a neurotic disease that is characterized by increased irritability, fatigability, and loss of the ability to endure prolonged mental and physical strain.
Neurasthenia was first described by the American physician G. Beard in 1869. The disease usually arises when psychic trauma occurs in conjunction with extremely tense work and such physiological deprivations as chronic lack of sleep. Endocrine disturbances, a poor diet, infections, and intoxications (from alcohol or cigarettes), all of which weaken the body, foster the development of neurasthenia.
A typical condition in neurasthenia is irritable asthenia, a state in which increased excitability and irritability are combined with fatigability and rapid exhaustion. On slight provocation the patient manifests turbulent irritable reactions or excitable outbursts that are usually brief but frequent. The increased irritability often expresses itself in tearful outbursts not previously typical for the patient or in impatience and agitation. Such stimuli as loud noises, bright lights, and sharp odors are not tolerated. The patient is easily distracted, shows an inability to control emotions, and complains of absentmindedness and poor memory. The moods are unstable, with a tendency toward depression. In severe forms of neurasthenia, a picture of depressive exhaustion can develop in which patients are gloomy, sluggish, and indifferent.
Neurasthenia is accompanied by sleep disturbances, including difficulty in falling asleep, superficial or unrefreshing sleep, disturbing dreams, sleepiness during the day, and insomnia at night. Appetite decreases or disappears entirely; eructation and regurgitation, heartburn, constipation, and a sensation of heaviness in the stomach occur. Patients frequently complain of headaches, tachycardia, and a sensation of numbness in the heart. Disturbances in sexual functioning can also arise.
Three stages of neurasthenia are distinguished. The initial stage—hyperesthenic neurasthenia—is the most common form and is manifested predominantly by irritability and excitability. The second, or intermediate, stage is characterized by irritable asthenia. In the third stage—hypoesthenic neurasthenia—weakness and exhaustion predominate. The principal symptoms are sluggishness, apathy, increased sleepiness, and depression. Hyperesthenic neurasthenia is treated by establishing a suitable routine for work and rest and by alleviating the causes of the emotional stress. The patient’s general physical condition should be improved by a regular diet, vitamin therapy, general restorative treatment, and psychotherapy. When necessary, a change of job is recommended. In cases of hypoesthenic neurasthenia, the patient is hospitalized, and the use of antidepressants and tranquilizers is indicated. The prognosis is usually favorable.
L. M. SHMAONOVA