We often ask ourselves the question: "why am I so tense", "why everything and everyone around me annoys me", "why can't I sleep"? In fact, mostly patients with neurosis come to neurological offices with such complaints. For an answer to the questions posed by our reader about neurosis, neurasthenia and nervous disorder, we sought Dr. Veselin Gerev, psychiatrist. It treats conditions of anxiety, restlessness, tension, panic attacks, depression and insomnia
He graduated in medicine at VMI - Plovdiv. He specialized in psychiatry at the psychodispensary in Plovdiv, worked as a consultant at the Military Hospital and DCC "St. Doctor”. He specialized in University Clinic Frankfurt/Main-Germany. He has participated in training programs of the World Association of Biological Psychiatry.
Dr. Gerev, are neurosis, neurasthenia and nervous disorder different diseases?
- These concepts are absolutely identical. What is more important is what changes they lead to in the nerve cells and the psyche and what needs to be done so that a person can recover as quickly as possible. Neurasthenia, neurosis and nervous disorder are concepts that have acquired citizenship. The scientific name for this condition is neurotic disorder. It is specified according to the symptoms whether it is an anxiety state, whether it is an anxiety-depressive state, whether it is just a state of fear and anxiety, nervous tension, sleep problems.
What is a neurotic disorder and what are its most characteristic clinical manifestations?
- Generally speaking, it is a state of nervous tension, anxiety, restlessness, insomnia and the most important associated with these symptoms, moments of somatization - blood pressure fluctuation, palpitations, sweating, headache, numbness of arms and legs, heaviness in the stomach, nausea, vomiting, a feeling that the legs are numb and one cannot walk. In general, these are the somatic symptoms of a nervous tension. Of course, you don't have to have all of these symptoms. Usually they rotate several times and with each crisis the symptoms are different.
The symptoms you described are very similar to those of common diseases such as high blood pressure, stomach problems, etc. How can one understand that the problem is elsewhere - in the psyche?
- Usually, such people first end up in cardiology emergency rooms or the ER because they have high blood pressure, very severe dizziness, loud tinnitus and palpitations. These symptoms make them feel like they are having a heart attack or stroke. After they get a cardiogram, they are usually told that they have a nervous heart and that they won't get better cardiologically until they get their head in order.
All these symptoms are accompanied by fear for he alth, for life and are very dramatic. However, a person must have at least one cardiogram for such complaints to rule out a more serious he alth problem. When the organic component is excluded, the person finds his way to us - the psychiatrists.
What treatment do you use for these conditions? It will be important for our readers to learn which treatment is more effective - medication or psychotherapy?
- Medicines and psychotherapy are used in the treatment of neurotic and depressive states. We use certain groups of specific medications that are effective and successfully administered. Individually and after a careful assessment of the symptoms, the severity and the duration of the condition, a specific selection of the medications, their dosage, method of administration and duration of treatment is made. Often it is long-term - several months. For the treatment to be effective, a good therapeutic relationship between the patient and the doctor is needed. A psychotherapeutic approach, periodic control examinations and systematic monitoring are necessary. It is not possible to give an unequivocal answer to the question of whether drug treatment is more effective or psychotherapy. In some conditions, drug treatment is more effective, in others - psychotherapy, in third conditions - both types of therapy, and in a fourth, the most effective is the combined application of drug treatment and psychotherapy.