repeated course of treatment.
3. Neurotic depression is characterized by the preservation of the basic personality qualities, the patient is aware of his condition. Obsessive phobias and pronounced hysterical manifestations appear.

Important! Psychotic depression is more dangerous for a person and requires immediate treatment.

Levels of neurotic disorders

Neurotic disorders occur at 3 levels: as a manifestation of individual symptoms, at the level of minor syndromes, and as specific disorders.

Levels of neurotic disorders.

1. Individual symptoms. They are also present in those who do not suffer from mental disorders.
2. A minor emotional disorder can be complemented by several neurotic syndromes, of which the leading one is not identified.

The patient population consists of 2 types:

• some suffer from an acute, short-term stress reaction;
• others experience long-term, chronic impairment.

Most patients recover within six months, while others recover in no less than 3 years.

Hyposthenic form

It can develop as the next phase of asthenic neurosis or occur immediately in people with an asthenic psychotype. At this stage, a patient with neurasthenia suffers from mental and physical weakness, lethargy, low mood, lack of interest in any activity, and passivity. Feelings of sadness and anxiety haunt him constantly, causing emotional instability. A neurasthenic person is prone to tearfulness, touchiness, and complaints about his health. Being focused on his sensations, he cannot concentrate to perform intellectual tasks or physical work. Asthenic neurosis can be either an independent disease or a harbinger or manifestation of more serious, difficult to treat mental disorders - schizophrenia, atypical depression. Neurasthenia can also be a symptom of somatic diseases - HIV, tuberculosis, oncology, etc. Therefore, it is so important to consult a specialist in time when the first signs of the disease appear. An experienced psychiatrist or psychotherapist at the Neopsy Mental Health Center is able to differentiate this disorder from other diseases and prescribe effective treatment with a lasting positive therapeutic result.

Diagnosis and treatment of neurotic disorders

A person should contact a psychologist or psychotherapist. Diagnostics requires an integrated approach.

The color technique is widely used.

1. All shades take part in it. Neurosis-like syndrome is noted when a person selects or repeats gray, purple, brown or black.
2. With hysterical neurosis, the patient chooses 2 colors - purple and red. This also indicates low self-esteem.

To determine the symptoms, a test is carried out - it makes it possible to identify the presence of chronic fatigue, anxiety, and self-doubt. Diagnosis and treatment of neurotic disorders are closely interrelated.

Drug therapy is used in the first stages to relieve internal tension and eliminate insomnia. Antidepressants and tranquilizers are widely prescribed. Depending on the severity and duration of the clinical picture, the doctor prescribes drugs from different groups to the patient:

• non-selective – Amitriptyline, Imipramine;
• selective influence - Maprotiline, Fluoxetine;
• sedative antidepressants – Doxelin, Azafen;
• balanced – Sertalin, Tryptophan;
• stimulants - Heptral, Bupropion.

Obsessive states are well relieved by drugs from the SIDS group - Prozac, Paroxetine, Escitalopram. Frequently prescribed tranquilizers include Phenazepam, Tofisopam, Meprobamate. All medications are prescribed in a short course of 5-7 days, sometimes extended to 10.

Important! If a person self-prescribes medications, the disease may transform and the condition may worsen.

Psychotherapy for neurotic disorders

To achieve maximum effect, doctors recommend supplementing drug treatment with rational, cognitive psychotherapy. The main objective of this technique is to eliminate the consequences of a stressful situation so that the general condition of a person improves and the symptoms of neurosis are eliminated. The doctor discusses the cause of the problem and works through the traumatic circumstances. The patient learns relaxation techniques, the ability to level out negative emotions and complexes. The most difficult thing to eliminate is negative attitudes given by parents. A person must show his will, diligence, and do his homework. Typically, psychotherapy for neurotic disorders consists of 7-15 sessions, depending on the degree of complexity of the problem. In severe cases, the patient is admitted to the department of borderline mental disorders.

How to overcome nervous irritation

Effective restoration of the body is possible only under the supervision of qualified doctors. The Korsakov Psychiatric Center is one of the modern institutions where the infrastructure has been developed to provide proper care and treatment in Moscow for this type of disorder, addiction and psychological illness.

A qualified psychiatrist prescribes treatment after diagnosis and guarantees positive dynamics in the recovery process.

We also recommend reading the article about low-grade schizophrenia.

Prevention

It is possible to prevent the development of neurotic disorders by leading a healthy lifestyle. It is important to sleep 7-8 hours a day, go to bed before 1.00, resolve internal conflicts in a timely manner, and avoid stress. If a person’s work involves difficult situations or psychological overload, it is worth thinking about changing the sphere of work.

Prevention of neuroses: effective tips.

1. Do not abuse alcohol or smoking. Intoxication provokes a deterioration in adaptive capabilities, and various diseases appear. When drinking alcohol regularly, the psyche suffers and a severe hangover occurs.
2. The food menu should always include a lot of vegetables, fruits, lean meats and fish. It is advisable to rely on dairy products and take a course of vitamins in the off-season. Overeating is also dangerous; you need to consume food in moderation.
3. Music. This is an effective prevention method that involves listening to calm melodies. This could be the sound of rain or sea, falling snow and other natural phenomena. You should listen to soothing music before bed, or after a stressful situation. It can be found on YouTube, social networks, it is advisable to record it on a smartphone so that you can always relax.
4. It is important to exercise in moderation. Physical activity is the key to mental health. It is advisable to do exercises every morning or evening, you can join a gym, go to the pool 2-3 times a week.
5. Plan your actions, act according to the plan. Then there will be fewer stressful situations if a person does not let everything take its course.
6. Treat all diseases in a timely manner. Regular pain causes emotional stress.
7. It should be remembered that family conflicts, especially constant ones, cause serious stress. Family is the rear, not the battlefield. If there are problems in your personal life and they are not resolved, it is better to change your partner.

If it was not possible to prevent neurosis, you need to seek help in a timely manner. Then the chances of leveling out the negative psychological state are maximum.

Proper diet

Nutritionists have developed a special diet for those who want to stop being nervous and start enjoying life. If the body lacks potassium, calcium, magnesium, phosphorus and iron, then the nervous system and the entire body will suffer. It is especially important to ensure that the body receives the required amount of magnesium.

• You need to eat buckwheat, oat and wheat porridge more often.
• Phosphorus relieves muscle tension and stabilizes the functioning of the nervous system. The trace element is present in milk, cereals and beans.
• Calcium – regulates the functioning of muscles and nerves. Contained in milk, nuts and cabbage.
• Iron – contributes to the normal functioning of the thyroid gland, ensures normal metabolic processes. Present in seafood, river fish, fruits, green vegetables, baked goods.
• Potassium – normalizes the smooth functioning of nerves and muscles, prevents stress and nervous breakdowns. The lack of microelements can be compensated for by vegetables, fruits, lean meat and fish, and dried fruits.

What happens if a neurotic disorder is not treated?

Neuroses can cause complications if left untreated. Many people ignore therapy and do not go to doctors. Post-Soviet stereotypes that going to a psychotherapist is shameful still live in people’s heads. Such negligence entails irreversible changes in the psyche.

What happens if a neurotic disorder is not treated:

• increased symptoms;
• the patient becomes hysterical and hypersusceptible;
• self-esteem suffers;
• other chronic diseases appear;
• the risk of catching a cold increases;
• the formation of an explosive personality that does not tolerate returns, is aggressive, and concentrates only on the negative.

A person becomes a hypochondriac, his personality is destroyed. The last stage is caused by complete apathy, the person does not get out of bed, and may refuse food. The patient is no longer able to do without medications or control his emotions. High risk of suicide. It is extremely difficult to treat this condition; it can lead to more serious mental pathologies. You cannot do without long-term psychotherapy, taking medications and staying in a neurosis clinic.

Irritable weakness

This is the next phase of the disease if adequate treatment was not carried out in the first. From the name it is clear that the stage is characterized by increased irritability against the background of increasing mental exhaustion. Easily excited for any reason, the patient, after a short-term, bright burst of temper, feels powerless. The state of excitement is easily replaced by a feeling of resentment and crying. Concentration and concentration are difficult, causing fatigue, headaches and other painful sensations of various localizations. Repeated distractions from the work process with the desire to take a break do not relieve fatigue, and returning to work does not bring the expected results, which leads the neurasthenic to severe mental exhaustion.

What is the difference between emotional exhaustion and fatigue?

If you are tired, you can regain your resource with a couple of days of rest. It’s enough to get enough sleep, spend the weekend without the phone and work issues, read a good book, agree with a trainer about training, take a bubble bath, and take a walk. And you are easily filled with strength and energy.

When it comes to burnout, you can't get rid of it in one walk. Over time, it can only get worse. From stress and constant nervous tension, sleep worsens, irritability increases, and conflict situations arise more often at home and at work. How does emotional exhaustion develop? How to deal with it?

How does depression develop in stages?

At first, the patient experiences a depressed state, which he himself attributes to fatigue, a hard work week, drinking alcohol and other reasons. At the same time, he wants to retire from others and at the same time is afraid of being left alone.

Then the stage of acceptance occurs: awareness of a dangerous condition occurs, the problem gets worse, the intensity of negative thoughts increases, the body and immune system malfunction.

The third stage - in the absence of adequate therapy, the patient loses control over himself, aggression increases.

Pathogenesis of emotional burnout

From an evolutionary and physiological perspective, humans are adapted to acute stress and respond to it with either flight or fight. This is the hereditary mechanism that has allowed the human species to survive.

The physiological response to stress occurs in three stages:

1. Alarm phase.

   It implements the hypothalamic-sympathetic-adrenergic axis, which involves the hypothalamus (a region of the brain), the sympathetic nervous system (or activator) and the medullo-adrenal glands.

   The sense organs (vision, hearing, smell, touch) perceive the stress factor and transmit information to the limbic system of the brain. The hypothalamus, a specific area of ​​the brain, receives this information and triggers a range of responses that facilitate flight or fight. The first reaction is immediate and follows the path of the autonomic nervous system: it occurs automatically, not consciously.

   The so-called sympathetic nervous system, a component of the autonomic nervous system, produces norepinephrine and activates the adrenal medulla (the central parts of the adrenal glands, the glands located above the kidneys), which in turn produce epinephrine and norepinephrine.

   These two substances, called catecholamines, increase heart rate, pulmonary ventilation, alertness, sensory acuity (pupil dilation), and blood sugar levels. The muscles tense, and so do the smooth muscle cells of the artery walls, hence the increase in blood pressure.

   The whole body is ready to fight or flee almost immediately. Everyone is familiar with the expression “adrenaline rush” and the sensations associated with it.

   In addition, norepinephrine activates two other areas of the brain: the amygdala and hippocampus. The amygdala analyzes and evaluates the severity of a situation compared to past experiences. The hippocampus is responsible for remembering experienced events and recording new information.

2. Resistance phase.

   It concerns the hypothalamic-pituitary-adrenal axis or corticotropic axis, in which the hypothalamus, pituitary gland and cortico-adrenal glands intervene.

   If the stressor persists, the hypothalamus activates the pituitary gland by producing corticotropin-releasing hormone or corticoliberin. The pituitary gland, in turn, activates the adrenal cortex, which produces cortisol, also called hydrocortisone.

   Cortisol is used to release energy from fats and carbohydrates to keep muscles working. In addition, cortisol, like the drug cortisone, has an anti-inflammatory effect: a person can run very fast or get injured, but does not feel pain at this moment.

   Cortisol also tends to travel into the brain and activate the hippocampus, an area of ​​the brain involved in memory and learning. In a physiological situation, the hippocampus slows down the hypothalamus. This is negative feedback control of the stress response.

   During the resistance phase, the corticotropic axis remains active, with corticotropic hormone and cortisol levels increasing and remaining high. This phenomenon is called the burning phase.

   Corticoliberin has a depressive and anxiety-producing effect, which explains the symptoms of people in a state of chronic stress: depression, anxiety.

   Elevated cortisol levels are toxic to the hippocampus, which gradually loses its ability to slow down the hypothalamus and the ability to remember events. This explains the deterioration of immediate memory and learning ability.

   In addition, levels of certain neurotransmitters fall in the central nervous system (brain and spinal cord). For example, dopamine (“the hormone of happiness”), associated with attention, initiative, pleasure, and serotonin (“the hormone of well-being”), associated with a feeling of completeness and satisfaction.

3. Exhaustion phase.

   Under conditions of chronic occupational stress, modern man can neither run nor fight most of the time. He experiences repeated stress, sometimes for long periods of time.

   When the burn-out state persists, the adrenal cortex becomes exhausted and cortisol production drops. Hypotension may be a sign of adrenal fatigue.

   There comes a point when a person no longer has energy. He is in a situation of physical, mental and emotional exhaustion. He is depressed, deficient in dopamine and serotonin. This phenomenon is called the burnout phase.

   The person becomes susceptible to infections. In people with burnout, there is a decrease in the activity of some immune defense cells, natural killer cells, and a decrease in the CD4 + / CD8 + ratio. CD4+ T cells are lymphocytes (white blood cells) that enhance the immune response.

   CD8 are suppressor or cytotoxic lymphocytes: they are able to prevent certain reactions and kill abnormal cells. The normal ratio is 2:1. A decreased CD4+/CD8+ ratio suggests abnormal functioning of the immune system with possible immunodeficiency.

   Burnout is associated with increased levels of proinflammatory cytokines, chemical mediators of inflammation, and reactive C protein, another marker of inflammation.

   Read also:  How to stop degrading and start developing? Analysis of 10 excuses and 4 effective tips to get the ball rolling

   VEGF (Vascular Endothelial Growth Factor) increases blood circulation in people with burnout. VEGF causes the formation of new blood vessels (which is unfavorable in cancer) and increases microvascular permeability.

   Conversely, the protein BDNF (brain-derived neurotrophic factor) reduces circulating levels. BDNF promotes the survival of existing neurons and the formation of new ones. It is present in the central and peripheral nervous system, with prominent activity in the hippocampus and cerebral cortex. Decreased BDNF levels suggest a decrease in the brain's ability to maintain and repair itself.

Consequences of emotional burnout

Ignoring burnout can have serious consequences. They can be like this:

• Chronic fatigue;
• Insomnia;
• Alcohol or substance abuse;
• Heart disease;
• High blood pressure;
• Diabetes mellitus type 2;
• Vulnerability to disease.

Therefore, it is so important to diagnose this syndrome in time and try to correct it as soon as possible.

“Emotional burnout can lead to quite serious consequences. It's not just weight changes or sleep disturbances. A whole cascade of pathological reactions in the body is launched.

The menstrual cycle is disrupted, ovulation disappears, which can lead to infertility, PMS develops, and many develop benign tumor-like diseases - fibroids, cysts, mastopathy, endometriosis. Some women begin to bleed, while others may miss their periods. Memory and concentration decrease significantly, it becomes difficult to work, study, and absorb new information. The nervous system cannot adapt to what is happening and fails. For some, this can result in neurosis or aggression, for others - in depression. Depletion of the entire endocrine and immune system leads to the development of a variety of diseases against this background - from systemic to oncological. And it is very important to stop this process in time.”

Lyudmila Vladimirovna Mudragel

obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostics doctor, specialist in aesthetic gynecology, doctor of integrative and anti-aging therapy

Experience: 23 years

Diagnosis of emotional burnout

Burnout is quite difficult to diagnose because it has no specific physical symptoms. However, its treatment is more effective when it begins after the first signs appear, which we described above.

You can seek help from a psychotherapist or an anti-aging doctor. The doctor will collect a family history, analyze working conditions and offer testing.

For this purpose, for example, there is the Maslach Burnout Inventory (MBI), which is used to assess the degree of emotional burnout and consists of 22 questions.

There are other questionnaires of the same focus: the Oldenburg Professional Burnout Questionnaire, the Copenhagen List, the Shirom-Melamed burnout indicator model and others. However, none of these tools provide a diagnosis that needs to be supplemented by clinical examination.

You will likely need to undergo laboratory tests to rule out underlying inflammation, infection or allergies, and analyze your eating habits to suggest any nutritional deficiencies.

“For a long time, we write everything off as fatigue or a difficult period in life. And only when problems arise at work, relationships in the family or with a partner deteriorate, or depression sets in, the question arises, where to go for help?

Since burnout leads to significant changes in hormonal levels, menstrual irregularities, decreased libido, weight changes, sleep disturbances, and the development of anxiety, such women turn to a neurologist, an endocrinologist, or a gynecologist for medical help.

But more often than not, the correct diagnosis is not made, and they do not receive effective therapy. That is why it is important to work with an integrative doctor who can understand the cause of what is happening and comprehensively influence the body, restoring all damaged links in this chain. Only an integrated approach to the treatment of such conditions can be successful.”

Lyudmila Vladimirovna Mudragel

obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostics doctor, specialist in aesthetic gynecology, doctor of integrative and anti-aging therapy

Experience: 23 years