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Neurasthenia: Signs, Symptoms and Treatment

Currently, this medical term can be found as a primary disease less frequently. As an independent primary diagnosis, it is almost never used, but as a concomitant syndrome, it is quite common, especially in the clinic of nervous diseases.

In everyday life, one can often hear how a curse on some mentally unbalanced subject who “throws himself at people” is a “neurotic” or “neurotic”.

In the theater and in the cinema, even such an actor's neurasthenic role that characterizes a person who is a toy in the hands of an evil fate is known - “a pale young man with a burning eye”. So, for example, Rodion Raskolnikov in Dostoevsky was a typical neurasthenic, and the era of romanticism in general generated interest in such subjects "not of this world."

Suffice it to recall, for example, Edgar Allan Poe or the great Frederic Chopin. It was the painful, heightened sensitivity of such a neurotic warehouse of personality that was in demand after the era of classicism.

Thus, Oleg Dahl, who played the unlucky hero - the lover in the second part of the “Can't Be” film trilogy, staged by Leonid Gaidai based on the works of Zoshchenko, showed a wonderful example of a refined and painful esthete - neurotic.

What does this term mean, and why such diagnoses can easily “reward” a person on the street?


Neurasthenia, what is it?


It should be said at once that the concept of "neurasthenia" is completely unequal to the concept of "mentally ill person", as it seems at first glance. What it is? The term “neurasthenia” is complex: nevros + asthenos, and means “weakness, exhaustion of the nervous system” or just a state of weak nervous status.

And here we are not talking about the fundamental, basic properties of the nervous system: it is arranged with neurasthenia in exactly the same way as a normal person, the speed of a nervous impulse, sensitive and motor sphere, higher nervous activity, coordination of movements during neurasthenia are exactly the same and completely healthy person.

But at the same time, neurasthenia is a functional, fully reversible state in which compensatory-adaptive mechanisms of the central nervous system are scooped, and the ability of a person to withstand stress is reduced.

Therefore, each of us can become a neurasthenic, for example, after abusing coffee and insomnia for one to two nights. On the other hand, this acquired state of weakness of the nervous system often accompanies severe somatic diseases.

For example, after severe pneumonia , after meningitis, a person is discharged from the hospital with recovery for the underlying disease and with the “neurasthenic syndrome” as a concomitant diagnosis.

It is precisely the weakness of the inhibiting effects of the cerebral cortex and the “complete shattering” that leads to acute reactions to minor irritants, which was appreciated in the era of romanticism. It should be added that tuberculosis , which then occurred very often, greatly enhanced the manifestations of neurasthenia.

Subject to a full regimen, proper nutrition, and continued treatment, the state of the nervous system soon returns to normal, and the patient is considered completely healthy. What forms and types of neurasthenia are there?

Classification and forms of neurasthenia

forms of neurasthenia

Here we should recall two types of reaction of the nervous system to a stimulus that is present in all living things: hyperreactive and sluggish. In the same way, it can be applied to a person under a variety of conditions. So, maybe arterial hypertension and hypotension.

And vegetative-vascular dystonia , for example, is realized in both hypertonic and hypotonic types. Neurasthenia is implemented in the same way, and it has three stages that successively replace each other in the development of the disease:

  • Neurasthenia hypersthenic. It is the initial form of the disease, in which the organism still “has strength”, but the inhibitory effects of the cerebral cortex are weakened. At the same time, the patient has a strong excitability and irritability, he reacts to all external manifestations exclusively emotionally, including trivialities. Dispersedness and distractibility increase, a person often quits his job, not because of fatigue, but because of distraction. Reduced sustainability of attention.
  • At the second, progressive stage, the degree of reaction is significantly reduced, while maintaining irritability. Emotional outbreaks become shorter due to the exhaustion of the reaction. The melancholicity of mood increases, weeping appears, attention is quickly exhausted. At this stage, there are shifts in sleep mode, lethargy and drowsiness appear during the day, and persistent sleeplessness at night, which becomes chronic.
  • The last stage of a functional disorder, already on the verge of a persistent, organic lesion, is hypodynamic, or hypostenic neurasthenia. At the same time, any reaction of the body loses brightness, and the main signs of such a state are indifference, apathy and depression. Performance, especially mental, dramatically reduced. The patient is anxious, his sphere of interest is narrowing, he is fixed on internal sensations, and this state very easily turns into depression, being forced out into the subconscious.

Neurasthenia in children can often be associated with perinatal birth trauma, beriberi, weight deficit and neuropsychiatric developmental delay.

In adults, in addition to the above-mentioned diseases, chronic stress, lack of sleep combined with increased mental activity lead to the development. Sometimes neurasthenia can be the result of alcohol abuse.

Symptoms of neurasthenia

Symptoms of neurasthenia

irascibility and irritability - the first signs of neurasthenia, photo

As it became clear, the manifestations and symptoms of neurasthenia completely depend on the stage of development of the disease.

At the first stage it is typical for the patient:

  • irritability,
  • noisy
  • quick temper,
  • inadequate “small things” reactions,
  • impatience.

It is easy to insult this patient and ruin him for the slightest reason; he constantly interrupts the conversation, raises his voice, "climbs into the bottle." At home, such a person turns into a tyrant, although he almost always sincerely believes that he is completely healthy, only “a little overworked”.

Night sleep is intermittent, morning awakening is painful, and in the first half of the day such a person is tormented by lack of concentration and inability to concentrate, which is why there are problems at work. Such a patient is often disturbed by headaches, constricting, like a "helmet" or "hoop".

Symptoms of the second period of neurasthenia

Symptoms of the second period of neurasthenia manifest signs of intolerance to bright light, loud sound, tearfulness, depression, significant problems at work and in the family, pronounced sleep disorders. Occasionally, this negative mood background is interrupted by short flashes of neurotic reaction.

Finally, in the third stage, the main symptoms will be a great feeling of depression and fatigue, fixation on the disease, hypochondriacal states, thoughts of death, a complete breakdown of sleep and loss of working capacity.

Treatment of neurasthenia - an integrated approach

As noted by old specialists by neurologists and psychiatrists, with neurasthenia, no special treatment is required in most cases, and the beginning of recovery in almost all patients coincides with the normalization of sleep.

Therefore, the first thing that a doctor should pay attention to is occupational health and rest, and the observance of sleep patterns. It is necessary to take walks before bedtime, to ventilate the room well, not to eat at night, you can use sedatives to improve sleep.

Treatment of neurasthenia

Other drugs for the treatment of asthenia can be:

  • multivitamin and mineral complexes;
  • activating drugs - adaptogens (tincture of eleutherococcus, schisandra, golden root, ginseng);
  • neurasthenia, drug treatment of which is ineffective (in severe cases, after diseases leading to general exhaustion) can be treated with the use of anabolic steroid hormones in short courses.

Neurasthenia, the symptoms and treatment of which are identified and carried out in a timely manner, may even be dispensed with medications. Most often this applies to those forms that are caused by chronic fatigue, in combination, for example, with the use of coffee and cigarettes as a "doping" that stimulates thinking.

As an example, one can cite the “programmer's neurasthenia,” in which often all the above-mentioned risk factors are combined with the use of beer at the computer, eye strain, and hypodynamia.

Therefore, treatment with such a development of neurasthenia is reduced to a complete change in lifestyle.

Which doctors to contact?

The thing is that underlies the damage to the central nervous system. If a person was in the hospital about a serious illness, then he is usually treated in a clinic with a specialist. For example, a pulmonologist after pneumonia, a TB specialist after tuberculosis.

Usually, with successful outpatient treatment of the underlying disease, neurasthenia also passes. Sometimes consultation of the neurologist (neuropathologist) is required.

In the event that neurasthenia appeared “from scratch”, for example, due to overwork, you can turn to a neurologist.


Primary prevention of neurasthenia comes down, first of all, to careful adherence to the daily regimen, especially sleep and wakefulness. As shown, it is with a sleep disorder that “like a snowball” all other symptoms appear, which the body can easily cope with if enough time is allowed to sleep.

The second “cornerstone” is the rejection of all types of artificial stimulants of the central system (alcohol, smoking, coffee abuse and, of course, a categorical refusal to take drugs). Amphetamine addiction is known to be particularly "malignant" to the central nervous system.

In addition, be sure to make active walks in nature, to harden, engage in swimming and physical culture, and in general, live a full life. And only then no one will think that you are a “neurotic”, and you will not be ashamed of a scandal over a trifling matter in the workplace.


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