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Anaesthesia => Psychiatry => Neurosis
Neurosis
INTRODUCTION
Neurosis, or psychoneurosis, term that describes a variety of psychological disorders, originally thought to have their origins in neuronal disturbances, but now regarded as having psychic or emotional origins. Neuroses are characterized by anxiety, personal unhappiness, and maladaptive behaviour. However, they are not usually severe enough to prevent totally a sufferer from continuing to function in society as opposed to psychosis, which usually requires hospitalization. See Mental Disorders.
These terms are no longer clinical definitions. Each neurosis is now classified according to its symptoms. The classifications in the Revised Diagnostic and Statistical Manual of Mental Disorders, published in 1987, do not include neurosis, although the conditions previously regarded as neuroses are described. These include:
GENERALIZED ANXIETY DISORDER
A condition of feeling uneasy or apprehensive much of the time and being likely to overreact to the types of mild stresses that would not be expected to affect a well-balanced person.
PANIC DISORDER
This is characterized by panic attacks, which also occur in generalized anxiety disorder-episodes of acute or overwhelming apprehension or fear accompanied by physical symptoms such as heart palpitations, perspiration, shortness of breath, muscle tremors, nausea, and fainting. People who suffer from panic attacks may feel as though they are going to die.
PHOBIAS
Response with intense fear to a stimulus (for example, a certain object) or a situation that is generally not regarded as particularly dangerous is classed as a phobic response. For this to be diagnosed as such, it must be sufficiently serious to interfere with everyday life. The intensity of reaction to the stimulus can range from strong unease to panic. Often the fear is realized as being irrational, but the sufferer is unable to control it.
A simple phobia is a phobia about one particular thing, for example spiders. People may have several simple phobias. Social phobias are phobias about social situations, such as fear of stuttering before having to speak to a stranger, even if this in fact does not happen. Agoraphobia (Greek agora, "marketplace"), a fear of open spaces, is probably the most disabling phobia and, in its most severe form, a sufferer may be unable to go outside.
OBSESSIVE COMPULSIVE DISORDER
Obsessive compulsive disorder consists of the persistent intrusion of unwelcome thoughts or impulses (obsessions) and irresistible urges (compulsions) to carry out particular actions or rituals that reduce anxiety. Both of these characteristics are almost always present in the disorder. For example, a person may be obsessed with the idea that his house is going to be burgled and the family attacked, and he may check repeatedly that all the windows and doors are locked. The most common compulsions are checking things and washing. These actions may be performed hundreds of times each day.
SEPARATION ANXIETY DISORDER
Separation anxiety disorder occurs during childhood, and is an irrational fear of being separated from one's parents. Often people who are agoraphobic in adult life suffered from separation anxiety as a child.
POST-TRAUMATIC STRESS DISORDER
The term "post-traumatic stress disorder" was coined following the Vietnam War to describe the psychological symptoms experienced by veterans of the war following their return home. In World War I soldiers were described as having "shell-shock" and in World War II they were said to have "combat fatigue". Post-traumatic stress disorder, however, can be used to describe symptoms following any type of disaster outside the normal human experience, such as an air crash or natural disaster.
The symptoms include reliving events that occurred during the trauma; sleep disturbances, including nightmares and insomnia; anxiety; detachment from normal surroundings; and a lack of interest in activities previously enjoyed.
MULTIPLE PERSONALITY
Multiple personality is an extremely rare disorder in which two or more personalities exist within the same person. Often one personality is unaware of events that occur while the other personality is dominant, leading to periods of amnesia. This disorder commonly occurs following an extremely traumatic childhood experience.
TREATMENT OF NEUROSES
Most neuroses are treated by psychoanalysis or other forms of dynamic psychotherapy. They can also be treated by behavioural modification, hypnotherapy, or psychotropic medication. Some neuroses respond well to treatment and their disruptive effect can be greatly reduced.
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