Anoreksija nervoza: Simptomi i liječenje
Anorexia.Today, many people write about this disease in the media and they say from the TV screen.The appearance of the exhausted bodies of patients frightens the inhabitants of at least the photographs of the prisoners of Buchenwald and Auschwitz.Experts call the terrible figures: the proportion of deaths from anorexia in the world reaches 10-20%.At the same time about 20% of patients have suicidal tendencies and attempt suicide.Anorexia chooses the young: the age limit of the sick is 12-25 years, 90% of them are girls.And one more statistical paradox: the higher the standard of living in the country, the more people are affected by the disease.
What is this disease that causes physically healthy people to quench their natural hunger and bring the body to complete exhaustion?Why is the desire to take food out of the need in it?Is it possible to somehow resist this pathological process?Let's talk about everything in order.Contents:
The term "anorexia"
Note: is used in the broad literature for both the symptom of appetite reduction and a separate disease - anorexia nervosa.
The name itself comes from the Greek( ἀν- - "not-", and also ὄρεξις - "appetite, a urge to eat").
This syndrome accompanies a large number of other diseases and is an integral part of them.
Symptoms of anorexia may occur when:
- infectious diseases: pneumonia, bronchitis, purulent diseases;
- diseases of the digestive system: gastritis and ulcers, colitis and enteritis;
- parasitic infestations: ascaridosis, giardiasis, amoebiasis;
- neurological diseases;
- endocrine pathology;
- oncological pathology: benign and especially malignant neoplasms;
- Side effects of drugs: antidepressants, certain types of hormones and anti-hormones
Anorexia nervosa is a mental illness that manifests itself in the form of an eating disorder that causes and sustains the patient.In this case, he has a pathological craving for weight loss, a strong fear of obesity and a distorted perception of his own physical form.
Considering anorexia as the only problem of excessive desire for fashionable leanness and slenderity is fundamentally wrong.Attempts to present everything in the light of excessive enthusiasm for diets, only aggravate the situation with the prevalence of the disease.It is a pathology with a complex etiology, in the development of which many causes, both internal and external, are associated with the organism of a particular person.
In addition, social and cultural factors play a very important role, as well as subtle human connections with society.That is why anorexia is considered a disease and for the correct fight against its development, medical measures are needed.After all, inadequate care is a serious threat to health and, unfortunately, often for human life.
A popular documentary film is devoted to the problems of the social background of anorexia.The authors try to answer the question of the global causes of the spread of such a disease as anorexia:
Male or female disease?
For a long time it was believed that anorexia is a disease that affects only representatives of the beautiful half of humanity, and many still adhere to such views.However, this is not entirely true.
There are certain data on the prevalence of anorexia:
- On average, in women, anorexia occurs in 1.3-3% of cases among all diseases.
- The incidence rate among men is 0.2%.
- There are cases of anorexia in children and adolescents
- In the absence of treatment, the mortality rate is 20%.
- Adequate therapy is prescribed only in 5-10% of cases.
- Among psychiatric diseases, anorexia is in the top three in the frequency of deaths.
Causes of anorexia
Anorexia, like any disease, has certain risk factors that increase the incidence of the disease.
The proven ones are:
- Genetic predisposition .Hereditary factors are expressed in the fact that in families where parents suffer from anorexia or other eating disorders( bulimia), children are born who, under adverse conditions, may experience anorexia much more often.
- Biological factors .They are manifested in the fact that children with initially high body weight are more likely to develop behavioral disorders.They are also facilitated by early sexual maturation and dysfunction of neurotransmitters regulating food behavior( norepinephrine, dopamine, serotonin).
- Food Factors .It is well proven that the shortage of microelements such as zinc in products can lead to a decrease in body weight, and its intake in a sufficient daily dosage helps in weight gain in patients at the stage of treatment.Zinc deficiency itself does not cause anorexia, but exacerbates its course.
- Family factors .The child, observing the behavior of family members suffering from anorexia or sitting on debilitating diets, gradually adopts this style of behavior and takes it for granted.Especially the significance of this factor is exacerbated with the encouragement of this style of behavior on the part of parents.The risk of developing an eating disorder increases with a close relative suffering from drug dependence, alcoholism, frequent depression.
- Personal factors .Mainly anorexia suffer especially hypochondriacal, insecure and obsessive-obsessive individuals.Also, personal factors provoking the disease include a low level of self-esteem and low mood, lack of positive emotions.
- Culture factors .Living in developed industrial countries with a developed beauty industry and accentuation on thinness, as one of the criteria of beauty;Living in prolonged stressful conditions can become a background for the development of anorexia.Here it is possible to carry any types of the transferred violence concerning the person.
- Age factor .Perhaps, one of the most significant, as for the juvenile group of patients with anorexia account for up to 90% of all cases of anorexia.At present, the age from 12 to 27 years is considered critical.Many authors note a gradual "rejuvenation" of the contingent for the first time sick.
- The choice of the style of behavior in society .In response to constant challenges from society, some people choose certain areas of activity in which they can prove first of all to themselves, the ability to actively resist constant pressure.Frequent surrender before the onslaught of adults, peers, circumstances forces some individuals to intensify their struggle with appetite.This desperate struggle is a kind of search for your own self and an attempt to restore lost self-esteem.So every uneaten piece gives a taste of victory and a sense of worth, which it is not so easy to refuse.
Anxorrhagic signs of anorexia
Some reliable signs are needed to make a clinical diagnosis of anorexia, however, there is a group of symptoms, the appearance and combination of which should alert the relatives of the patient or the patient about the possibility of the onset of a painful process.
- sensation by a man of his own completeness;
- expressed fear of weight gain;
- changing the way you eat;
- sleep disorders;
- constant low mood;
- unmotivated mood swings;
- a propensity for solitude;
- hobby for cooking with the preparation of elegant meals without taking part in meals;
- close attention to diets and weight loss methods;
- is an obvious denial by a person of an existing problem.
In the presence of these symptoms, especially when several symptoms are combined with each other, or when adding one to the already existing ones, mandatory specialist consultation is necessary!
Note: uses a specially designed for this test of the relationship to food intake as an estimate of the risk of developing anorexia.
Clinical symptoms of anorexia
Important! when seeking medical help, the ultimate goal is to visit the psychiatrist's doctor.No nutritionists, endocrinologists, nutritional specialists, therapists and physicians of other specialties will not be able to provide really adequate help to anorexic patients, although in the process of examination and treatment you will have to consult many specialists.
At present, the combination of ALL of the following symptoms is a reliable indication of the patient's anorexia:
- Body weight is more than 15% below the required level, with the Bodylet's Bodyweight Index being below the value of 17.5.An important point is the child's inability to gain weight in the pubertal period.
- Vomiting, taking laxatives or diuretic( diuretic) drugs, drugs that reduce appetite, and excessive physical activity.
- Distortion of the image of one's own body by the type of dysmorphomania, in the particular case of which the patient admits exceptionally low weight for the unattainability of the ideal result.
- Multiple endocrine disorders, manifested in abnormal secretion of sex hormones, adrenal hormones, pancreas, thyroid gland.An important point is the altered synthesis and secretion of regulatory factors in the hypothalamic-pituitary system.In this case, there are symptoms such as changes in growth rates, up to its slowdown.
- Separate moment marked a violation of sexual development, which can occur in girls in amenorrhea( no monthly), underdevelopment of the mammary glands.The boys are delayed development of the genitals, there is no development of hairy style in the male type.
Important! All these symptoms of anorexia are diagnosed in seemingly healthy adolescents whose thinness can easily be confused with the constitutional features of the organism itself.
Verification of the diagnosis of anorexia does not consist of a psychiatrist alone.To confirm the diagnosis and exclude other reasons that may also occur, consultation with other specialists is also needed.
Stages of anorexia
Anorexia is a progressive disease and in its course there are a number of definite stages that are related to each other.Each of the following is not only more severe on clinical symptoms, but also reflects the evolution of the disease, its aggravation and the formation of ever more damaging consequences for the organism.
The main stages of anorexia nervosa include:
Symptoms of the stage of dysmorphia
It is mainly characterized by the predominance of mental and psychological symptoms.The patient is dissatisfied with his own weight, considering it superfluous, and the assessment is subjective.Very often, such patients are depressed or anxious.Gradually, the style of their behavior begins to change.Their activity is quite intensive in terms of finding the ideal diets and maximizing effective ways of losing weight.
It is believed that the full completion of this stage is marked with the beginning of the first attempts to change their own eating behavior( fasting, vomiting, exhausting workouts against a background of insufficient food intake).
Symptoms of the stage of anorexia
It is considered the flowering of the clinical picture and is observed against the background of persistent starvation.Each fixation of weight loss is regarded as an achievement and at the same time is a stimulant for an even greater diet or the use of several ways to change eating behavior.
Anorexia patients with reduced food intake may specifically induce vomiting with the use of laxative pharmacological agents and intense physical exertion.At this stage of anorexia nervosa, any praise for their thinness is perceived as a compliment and at the same time as a "hidden mockery".
Critical remarks can cause significant affective reactions with autoaggression, or maximum, unreasonable, repeated tightening of the "perfect weight" regimen.All the results achieved are never sufficient because of a persistent change in the perception of one's own body.It is at this stage of anorexia nervosa that symptoms of changes in the functioning of all organs and systems begin to be observed.
The stage of cachexia
At its core is the final stage.There is a depletion of the body with irreversible changes in all organs and tissues.At this stage, treatment is ineffective due to multiple irreversible multi-systemic damage to the entire body.The average time of this stage is 1-2 years.
Important! In anorexia, absolutely all organs of the human body suffer, and the defeat of especially important systems leads to an increase in the rate of progression of the disease and the early onset of the lethal outcome of .
Treatment of anorexia
Anorexia treatment is possible, however it is a rather complex, multicomponent and time-consuming process that has many application points
In the treatment of anorexia nervosa,
- psychotherapeutic techniques are used;
- power supply correction;
- emotional support;
- medical methods
Psychotherapeutic methods of treatment of anorexia
Different types of psychotherapy aim at normalizing the patient's mental background.Many specialists consider them as a basis for recovery.
With the implementation of various programs for the correction of the psyche, it is possible to correct previously distorted ideas about inferiority, overweight.
Psychological methods of treating anorexia contribute to the normalization of the perception of one's own body.A separate direction is the normalization of relations in the family and the immediate environment of the patient with anorexia.
Create a background of emotional support and help with anorexia.
In fact, this is one of the types of psychological help in the treatment of anorexia.Only it does not come from the doctor, but from the closest people, thanks to which a positive emotional background is created, which allows receiving a positive response of patients in response to difficult or unusual decisions for them.This contributes to the resolution of crises and the removal of permanent stresses.
Therapeutical nutrition for anorexia
An extremely important moment in the treatment of anorexia is the normalization of body weight, which requires a gradual increase in the food intake.For this purpose, appropriate programs have been developed that allow to restore the mass without negative effects for the "practically atrophied" digestive system.
Medical methods for the treatment of anorexia
Pharmacotherapy in this situation is an additional factor and consists in the correction of mental disorders with appropriate drugs.Showing and taking medicines to increase appetite.Also, some schemes include drugs to reduce the likelihood of possible relapses.
Forecast of the disease
The following development options are typical for anorexia:
- Complete recovery.
- Recovery with the existing organic consequences of organs and systems.
- Recurrent course with varying frequency and duration of exacerbations.
- Death for various reasons - from suicide to cachexia.
- In rare cases, there is a transformation of the disease into bulimia - uncontrolled overeating.
Remember! Cachexia therapy is a long process and depends largely on its correctness and the timing of the initiation of adequate treatment of anorexia.Ignoring the problem, as well as self-medication, is harmful not only for health, but also for the life of patients.
Physician therapist, Sovinskaya Elena Nikolaevna