Phobic neurosis treatment. What is obsessive phobic syndrome

The phobic form of a neurotic disorder is an integral part of a phobic-anxiety neurosis, in which fears (phobias) become the main acting disorder. They arise against the background of unpleasant memories, experiences, difficult life events. Very often, complaints look like obsessions (compulsive states). Such patients are simply pursued by fears everywhere - at home, at work, in transport, on vacation. A person feels in constant danger, which leads to mental disorders and the vital activity of the organism as a whole. Such patients require consistent treatment for phobic neurosis.

Who and for what reasons is most susceptible to the development of phobic neurosis

This malaise can develop both as an independent disease against the background of existing specific character traits and temperamental characteristics, and as a complication of existing diseases - psychopathy, psychasthenia, alcoholism, drug addiction. Neurosis with fears can aggravate the course of diseases of internal organs (myocardial infarctions, strokes), oncological processes, endocrine pathologies.
Phobic neurosis affects both men and women. The primary development of the symptoms of the disease is characteristic of adolescence, as well as the transitional stage from maturity to old age. Often you can observe phobias in women during menopause.

People's fears develop against the background of:

chronic psychophysical overwork and overstrain;
received mental trauma;
any long-term, debilitating disease;
regular lack of sleep and malnutrition;

Symptoms and manifestations of phobic neurosis

The main type of phobic neurosis are panic attacks. These conditions can occur at different intervals, sometimes several times a day. The duration of the attack ranges from several minutes to 1-2 hours. Night attacks are especially painful. The impetus for their beginning can be any strong irritation, both external factors and internal sensations, as well as stress, alcohol, or drugs.

The patient develops:

excruciating feeling of fear with panic;
feeling of near death;
pronounced vegetative manifestations - severe sweating, trembling in the body, nausea and headache, stiffness of the body, especially fingers, their coldness, numbness.

In the interictal period, malaise can be expressed by fear of open places, or vice versa, closed ones. Some patients are afraid to go outside, they experience fears of crowds of large numbers of people. Some patients cannot travel by transport, especially in the subway. In these cases, the treatment of phobic neurosis should be started as early as possible, otherwise there will be an expansion of the range of fears that can bring the sick person to suicidal thoughts.
A separate category of people suffering from phobias are hypochondriacs. The fears of this category are due to the fear of getting sick with incurable and serious diseases - cancer, tuberculosis, stroke. AIDS, etc.
Some patients experience social phobias. The existing inferiority complexes can give a vivid picture of personal failure at work, in the family, in any other situation. People around often do not understand that a loved one is simply sick, they begin to subject him to ridicule, which tightens the “vicious noose” even more.

Treatment of phobic neurosis

The main type of assistance in the development of this disease is psychotherapy. The psychotherapist directs his efforts to eliminate feelings of fear, anxiety, obsessive experiences. The goal is gradually achieved by using individual psychotherapeutic techniques. The doctor uses the methods of rational persuasion to achieve a therapeutic result. Hypnosis is additionally used to enhance the effect of the therapy. In this state, a suggestion is made to a person suffering from a phobic neurosis, which helps to form healing attitudes and move away from the dominant symptoms of fear.

After mitigating the main manifestations of the disease, group psychotherapy sessions are recommended, in which people with similar problems, using the mutual induction created by the psychologist, try to eliminate the roots of their problems.
Conceived with phobic neurosis, patients are shown acupuncture and other types of reflexology.
More severe cases in the treatment of phobic neurosis are corrected with medication.

Depending on the main symptoms, patients are prescribed:

antidepressants (with pronounced degrees of depression of the psyche);
tranquilizers (in order to relieve stress reactions, smooth out fears);
sleeping pills (contributing to the normalization of night sleep);

In a hospital, in the treatment of phobic neurosis, physiotherapeutic procedures are actively used - electrosleep, manual therapy, soothing, therapeutic massage, physiotherapy exercises.

lethargic, apathetic, facial expressions are frozen, speech is poor, often of ridiculous content. In bed, they take elaborate poses, close their heads, make faces, make stereotypical movements, imitate animals, eat with their mouths.

The course of hysterical disorders:

Hysteroneurotic psychogenic reactions can be short-term, episodic and disappear spontaneously without treatment. It is also possible to fix hysterical manifestations for a long time, for several years. After their attenuation, there may remain a tendency to the emergence of individual hysterical stigmas (paresthesia, unsteadiness of gait, fainting) in situations that cause affective tension. Patients with functional hysteroneurotic disorders need a thorough somatic and neurological examination to rule out organic pathology.

II. Anxiety-phobic neurosis

The problem of phobias and obsessions attracted the attention of clinicians even in the prenosological period of psychiatry. Mentions of obsessions are found in the writings of Ph. Pinel (1829). I. Balinsky proposed the term "obsessive ideas", which took root in Russian psychiatric literature. In 1871, C. Westphal introduced the term "agoraphobia", which meant the fear of being in public places. However, only at the turn of the XIX-XX centuries. (1895-1903), thanks to the studies of Z.Freud and P.Janet, attempts were made to combine anxiety-phobic disorders into an independent disease - anxiety neurosis (Z.Freud). Somewhat later, P.Janet (1911) combined agoraphobia, claustrophobia, transport phobias with the term “positional phobias” [Tiganov A.S., 1999].

In accordance with ICD-10, psychopathological manifestations of anxiety disorders include the following symptom complexes:

disorder without agoraphobia, panic disorder with agoraphobia, hypochondriacal phobias, social and isolated phobias, obsessive-compulsive disorder.

Clinical manifestations:

Anxiety-phobic syndrome develops mainly in those cases when pronounced vegetative-vascular paroxysms were observed in the initial period of the disease. The affect of anxiety and fear, which arose at first in connection with vegetative-vascular paroxysms, becomes more and more constant as the syndrome develops. Against the background of indefinite anxiety, obsessive fears develop, associated with the possibility of a recurrence of the paroxysm and its tragic consequences. The intensity of obsessive fears is not measured by previous experience, which testifies to their groundlessness. Phobic phenomena are also intensified under conditions that place increased demands on the vestibular apparatus: when using various types of

transport, industrial vibrations, rhythmic visual stimuli (for example, when a stream of people flickers before the eyes). During periods of exacerbation of the condition, other psychopathological symptoms characteristic of the disease also arise or intensify: senestopathies, psychosensory disorders, derealization disorders.

Alarm states appear in two main forms. At generalized anxiety disorder anxiety is persistent and is not limited to any specific circumstances. The most common are complaints of a feeling of constant nervousness, restlessness, trembling, muscle tension, sweating, palpitations, dizziness, discomfort in the epigastric region, accompanied by fears and fears for their health and the health of their loved ones, as well as other various worries and forebodings. This disorder is more common in women and is often associated with chronic stress.

At panic disorder(episodic paroxysmal anxiety) anxiety manifests itself in the form of severe panic attacks, which are also not limited to a specific situation and therefore unpredictable. Dominant symptoms: sudden onset of palpitations, chest pains, a feeling of suffocation, dizziness, a feeling of unreality, often accompanied by fears of death, loss of self-control or insanity. Subsequently, the person tends to avoid the situation in which the first panic attack occurred. In addition, he may develop a constant fear of a repeat attack. Panic disorder most often determines the onset of the disease. At the same time, three variants of the dynamics of psychopathological disorders of the anxiety series, manifested by panic attacks, can be distinguished.

Option 1: the clinical picture of anxiety-phobic disorders is represented only by panic attacks. Panic attacks manifest themselves as an isolated symptom complex with a combination of signs of cognitive and somatic anxiety and are not accompanied by the formation of persistent mental disorders. The clinical picture of panic attacks expands only due to transient hypochondriacal phobias and the phenomena of agoraphobia, which are of a secondary nature. After the acute period and the reduction of panic attacks, the reverse development of concomitant psychopathological disorders also occurs.

Option 2: Anxiety disorders include panic attacks and persistent agoraphobia. Panic attacks occur suddenly, without any precursors, are characterized by vital fear, generalized cognitive anxiety with a feeling of a sudden, life-threatening bodily catastrophe with minimal severity of autonomic disorders and rapid (sometimes after the first attack) the formation of agoraphobia, phobophobia and avoidant behavior. As panic attacks regress, there is no complete reduction of psychopathological disorders.

Option 3: phobic anxiety disorders with panic attacks that develop as a vegetative crisis (Da Costa syndrome) and culminate in hypochondriacal phobias. Distinctive features of panic

attacks: subclinical manifestations of anxiety, combined with algia and conversion symptoms; psychogenic provocation of seizures; the predominance of somatic anxiety with the dominance of symptoms from the cardiovascular and respiratory systems without vital fear (“alexithymic panic”); expansion of the picture due to hypochondriacal phobias with minimal severity of phobic avoidance and agoraphobia. After the advanced panic attacks (acute period) have passed, there is no complete reduction of psychopathological disorders of the anxiety series. Hypochondriacal phobias (cardio-, stroke-, thanatophobia), which determine the clinical picture for months and even years, come to the fore.

Phobic disorders- These are disorders characterized by the occurrence of anxiety mainly in relation to certain situations or external objects. As a result, these situations are avoided or endured with a sense of fear. The experience of fear is usually accompanied by a variety of autonomic symptoms - palpitations, shortness of breath, feeling dizzy, dizziness, weakness in the legs, as well as secondary fears of death or loss of self-control. At the same time, anxiety is not reduced by the knowledge that other people do not consider this situation dangerous or threatening. Subsequently, the mere idea of entering a phobic situation triggers anticipatory anxiety in advance.

There are several types of phobias:

– fear of open spaces (being in a crowd or public places, moving outside the home, traveling alone);

– fear of individual animals;

- fear of heights;

– fear of closed spaces (travels in airplanes, elevators, metro);

– fear of blood or injury;

– fear of getting sick with a certain disease (myocardial infarction, cancer, sexually transmitted disease, HIV, etc.);

- fear of darkness;

– fear of exams, etc.

It should be noted that anxiety and phobic disorders are very often accompanied by a variety of sleep disorders (difficulty falling asleep, superficial night sleep, early awakening), depression (low mood, reduced self-esteem and self-confidence, poor appetite, loss of interests and ability to enjoy activities that used to give such pleasure, a pessimistic vision of the future), neurasthenic symptoms (fatigue, irritability) [Karvasarsky B.D., 1990].

Among the psychopathological manifestations of anxiety-phobic disorders, first of all, it is necessary to consider panic attacks, agoraphobia, hypochondriacal phobias, social phobia and mysophobia, since the greatest comorbid relationships are found in the dynamics of these symptom complexes.

Panic attacks- unexpectedly arising and quickly, within a few minutes, growing symptom complex of autonomic disorders (vegetative crisis - palpitations, chest tightness, feeling of suffocation, lack of air, sweating, dizziness), combined with a feeling of impending death, fear of loss of consciousness or loss of self-control , crazy. The duration of manifest panic attacks usually does not exceed 20-30 minutes.

Agoraphobia, contrary to the original meaning of the term, includes not only the fear of open spaces, but also a number of similar phobias (claustrophobia, phobia of transport, crowds, etc.), defined by P. Janet (1918) as position phobias. Agoraphobia, as a rule, manifests itself in connection with (or after) panic attacks and, in essence, is the fear of being in a situation fraught with the danger of a panic attack. As typical situations that provoke the occurrence of agoraphobia, there are a trip to the subway, being in a store, among a large crowd of people, etc.

Hypochondriacal phobias (nosophobia) - an obsessive fear of any heavy

yellow disease. The most common are cardio-, carcino- and stroke-phobia, lyssophobia (fear of getting sick with a mental illness), as well as syphilo- and AIDS-phobia. At the height of anxiety (phobic raptus), patients sometimes lose their critical attitude to their condition - they turn to doctors of the appropriate profile, require examination.

social phobias- fear of being in the center of attention, accompanied by fears of negative assessment by others and avoidance of social situations. Data on the prevalence of social phobias in the population varies from 3 to 5% [Kaplan G.I.. Sadok B.J., 1994]. These patients rarely come to the attention of psychiatrists. Among those not covered by therapeutic measures, persons with subthreshold social phobias that do not significantly affect daily activity predominate. Most often, those suffering from this disorder, when contacting a doctor, focus on comorbid (mainly affective) psychopathological symptom complexes. Social phobias usually manifest during puberty and adolescence. Often their appearance coincides with adverse psychogenic or social influences. At the same time, only special situations act as provoking ones (answer at the blackboard, passing exams - school phobias, appearing on stage) or contact with a certain group of people (teachers, educators, representatives of the opposite sex). Communication with family and close friends, as a rule, does not cause fear. Social phobias may occur transiently or tend to develop chronically. Patients suffering from social phobias are more likely than healthy people to live alone and have a lower level of education.

Social phobias are characterized by a high level of comorbidity with other mental disorders. In most cases, they are combined with simple phobias, agoraphobia, panic disorder, affective

pathology, alcoholism, eating disorders, which worsens the prognosis of the disease and increases the risk of suicidal attempts. There are two groups of states - isolated and generalized social phobias.

The first of these includes monophobia, which is the fear of not performing habitual actions in public associated with anxious expectations of failure (fear of public speaking, communication with superiors, eating in public places), and as a result, avoidance of specific life situations. At the same time, there are no difficulties in communication outside of such key situations. This group of phobias includes ereitophobia - the fear of blushing, showing awkwardness or confusion in society. Accordingly, shyness, embarrassment appear in people, accompanied by internal stiffness, muscle tension, trembling, palpitations, sweating, dry mouth.

Generalized social phobia is a more complex psychopathological phenomenon, including, along with phobias, ideas of low value and sensitive ideas of attitude. Disorders of this group most often act as part of the scoptophobia syndrome. Scoptophobia (Greek scopto - to joke, mock; phobos - fear) - the fear of seeming ridiculous, to find signs of imaginary inferiority in people. In these cases, in the foreground there is an affect of shame, which does not correspond to reality, but determines behavior (avoidance of communication, contacts with people). Fear of disgrace may be associated with ideas about people's hostile assessment of the "flaw" ascribed to themselves by the sick, and the corresponding interpretations of the behavior of others (scornful smiles, ridicule, etc.).

Mysophobia (fear of pollution)) . This group of obsessions includes not only the fear of pollution (by earth, dust, urine, feces and other impurities), but also phobias of penetration into the body of harmful and toxic substances, small objects, microorganisms, i.e. phobias of extracorporeal threat. In some cases, the fear of contamination may be limited, remain for many years at a subclinical level, manifesting itself only in some features of personal hygiene (frequent change of linen, repeated washing of hands) or in housekeeping (thorough handling of food, daily washing of floors). , "taboo" on pets). This kind of monophobia does not significantly affect the quality of life and is evaluated by others as habits [Tiganov A.S., 1999].

Clinically completed variants of mysophobia belong to the group of severe obsessions, in which a tendency to complication and generalization is often found. In these cases, gradually becoming more complex protective rituals come to the fore in the clinical picture: avoiding sources of pollution, touching "unclean" objects, processing things that could get dirty. Stay outside the apartment is also furnished with a series of protective measures: going out into the street in special clothing that covers the body as much as possible, special processing of wearable items upon returning home. In the later stages of the disease, patients, avoiding

touches with dirt or any harmful substances, not only do not go outside, but do not even leave the limits of their own room.

Mysophobia is also associated with the fear of contracting a disease, which does not belong to the categories of hypochondriacal phobias, since it is not determined by fears of the presence of a particular disease. In the foreground - the fear of a threat from the outside - the fear of penetration into the body of pathogenic bacteria. The fear of infection in these cases sometimes arises in an unusual way: for example, due to fleeting contact with old things that once belonged to a sick person.

III. obsessive-compulsive disorders Clinical manifestations:

The manifestation of clinically defined manifestations of obsessive-compulsive disorders falls on the age interval of 10 years - 24 years. Obsessions are expressed in the form of obsessive thoughts and compulsive actions, perceived by the patient as something psychologically alien to him, absurd and irrational [Asatiani N.M., 1985]. obsessive thoughts- painful ideas, images or drives that arise against the will, which in a stereotyped form again and again come to the mind of the patient and which he tries to resist. Compulsive actions- repetitive stereotypical actions, sometimes acquiring the character of protective rituals. The latter are aimed at preventing any objectively unlikely events that are dangerous for the patient or his relatives.

Despite the diversity of clinical manifestations, in a number of obsessive-compulsive disorders, outlined symptom complexes are distinguished: obsessive ideas, thoughts, fears, actions [Svyadoshch A.M., 1982].

1) Obsessions often have the character of vivid obsessive memories. This includes some melodies, words or phrases, from the sound images of which the patient cannot free himself, as well as visual representations. Sometimes they have a bright sensual coloring, characteristic of sensations, and approach obsessive or psychogenic hallucinations. Obsessive images very often arise in the form of extremely vivid obsessive memories, reflecting the psycho-traumatic effect that caused them.

2) obsessive thoughts can be expressed in the form of obsessive doubts, fears, blasphemous or "blasphemous" thoughts and sophistication.

* With obsessive doubts, there is usually a painful uncertainty about the correctness or completeness of this or that action, with the desire to check its implementation again and again. Obsessive doubts can sometimes force the patient to exhaustively check the correctness of the performed action for hours. Compulsions in these cases stop only after the restoration of the internal feeling of completeness of the completeness of the motor act.

* With obsessive fears, patients are painfully afraid that they will not be able to perform this or that action when it is required, for example, play a musical instrument in front of an audience or remember dictionaries, answer without blushing (ereitophobia), fall asleep, start walking, getting out of bed after an illness , swallow the food. d.

* Contrasting obsessions ("aggressive obsessions", according to S.Rasmussen, J.L.Eisen, 1991) - blasphemous, blasphemous thoughts, fear of harming oneself and others. They are distinguished by a sense of alienation, unmotivated content, as well as a close combination with obsessive drives and actions, which are a complex system of protective rituals. Patients with contrasting obsessions complain of an irresistible desire to add certain endings to the remarks they have just heard, giving an unpleasant or threatening meaning to what has been said, to shout out cynical words that contradict their own attitudes and generally accepted morality; may experience fear of losing control of themselves and the possible commission of dangerous or ridiculous actions, self-aggression, injuring their own children. In the latter cases, obsessions are often combined with object phobias (fear of sharp objects). The contrasting group also partially includes obsessions of sexual content (obsessions of the type of forbidden ideas about perverse sexual acts, the objects of which are children, representatives of the same sex, animals).

* With obsessive sophistication (“mental chewing gum”), patients are forced to endlessly think about certain things that have no meaning and are of no interest to them, for example, to think about what will happen if a state of weightlessness occurs on earth, or if humanity is stripped of its clothes and everyone has to go naked.

3) Obsessive fears (phobias) are the most diverse and wind up most often. These include: fear of death (thanatophobia) from various causes: heart disease (cardiophobia), the possibility of committing suicide, etc., fear of contracting syphilis (syphilophobia), cancer (carcinophobia), myocardial infarction (heart attack), mental (lyssophobia) ) and other diseases, fear of pollution (mysophobia), phobia of penetration into the body of harmful and toxic substances, small objects, microorganisms, fear of open space (agarophobia), enclosed spaces (claustrophobia) and the like. Many patients, in an attempt to facilitate overcoming obsessive fear, perform protective actions (rituals) that should “prevent” what they are afraid of.

4) obsessive actions relatively rarely act in isolation, not combined with verbal obsessions. A special place in this regard is occupied by obsessive actions in the form of isolated, monosymptomatic movement disorders. Among them, tics predominate, especially often in childhood. Tics give the impression of exaggerated physiological movements. This is a kind of caricature of certain motor acts, natural gestures. Patients suffering from tics may shake their heads (as if checking if the hat fits well), make hand movements (as if

Usually, fear, panic and anxiety are manifestations of a pathological condition that has received the name phobic neurosis in medicine. A phobia is a psycho-state of intense fear, which leads to neuroses, including those of a phobic nature.

Most often, pathology is found in adolescents and young men. During this period, the child's body undergoes active hormonal changes, which leads to various mental disorders. Anxiously phobic neurosis is expressed in timidity, shyness, suspiciousness.

If an illness develops, then the child enters into a conversation with peers a little. When they start talking to him, this leads to panic fear and even hysteria. The child subsequently tries to exclude communication with people, which leads to various mental disorders.

At the initial stage of the development of the disease, the appearance of fear is due to a number of factors, but soon its occurrence occurs when any situation or object is mentioned. Subsequently, a person begins to be pathologically afraid of everything. Even with the understanding of his illness, he is afraid of everything against his will. People who have a problem in the form of phobic manifestations during their lives try to protect themselves from panic attacks.

In addition, with phoboneurosis disease, other unpleasant symptomatic signs may appear in the form of headaches, dizziness, depression, heart pathologies, and some others. Seeing something that causes terrible associations, a person again becomes subject to phobias. The patient is very tense and cannot be relaxed, no matter how hard he tries to do it.

People who are prone to phobias diligently avoid the conditions that caused the pathology. They try to think of other situations and objects.

A person is prone to phobo-states in the following situations:

if there is a negative association about the subject;
with bad experiences in the past.

Symptoms of the disease may occur due to:

dysfunction of the endocrine system of the body;
a number of hereditary factors;
increased anxiety, constant anxiety, excessive responsibility, suspiciousness;
emotional overstrain and physical exhaustion;
dysfunction of sleep processes;
malnutrition and daily routine;
infectious pathogenic conditions;
excessive drinking of alcoholic beverages, tobacco smoking, drug use and other bad habits that are incredibly harmful to the human body.

The occurrence of phoboneurosis is due to the development of other pathological psycho-states, including schizophrenic, obsessive-compulsive, psychoasthenic manifestations.

Phobic neuroses arise at certain stages of a person's life path. Especially at risk are people in adolescence, in adolescence, and before menopause.

Types of neurosis

When a person is stricken with fear at the sight of people or objects, he develops a phobic state. Sometimes the patient only needs to remember something to start to be afraid and afraid of everything. In the modern world, the development of phobias occurs in two ways:

If a person unsuccessfully performed some work and this contributed to the appearance of negative consequences, then this served as the development of a primary reflex. For example, a person burned himself on the surface of a hot iron and is now afraid to iron clothes.
The appearance of fears is due to a secondary reflex. For example, the patient is afraid to talk on the phone, because some time ago during the conversation there was a fire or an accident.

Modern man becomes subject to agoraphobia, fear of open space. He is afraid to leave the room. A person may also experience claustrophobia, which is expressed in a strong fear of enclosed spaces. The patient makes attempts to visit only spacious rooms and stay in outdoor conditions.

If a person has a fear of heights, then this leads to acrophobia. With the fear of various living beings, a zoophobic phobo-state occurs. When a person is in the center of attention, they talk about the presence of social phobia.

In the modern world, there are a large number of psychoneurotic phobo-states that are united by one thing - dysfunction of mental processes.

Experts distinguish 3 types of panic fear:

A person tries not to touch the objects that caused his panic fear.
The person expects to touch the object that caused the phobic condition.
Patients seem to touch the object, after which fear appeared, which leads to the onset of psychophobic states.

Real Examples

Agoraphobia and nosophobia are rare in nature. A close connection with panic psychostates is not formed.

But sometimes the occurrence of agoraphobic manifestations due to panic attacks is possible. Such phenomena can arise for no reason, for no reason at all, a person begins to worry, to be afraid of everyone and everything. A person understands a panic attack as a catastrophic threat to life. At the same time, there is a weak severity of vegetative symptoms.

Panic attacks disappear in the second variant of phobic disorders along with obsession and hypochondriacal symptoms. At this time, the patient is trying to eliminate the factors that led to the emergence of panic. Patients develop certain rules, the observance of which will not lead to the development of the disease. People often write a letter of resignation and change their working conditions, area of residence, they observe the correct daily routine, do not communicate with anyone outside.

If vegetative-crisis phobo-states develop, then the occurrence of panic attacks against the background of residual insufficiency is due to the appearance of severe anxiety, various painful sensations. If psychogenic factors are not eliminated, then this leads to the appearance of a rapid heartbeat, sensations of lack of air, and suffocation. The patient does not feel better as the disease progresses. People begin to carefully monitor their health, believing that they develop a serious pathological disease.

signs

Experts identify the following common signs of phobic neurological conditions:

frequent feelings of panic and fear;
dysfunction of the heart, blood vessels, respiratory organs and other organs and systems of the human body;
dysfunction of sleep processes;
constant headache and dizziness;
feeling of general weakness;
depressive manifestations;
the person becomes emotionally and mentally tense.

Detection of all of the above signs occurs as a result of contact, sick with the object of phobic pathology.

Symptoms

Experts divide symptomatic signs into several groups:

The occurrence of panic attacks. The patient is afraid and expects a speedy death. All this is accompanied by an increase in sweating, dysfunction of the heart rhythm, and the appearance of dizziness. A person begins to feel sick, he suffocates and feels the unreality of the situations that are happening.
The emergence of agrophobia, manifested by fear of a large crowd of people, open space. If the disease has passed into a difficult stage, then he is afraid to leave his own home.
If the patient is afraid of some disease, then he may develop the pathology of hypochondriacal phobia. It seems to him that an incurable disease has already struck his body.
In the modern world, one can often encounter social phobias, expressed in fear of the attention of other people, fear of criticism or ridicule.

Treatment

Anxious phobic neurosis is often treated in combination. Specialists prescribe psychotherapeutic measures and methods of treatment.

The elimination of the state is possible with the help of psychotherapeutic influence. Patients are taught to avoid objects of phobia and apply relaxation techniques. Sometimes behavioral therapy and hypnosis are used. Patients are trained to withstand fear-inducing objects, apply a variety of methods of relaxing procedures.

Panic attacks are eliminated with the help of antidepressants. Neurosis is effectively treated with Anafranil (Clomipramine), Fluvoxamine, Sertraline, Fluoxetine.

If social neurosis develops, then treatment is carried out with Moclobemide (Aurox).

In addition to antidepressant drugs, it is necessary to take tranquilizers in the form of Meprobamate, Hydroxyzine, Alprazol and Clonazepam. They can only sometimes lead to side effects. If drugs are used for a long period of time, then drug dependence is not observed. It is necessary to strictly monitor the use of Diazepam and Elenium, as a person soon gets used to them.

Perhaps the use of neuroleptic drugs, especially Triftazin, Haloperidol and others.

The appearance of phobic disorders often occurs due to various factors, which can only be eliminated by a neuropsychiatrist after examination and the appointment of various methods of treatment procedures. If the patient ignores the psycho-state, then undesirable consequences for the human body may occur, therefore, at the first appearance of fear, it is better to consult a doctor.

Phobic neurosis is a type of disorder in which a person experiences a feeling of fear and anxiety associated with an object, phenomenon or memory. The condition is uncontrollable, the person is panic-stricken. But at the same time, the person is aware of the irrationality of his reactions.

Types of phobic neuroses and causes

There are dozens of types of phobias. Consider the most common disorders (the object of fear is indicated in brackets):

acrophobia (height);
agoraphobia (open large spaces, crowded places);
claustrophobia (enclosed spaces);
nosophobia (deadly disease);
hypochondria (disease);
social phobia (fear of being the center of attention);
thanatophobia (death).

Phobic neurosis develops in two scenarios:

It is formed as a primary conditioned reflex. Fear is associated with the negative experience of the individual, mental trauma. For example, a person is afraid of dogs because they bit him badly as a child.
Occurs as a secondary conditioned reflex. Fear is not associated with the object itself, conditions, event, but arises against the background of association. For example, a person is afraid to go outside because he was bitten by dogs as a child.

Causal relationships are established arbitrarily, depending on the characteristics of the individual.

The occurrence of obsessive-phobic neurosis is affected by:

heredity;
character accentuations (anxiety, suspiciousness, hyperresponsibility);
suggestibility (news from the media can cause fear);
overwork, psychophysiological exhaustion;
endocrine disorders;
malnutrition, disturbed sleep patterns, bad habits;
infections, brain injuries that caused disturbances in the functioning of nerve cells;
mental personality disorders (schizophrenia, psychasthenia, depression).

The likelihood of a phobic neurosis increases during periods of natural hormonal changes in the body: transitional age, pregnancy and menopause in women, a midlife crisis.

Can phobic neurosis be cured?

Without treatment, fear accumulates and grows like a snowball, over time it takes a person's entire life. But you can get rid of obsessive thoughts, memories and fears.

The choice of treatment depends on the symptoms and severity of the neurosis. In total, there are 3 degrees:

Mild: Fear arises upon contact with an object.
Medium: fear arises when contact is expected.
Severe: fear arises from the mere thought of the object.

The earlier treatment is started, the better the prognosis.

Symptoms and treatment of phobic neurosis

Symptoms of neurosis include:

isolation, avoidance of places, objects, conditions reminiscent of trauma;
irrational fear and anxiety;
obsessions, or intrusive thoughts related to the subject of fear;
compulsions (obsessive actions), as an attempt to compensate for the feeling of losing control over the situation;
panic attacks.

Panic attacks are manifested by a number of somatic symptoms: heart rhythm disturbance, breathing problems, suffocation, sweating, fear of death. The condition is beyond the control of the patient.

Due to phobic neurosis, obsessive-compulsive disorder often develops. The person invents that obsessive actions (rituals) will help to cope with anxiety. For example, the patient washes his hands 10 times to get rid of germs, or, leaving the house, checks the switches 6 times so that there is no fire. In advanced cases, people can stand in the shower for hours, waiting for the water to “wash” the obsessive thought out of their heads.

You can’t get rid of obsessions and phobias on your own. You need to see a doctor so that he tells you how to treat a phobic neurosis in a particular case.

Phobias require complex treatment, which include:

Psychotherapy. Fear arises due to psychotrauma. We need to find and eliminate it. The problem is that the cause is hidden in the subconscious, is not realized by the person himself, especially in the case of a secondary origin of neurosis. The doctor will help to find the deep causes of the phobia, break the erroneous cause-and-effect relationships, accept negative memories and change the attitude towards them. Cognitive behavioral therapy and neurolinguistic programming (NLP) are used to work with phobias.
Medical treatment. The purpose of drugs depends on the characteristics and severity of neurosis. The doctor may prescribe antidepressants, tranquilizers, sedatives. Inhibitors may be needed to restore normal brain function.
Lifestyle change. It is necessary to normalize the diet, sleep and work. You need to relax, conduct calming activities, walk, play sports. All this supports the normal hormonal background, helps to distract, relieve stress.
Support and love of family and friends. We need to recognize the problem and find like-minded people.

Trying to deal with anxiety on your own only makes it worse. A person accuses himself of being weak-willed, but this has nothing to do with it. Neurosis is a disease, not a defect of character. Therefore, you can’t blame yourself and self-medicate, you need to contact a psychotherapist.

Phobic neurosis is a mental illness characterized by obsessive fears, thoughts, and memories. These obsessions are unpleasant for patients because they occur without their knowledge and are not amenable or poorly controllable. Due to its negative connotation, obsessive phobia is perceived by the patient as alien, thus reinforcing his fear according to the “snowball” principle. Gradually, obsessive fear takes the whole life of the patient, and he loses the ability to think about anything other than a phobia.

The occurrence of phobic neurosis may be due to:

hereditary factors. We are talking about certain character traits, such as timidity, shyness, suspiciousness. A person with such a set of qualities experiences his own failures more than others, is prone to excessive introspection and a heightened sense of guilt.
situational factors. These phobic neuroses are divided into primary and secondary reflexes. The first arise as a response to an external stimulus. For example, a person with this disease begins to be afraid of heights after he almost fell off the roof. In the case of a secondary phobic disorder, the person does not connect events directly and begins to experience fear of indirect phenomena related to fear. So, the patient will be afraid of cockroaches, because he observed them during a stressful situation (for example, when a fire started).
physical factors. Chronic fatigue, poor sleep, eating disorders, constant stress can lead to the development of the disease.

What are the symptoms of phobic neurosis?

Patients try to avoid phenomena, objects, conversations that directly or indirectly remind of their fear.
Phobic neurosis can manifest itself in various forms. So, with agoraphobia, the patient will be afraid to be in crowded places, in open spaces. Other forms of the disease are also possible. The most common:
- acrophobia - fear of heights;
- claustrophobia - fear of closed spaces;
- nosophobia - fear of getting sick with a deadly disease;
- social phobia - fear of social contacts;
- thanatophobia - fear of death.
In various forms of phobic neurosis, a person tries to compensate for the influence of obsessions. Then there are compulsions (rituals) designed to alleviate negative thoughts. A person with this form of phobic neurosis can check many times whether he closed the front door before leaving, whether he turned off the light. Almost always, the ritual is accompanied by a count of the number of actions performed. In severe forms, a person can wash their hands for hours or close / open the locker door and, as a result, do not even leave the house. It is worth noting that compulsions can manifest themselves not only as actions, but also as compensatory thoughts aimed at combating obsessive fear.
Panic attacks are sudden attacks of severe anxiety. Accompanied by lack of air, rapid heartbeat, fear of death. Seizures are not controlled by patients.

Treatment of phobic neurosis

It is impossible to cure this disease on your own. The fact is that the fight against obsessions only increases anxiety, closing a vicious circle for the patient. Not thinking about it is an impossible task. The patient would be happy to get rid of obsessive fear, but is not able to. Not because he does not have an iron will and does not know how to control himself. Phobic neurosis is a disease, and, like bronchitis, you cannot get rid of it by willpower.

What should be done?

We recommend contacting a good psychiatrist. We know that it is not easy to decide to make an appointment - fear, fear of misunderstanding interferes. But it should be understood that it is impossible to do without the help of a doctor, you cannot solve problems on your own.

Treatment of phobic neurosis is carried out in a complex manner. Medications and cognitive-behavioral therapy can relieve the patient of obsessive fear, thoughts, memories. Also, a good help on the road to recovery will be the love and support of loved ones.

Let fear be free. As soon as you stop resisting him, he will immediately weaken. Remember that most of our fears are irrational, that is, there is no real cause for concern.
If you are tormented by obsessive ideas, vivid images of fear, fixate on this mental image. Regular analysis of the phobia will allow you to reduce the level of anxiety somewhat.
The disease severely debilitates the psyche. Relaxing baths, soothing essential oils, such as ylang-ylang or clary sage, will help to cope with this. Drinking peppermint tea and other soothing herbs won't hurt either.
A walk in the fresh air and regular sports activities can distract the patient from unpleasant thoughts and fears.

To get the help of a psychotherapist, it is enough to make an appointment by phone.