Other neurotic disorders: neurasthenia, hysterical neurosis


The term “neurasthenia” (nervous weakness) was proposed by the American neurologist J. Byrd (1869, 1880). Among the main symptoms were identified mental and physical exhaustion (weakness) in combination with headache, irritability and sleep disturbance (insomnia). He stressed that the development of neurasthenia requires excessive mental and physical stress, which leads to “nervous bankruptcy” (the requirements for the nervous system exceed the level of its resources). The author saw in the causes of neurasthenia the special specific conditions of life and the struggle for survival, enrichment, fierce competition (sometimes at the cost of life). He called it a disease of American society – “American neurosis.”

Moreover, the symptoms of these disorders are so confused that each specialist makes his own diagnosis. For example, when contacting a therapist – ischemic heart disease, gastrointestinal diseases. The urologist will see his diagnoses – cystitis, pyelonephritis. Traumatologist – arthritis. Neurologist – neuralgia. And only by contacting a psychiatrist, the patient will receive the correct diagnosis.

Main complaints:

  • increased fatigue with minimal labor activity;
  • the presence of headaches, dizziness, tightening pains in the head (“neurasthenic helmet”), disturbed sleep rhythm, irritability, nightmares, meteorological dependence, emotional dissatisfaction with life, inability to relax, muscle pain, decreased social activity, adaptability.

Hysterical neurosis

Hysterical neurosis can change depending on the circumstances and is characterized by increased impressionability, sensitivity, conflict (gossip, squabbles), and rapid mood swings.
In unfavorable situations, the condition of patients worsens. Patients have more pronounced “emotional logic” (more often primitive logic) than the intellectual sphere. Patients can be diagnosed with impaired memory, motor functions, loss of voice (aphonia), impaired sensitivity, eyelid spasm, etc.

In practice, hysterical manifestations (hysterical seizure) are so pronounced that the patient can be hospitalized in a non-core department and even be subjected to surgery. For example, dysfunctions of the cardiovascular system, respiration, gastrointestinal tract, tremor (“shaking”).

About patients with hysterical neurosis, one of the leading psychiatrists P.B. Gannushkin (1875-1933) wrote: “Their emotional life is capricious, unstable, feelings are superficial, attachments are not strong and interests are not deep … Their judgments are striking in their inconsistency … They often act out of themselves offended and unhappy … Hysterical usually they are envious and jealous … Being inexhaustible and indiscriminate in their means, they feel best in an atmosphere of scandals, gossip, and squabbles. ”

Such patients in a team or in a family may demonstrate incorrect statements and actions, from which yesterday’s, very prosperous team or strong family is bursting at the seams and, even quite possibly, crumbled.