The neurasthenic patient

  1. Gastroepato
  2. Phsichiatry
  3. The neurasthenic patient
  4. Stress clinic


Calmness is the virtue of the strong

It also means that who can tolerate frustrations is strong and he has a good mental health.

 It means that the neurasthenic loses calm easily and does not tolerate stressful conditions, for example,  a boss who breaks the soul, disturbs, pretends, snares and stresses

The real fact.

In August, the undersigned webmaster goes into a refueling to put diesel  in his poor FIAT Punto, under a scorching sun.

A guy has just parked  front at an other pump that dispenses only diesel, while he has to put gasoline in his car.

The column where I am, instead, delivers gasoline and diesel fuels and I  have already placed my car in this place with a fast maneuver.

He comes to me and looks at me  with a badass appearance, to try to make me move, but the voice and hands shake, while he tells me with threatening tone:

- Do you always do that?

I answer joking:

- Even worse!"

 He does not know what to do but I understand that I am in front of a neurotic and to avoid the collision, otherwise I should defend and raise my hands against him, but like  a pacifist,

 I prefer to avoid the blow! With a smile I put in motion and go a few meters forward. While the amused looking pump-driver makes me gesture that we are facing an exhausted guy, a nevrotic!

The guy parks the car behind me, at the right pump, as I gave him the faculty: I go down and look at him with aplomb.

The guy gets clumsy and sweaty, and unplugs the pump and thinks to put gasoline, but the fuel doesn't go  because he is at an automatic pump and   has before to  put the card or cash.

A few minutes later he realizes the thing and goes to the machine to insert the banknotes and choose the number of the pump, but he cannot because his hands are shaking; he snorts, pants but wants to seem a bully at all costs !

He is a subject with anxiety neurosis that hides its insecurities behind arrogant attitudes.

Neurosis is a group of personality disorders that, although not involving a substantial fracture with reality, are characterized by an altered intra- and inter-personal relationship linked to conflicting problems and the emergence of freely fluctuating anxiety or converted into symptoms.

Etiopathogenesis

Neuroses must be considered from a multifactorial point of view, so that the current psychiatric orientation is aimed at overcoming the "neurotic" phenomenon by evaluating and understanding the type of interpersonal relationships that the subject establishes with his socio-cultural and family group. Depending on the schools and addresses, neuroses are considered:
* as external manifestations of endopsychic conflicts (psychodynamic disorders);
* as results of conflicts arising from alterations in "significant" interpersonal relationships (sociodynamic disturbances);
* as «products» of a pathogenic social environment (socio-genetic disorders);
* as results of learning disorders with the structuring of maladaptive behavioral models (behavioral disorders);
* as abnormalities of abnormal personalities thus understood in the genetic-constitutional sense (constitutional problems).
 

Classifications of neuroses

A classification of neurosis should be understood in a non-absolute sense but in an indicative form, both for the continuous development of our knowledge on the subject, but above all for the practical impossibility to reduce the individual neurotic experience in a rigid schematism. Provisionally. and in the absence of alternative and more valid models on the heuristic-cognitive and pragmatic level, we refer to the traditional classification:
1) Neurasthenic neurosis (and hypochondriac)
2) Anxiety neurosis
3) Obsessive neurosis
4) Phobic neurosis
5) Hysterical neurosis
6) Post-traumatic neurosis

The neurasthenic neurosis

Symptoms of nervous exhaustion include:

Physical and / or mental asthenia (neurasthenia);
Easy fatigue;
Headache;
Depressive disorder;
Nervous system disorders;
Disorders of sleep, attention and mood;
Emotional-emotional changes (feelings of insecurity, distrust, tension, nervousness);
Psychomotor agitation, hyperemotivity;
Hypochondria;
pathophobia;

Neurasthenia is characterized by:

A) a state of anxiety that is subcontinuous with the characteristics of the «neurasthenic alarm»; B) hypochondria; C) basic "asthenic" personality.
A) Anxiety takes the aspect of "alarm": an apprehension and anxious doubt about one's physical condition, focused from time to time on various organs and functions. Characteristics of the cenestopathy (alarm psychology) which are the main reason for the patient's complaints and headaches, occipital headaches, rachialgia, dyspeptic disorders, subjective sensations vertigo or uncertain walking, visual disturbances without any objective data, disorders of the sexual sphere. In the absence of such locations, neurasthenics constantly complains of easy fatigue, a general feeling of physical and intellectual asthenia, sleep disorders.


B) The tendency towards hypochondria typical hypothesis leads to a vicious circle: alarm- »hypochondria-cenestopathy-» alarm, a continuous self-reinforcing of the elements of this neurotic circle. This leads to hypochondriacal neurosis, where the patient's interests are narrowed around the nucleus of anxious preoccupation with one's own health and, according to psychodynamic interpretation, neurasthenic neurosis represents a defensive modality of anxiety resulting from environmental situations provoking frustrations. and humiliations with resentment and rancor not expressed. "Neurasthenia" represents a defensive system against one's hostility. Differential diagnosis: a) with the neurastheniform syndrome of some initial modalities of schizophrenia; b) with endogenous depression; c) with neurasthenic syndromes that mark the beginning of organic diseases.

Characteristic of neurasthenics is the attribution of enormous importance both to the doctor and to the drugs, almost with a magical attitude, which is also reflected in an equally easy loss of confidence both in therapies - which regulate, are never completed - and in the doctor, so the history of these subjects is studded with an endless series of consulted health care and therapies practiced «without results». The mood of neurasthenics is oriented towards pessimism. Episodically, more pronounced mood swings can occur and then the picture can change to neurotic depression on a neurasthenic basis (especially after debilitating intercurrent malignancies).


C) The basic personality is characterized by an insecurity and uncertainty of feelings related to one's physical individuality ("asthenic" personality).

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