What are the characteristics of neurasthenia?
Neurasthenia is a kind of mental illness, and it is a neurosis prone to excitement and fatigue, which often causes emotional distress and psychological and physiological symptoms. There are standards for the diagnosis of neurasthenia. Neurasthenia is a dysfunctional disease with various clinical symptoms, but to diagnose this disease, it should have the following five characteristics: (1) neurasthenia patients have obvious weakness or persistent fatigue symptoms. If you often feel lack of energy, listlessness, brain failure, memory loss, mental retardation, inattention in study and work, and work efficiency is obviously reduced, even full rest can't eliminate fatigue. General examination, no physical diseases such as hepatitis, no brain organic lesions. (2) Any two of the following symptoms: ① excitability and fatigue. (2) Emotional fluctuations, easily excited, impatient, worried and nervous. ③ Tension headache or muscle pain caused by emotional tension. ④ Sleep disorder. It is difficult to fall asleep, easy to wake up and dreamy. (3) The above situation has a negative impact on study, work and social interaction. (4) The course of disease is more than 3 months. (5) Exclude other neurosis and psychosis. In addition, when diagnosing neurasthenia, we should pay attention to distinguish it from other diseases that may cause similar neurasthenia syndrome. Chronic consumptive diseases such as tuberculosis, hepatitis, rheumatism, hyperthyroidism and diabetes often produce physical and mental fatigue and are easily misdiagnosed as neurasthenia; Chemical occupational poisoning caused by occupational relationship often takes neurasthenia as the early symptom; There are also chronic inflammation of the head, such as chronic rhinitis, chronic sinusitis and chronic pharyngitis. , and often appear neurasthenia syndrome. Therefore, a comprehensive understanding of the medical history, careful physical examination, combined with necessary laboratory tests, can generally be diagnosed. Symptoms 1. Excited and irritable. 2. Mental fatigue is easy. If you read and study for a long time, you will feel bloated and dizzy. Lack of concentration. 3. Headache and loose posture. 4. Sleep disorders are mostly difficult to fall asleep, wake up early, or it is difficult to fall asleep after waking up, and there are many nightmares. 5. Vegetative nerve dysfunction, including tachycardia, sweating, anorexia, constipation, diarrhea, menstrual disorder and premature ejaculation. 6. The concept of secondary hypochondriasis. Summary of clinical manifestations The clinical manifestations of neurasthenia patients are complex, and there are many kinds of mental symptoms and physical symptoms, which can be summarized into six categories: mental deficiency syndrome and mental burnout. When stimulated by internal and external stimuli, the nerve cells of neurasthenia patients are easily excited and consume too much energy. If this situation persists for a long time, patients will show a series of debilitating symptoms: patients often feel lack of energy, listlessness, inability to use their brains, or mental retardation, inattention and memory loss. Sensitive to internal and external stimuli in daily work and life, reading newspapers, watching TV and other ordinary activities can often be used as a kind of entertainment and relaxation activities. However, at this time, patients with this disease can not only relax their nerves and eliminate fatigue, but are particularly excited and can't help thinking about it. Past scenes are displayed in front of our eyes, our eyes are watching TV, and our brains are often "showing movies". Especially before going to bed, the patient should fall asleep quietly, but he can't help but recall and associate the past, and he is too excited to sleep, which is deeply distressing. In addition, some patients are particularly sensitive to the surrounding sounds and light, and they are "haggle over every ounce" about the changes of their own strength, which leads to distress. Some doctors believe that this is because the patient's "sensory threshold" has dropped. The so-called "sensory threshold" is the minimum stimulus intensity that our body can feel. There are always different stimuli around us and inside our bodies, but not all of them can be felt by our senses. If the stimulus intensity is too weak, we won't feel it. Only when the stimulus intensity reaches a certain level can it be perceived by our receptors. The lowest stimulus intensity we can feel is called "sensory threshold". People and some animals have different sensory thresholds. For example, dogs are much more sensitive to smell than people's noses. When a certain smell is weak, dogs can distinguish it, but people can't perceive it, which shows that the threshold of dogs' perception of smell is much lower than that of people. Therefore, dogs can be police-police dogs, and they are the police's right-hand man to solve crimes. Combining the symptoms of many patients, the characteristics of neuroticism can be summarized as follows: ① No organic diseases; ② The more patients pay attention to a certain part and a certain symptom, the more obvious the pain will be. If the patient diverts attention, it will be obviously relieved or even eliminated. (3) The distribution of lesion site does not necessarily conform to anatomical site, and its position is not fixed or may change; The symptoms described by the patient are numerous and complicated, which makes people irrelevant. After talking for a long time, he finally couldn't figure out what was wrong with him. Emotional fluctuation, irritability and impatience are undoubtedly the decisive factors that cause and influence people's emotional activities, but they are not the only factors. Why do different people react differently to the same stimulus? This is because man is the tallest animal in nature, and conscious spiritual life has a strong restrictive effect. Of course, this limiting effect varies from person to person and is mainly determined by the internal inhibition of nerves. Patients with neurasthenia are easily excited when they encounter something (stimulus) due to the weakening of internal inhibition, thus lacking the patience and necessary waiting of normal people. Often manifested as: ① anxiety and worry about various contradictions and difficulties in life, even if it is easy to solve, normal people may "disdain". He always feels that there are many difficulties that he can't solve, and even sighs and pulls a long face all day. If you feel unwell, you will be more worried and nervous. For example, patients are worried about gastric cancer or other incurable diseases because of abdominal distension and anorexia. This is a hypochondriac psychology. Some doctors believe that 40% of neurasthenia patients have a short and mild depression during the course of the disease. The patient blames himself or hates others for what has happened, but I won't have suicidal attempts or thoughts. ② Emotion and anger help us to deal with problems calmly. Patients with neurasthenia, due to the decline of internal inhibition, are characterized by large emotional fluctuations, and they are furious or overjoyed without careful analysis and identification of various stimuli, lacking the patience of normal people. Show impatience, like to quarrel with others, and lose your temper with others if you are slightly dissatisfied with your work. If you meet good news, you will be overjoyed and burst into tears immediately. Tension pain is usually caused by tension, and tension headache is the most common. Patients feel heavy head, bloated head, tight head or stiff neck, and some also show muscle pain in back and limbs. The degree of this pain has no obvious relationship with fatigue, and even rest can't relieve it. The manifestations of pain are often complicated, which can be manifested as persistent pain or intermittent pain, and some patients also show dull pain or tingling. Generally speaking, neurasthenia patients have various manifestations of tension pain, but they are closely related to emotional tension. Insomnia and dreamy sleep is one of the best ways for human brain to rest. Generally speaking, about 1/3 of life is spent in sleep. During sleep, the subcortical layer of the cerebral cortex is in a state of extensive inhibition, which is regulated by the specific center in the brain stem, so that the brain can be reorganized, rectified and restored. Neurasthenia patients are easy to get excited because of the decrease of inhibition in cerebral cortex, and it is difficult to cause extensive inhibition and diffusion during sleep, and it is difficult or not deep enough to fall asleep, and it is easy to wake up or sleep for too short a time, or it is difficult to fall asleep again after waking up. After a long time, it is bound to form intractable insomnia. After insomnia, dizziness and listlessness during the day make the study and work inefficient, and patients feel deeply painful. In the evening, I worry about insomnia. Therefore, insomnia due to anxiety, anxiety due to insomnia, mutual cause and effect, repeated influence, and finally insomnia due to neurasthenia. Patients with neurasthenia often complain that they can't sleep. The typical process is: I look dizzy before going to bed, but after going to bed, my brain can't calm down, my mind is active, I think wildly, and I am very anxious. The more anxious they are, the less they can sleep. Patients may try various methods to calm themselves down or do other relaxation tests, but it is often ineffective. At this time, the patient is particularly sensitive to all kinds of sound and light stimuli around him. The ticking of the clock, the horn of the car, footsteps, the snoring of others, outdoor lights, music, etc. Will be the cause of his insomnia. The patient can't wait for any light and sound around him. But even in a very quiet environment, patients will have "reasons" for insomnia. For example, their heartbeat will be very annoying and they can't sleep, so they can sleep for a few hours. Soon, it's time to get up at dawn. Psychophysiological Disorders For some neurasthenia patients, the chief complaint (the most painful and main symptom of patients) may not be the above five kinds, but a group of symptoms of psychological disorders, such as dizziness, dizziness, palpitation, chest tightness, shortness of breath, frequent urination, excessive sweating, impotence, premature ejaculation, irregular menstruation and so on. It is easy to cover up the basic symptoms of this disease. Anxiety is one of the basic symptoms of many patients. Anxiety may be a secondary symptom of fatigue, memory disorder and insomnia. Patients often worry about some problems in real life or worry too much, and also worry about some unpredictable dangers that may occur in the future. Generally speaking, the clinical manifestations of neurasthenia patients are more complicated, and it is generally believed that the main manifestations are lack of brain power, insomnia, sensitivity, mood swings and so on. Manifestations of physiological disorders caused by neurasthenia (1) Vegetative nerve dysfunction: palpitation, chest tightness, hyperhidrosis, dyspepsia and menstrual disorder; (2) Tension pain: manifested as head tightness, heavy head, stiff neck and muscle pain in limbs; (3) Sleep disorder: The symptoms of sleep disorder are the decrease of cerebral cortex and the decrease of nerve excitability due to long-term stress; Neurasthenia does not develop into schizophrenia. A patient with neurasthenia consulted a doctor: after years of poor medical treatment, will neurasthenia turn into schizophrenia? The doctor will tell you clearly: no, psychologists point out that neurasthenia and schizophrenia are two completely different diseases. There are not only fundamental differences in clinical manifestations, but also differences in etiology, treatment methods, drug use and prognosis. In long-term clinical research and observation, neurasthenia has not developed or transformed into schizophrenia. Mental health experts found in clinical research that some patients with schizophrenia did have neurasthenia symptoms such as dizziness, headache, general malaise, mood swings, paranoia, insomnia and memory loss in the early stage. However, there are essential differences between schizophrenics and real neurasthenia. Unlike the latter, the former is not as anxious and attaches importance to his own disease, and often leaves it alone, lacking the initiative to seek treatment. Moreover, the emotional reaction of schizophrenic patients is obviously reduced, and they are indifferent to others, irresponsible to their work and lack enthusiasm for their loved ones. Some schizophrenics also show strange thoughts and behaviors that people can't understand and so on. Pharmacologists in China suggest that schizophrenia is difficult to treat and easy to relapse. The treatment should be timely, systematic and thorough, and the medication should be timely, quantitative and uninterrupted. Society, families and doctors should be patient, considerate and reasonable when taking care of patients.