Asthenic syndrome: what is it, symptoms and treatment

In the conditions of modern life, with its global informatization and a constant flow of various information, dressed up mental stress, physical fatigue and an increasing level of morbidity, it is more and more difficult for a person to be able to balance.

Adding disharmony is an unbalanced diet, neglect of the daily routine, an almost total replacement of being in the fresh air with leisure time in front of a TV or computer monitor. The latter is further aggravated by a decrease in active socialization - direct communication between people without the use of technical devices. All these factors, alone or in combination, become a solid basis for the development of asthenia (asthenic syndrome).

There is a widespread misconception about asthenic syndrome that this is a purely psychiatric definition. Undoubtedly, higher nervous activity is directly related to it. However, of all the factors that provoke asthenia, brain diseases are only one of the possible causes.

For a general understanding of the issues: what it is, what happens and who is in risk groups, we will help you understand this terminology.

Definition and variants of the syndrome

The term "asthenia" is formed from the Greek word "sthenos", literally means - strength, vital activity. The prefix "a-" means negation. As a result, asthenia - impotence, vital inactivity.

Medical definition asthenic syndrome is a state of exhaustion of the body against the background of pre-illnesses or already existing or arrested pathologies, manifested by psychopathological disorders.

In general terms, these are emotional disorders in the form decreased mood with hyposthenic type or, on the contrary, manifested nervousness (irritability) with hypersthenia. Usually this condition occurs against the background of a current or previous illness. But it can also manifest itself as a result of a pronounced emotional shock, as well as, in the form of the mildest degree, against the background of complete health - asthenia of overwork.

Information sources contain variations of the term: neuro-asthenic syndrome, neuropsychic weakness, asthenic conditions or reactions, chronic fatigue syndrome.

According to the international classification of diseases (10th revision) it is defined as neurasthenia (code F48.0) and belongs to other neurotic disorders.

Manifestations of asthenic syndrome

Not taking into account the signs of diseases, against the background and due to which there is a neuropsychic weakness, a set of signs that characterize the state of emotional exhaustion. These are mainly disorders in the processes of higher nervous activity. These include:

• severe weakness;
• extremely fast fatigability (even with light loads) and reduced performance;
• daytime sleepiness and sleep disturbance (prolonged falling asleep, rare or absent dreams, light superficial sleep);
• decrease in vital interest, apathy, loss of desire for favorite activities;
• violations of the processes of memorization (short-term), difficulties in assimilating new material, oppression of analytical abilities;
• nervousness, irritability, negativity in views and contradictions, increased criticism of others;
• decreased libido, sexual dysfunction;
• drops in blood pressure and pulse rate, unmotivated shortness of breath, pain in the muscles of the lower back, chilliness in the legs, disorders of the digestive system and urinary system.

The last section of signs is the manifestation of autonomic disorders. What brings asthenic syndrome closer to the vegetative and neurocirculatory dystonia.

Causes and provoking factors

Asthenia, in the mildest degree, can develop in an absolutely healthy person.

A short period of intense intellectual work may be a sufficient reason for this. (exams, quarterly reports, etc.) or physical strain for several days without due recreation.

As a starting point, a long flight with acclimatization or being on the road for several days is even possible.

Etiologically significant factors are divided into 4 main groups.

1. Emotional. In addition to the above reasons, a pronounced stress reaction is taken into account (breakdown of relationships, death of a loved one, catastrophe). In adolescents - a conflict between generations or among peers (rejection by the group). For the elderly - a feeling of being unnecessary. Careerists are prone to emotional asthenia.
2. Somatic. Chronic diseases of internal organs, accompanied by frequent exacerbations or in a subclinical form, according to the severity of their own symptoms, lead to an exhausting state of the patient. In such a situation, they say about asthenic syndrome, that this is a patient "when he is tired of being treated and fighting." Neurasthenia develops gradually, but with increasing manifestations.
3. Cerebral. This group contains diseases of various nature: craniocerebral trauma; congenital malformations leading to disruption of the central nervous system; infections - meningitis, encephalitis; vascular disorders - atherosclerosis, stroke. In such situations, there is a direct impact on the emotional centers.
4. General and specific infectious. Any possible extracerebral inflammatory processes of a microbial nature are conventionally considered here. Many viral and bacterial diseases occur with cerebral syndrome - directly or indirectly affecting brain function. Not wanting to lose hours of work or for other reasons, people are able to ARVI do not limit their activities, which quickly leads to severe exhaustion.

Other factors include:

• social - the inability of self-realization as a person;
• psychogenic - against the background of depression or other psychiatric abnormalities;
• female endocrine - with a physiological change in the hormonal profile during pregnancy, lactation, pre-menopause;
• cephalgic - due to frequent, but stable migraines of unclear reasons (characteristic of some women, children 10-16 years old);
• alcoholic / narcotic.

Special attention is required by children of any age who are in unfavorable social conditions - in case of divorce of parents or their failure to fulfill their due duties (lack of attention), orphans and orphaned, subjected to violent actions.

Diagnostic features

The identification of asthenic syndrome is based on a thorough analysis of the patient's complaints. Long-term, repeated polls are aimed at clarifying the connection between neurasthenia and a psycho-emotional basis, or with the presence somatic diseases, or for other reasons. Difficulties in clinical search are already possible in the initial stages.

An individual in a state of asthenia, as a rule, does not critically determine the need for his own treatment, considering that this is such overwork. And he does not need specialized help. In addition, there is still apathy and irritability.

It is extremely difficult to question such a patient. And, since it is necessary to identify the main provoking factor (or their combination), it is recommended to carry out the primary diagnosis in a specialized hospital. The lack of reliable information about the general somatic state of health adds to the difficulties in clinical search.

Examining a child, the doctor also needs to find out interpersonal family relationships. Which directly affects the interests and personal life of the patient's parents. Quite often, not only mom and dad, but also other relatives are influential people. Adding to this adolescent hormonal surges, any response from the patient can be expected indefinitely.

Given the high prevalence of the state of neuro-vegetative exhaustion, the patient himself and his immediate environment are required to be as open and truthful as possible in communication with a specialist. Since the reasons not identified in a timely manner make all therapeutic and restorative prescriptions ineffective.

Specialized examination

To determine the causes of the somatic group, clinical, laboratory, functional and hardware diagnostic tests recommended for a specific disease are used. Consultation of a specialized specialist is required.

The mandatory list of studies includes:

• general blood analysis;
• general urine analysis;
• blood chemistry;
• blood pressure monitoring;
• electrocardiography;
• echocardiography (ultrasound) with Doppler examination;
• electroencephalography;
• reo-encephalography.

According to the indications, MRI and / or CT of the brain, ultrasound examination of the vessels of the neck, and other narrow-profile examinations are prescribed.

Rehabilitation tactics

The relief of asthenic syndrome is a complex of measures aimed, first of all, at eliminating the predisposing factor. If in its capacity there is a chronic somatic pathology, its treatment is prescribed by a specialized specialist.

An individual therapeutic action plan is developed for each patient. It is recommended to start the recovery period in a specialized hospital.

Basic general therapeutic measures.

1. Daily regime. The balance of sleep and wakefulness is brought into an optimal ratio with the allocation of at least 8 hours a day for complete rest. If necessary, mild sedatives are prescribed to improve sleep and sleep quality.
2. Activity mode. In the waking state, the patient is limited to physical and intellectual activity. Ideally, hobby classes are organized. It is highly undesirable to resolve work issues, communication via telephone, Internet, watching news channels and programs / films with a pronounced emotional load.
3. Diet. During the recovery period, an increased protein diet, enriched with vitamins and minerals, is required. It is not recommended to eat foods with a high content of spices / marinades, smoked and fatty ones. Alcohol is absolutely contraindicated.
4. Purpose of adaptogens - tonics and drugs that improve intracellular metabolism. Low-dose antidepressants may be used if indicated.

In consolidating the rehabilitation, it is recommended to use sanatorium treatment without visiting resort areas with active rest. For a complete recovery, small holiday homes located in a forest area are more in demand.

The main preventive direction of the recurrence of asthenia is to maintain compliance with the regimes of the day, activity and nutrition. Hobbies are of no small importance.

The insidiousness of asthenic syndrome lies in its widespread prevalence. And so that many patients are not aware of the presence of exhaustion in them. Developing gradually, neurasthenia can progress dramatically. In such conditions, the likelihood of developing more serious psychiatric disorders is high. In particular, deep depression and even suicidal tendencies.

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