Asthenic depression syndrome ICD10

One type of psycho-emotional disorder is astheno-depressive syndrome. The pathological condition is accompanied by a loss of all interest in life. A person with this disorder constantly faces difficulties in making even the simplest decisions. This syndrome precedes depression, which it can develop into if medical care is refused.

The disease does not have its own ICD-10 code, since this condition is not classified as a separate diagnosis. At the same time, it is classified into different categories, which include the international classification of diseases. The pathology is most often classified as other neurotic disorders, which are listed in the international classification of diseases under the code F48.

Astheno-depressive syndrome is considered to be a condition that is classified as a group of affective disorders of an atypical type. In various publications it is called asthenic depression or exhaustion depression. Pathology can significantly worsen a person’s life. Without adequate treatment, it can develop into more serious mental problems that are difficult to treat. During the course of astheno-depressive syndrome, the systems and internal organs of a person function at the limit of their capabilities. Therefore, they periodically fail, which is why the patient exhibits characteristic symptoms of malaise.

Specialists at the Yusupov Hospital treat many psycho-emotional disorders, including asthenic-depressive syndrome. Using an integrated approach to diagnosis and treatment allows the clinic’s doctors to find the true causes of the disease. Honored doctors with the highest category work within the walls of the hospital, who are constantly improving in their field of activity. The developed methodology, together with leading doctors in Russia and Europe, always achieves the desired goal.

Who is susceptible to astheno-depressive syndrome?

Astheno-depressive syndrome, for which special treatment is selected, most often occurs in people who have a predisposition to it. We are talking about people who are at risk. These include:

Representatives of creative professions;
Persons holding leadership positions;
Adults and children who are prone to developing mental illness;
Patients with inflammatory diseases that are chronic.

People who are at risk should take more responsibility for their physical and mental health. Otherwise, it will be difficult for them to avoid astheno-depressive syndrome.

Anxious expectations

Already in the first wave of the pandemic in 2022, psychiatrists drew attention to changes in the mental health of the population. Lockdowns, other coronavirus restrictions, remote work, a person constantly being at home - all this has already provoked negative psychological effects. Add to this anxious expectations - fear of becoming seriously ill, fear for loved ones, the possibility of losing a job - and here it is, a set that places a heavy burden on the human psyche.

At the same time, some researchers have started talking about the increase in suicidal and depressive feelings among completely healthy citizens in different countries of the world. Moreover, data began to appear about increasing cases of domestic violence and divorce.

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When a person gets sick, his anxious expectations intensify. The patient begins to monitor his condition, symptoms, temperature, and breathing with fear. No one wants to end up in a hospital under strict quarantine. Even more fears are caused by the possibility of developing severe complications, the use of ventilators and other procedures. Now doctors already know that the most severe psychological consequences occur precisely in patients who have undergone artificial ventilation.

Causes of development of astheno-depressive syndrome

Finding out the cause of the development of astheno-depressive syndrome is not so easy. Only an experienced specialist can handle this task. There are many factors that can lead to the development of pathology. In most cases, the disease manifests itself due to the influence of the following negative factors on the human body:

Prolonged experience of a traumatic situation;
Hereditary predisposition to the disorder;
Traumatic brain injuries;
Mental stress or overload;
Cardiovascular diseases;
Weakened immunity;
Thyroid gland dysfunction;
Long-term course of vitamin deficiency;
Various types of intoxication of the body, including alcohol and nicotine;
Leading a sedentary lifestyle.

Many of these reasons can lead a person into a state of panic. If you don't deal with panic attacks, they begin to intensify. As a result, the patient develops new problems, among which this syndrome stands out. Any shock can lead to the development of mild depression. Gradually, this condition will only worsen if the person fails to find relief. If a man or woman often exposes himself to depressive conditions, then he should seek help from a specialist, since in the future the person risks encountering asthenic-depressive syndrome.

Symptoms and consequences

People suffering from this organic disorder are quick-tempered, angry, and even for minor reasons they experience violent outbursts of emotions. Their loved ones irritate them, and troubles are perceived literally like this: “everything is lost.” The mood changes abruptly and dramatically, like the weather in spring. Negative reactions arise spontaneously and cannot be adjusted.

Patients are touchy, prone to sentimentality, and tearful. Asthenia is manifested by weakness, rapid fatigue - even 2-3 hours of work is enough for them to get tired. Then complete powerlessness sets in, requiring serious rest.

Such people experience frequent headaches, even dizziness. Typically, such sensations occur when weather conditions change. They cannot tolerate a lack of oxygen and stuffiness, so it is difficult for them to travel on public transport. Sunlight hurts the eyes, normal sounds are perceived as very loud, even a slight touch causes pain.

Children with psychoorganic syndrome may talk in their sleep or walk.

As the disease progresses, problems with emotions, thinking and memory become more severe. The patient, talking about something, is distracted from the main thread of the story, going into insignificant, insignificant details. His thoughts become viscous, he often repeats the same phrases, his vocabulary becomes impoverished, and rhymes slip through his everyday speech.

The individual completes the assigned task slowly, since his mental processes proceed inertly. He remembers recent events poorly, not to mention those that happened long ago.

Critical abilities are impaired, and, although the patient understands the line between good and bad, he may speak tactlessly or commit an unacceptable action.

Character deteriorates, and what a person previously tried not to demonstrate, considering it a bad trait, comes out. He becomes boastful, sticks out his merits, exaggerating and pathetically praising them. Such euphoria abruptly turns into gloom, melancholy and suddenly - an affective outburst over a small matter. At this moment, the patient loses self-control, his consciousness narrows and focuses on the immediate task - to immediately punish the one who offended him, even if nothing of the kind actually happened. And then a tragedy may occur: he will commit a crime, maybe even kill.

As the disorder progresses, it leads to negative personality changes, namely social maladjustment. Relationships with loved ones deteriorate, difficulties arise in school and work. Professional performance deteriorates so much that it leads to dismissal.

Neurological disorders are added to psychoorganic disorders. These may be seizures or nocturnal diuresis (paroxysms).

To escape from problems, patients begin to drink alcohol and take drugs. This, in turn, leads to delirium tremens and amnesia, increasing the risk of increased criminal behavior and death.

The main feature of the disorder: loss of control over aggressiveness, the outbreak of which occurs without any reason. The internal tension for such a surge can increase in a minute or several hours. After a momentary attack of rage, the patient moves away and repents of what happened, which distinguishes this disease from dissocial personality disorder.

All of the above clearly convinces that organic emotional labile asthenic disorder must begin to be treated in the early stages. This should be done jointly by a psychiatrist and a neurologist.

Very often, the patient himself and those around him attribute the above-mentioned behavior to bad character, without resorting to therapy and wasting time. An experienced specialist will make a diagnosis at the first appointment and prescribe treatment. The result of therapy is very favorable if the patient follows all the instructions and recommendations of the attending physician.

Symptoms of astheno-depressive syndrome

Characteristic symptoms help determine astheno-depressive syndrome in a person. They are the reason for diagnostics, based on the results of which treatment is prescribed. A patient with a mental disorder may experience only a few symptoms. As a rule, many people do not pay much attention to them, as they attribute them to ordinary fatigue. The painful condition can be recognized by the following symptoms:

Unreasonable loss of interest in events that occur in a person’s life;
Constant irritability and aggressiveness, which manifests itself for any reason;
Inability to complete the work started;
Sudden mood changes several times a day;
Inability to concentrate normally on a specific topic during a conversation or activity;
The development of phobias that did not previously bother the person;
Frequent panic attacks;
Excessive appetite or its complete absence;
The patient may also experience worsening sleep. He begins to suffer from insomnia, which he is unable to cope with;
Bradypsia is inhibition of thinking. A person's reaction speed decreases, speech and motor activity slow down.

The main symptoms of astheno-depressive syndrome are complemented by physiological signs of malaise. People with this disorder may experience episodes of tachycardia, shortness of breath, excessive sweating, persistent headaches and nausea. Along with this, diseases appear that disrupt the functioning of internal systems.

Often people complain of non-existent pain in the body. The manifestation of the disease can be observed not only in adults. Children also complain of signs of astheno-depressive syndrome. Parents should start sounding the alarm if they notice the following symptoms in their child:

Unreasonable weight loss;
Abrupt change of activities every 30 minutes;
Unsociability and self-isolation;
Insomnia.

If a child suffers from constant mental stress and leads a sedentary lifestyle, then he can become hostage to asthenic-depressive syndrome.

Clinical manifestations

Unlike ordinary overwork (with which, by the way, asthenic depression is often confused), the symptoms of this disorder do not go away after proper sleep, rest, or a change of environment. For many weeks (and often months and even years), a person constantly feels tired and weak. This condition is accompanied by:

unstable, usually low mood: excessive, hypertrophied emotional elation and excitement can at any moment suddenly give way to tears, despair, melancholy;
sleep disorders;
increased sensitivity to sharp sounds, bright light, intense odors;
regular headaches, attacks of dizziness, worsening in the morning, often accompanied by nausea;
meteosensitivity: patients react to changes in weather not only with a general deterioration in well-being and an increase in weakness, but also with increased irritability (everything goes out of hand for a person, nothing works out, and he reacts to such troubles very sharply);
inability to relax: the patient is constantly overcome by pessimism, when he tries to “switch” and relax, his thoughts constantly return to pressing troubles, possible or existing health problems.

Asthenic depression is also characterized by decreased concentration and absent-mindedness. Experts associate such symptoms with apathy, indifference and loss of interest in everything that is happening around: be it some work issues or family joys and troubles, etc.

Sexual disorders are also typical: decreased libido, impotence in men, anorgasmia in women. Vegetative symptoms often develop. This:

fluctuations in blood pressure (but hypertension usually predominates);
tachycardia with a feeling of heartbeat, pulsation in the temples, chest, ears;
pain and/or discomfort in the chest;
increased sweating;
redness (sometimes focal) or, conversely, pallor of the skin;
feeling of chills or hot flashes at normal body temperature.

Diagnosis of astheno-depressive syndrome

Adults and children with severe symptoms of astheno-depressive syndrome must undergo diagnostics. You should consult a doctor, even if the signs of the disorder are still mild. Patients suspected of having this disease should be examined in the office of highly specialized specialists. We are talking about an endocrinologist, neurologist, gastroenterologist and urologist. For depression, it is recommended to consult a psychotherapist. He will determine the root cause of the disorder and tell you how to treat it. Consultation with highly specialized doctors is required in order to identify the presence of chronic pathologies that could have an impact on the development of astheno-depressive syndrome. If no organic causes of the disease are identified in a person, then further diagnosis will be carried out by a psychotherapist. He must talk to the patient. During the collection of anamnesis, he will be able to find an explanation for the manifested symptoms of the syndrome.

The Yusupov Hospital has a modern diagnostic facility, and specialists treat patient complaints carefully and thoughtfully. Yusupov Hospital is a multidisciplinary treatment center where every person is guaranteed comprehensive and highly qualified treatment.

“Fuzzy head” is one of the main signs of astheno-neurotic syndrome

If “fuzzy head”, “cloudy head” is the feeling with which you get up and lie down, and if increased irritability, fatigue and poor sleep are added to this, most likely we are talking about astheno-neurotic syndrome
.

Main symptoms:

Many people complain of “fog in the head”, “head like cotton wool”, “fuzzy head” and similar symptoms.

If you notice fatigue, sleep disturbances, and constant irritability, then you may have a mental disorder called astheno-neurotic syndrome.

Prevalence:

This disease is one of the most common “diseases of civilization.” It is often called "managers' flu."

Educated and successful people are susceptible to the disease. The most typical age is from 20 to 40 years. These are entrepreneurs, managers, doctors, teachers. People whose work involves increased responsibility, such as air traffic controllers, are at particular risk.

In the past, astheno-neurotic syndrome was called “nervous exhaustion”

Creative individuals are also at risk.

Causes:

The main causes are stress, prolonged nervous excitement, chronic lack of sleep, and constant overwork. Also factors contributing to the occurrence of astheno-neurotic syndrome are previous diseases, including colds, some viruses, poisoning, and poor environmental conditions.

Similar symptoms:

What diseases can manifest themselves as “foggy head”, poor sleep, weakness and irritability, except neurasthenia? First of all, these are asthenic conditions with the onset of serious illnesses. The second is masked depression, which at the beginning can easily be confused with astheno-neurotic syndrome. And chronic fatigue syndrome can manifest itself in a similar way.

So only a psychotherapist or psychiatrist can make a correct diagnosis. To make a diagnosis, professional psychological diagnostics (psychotests) are usually used, which you can take yourself (follow this link).

How the disease develops:

The syndrome occurs gradually, with a combination of emotional and physical stress, constant fatigue. Most often, patients complain of loss of strength, general weakness, increased irritability, “fog” in the head, and inability to cope with normal amounts of work.

If a person continues to be exposed to stress and does not seek medical help, his condition worsens - the usual set of complaints about a “cotton” head is joined by tearfulness, complaints about the heart, and fog in the head. Irritability increases to an extreme degree, but irritation quickly gives way to weakness. Sleep is usually unstable, does not bring a feeling of rest, and after sleep the head feels like cotton wool. Appetite worsens, constipation or diarrhea may bother you. Sexual desire decreases in both men and women. The condition worsens before a change in weather (so-called “meteosensitivity”). In the absence of treatment at this stage, apathy, lethargy, severe weakness and persistent depression of mood are further added. Interest in life decreases, the patient thinks only about his painful condition, about his “fuzzy” head.

Left untreated, psychotic disorders may develop.

Treatment:

The prospects for treatment are positive; usually psychotherapeutic methods give excellent results, including complete recovery. In severe cases, a combination of psychotherapy and psychopharmacotherapy is used.

Self-medication usually worsens the condition and leads to progression of the disease.

At the initial stage of the disease, in order to make a correct diagnosis, a psychotherapist needs to exclude all diseases that exhibit similar symptoms, because the more accurate the diagnosis, the more successful the treatment will be.

Different diseases with similar symptoms must be treated differently. Therefore, you should definitely consult a psychotherapist. A good psychotherapist selects therapy that matches the specific manifestations of the disease and the individual characteristics of each patient.

Astheno-neurotic syndrome is one of the most common “diseases of civilization.” It is often called "managers' flu."

Treatment of the syndrome depends on the severity of painful symptoms, but is primarily aimed at eliminating psychotraumatic factors. It is necessary to reduce both mental and physical stress. This is the most important condition for treatment; without such measures it will not be possible to defeat the disease. In the early stages of the disease, normalizing the rhythm of life, eliminating stress and psychotherapy may be enough to significantly improve health. And, of course, at this stage, psychotherapy methods that do not use drugs - cognitive-behavioral, psychoanalysis - have a very good effect, and group psychotherapy methods are very effective.

In any case, you need to see a psychotherapist.

In more advanced cases, additional psychopharmacotherapy may be required. General strengthening drugs, tranquilizers, and, if necessary, sleeping pills and antidepressants are used. Psychotherapy is also actively used in the treatment of advanced astheno-neurotic syndrome.

The first indicator of improvement is the normalization of sleep and the disappearance of the feeling of “fog” in the head. With timely treatment, the problem can usually be completely overcome, however, if the tense environment and stress at work and in personal life continue to persist, various complications are possible.

Terminology and other names:

In the past, astheno-neurotic syndrome, together with diseases of similar symptoms, was called “nervous exhaustion.”

In modern psychiatry, the term “neurasthenia” is more often used to refer to neuro-asthenic syndrome (synonyms). In the everyday sense, neurasthenia is usually perceived as a painful, nervous, unbalanced state, characteristic of weak-willed people, easily susceptible to various influences and moods, and in a state of acute mental crisis. And in the medical sense, this is a state of depression, irritability, “fuzzy head.”

Anxiety

Anxiety is common in astheno-subdepressive syndrome. 16% of requests for psychiatric consultation are related to anxiety symptoms. As with assessing symptoms of depression, pain must first be addressed because uncontrollable pain is a common cause of anxiety and agitation.

Symptoms

Anxiety symptoms can manifest more as an emotional disorder or as physical symptoms. Existential problems, such as fear of pain and death, and loss of autonomy, have a serious impact on patients with terminal illness.

Somatic symptoms of anxiety often overlap with other symptoms of physical illness:

dyspnea;
tachycardia;
sweating;
nausea;
tremor.

In addition, there are common symptoms that are often observed with depression:

anorexia;
insomnia;
decreased libido;
problems with concentration;
irritability.

Causes

Some illnesses are known to cause anxiety symptoms. Hormone-secreting tumors (pheochromocytoma), although rare, can cause anxiety symptoms.

Abnormal metabolic and physiological conditions (electrolyte and glucose imbalances, severe constipation) cause anxiety, which can develop into outright delirium with agitation and impaired consciousness.

Therefore, symptoms of anxiety that a patient develops may be early warning signs of impending delirium.

Diagnostics

The role of medications and illicit substances in relation to anxiety should not be overlooked. Withdrawal states from alcohol, opioids, and benzodiazepines cause anxiety, turning into agitation and delirium.

A previous history of substance abuse, including alcohol, prescription drugs, caffeine, and use of illicit substances, should be considered.

Iatrogenic causes of anxiety can often be seen with corticosteroids, stimulants, bronchodilators, and other common medications.

Effective assessment and treatment of anxiety begins with addressing the underlying causes (metabolic disorders, withdrawal states) and relieving physical symptoms (eg, pain).

"Side effect"

Another factor is the side effects of medications used to treat COVID-19. For example, glucocorticosteroids (GCS) are widely used in modern anti-Covid therapy. They are often prescribed in high doses and for a fairly long period. But at the same time, GCS can cause hallucinations, delusional states, depression and even manic-depressive states and paranoia. Taking other medications used in the treatment of Covid, for example, some antiviral drugs, also has a negative impact on the psyche.

Asthenia

Anxiety and depression are underestimated. But asthenia is the most common symptom of many conditions. Defined as a decrease in vitality and energy.

Asthenia has a broad nosological interpretation in the medical literature. Silas Weir Mitchell, one of the first doctors to use the term asthenia.

Further, neurologists enriched the meaning by adding to the definition a decrease in the number of thoughts, actions, and a slowdown in reaction time. Indifference to generally accepted social practices, lack of initiative, and spontaneity are typical and are accompanied by a reluctance to solve complex problems.

Excessive irritability, emotional lability, mental inertia, misunderstanding, decreased range of mental activity. Victor and Ropper coined the term “psychomotor asthenia.” MacCabe separated mental asthenia from depression.

Covid as trauma

Specialists from the National Medical Research Center named after. V. M. Bekhterev believes that after COVID-19, patients experience symptoms characteristic of the so-called post-traumatic stress disorder (PTSD).

PTSD is a mental disorder that occurs after events that have a traumatic effect on the individual’s psyche. At the same time, the traumatic nature of the events that occurred is associated with a person’s feeling of helplessness, the inability to influence what is happening, and to resist danger. Characteristic symptoms of PTSD include flashbacks, nightmares, partial amnesia, emotional instability and panic attacks. These manifestations can occur not only immediately after a traumatic event, but also months and even years later.

PTSD is well known to psychiatrists - this disorder can occur after any event that traumatizes the individual’s psyche. And Covid may well be one of them.

Post-Covid syndrome?

The entire diverse set of consequences in people who have survived a new coronavirus infection has already been called “post-COVID-19 syndrome.” Among its symptoms are mental disorders that are already well known to us: “fog in the head,” disorientation in space, panic attacks and cognitive disorders. However, some researchers say that mental problems in Covid survivors are not unique consequences of the new disease, but complications that cause any severe infectious disease.

So, back in 2022, an article appeared in the authoritative medical journal The Lancet, which analyzed 72 studies of the consequences of epidemics - the precursors of COVID-19 - the SARS-1 and MERS viruses. Mental disorders in those who recovered from these infections turned out to be identical: confusion, depressed mood, anxiety, memory impairment, insomnia and even delirium. Thus, we can draw a preliminary conclusion: the COVID-19 virus does not necessarily have any unique properties that affect the psyche.