Hysterical neurosis is a manifestation of mental discomfort directly related to the pathological transfer of internal conflict to somatic soil. Characteristic are motor (tremor, problems with coordination, aphonia, convulsions, paresis or paralysis), sensory (impaired sensitivity) and somatic disorders (disruption of the internal organs), as well as hysterical seizures. The diagnosis is established on the basis of serious complaints that do not correspond to reality. Treatment activities include psychotherapy, general health promotion and the elimination of current clinical symptoms.
Hysterical neurosis is a form of mental disorder associated with the desire to attract attention. More often, hysterical disorders are manifested in persons with an unstable psyche. These people are usually emotionally unbalanced, any change in the situation causes a strong reaction from them. The immaturity of the psyche is manifested by increased suggestibility and impressionability. At the same time, patients have narcissistic qualities. They have a desire to draw attention to their own person by any means, which further translates into manipulation of others.
Often hysteria is observed in children whose parents suffer from mental disorders or alcoholism. Women get sick much more often than men. The share of hysterical neurosis accounts for about 30% of all types of neurosis. The nature of the patient with hysteria is characterized by theatricality and demonstrativeness (89%), egocentrism (97%), the desire to focus on his person (84%), the desire to become a leader in the family or school, manipulate people (80%), excessive sociability and fantasies that result to deceit (86%), infantilism (58%), heightened suggestibility (78%), high self-esteem (88%), self-dramatization (77%).
Causes of Hysterical Neurosis
The hysterical warehouse of the psyche is not the only psychopathy that can later on acquire the form of seizures. Persons with schizoid and excitable personality disorder are prone to this condition.According to Freud’s theory, absolutely all the causes of mental disorders should be sought in childhood. Along with the traumatized psyche, the underlying cause of hysteria lies in sexual complexes. This explains the fact that the first manifestations of hysterical neurosis often occur in childhood or during puberty.
The immediate impetus to the manifestation of hysteria are suddenly developed stressful situations: family quarrel, conflict at work, a break with your loved one, or a sudden threat to life. A person finds the output of his emotions in hysterics, while extracting his own benefit from others (attention, sympathy, participation).
Symptoms of hysterical neurosis
Unlike psychopathy, manifestations of hysteria appear most clearly when other people participate. It is characterized by demonstrativeness – an essential condition for the manifestation of hysterical neurosis.Patient complaints and manifestations of the disease are not based on organic changes. All the symptoms of mental pathology end as suddenly as they began.
The clinical picture of hysterical neurosis is characterized by variegation and polymorphism . Movement disorders are observed: finger tremor, impaired coordination, loss of voice (aphonia). Often demonstrated muscle tics (hyperkinesis) and seizures. At the same time, all the symptoms are aggravated by a medical examination by a pediatrician, general practitioner, neurologist and other specialists.
The hysterical aphonia is distinguished by a loud cough against the background of a lack of voice. In case of stuttering on the background of hysteria, the patient does not feel uncomfortable and constrained.Paralysis in hysteria is never accompanied by tissue atrophy (the difference with ischemic stroke). The main difference of this paralysis is its localization: the patient indicates weakness or insubordination of the muscles on the arm to the elbow or on the legs to the knee, which is incompatible with an organic lesion of a neurological nature.
A severe form of the disease may manifest partial (paresis) or complete paralysis of the limbs and muscles of the tongue. There is no organic pathology at the base of the movement disorders, the motor impairment is short-lived and depends on the patient’s peace of mind. The desire to attract maximum attention stimulates the patient to fainting, demonstrative hand wringing , breathing and throwing.However, if it is possible to shift the patient’s attention from his person to another object, the motor impairments will either greatly weaken or disappear altogether.
Sensory disturbances can manifest as a decrease or lack of sensitivity (hypoesthesia, anesthesia), and its increase (hyperesthesia). At the same time, the spread of such signs is characteristic: patients limit the zone of numbness to the area of gloves, socks, waistcoats, etc. Often there are specific pains – causeless pain in any part of the body.
Frequent manifestations of hysterical reactions are sudden deafness or blindness (one- or two-sided). Patients may exhibit perverse color perception and narrowing of the visual fields, but this does not prevent them from being adequately oriented in space. Deafness is often combined with paresthesia/anesthesia of the auricle.
Vegetative manifestations are limited to the patient’s imagination. He may complain of pain in any internal organ, most often it is the digestive tract and heart. Sometimes patients refuse to eat because of a false spasm of the esophagus. Nausea, abdominal pain, urge to vomit, pain in the heart, difficulty breathing, palpitations, or heart failure do not have a foundation; pathological changes in these organs that can cause similar symptoms, in most cases, no.
The patient may complain of burning and itching of the skin, demonstrating scratching the hands and feet as a confirmation to the doctor. Almost always, patients notice dizziness and headache, explaining that the pathology in the brain. Sometimes patients mimic the symptoms of appendicitis and asthma.
A sharp deterioration (seizure) in hysteria is very similar to the manifestation of epilepsy. Any situation that is psychologically difficult for the patient to perceive is a quarrel, unpleasant news, the refusal of others to fulfill the patient’s desire, ends with a dramatized fit. This may be preceded by dizziness, nausea and other signs of deterioration.
The patient falls, curving in an arc. At the same time, the patient will always fall “right”, trying to protect himself as much as possible from injury . Waving arms and legs, hitting his head on the floor, violently manifesting his emotions with tears or laughter, the patient depicts unbearable suffering. Unlike epileptic, hysterics do not lose consciousness, the reaction of the pupils is preserved. A loud shout, irrigation of the face with cold water or a slap in the face quickly bring the patient to his senses. Also, the patient displays the complexion: the face is purple-bluish during an epileptic seizure, and in hysteria – red or pale.
Hysterical seizure, unlike epileptic seizures, never happens in a dream. The latter always happens in public. If the public stops paying attention to the convulsions of hysterics or withdraws, the seizure will end quickly. After an attack, the patient may show amnesia, up to the ignorance of their own names and surnames. However, this manifestation is short-term, memory recovery occurs quickly enough, as it is inconvenient for the patient himself.
Hysteria – “the great simulator.” The patient vividly talks about his complaints, overly demonstrating their confirmation, but at the same time showing emotional indifference. You might think that the patient gets pleasure from many of his “sores”, while considering himself a complex kind, which requires close and comprehensive attention. If the patient finds out about any manifestations of the disease that were previously absent, these symptoms will most likely appear.
Diagnosis of hysterical neurosis
Hysteria – the translation of the patient’s psychological problems in the physical direction. The absence of organic changes on the background of serious complaints is the main symptom in the diagnosis of hysterical neurosis. Most often, patients refer to a pediatrician or general practitioner. However, if a patient is suspected of hysteria, they are referred to a neurologist. With all the variety of manifestations of hysterical neurosis, the doctor finds discrepancies between the symptoms and the actual state of the body. Although the patient’s nervous tension can cause some strengthening of the tendon reflexes and finger tremor, the diagnosis of “hysterical neurosis” is usually not difficult.
Important! Seizures in children under 4 years old who want to achieve the fulfillment of their desires are a primitive hysterical reaction and are also caused by psychological discomfort. Usually, affective seizures disappear on their own by 5 years.
Instrumental studies are conducted to confirm the absence of any organic changes from the internal organs. Spinal CT and MRI of the spinal cord are prescribed for movement disorders. CT and MRI of the brain confirm the absence of organic pathology. To angiography of cerebral vessels, rheoencephalography, USDG of the vessels of the head and neck are used to exclude vascular pathology. EEG (electroencephalography) and EMG (electromyography) can confirm the diagnosis of hysteria.
In hysteria, the data from the above studies refute the pathology of the structures of the brain and spinal cord. Depending on the complaints that the patient confirms by some external manifestations, the neurologist decides to appoint a consultation with a neurosurgeon, an epileptologist and other specialists.
Treatment of hysterical neurosis
The essence of the treatment of hysteria lies in the correction of the patient’s mind. One of these techniques is psychotherapy. In this case, the doctor does not pay excessive attention to the complaints of the patient. This only provokes an increase in hysterical seizures. However, complete disregard can lead to the same results. Repeated courses of psychotherapy with the identification of the true cause of the arisen condition are obligatory. A psychologist or psychotherapist, using suggestion, will help the patient to adequately assess himself and the events taking place. The importance of hysteria is given to occupational therapy. Bringing the patient to work, searching for a new hobby distracts the patient from the neurotic state.
Drug treatment mainly comes down to the appointment of restorative means. With increased excitability, it is advisable to prescribe medications based on medicinal herbs (Valerian, motherwort), bromine. In some cases, the use of tranquilizers in small doses and short-term courses is justified. When establishing insomnia (prolonged insomnia), hypnotics are prescribed.
Forecast and prevention of hysterical neurosis
The prognosis for the life of such patients is quite favorable. Longer follow-up is required for patients with signs of anorexia, somnambulism and suicide attempts . Longer and sometimes prolonged treatment is required for patients of an artistic type and with symptoms of hysteria that originated in childhood. A more unfavorable outcome is observed when a hysterical neurosis is combined with organic lesions of the nervous system or severe somatic diseases.
Prevention of hysterical neurosis includes measures to prevent mental disturbances and nervous processes, as well as to strengthen and prepare the nervous system for overstrain. These events are especially important in relation to people of the artistic type and children.
It is necessary to limit the imagination and imagination of the child, to try to create a calm atmosphere for him, to attract to the sport and stay with peers. You should not constantly indulge in whims and be surrounded by excessive care. An important role in preventing the development of hysterical neurosis is played by the proper upbringing of the baby and the formation of a full-fledged personality. The patient himself should not ignore his psychological problems, their quick resolution will eliminate a stressful situation and will not allow psychopathy to take root.