Asthenia: symptoms, treatment

Asthenic syndrome, or asthenia (in translation from Greek means "lack of strength", "impotence") is a symptom complex, indicating that the body's reserves are depleted, and he is working out of his last efforts. This is a very frequent pathology: according to the data of different authors, the frequency of morbidity is from 3 to 45% in the population. About why there is asthenia, what are the symptoms, the principles of diagnosis and treatment of this condition, and will be discussed in our article.

What is asthenia?

Asthenia is a psychopathological disorder that develops against the background of diseases and conditions that in one way or another deplete the body. Some scientists believe that the asthenic syndrome is a harbinger of other, very serious, diseases of the nervous system and the mental sphere.

For some reason, many townsfolk think that asthenia and usual fatigue are one and the same state, named differently. They are mistaken. Natural fatigue is a physiological condition that develops as a result of exposure to physical or mental overload, is short-lived, completely passes after a proper rest. Asthenia is a pathological fatigue. The organism does not experience any acute overloads, but experiences chronic loads due to this or that pathology.

Asthenia does not develop overnight. This term is applicable to people who have symptoms of asthenic syndrome for a long time. Symptoms gradually increase, the patient's quality of life decreases significantly over time. Just one full rest to eliminate the symptoms of asthenia is not enough: complex treatment is necessary for a neurologist.

Causes of asthenia

Asthenia develops when, under the influence of a number of factors, the mechanisms of energy generation in the body are depleted. Overexertion, depletion of structures responsible for higher nervous activity, combined with a deficiency of vitamins, microelements and other important nutrients in the diet and disorders in the metabolic system form the basis of asthenic syndrome.

We list the diseases and conditions, against which, as a rule, asthenia develops:

• infectious diseases (influenza and other acute respiratory infections, tuberculosis, hepatitis, food poisoning, brucellosis);
• diseases of the digestive tract (peptic ulcer, severe dyspepsia, acute and chronic gastritis, pancreatitis, enteritis, colitis, etc.);
• heart and vascular disease (essential hypertension, atherosclerosis, arrhythmias, ischemic heart disease, in particular, myocardial infarction);
• diseases of the respiratory system (chronic obstructive pulmonary disease, pneumonia, bronchial asthma);
• kidney disease (chronic pyelo- and glomerulonephritis);
• diseases of the endocrine system (diabetes mellitus, hypo- and hyperthyroidism);
• blood diseases (especially anemia);
• neoplastic processes (all kinds of tumors, especially malignant ones);
• pathology of the nervous system (neurocirculatory dystonia, encephalitis, multiple sclerosis and others);
• diseases of the mental sphere (depression, schizophrenia);
• trauma, especially craniocerebral;
• the postpartum period;
• postoperative period;
• pregnancy, especially prolific;
• lactation period;
• psychoemotional stress;
• taking certain medicines (mainly psychotropic drugs), drugs;
• children - unfavorable situation in the family, difficulties in communicating with peers, excessive demands of teachers and parents.

It is worth noting that in the development of asthenic syndrome can have a value of continuous monotonous work, especially with artificial lighting in a closed space (for example, submariners), frequent night shifts, work that requires processing a large amount of new information in a short time. Sometimes it occurs even when a person moves to a new job.

Mechanism of development, or pathogenesis, asthenia

Asthenia is a reaction of the human body to conditions that threaten the depletion of its energy resources. In this disease, first of all, the activity of the reticular formation changes: a structure located in the region of the brain stem responsible for motivation, perception, level of attention, providing a mode of sleep and wakefulness, vegetative regulation, work of muscles and activity of an organism as a whole.

There are changes in the work of the hypothalamic-pituitary-adrenal system, which plays a leading role in the realization of stress.

Numerous studies have shown that the mechanisms of development of asthenia play a role and immunological mechanisms: in persons suffering from this pathology, certain immunological disorders were detected. However, the viruses known to date have no direct significance in the development of this syndrome.

Classification of asthenic syndrome

Depending on the cause that caused asthenia, the disease is divided into functional and organic. Both of these forms occur approximately at the same frequency - 55 and 45%, respectively.

Functional asthenia is a temporary, reversible condition. It is a consequence of psychoemotional or post-traumatic stresses, acute infectious diseases or increased physical exertion. This is a unique reaction of the body to the above factors, so the second name for functional asthenia is reactive.

Organic asthenia is associated with these or other chronic diseases that occur in a particular patient. Diseases that can cause asthenia are listed above in the "causes" section.

According to another classification, the etiological factor of asthenia is:

• somatogenic;
• postinfection;
• postpartum;
• posttraumatic.

Depending on how long ago there is an asthenic syndrome, it is divided into acute and chronic. Acute asthenia occurs after a recent acute infectious disease or severe stress and, in fact, is functional. Chronic, however, is based on some kind of chronic organic pathology and proceeds for a long time. Separately, neurasthenia is distinguished: asthenia, arising from the depletion of structures responsible for higher nervous activity.

Depending on the clinical manifestations, there are 3 forms of asthenic syndrome, which are also three consecutive stages:

• hypersthenic (the initial stage of the disease, its symptoms are impatience, irritability, disorderly emotionality, increased reaction to light, sound and tactile stimuli);
• form of irritability and weakness (there is increased excitability, but the patient at the same time feels weak, exhausted, the mood of a person sharply changing from good to bad and vice versa, physical activity also ranges from heightened to total unwillingness to do anything);
• gipostenicheskuyu (this is the last, the most severe form of asthenia, characterized by a reduced to almost minimum performance, weakness, fatigue, constant drowsiness, complete reluctance to do something and lack of any emotions; interest in the environment is also absent).

Symptoms of asthenia

Patients suffering from this pathology make a lot of various complaints. First of all, they are worried about weakness, they feel tired all the time, there is no motivation for any activity, memory and ingenuity are broken. They can not focus their attention on something specific, are distracted, constantly distracted, cry. Long can not remember the familiar surname, word, the right date. Read mechanically, not understanding and not memorizing the material read.

Also, patients are concerned about symptoms from the vegetative system: increased sweating, hyperhidrosis of the palms (they are constantly wet and cool to the touch), a sense of lack of air, shortness of breath, lability of the pulse, blood pressure jumps.

Some patients also note various pain disorders: pain in the region of the heart, in the back, stomach, muscles.

On the emotional side, there is a feeling of anxiety, inner tension, frequent mood changes, fears.

Many patients are concerned about a decrease in appetite until its complete absence, weight loss, decreased sexual desire, disorders of menstrual cycle, pronounced symptoms of premenstrual syndrome, increased sensitivity to light, sound, touch.

From sleep disturbances, heavy sleep should be noted, frequent awakenings at night, nightmarish dreams. After sleeping, the patient does not feel rested, but, on the contrary, feels tired again and broken. As a result, the person's health deteriorates, which means that working capacity decreases.

A person becomes excitable, irritable, impatient, emotionally unstable (his mood deteriorates sharply at the slightest failure or in case of difficulty in performing any action), communication with people makes him tired, and the tasks posed seem impossible.

Many people with asthenia have a temperature increase to subfebrile values, sore throat, enlarged some groups of peripheral lymph nodes, in particular, cervical, occipital, axillary, tenderness in palpation, pain in muscles and joints. That is, there is an infectious process and a lack of immunity functions.

The patient's condition worsens significantly by the evening, which is manifested by an increase in the severity of all or some of the above symptoms.

In addition to all these symptoms related directly to asthenia, a person is concerned about the clinical manifestations of the underlying disease, the one against which the asthenic syndrome developed.

Depending on the cause that caused asthenia, its course has some peculiarities.

• The accompanying neurosis asthenic syndrome manifests itself by the tension of the striated muscles and the increase of the muscle tone. Patients complain of constant fatigue: both at movements and at rest.
• With chronic circulatory insufficiency in the brain, the motor activity of the patient, on the contrary, decreases. Muscle tone is lowered, the person is sluggish, does not feel the desire to move. The patient experiences the so-called "incontinence of emotions" - it would seem, without reason, crying. In addition, there is a difficulty and a slowdown in thinking.
• With brain tumors and intoxications, the patient feels a pronounced weakness, impotence, reluctance to move and engage in any, even previously loved, affairs. The muscle tone is reduced. A symptom complex resembling myasthenia can develop. Typical mental weakness, irritability, hypochondriacal and anxious-fearful moods, as well as sleep disorders. These violations are usually persistent.
• Asthenia, which arose after trauma, can be both functional - traumatic cerebral, and be organic - traumatic encephalopathy. Symptoms of encephalopathy, as a rule, are pronounced: the patient experiences constant weakness, notes a worsening of memory; the circle of interests is gradually decreasing, there is a lability of emotions - a person can be irritable, "explode" over trifles, but suddenly becomes listless, indifferent to what is happening. New skills are learned with difficulty. Signs of dysfunction of the autonomic nervous system are determined. Symptoms of cerebrosthenia are not so pronounced, but it can last for long, months. If a person leads a right, sparing, way of life, rationally eats, protects oneself from stress, the symptoms of cerebrosthenia become practically imperceptible, however, against the background of physical or psycho-emotional overload, during acute respiratory viral infections or other acute diseases, cerebral is aggravated.
• Postgrippoznaya asthenia and asthenia after other acute respiratory infections is initially hypersthenic. The patient is nervous, irritable, experiencing a constant sense of internal discomfort. In case of severe infections, the hyposthenic form of asthenia develops: the activity of the patient is lowered, he is constantly feeling sleepy, irritated over trifles. The strength of muscles, sex drive, motivation is reduced. These symptoms persist for more than 1 month and become less pronounced in the course of time, and a decrease in the ability to work, a reluctance to perform physical and mental work comes to the fore. Over time, the pathological process acquires a protracted course, in which symptoms of the vestibular frustration, memory impairment, inability to focus and perceive new information.

Diagnosis of asthenia

Often, patients feel that the symptoms they are experiencing are not terrible, and everything will work out itself, it is only necessary to get enough sleep. But after a dream symptoms do not pass, and in due course only are aggravated and can provoke development of rather serious neurologic and psychiatric diseases. To prevent this from happening, do not underestimate asthenia, but should it occur in the presence of symptoms of this disease contact a doctor who will make an accurate diagnosis and tell you what steps to take to eliminate it.

Diagnosis of the asthenic syndrome is based primarily on complaints and data of an anamnesis of the disease and life. The doctor will ask you how long these or other symptoms have appeared; whether you are engaged in heavy physical or mental work, have you experienced recent overloads related to it? do you connect the occurrence of symptoms with psychoemotional stress; Do not you suffer from chronic diseases (what - see above, in the "reasons" section).

Then the doctor will conduct an objective examination of the patient to detect changes in the structure or functions of his organs.

Based on the findings, the doctor will assign a series of laboratory and instrumental studies to confirm or deny a disease:

• general blood analysis;
• general urine analysis;
• biochemical blood test (glucose, cholesterol, electrolytes, renal, liver tests and other indicators required by the doctor);
• a blood test for hormones;
• PCR-diagnostics;
• coprogramme;
• ECG (electrocardiography);
• Ultrasound of the heart (echocardiography);
• Ultrasound of the abdominal cavity organs, retroperitoneal space and small pelvis;
• fibroadastroduodenoscopy (FGDS);
• Chest X-ray of chest organs;
• Ultrasound of cerebral vessels;
• computer or magnetic resonance imaging;
• consultations of related specialists (gastroenterologist, cardiologist, pulmonologist, nephrologist, endocrinologist, neurologist, psychiatrist and others).

Treatment of asthenia

The main direction of treatment is the therapy of the underlying disease, the one against which the asthenic syndrome arose.

Lifestyle

Important lifestyle modification:

• optimal mode of work and rest;
• night sleep lasting 7-8 hours;
• refusal of night shifts at work;
• quiet atmosphere at work and at home;
• minimization of stress;
• daily exercise.

Often, for the benefit of patients is a change in the situation in the form of a tourist trip or rest in a sanatorium.

The diet of people suffering from asthenia must be rich in protein (lean meat, legumes, eggs), group B vitamins (eggs, green vegetables), C (sorrel, citrus), amino acid "tryptophan" (bread, bananas, hard cheese) and other nutrients. Alcohol from the diet should be excluded.

Pharmacotherapy

Medication for asthenia may include drugs from the following groups:

• adaptogens (extract of Eleutherococcus, ginseng, magnolia vine, rhodiola rosea);
• nootropics (aminalon, pantogam, gingko biloba, nootropil, cavinton);
• sedatives (novo-passit, sedasen and others);
• preparations of procholinergic action (Enerion);
• antidepressants (azafen, imipramine, clomipramine, fluoxetine);
• tranquilizers (phenibut, clonazepam, atarax and others);
• Neuroleptics (eglonil, teralen);
• vitamins of group B (neurobion, milgamma, magne-B6);
• complexes containing vitamins and trace elements (multitabs, duovite, Berroc).

As it became clear from the list given above, there are a lot of drugs that can be used to treat asthenia. However, this does not mean that the whole list will be assigned to one patient. Treatment of asthenia is predominantly symptomatic, that is, prescription medications depend on the prevalence of certain symptoms in a particular patient. Therapy starts with the use of the minimum possible doses, which, with normal tolerance, can subsequently be increased.

Non-drug therapies

Along with pharmacotherapy, a person suffering from asthenia can receive the following types of treatment:

1. Use of infusions and broths of soothing herbs (valerian root, motherwort).
2. Psychotherapy. It can be carried out in three directions:
   • influence on the general condition of the patient and on certain neurotic syndromes diagnosed in him (group or individual auto-training, auto-suggestion, suggestion, hypnosis); techniques allow to strengthen the motivation to recover, reduce anxiety, increase emotional mood;
   • therapy, affecting the mechanisms of the pathogenesis of asthenia (conditioned reflex techniques, neuro-linguistic programming, cognitive-behavioral therapy);
   • methods affecting the causative factor: Gestalt therapy, psychodynamic therapy, family psychotherapy; The purpose of these methods is to make patients aware of the onset of the syndrome asthenia with any personality problems; During the sessions, children's conflicts or traits that are characteristic of the person in adulthood, which contribute to the development of asthenic syndrome, are identified.
3. Physiotherapy:
   • Exercise therapy;
   • massage;
   • hydrotherapy (Charcot's shower, contrast shower, swimming and others);
   • acupuncture;
   • phototherapy;
   • stay in a special capsule under the influence of thermal, light, aromatic and musical influences.

In conclusion of the article I want to repeat that asthenia can not be ignored, it is impossible to hope for "it will pass by itself, I will only get a good sleep". This pathology can develop into other, much more serious neuropsychiatric diseases. With timely diagnosis, it is fairly simple to deal with it in most cases. Self-medication is also unacceptable: illiterate drugs can not only not give the desired effect, but also cause harm to the health of the patient. Therefore, if you find yourself experiencing symptoms similar to those described above, please ask for help from a specialist, in this way you will greatly approximate the day of your recovery.