Institute of Clinical Psychiatry and Psychology

Respiratory neurosis is a disease characterized by difficulty breathing. In the medical field, the disease is also called “hyperventilation syndrome” or “dysfunctional breathing.” Such a diagnosis is not only dangerous to health, but also brings inconvenience to everyday life. What are the causes, symptoms and how to treat the disease?

Respiratory neurosis: causes

The disease can be caused by a number of factors. In addition, it exists as a separate ailment or pathology in another disease. In addition, the human body is able to “remember” the reason that led to breathing problems. If those circumstances are repeated, the disease may make itself felt again. Most often, hyperventilation syndrome occurs due to a whole set of factors:

• constant emotional and mental turmoil;
• being in a stressful state for a long time;
• disease of the respiratory system;
• cardiovascular diseases;
• poisoning with toxic substances;
• drug overdose;
• problems in the digestive system;
• autonomic dysfunction;
• unstable psychological state;
• depression.

In most cases, the disease occurs due to physical factors, such as lack of sleep or increased fatigue. Difficulty breathing syndrome can also be provoked by alcoholic drinks, narcotic and psychotropic substances.

Tachycardia: causes and signs. How to treat?

Tachycardia, along with a heart attack, is considered the “heart” disease of our century. It can be primary if it is a manifestation of ischemia, heart defects and chronic lung diseases - bronchitis, bronchial asthma.

The rapid heart rate (more than 90 beats/minute), which characterizes this heart disease, can be a consequence of frequent stress, fear, anxiety, and even simple physical activity. In this case, tachycardia is considered secondary.

The type of tachycardia can be determined by echo monitoring , ECG, ultrasound of the heart and thyroid gland. If the test result is negative, tachycardia is secondary.

If there is a sharp increase in heart rate that lasts for 10-15 minutes, you must immediately take a sedative - valocordin, Corvalol with water or sugar, put glycine under the tongue, drink tincture of valerian, mint or lemon balm. It may also be helpful to place a damp cloth or cold cloth on your forehead or neck.

With anemia, tachycardia is also possible, since with low hemoglobin, the blood supply to the tissues decreases, and the heart begins to contract faster to compensate for the lack of oxygen in the tissues. For anemia, it is necessary to consume iron supplements and vitamin C.

How to quickly stop tachycardia? Tachycardia is considered a normal phenomenon in adolescents during a period of active growth, and is also not excluded at elevated body temperatures: 70-80 pulse beats per minute at temperatures up to 39 degrees is absolutely normal. At a temperature above 39 degrees, you need to take Coldrex or paracetamol to bring it down, since with an increased heartbeat the body quickly gets tired.

Secondary tachycardia can be pacified with a variety of herbal infusions. For its long-term treatment, you can prepare a decoction of lemon balm, mint and valerian, pour 2 tbsp. spoons of herbs 0.5 liters of boiling water for 5-10 minutes and take the infusion for 2-3 weeks.

To reduce the release of adrenaline, you can put half a tablet of mezapam or phenazepam under your tongue.

It is better to replace evening coffee or tea with soothing infusions of rosehip and motherwort, which lower blood pressure.

Doctors do not advise getting carried away with valerian: take no more than 1 tablet 3 times a day for 10 days. You don't need excessive sleepiness, do you? For people for whom sleeping at work is contraindicated, we can recommend 1 tablet of Grandaxin under the tongue 2 times a day.

Cardiovascular drugs such as mildronate, trental or teopeca, which stimulate blood flow, can cause tachycardia. Alcoholic drinks of any strength can also become tachycardia stimulants, along with unusual and spicy foods.

Your fiery engine cannot forever “take the rap” for your frivolous attitude towards health. Get a preventive examination from a cardiologist , take care of your heart, and it will serve you for many years.

Symptoms of respiratory neurosis

To recognize the disease, you need to know its main signs. Symptoms of dysfunctional breathing are:

• breathing problems;
• dyspnea;
• dry cough;
• belching;
• eating disorder;
• muscle pain;
• pain in the stomach and abdomen;
• constipation;
• panic attacks;
• headaches and dizziness;
• problems sleeping, insomnia;
• severe pain in the heart and chest;
• fast fatiguability;
• trembling in the body;
• sensation of “goosebumps” on the skin.

The above symptoms may appear depending on the situation. The most common and characteristic signs of respiratory neurosis were and remain psycho-emotional disorders, chest pain, lack of air, and shortness of breath.

As soon as you notice several of these symptoms, contact your healthcare provider for advice. Timely diagnosis and treatment will help to quickly cope with the disease, as well as avoid the appearance and development of various pathologies.

Obsessive-compulsive disorders (OCD)

They are demonstrated by a feeling of fearfulness, intimidation, and anxiety. Obsessive thoughts haunt the patient against his wishes and will, although they are assessed by him as meaningless and harmful. There are syndromes of the following obsessive states:

• doubts – uncertainty about the correctness of actions taken or not taken, contrary to logical arguments. Such a person doubts whether he turned off electrical appliances, closed the door, whether the document was written correctly, etc., although he has repeatedly checked the action performed;
• Memories are annoying pictures of the past. Often a sad, unpleasant or shameful incident for the patient, and he tries not to think about it;
• imagination - the emergence of implausible images, perceived as real despite their absurdity. There may be a belief that the buried relative was alive, or other similar misconceptions. In this case, the patient imagines and painfully experiences the suffering of the “obviously dead” person in the grave or other unpleasant feelings;
• drive - a desire to carry out some extremely undesirable action, accompanied by horror and panic due to the impossibility of freeing oneself from such a desire. For example, it covers the desire to harm a loved one, throw yourself under a train, a car, or push someone under it. At the same time, an unbearable fear is experienced that this is happening (contrasting attraction);
• phobias (fears) - an unreasonable fear of heights, open or confined spaces, crowds of people, sudden death, etc. Sometimes they are accompanied by rituals - monotonous actions that have the meaning of spells and amulets. Such actions are performed with the aim of protecting against a certain misfortune, despite the critical attitude towards them. So, by walking around the arch, instead of passing under it, a person seems to be saving his relatives from harm; when starting something, he snaps his fingers twice or says the “cherished” word out loud - in order to avoid failure.

Some obsessive actions fill the patient’s thoughts until they are implemented, others pass and are forgotten. To keep himself from becoming obsessed, he needs to constantly monitor himself, which is extremely tiring for him.

Close to obsessional neurosis in clinical terms are psychasthenia and psychasthenic neurosis. They are characterized by:

• predominance of asthenia (enduring fatigue, weakness);
• constant general feeling of tension with heavy foreboding;
• conviction of personal social inadequacy, ugliness and inferiority relative to others;
• excessive impressionability due to criticism addressed to oneself;
• reluctance to make contact without a guarantee of being liked;
• avoidance of social or professional activities associated with significant social contacts due to fear of criticism, disapproval, or ignorance;
• limited life and social way of life due to the need for physical and psychological safety.

Differential diagnosis is necessary to distinguish obsessional neurosis from schizophrenia, cerebral atherosclerosis, and the consequences of encephalitis. The distinctive feature of neurosis, and at the initial stage the only psychopathological symptom, will be obsession. There are no intellectual disorders. If the disease takes a long course and is not sufficiently treatable, it can affect the patient’s personality and his future fate.

How to diagnose?

Pulmonary hyperventilation syndrome is very difficult to diagnose; it is arrived at by the method of exceptions, since the symptoms are very similar to other diseases. Most often, the patient needs to undergo a number of examinations.

But the most effective method for making a diagnosis is capnography. The equipment calculates the concentration of carbon dioxide in exhaled air. If the indicators are normal, the occurrence of breathing problems is considered accidental. Otherwise, respiratory neurosis is diagnosed.

Also, to more accurately determine the manifestation of symptoms, a special questionnaire is used. The table lists all the symptoms of dysfunctional breathing, and the patient must mark the degree of manifestation of each indicator according to points.

Hysterical neurosis

The clinical picture of hysteria is characterized by increased lability of emotions and the transition of the mental component to the somatoneurological one. This is the only form of neurosis when qualitative changes in consciousness are possible. Almost all symptoms of hysteria are protective for the patient, corresponding to a specific psychotraumatic situation. They bring a certain moral benefit to the individual, since they provide an opportunity to get rid of another difficult experience. Therefore, hysteria can be considered as a kind of protective phenomenon that occurs under the influence of a super-powerful stimulus.

Example: a mother received unexpected news about the tragic death of her son; while waiting for the body to be brought, she thought with horror that she would not be able to see him dead, and suddenly became blind; After a while, the hysterical blindness passed.

Emotional lability during hysteria manifests itself in a sharp change in emotions and their inconstancy. But, unlike neurasthenia, they are indicated by high intensity and duration. The patient, who a minute ago was crying bitterly and in deep despair, without much effort not only calms down, but also easily comes into a good mood. Such lability of emotions leads to instability in desires, intentions, behavior, likes and dislikes. In addition to emotional lability, a clear symptom of hysteria is easy suggestibility - both self-suggestion and the ability to be suggested by others.

The most striking reaction to a stimulus from the motor system will be a hysterical attack. Seizures do not occur when no one is near the patient, and are not accompanied by a sharp fall with bruises and injuries. Movement disorders have a pronounced neurotic character and coincide with the content of the patient’s experiences. He falls, chaotically swings his arms and legs, hits them on the floor, bends over, shouts out individual words. The seizure lasts from several minutes to hours. Unlike epileptic paroxysm, hysterical paroxysm is not accompanied by a clear violation of muscle tone, spasm of the sphincters with their relaxation and incontinence of urine and feces, the reaction of the pupils to light is preserved, and treatment is perceived adequately. After the attack, only a vague memory of it remains.

One type of hysteria is a disorder of consciousness under the influence of mental trauma. The perception of the surrounding reality is distorted. Behavior takes on childlike features, helplessness, and elements of fake dementia - pseudodementia. Some experience neurological symptoms: decreased sensitivity, trembling hands, hysterical deafness or muteness.

Significant strength and lability of emotions can sometimes cause a deviation of consciousness such as twilight stupefaction (hysterical delirium) and painful constriction (hysterical unconsciousness). The twilight state of hysteria usually demonstrates a pure type of painfully narrowed consciousness without stupor or other signs of its disturbance.

Drug therapy

The course of neurosis is associated with a simultaneous decrease in the level of brain serotonin, therefore long-term use of antidepressants - selective serotonin reuptake inhibitors - is prescribed for treatment. At the initial stage of treatment with antidepressants, their adverse reactions may occur, and the patient’s condition may worsen. In view of this, it is important not to stop taking the prescribed treatment, but only to reduce the dose of the drugs. Then, as tolerance improves, the dosage is gradually increased to the recommended values. Over time, the symptoms of neurosis decrease and the patient's condition improves.

Important: the antidepressant must be selected by a doctor! The selection takes into account the individual tolerability of the drug and its effectiveness for specific neurotic symptoms.

For the treatment of neuroses accompanied by insomnia or poor sleep, sedative and hypnotic antidepressants are prescribed. Sometimes, with great caution and in small doses, in short courses (to avoid addiction), tranquilizers are prescribed. When treating neuroses with concomitant weakness, memory loss, and asthenia, nootropic drugs are used. The duration of treatment is usually several months; if necessary, the course must be repeated.

Diagnostics

In each specific case of a neurotic disorder, a varied pattern of symptoms of different types of neurosis may be demonstrated. All this can be accompanied by various symptoms of mental and somatic disorders, which creates certain difficulties in diagnosis. Therefore, the qualifications of the attending physician, his medical experience and professional skills are so important.

The collected anamnesis is of great importance - the patient’s complaints, his description of the nature and intensity of the symptoms, the time of their manifestation. It will also be important to talk with loved ones, since they can often provide valuable information. Medical observation in a hospital setting may be required to confirm or refute the diagnosis.

It is necessary to carefully check the level of hormones in the body, since the development and course of depression or neurosis are strongly influenced by hormones. This is especially true for thyroid hormones; even minor changes in their levels, which are difficult to detect using conventional tests, can have a very significant effect on well-being. If a hormonal imbalance is detected, proper hormonal therapy must be initiated. In some cases, normalization of thyroid function leads to a complete cure for neurosis.

Differentiated diagnosis is important when you need to be able to distinguish one pathology from another. Provided that neuroses are often accompanied by somatic symptoms, the doctor will prescribe an appropriate examination. In addition to general laboratory tests (blood, urine), specific studies (hormonal levels) may be required. If a brain disorder is suspected, magnetic resonance imaging (MRI) or computed tomography (CT) is recommended.

Advantages of treatment at the clinic of JSC "Medicine"

The course of neurosis does not lead to disability, but often disrupts the full life of the patient and people close to him. In modern medicine, there are 3 stages of development of neuroses. The later the stage, the more difficult the treatment; this must be clearly understood. Medical specialists (academician Roitberg’s clinic) successfully treat neuroses in adults and children at any stage of complexity.

Remember: it is impossible to cure neurosis on your own, but in the conditions of the clinic of JSC “Medicine” it is absolutely possible to recover completely! Leading specialists of domestic medicine, including academicians, professors, doctors and candidates of medical sciences, conduct receptions here. Modern material and technical base, coupled with the professionalism of doctors, allows patients with neuroses to recover in the shortest possible time!

Causes

The main causes of neuroses are mental trauma and stress. They can be provoked by certain life circumstances, diseases, alcohol or drug use.

A neurotic breakdown is possible for any person, but its nature and form are determined by a whole group of factors. On the one hand, the formation of neurosis depends on the individual characteristics of the individual, hereditary selective tolerance to external influences, and the level of adaptive capabilities of the body. On the other hand, the occurrence of a particular neurosis is determined by the nature of the mental trauma. It can be sudden (death of a loved one) or arise as a result of long-term unfavorable conditions (conflict and tension in the family, at work).

But such situations do not always lead to neurosis. It all depends on how important it is to a person and how he feels about it. Favorable factors include mental trauma suffered in childhood, upbringing in a negative environment, and frequent somatic illnesses.

What doctors treat neuroses

Psychiatrists, psychotherapists and psychoneurologists play a leading role in the treatment of neuroses. Doctors of many specialties also take part in the treatment process: therapists, cardiologists, gastroenterologists, neurologists, etc.

Such a large list of specialists is explained by the need for accurate diagnosis while simultaneously excluding other pathologies. Quite often, neurosis is disguised as symptoms of neurocirculatory dystonia, insomnia (insomnia), migraine, vestibulopathy and many other diseases. To definitely confirm or refute a particular diagnosis, the participation of a specialized specialist is required.

Treatment

You need to know: all psychogenic disorders in neurosis are reversible, that is, they are completely curable! Since the main cause of pathology is internal conflicts in the human subconscious, the first priority for the successful treatment of neurosis will be to eliminate the traumatic situation, stress, or mitigate the reaction to them. Excluding the patient from traumatic circumstances (family troubles, conflict at work, etc.), they are analyzed. The next steps will be the use of treatment methods based on drug therapy and psychotherapy.

Psychotherapy

In order to alleviate neurotic symptoms (by taking antidepressants), psychotherapy is carried out:

• Cognitive-behavioral therapy – formation in the patient of the correct reaction to the situation, strengthening his adequate assessment of his behavior in a traumatic situation, changing the way he responds to it;
• group psychotherapy – takes place for 1.5 hours daily or weekly, in the form of discussions. Topics are determined in advance; they relate to the biography, behavior of group members, and life situations. Group therapy has rules: strict confidentiality, sincerity of participants, experience “here and now,” specificity of topics. Groups can be closed - with a constant composition of participants, or open - someone comes, someone stops visiting;
• hypnotherapy - suggestion is carried out in a special state of the patient, hypnotic. The session includes 4 stages: hypnotization, therapeutic suggestion, therapeutic rest, dehypnotization;
• autogenic training;
• breathing exercises for relaxation and concentration;
• non-verbal methods of psychotherapy - music therapy, art therapy, dancing and pantomime.

The most effective treatment is a combination of antidepressant medication and cognitive behavioral therapy.

Neurotic depression

Neurotic depression is typically characterized by a depressed state with some inhibition of psychomotor reactions and thinking. There are monotonous depressive memories, pessimistic views of the future, and fixation on the traumatic situation. There is a tendency to tearfulness, irritability, decreased appetite, sleep disturbance, sensitivity (excessive emotional sensitivity).

Neurotic depression does not reach the depth of psychosis, is reversible, and goes away when a traumatic situation is analyzed or under the influence of treatment.