Somatoform disorder (psychosomatic illness) - symptoms and treatment

Even in Greek philosophy and medicine, the idea of ​​the influence of the soul and spirit on the human body was widespread. Translated from Greek, “psycho” means soul, and “soma” means body. The soul and body are inextricably linked - Hippocrates, Plato, Aristotle spoke about this. The term “psychosomatics” will soon be two hundred years old; it was coined in 1818 by the German physician Heinroth.

Psychosomatic diseases are diseases of internal organs and systems that arise as a result of mental ill-being.

Psychotherapists say: any disease first arises in the subconscious and only then manifests itself at the body level. That is, most of our ailments are associated with unresolved internal problems. The main psychological causes of illnesses are anger, envy, anxiety and guilt.

Many scientists believe that 80% of all diseases are actually psychosomatic. Our well-being depends on our thoughts, mood, ability to find and see positive things, beauty and enjoy it all. The state of health is associated with the ability to be happy, character traits, attitude to successes and failures at work, and everyday problems.

According to the psychoanalytic theory of Sigmund Freud, symptoms and diseases of various organs are a symbolic language with the help of which the body wants to communicate repressed mental conflicts.

Almost half of all human diseases can be psychosomatic in nature. Among them are diseases:

• heart and blood vessels (arterial hypertension, hypertension, rheumatism, vegetative dystonia, coronary heart disease, heart rhythm disturbances, heart attacks)
• gastrointestinal tract (peptic ulcer of the stomach and duodenum, ulcerative colitis, biliary dyskinesia)
• nervous system (chronic headaches, tension pain, dizziness)
• skin (neurodermatitis, relapses of psoriasis)
• gynecological, including those related to the woman’s reproductive cycle (premenstrual tension syndrome, gestosis, postpartum depression)
• endocrine
• and many others.

Content:

1. What causes psychosomatic illnesses
2. Features of the formation of disorders
3. Classification
4. Symptoms of pathologies of psychostasis
5. Consequences of lack of therapy
6. Clinical diagnosis
7. Treatment of psychosomatic diseases

A number of human diseases are due to their psychogenic origin with primary functional failures. If attention is not paid to them in a timely manner, they become classic ailments. We are talking about psychosomatic disorders, which are often the source of the formation of a number of internal diseases and psychopathology. They are characterized by polymorphic symptoms. Establishing a correct diagnosis requires the participation of a psychiatrist. Therapy includes a complex of psychotherapeutic techniques, prescription of medications, rehabilitation and preventive measures. In medicine, the following terms are also used to refer to these deviations: pathology of psychostasis, psychophysiological disorder.

Joints and assertiveness

This quality is a consequence of a combination of greed - a strong aspiration of feelings towards some material object and pride. A proud and greedy person acts assertively, putting his own interests above the interests of the people around him. Such activity always leads to degradation of consciousness, so a group of diseases arises that gradually deprive him of the opportunity to work actively. Among such diseases are all kinds of metabolic disorders in the joints and the accumulation of salts in them.

What causes psychosomatic illnesses

The reasons for the formation of deviations are considered based on various areas of schools of psychiatry. We will try, without going into details, to identify the main factors leading to the development of pathology. It is assumed that psychosomatics arises as a result of a combination of the organ’s readiness for physiological disruptions and destructive mental processes occurring in a particular individual.

The most common causal conditions leading to the onset of psychosomatic diseases:

• Conflict within one's own personality. A person develops emotional overstrain over the years. It is caused by the impossibility of realizing desires against the background of insufficient opportunities.
• Anamnestic block. Impaired functions of the psyche and internal organs appear as a result of previously suffered (especially in childhood) traumatic episodes. Leaving behind an unhealed anxiety complex, the blocking source is reduced into a multitude of symptoms.
• The "sick" complex. A number of people with a neurotic predisposition show a constant need to be in a painful state. Thanks to him, they achieve increased attention to their person, avoid responsibility, study, and work.

• Increased suggestibility. Excessive impressionability of character often leads to the subconscious process of introducing negative information into consciousness. The patient himself cannot explain the reasons for the painful changes in him.
• Social infantilism. Individuals with this feature, due to the impossibility of understanding other people and what is happening around them, withdraw and become insecure. The lack of productive interpersonal relationships causes them to experience affective tension, which turns into somatic complaints.
• Contact with the patient. Long-term communication with a person suffering from some, often serious, illness leads to psychosomatics. Excessive emotivity subconsciously “copies” similar symptoms.
• Auto-aggression. A certain category of people develops a feeling of guilt, shame, and aggression. Deviations form excessive psycho-emotional stress with subsequent transition to functional failures of the whole organism.

The listed factors are taken into account during diagnosis.

Who is at risk of developing a psychosomatic disorder?

People who are accustomed to restraining their emotions and experiences are most susceptible to psychosomatic diseases. But there are situations when even the most balanced and calm people cannot cope with emotions, so it cannot be said that anyone is completely immune from psychosomatic diseases.

If a psychosomatic disease or a tendency to it is not detected in childhood or adolescence, then subsequently diagnosing the disease is very difficult. For example, a disease such as alcoholism usually develops due to a feeling of inadequacy to expectations or requirements, constant guilt and rejection of oneself as an individual. This begins in childhood, if parents place too high demands on the child, and a person becomes a real alcoholic in adulthood, when it is not easy to find the roots of the problem.

The cause of frequent colds can be a lack of simple joy in life, and anemia can be caused by fear of the unknown. Throat diseases are more often diagnosed in patients who cannot express their opinions and express their anger. Life uncertainty and some doom can cause the development of gastritis. Infertility often affects people who are afraid of changing their role in the world and the passage of time. In general, people who are afraid to live, are not confident in themselves and their capabilities, cannot realize themselves, risk getting many unpleasant diseases, including neoplasms, which can also have psychosomatic causes.

Features of the formation of disorders

The pathogenetic scheme of disease development includes several stages.

The violation is formed against the background of:

• The tendency of the target organ to be affected by a stress agent.
• Accumulation of affective tension.
• Excessive response to stress of the autonomic nervous system.
• The appearance of deviations in the functioning of neuroendocrine reactions.

Due to disease processes:

• Physiological nerve impulses are disrupted.
• The innervation of blood vessels and blood circulation suffers.
• Ischemia and metabolic failures occur in the organs.

In the very initial (functional) stages, if treatment is used, the process is reversible. If timely assistance is not provided, the patient develops somatic pathology.

Joints and touchiness/anger

Resentment is anger directed inward. An offended person no longer wants to notice those who treated him poorly. This always happens when there is no real power to punish your offender. On the contrary, if there is a mental opportunity to punish the offender, anger immediately comes out. Anger destroys the liver, adrenal glands, nervous system, and also joints. Usually for women, resentment arises first, and when it goes over the edge, anger appears. In men, most often, on the contrary, anger appears in advance and if personal interests are not satisfied, then resentment arises. Resentment is anger aimed at self-destruction (let it be worse for me to spite them). When a person experiences some kind of suffering, he receives the moral right to blame. It is for this opportunity to blame someone that we take offense. Resentment makes you stop acting. Anger has a more destructive effect on the joints, causing destruction in them.

Classification

Psychosomatic disorders (PSD), based on the causes that cause them and other factors, are classified into three main groups. There are other classification options, but they are less applicable in practice and are more used by scientists.

The following types of psychophysiological disorders are distinguished:

• Conversion. This subgroup of deviations includes neurotic pathologies. The symptoms of neuroses eventually enter the somatic phase. Neurotics, not receiving the sympathy of others, subconsciously transform psychogenic manifestations into pathophysiological ones. They experience mental “loss” syndromes: paralysis, nausea, vomiting, deafness, blindness, muteness, etc. They are exclusively psychopathological in nature and sometimes last for years.
• Functional. These syndromes are characterized by dysfunctions of organs, in the complete absence of damage to them. Patients complain of: heart failure, difficulty breathing, problems of the digestive tract, musculoskeletal and endocrine systems.
• Psychosomatosis. We are already talking about a specific group of ailments, the causal basis of which can be traced to a psychogenic agent. Such diseases include cases of: bronchial asthma, gastric and duodenal ulcers, neurodermatitis, obesity, rheumatoid arthritis, ulcerative colitis, type II diabetes mellitus.

It is quite natural that each of the described groups has its own characteristics in treatment tactics.

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PSYCHOSOMATIC MEDICINE

The term “psychosomatics” appeared in 1818. It was proposed by the German doctor R. Heinroth.

In 1918, BS Openheimer and MA Rothschild introduced the concept of neurocirculatory asthenia, in which symptoms of neurosis were accompanied by increased fatigue.

Da Costa (1871) described the "excitable" soldier's heart (Da Costa's syndrome) and irritable bowel syndrome. In the 30s of the twentieth century. The concept of “organ neurosis” appeared. Organ neuroses of G. Bergmana were considered by G.I. Markelov (1948) as “vegetoses”, V.G. Myasishchev (1960) as systemic neuroses and as somatoform disorders in the current classifications [145].

Since the beginning of the last century, issues of the course and development of any disease began to be considered from the perspective of the whole organism. The fact that every mental act is reflected in bodily sensations (and vice versa), both normally and in pathology, seems to have not been disputed by anyone. But even at the beginning of the 21st century, the unity of the organ and the soul did not become dominant either in the minds of clinicians or researchers.

The pathogenesis of the formation of a psychosomatic disorder/disease is quite complex due to the huge number of its components, the specific weight of each of which is only speculative, and the relationships have not been established. In general terms, these are hereditary somatic and mental disorders and predisposition to them; the mental and physical state of the individual during a traumatic event - the characteristics of the event itself and the background against which it occurs.

The key role in the formation and interpretation of psychosomatics, of course, belongs to psychoanalysis. The theory of the “symbolic language of organs” explains the occurrence of certain symptoms by the manifestation of the so-called “shadow” - thoughts, aspirations, fantasies, repressed into the unconscious [33]. Thus, sexual starvation manifests itself in dysfunction of the stomach; constipation – a tendency to disgust, accumulation of money; respiratory diseases - the desire to return to the mother's womb.

The key concept of psychoanalysis - conversion - means the displacement of influence on an organ (disorder of its function). If this tendency is reversible, then we are talking about neurosis (hysteria); if not, it is a somatic disease.

F. Dunbar (1938, 1943) formulated the concept of “constellation of personality traits,” which gave rise to numerous multi-level and diverse studies to identify specific personal characteristics of psychosomatic patients. She described the “coronary personality type”, “ulcerative”, “hypertensive”, “allergic”, etc. Many of the results of work carried out in this direction are already generally accepted.

The work of the American psychoanalyst F. Alexander “Psychosomatic Medicine,” published in 1950, summarized the experience of the rapid development of psychosomatics in the first half of the twentieth century. The author considers the concept of the appearance of a symptom as a normal physiological accompaniment of a chronic emotional state. Any suppressed emotional reaction has its somatic equivalent. The depth of the repressed specific emotional conflict determines the form of the psychogenic illness: hysterical conversion, autonomic neurosis, psychosomatic illness. Each psychosomatic disease, according to F. Alexander, is characterized by its own intrapsychic conflict.

The behavioral (behavioural) direction interprets psychosomatic illness as the result of incorrect learning and various forms of incorrect behavior.

The theory of cortico-visceral relationships, starting from a biological platform, put forward a hypothesis about the cortico-visceral origin of psychosomatic diseases, when, in contrast to the above concepts, the main role is given not to the repressed, suppressed, replaced subconscious, but to primary violations of the cortical mechanisms of control of visceral organs due to overexcitation and inhibition in the cerebral cortex.

Research by the school I.P. Pavlova (K.M. Bykov, I.T. Kurtsin, 1960) continue to remain relevant in the formation of modern ideas of psychosomatic medicine.

* * *

The clinic of neurasthenia and hysterical neurosis is associated with a non-existent disease. If in the first case it is psychoprotective depression and asthenia (fatigue, weakness), when a person, firmly believing what has been said, says that he is “tired of life,” then in the second case the person subconsciously recreates a model of any disease.

In a neurotic person with somatoform disorders, somatovegetative symptoms are obvious, while psychopathological ones are masked. In this case, morphological changes in tissues are not detected, which distinguishes them from psychosomatic diseases.

V.V. Marilov (1993) proposes the concept of a single process - psychosomatosis, at one pole of which there is a psychogenically caused functional pathology, and at the other - organic [98]. He distinguishes 4 stages of psychosomatosis: the stage of mental depression, the stage of psychosomatic reactions, the stage of psychosomatic cycles, the stage of psychopathization.

A big event for clinicians was the appearance in 1986 of V.D.’s monograph. Topolyansky and M.V. Strukovskaya “Psychosomatic Disorders” [128], which immediately became a medical bestseller.

The book is not written in generally accepted scientific language. The emotional intensity, the careful selection of illustrations, the excellent language and style of presentation of the material, and the conviction of the authors put it among the outstanding ones. The book emphasized the problem, as if it reoriented the vast factual material accumulated by clinicians of almost all specialties in the interpretation of the causes of diseases towards the mental origin.

The famous statement of E.K. Krasnushkina (1934) that the internal speech of emotions is a function of organs, both in normal conditions and in pathology, was developed and superbly illustrated.

According to Izard [45], at the neurophysiological level, emotion is determined by the electrochemical activity of the nervous system (cortex, hypothalamus, basal ganglia, limbic system, facial and trigeminal nerves). At the neuromuscular level, emotion is, first of all, a facial activity. At the phenomenological level, emotion manifests itself either as a strongly motivated experience, or as an experience that has direct significance for the subject.

When neurochemical processes through innate programs cause complex facial and somatic manifestations, and with the help of feedback they become conscious, a separate fundamental emotion appears. The autonomic nervous system acts as an intermediary between the central nervous system (read: emotion) and internal organs.

An option to focus specifically on the participation of the autonomic nervous system, which is only one part of the triune complex, was the emergence of the rather popular “vegetative-vascular dystonia”. When a patient complains not only of headache, fatigue, labile fluctuations in blood pressure, but also of irritability and anxiety, the diagnosis sounds like “psycho-vegetative syndrome.”

Academician P.K. Anokhin in the middle of the last (twentieth) century developed the biological theory of functional systems as a closed loop of automatic regulation with constant signaling of the results of action to obtain a certain adaptive effect necessary at a given moment in the interests of the whole organism. Any qualitatively defined emotion is considered in the light of this theory as an integral functional system with all its inherent patterns. The inclusion of emotions in the content of the functional system is determined by their biological role, phylogenetically aimed, first of all, at satisfying the need to preserve the bodily and mental constancy of the “I”. Emotions act as the first link in a general chain of adaptive reactions, which, replacing each other, cover the entire body almost instantly, without a primary evaluative component, and allow one to respond to any environmental influences even before their specific parameters are established. Thus, emotions act as an absolute and instantaneous signal of the usefulness and harmfulness of any influence, which determines their exceptional significance in relation to all other adaptation mechanisms.

If stress does not flow through the natural path of affective discharge - screaming, running away, fighting, etc., when it is impossible to satisfy it, constant emotional arousal of a negative sign is formed - psychosomatic depression. The considerable complexity of separating one from the other (stressful and emotional manifestations), of course, will be resolved over time. In the meantime, we have facts waiting to be explained. For example, monkeys that were systematically frightened while eating developed stomach ulcers, while others were forced to sit still after intense physical exertion, which led to the development of hypertension. What is it: exposure to stress of those functional systems that worked with the greatest tension to the limit, or are these different stresses?

The stronger and longer the impact of a negative emotion, the more significant and persistent the viscero-vegetative disorders, the more grounds for psychosomatic disorders (diseases) and, accordingly, hypochondriacal personality development.

Long-term memory is always an emotional memory that firmly imprints traces of a one-time psychophysiological state that arose as a result of psychogenic or somatogenic influence and was extreme for one reason or another. And the fact is “ultra-fast retrieval of the same neurochemical pathway from memory” [128] in response to a stimulus that clearly does not correspond to the severity of the stressful situation.

The uniqueness of each person determines the endless variability of both mental and somatic manifestations of emerging disorders.

At the same time, self-absorbed, suspicious, anxious and emotionally unstable introverts are less likely to suffer from certain types of cancer. In those whose personality is most susceptible to cardiovascular disorders, cancer is less common than in balanced people. Periodic acute stress, often experienced by extroverts, contributes to the development of carcinoma. It is as if the immune system, under chronic stress, acquires anti-cancer skills and does not have time to respond under acute stress.

N.P. Bekhtereva [13] formulated a theory of stable pathological conditions, based on which, in order to overcome uncertainty/instability (one of the most stressful agents), a new memory matrix is ​​formed and consolidated, limiting sharp fluctuations in possible response reactions with the formation of a unique new pathological homeostasis.

One of the ways of progression of this seemingly stable state, created according to the laws of adaptation, is the transition to the destabilization phase with a significant disruption of not only the function, but also the structure of the organ.

The scheme of development of psychosomatic disorders considered here includes transient conditions, persistent psychopathological manifestations of somatized depression and their organ-system equivalents, and, finally, specific diseases with known symptoms. Transient depressive states should probably be considered a variant of the norm in the development of any person’s life. These are conditions that he was able to overcome and emerge victorious. Another thing is what the quantity and quality of the “depressive” are. R. Kipling, who was subjected to cruel pressure from his teacher as a child, began to go blind. The change in situation and subsequent favorable life made Kipling out of him. But he was unable to fully restore his vision.

Persistent somatogenic depression is extremely variable in severity and the individual’s emphasis on mental manifestations or organ disease. The authors [128] note the increasing somatization of depression (depression without feelings of depression and melancholy), noted in all civilized countries.

My first teacher in surgery was a clear illustration of the paraphrase of the famous saying: “It is not true that in a healthy body there is a healthy mind. A healthy spirit settles wherever it wants.” He felt great, mixing alcohol with pills, suffering from severe hypertension, even to the point of stroke.

The cardinal questions of psychosomatics today are little different from the general questions of etiopathogenesis and include the search for the trigger mechanism of the pathological process, a measure of individual reactivity in the form of a pronounced emotional reaction and a complex of specific vegetative-visceral shifts or the complete absence of them and the specificity of the manifestation of the disease.

According to TH Holmes, RH Rahe (1967), during the course of a year a person experiences about 150 noticeable life changes. When their number doubles, the development of psychosomatic illness increases to 80% [98].

The following psychosomatic diseases are distinguished: hypertension, arterial hypotension syndrome, coronary heart disease, peptic ulcer, nonspecific ulcerative colitis, bronchial asthma, thyrotoxicosis, diabetes mellitus, nonspecific chronic polyarthritis, skin diseases, chronic pain. The list does not include diseases that, according to the ancients, are diseases of “cloudiness” and improper behavior: aggression, overeating, alcoholism, smoking, etc.

At the same time, it is difficult to disagree with the opinion of A.L. Groysman [29] about a significant expansion of the presented list and include irritable bowel syndrome, refluxes - a direct path to stomach and esophageal cancer, gallbladder dyskinesia, resulting in the most common surgical pathology today - cholelithiasis with all its complications; and the scourge of modern surgery – pancreatitis/pancreatic necrosis. Among the 120 causes of the latter, currently the most significant is one associated with the blood supply to the pancreas. Classical experiments on creating biliary hypertension in the pancreatic tract, which occurs in natural conditions during obstruction with a stone, did not give stable development of pancreatic necrosis, while ligation of any pancreatic vein ensured its guaranteed development [4]. The dystonic mechanism of the onset of the disease, provoked by any of the 120 named causes, in my opinion, is the most likely.

In cardiology and angiology, these are cardialgia of a functional nature, arrhythmias, vegetative dystonia and neurocirculatory disorders.

In endocrinology – hypothyroid reaction, hormonal dysfunctions.

Currently, 10 diseases are identified as the main causes of premature death in developed countries: heart and vascular diseases (coronary heart disease, myocardial infarction), strokes (hypertension, atherosclerosis, heart disease), atherosclerosis (diabetes mellitus, hypertension), bronchial asthma, diabetes, nephritis and nephrosis, influenza and pneumonia, cancer, cirrhosis of the liver, accidents. And if the last three groups of diseases can be included in psychosomatics with a reservation (just like pancreatic necrosis, which is now dominant in surgery), then the genesis of the 7 others fits perfectly into the psychosomatic concept.

With a certain degree of tolerance, one can accept the psychosomatic concept as universal. IN AND. Garbuzov [22], combining the fundamentals of Chinese and Tibetan medicine about the relationships and mutual influence of, in our opinion, unrelated organs and their diseases with modern views on the “bundle” psychovegetative - psychoasthenic - somatodepressive syndrome - psychosomatic disease, considers the latter to be the “scourge of the 20th century” century."

The language of disease interpretation today has promoted immunology as an all-explanatory concept. Immunology itself still does not have a strong theoretical basis, but such a phrase as reduced immunity is understandable to absolutely everyone*.

The data obtained by both clinicians and experimenters on the relationship between socio-psychological factors and immune processes is rich and unambiguous. Stressful events - rapid or long-term - directly determine the incidence of cancer and infections, allergic and autoimmune manifestations. The latter include Graves' and Hashimoto's disease, rheumatoid arthritis, Crohn's disease, systemic lupus erythematosus, psoriasis, neurodermatitis, myasthenia gravis. It would be simpler to say that it is difficult to identify a disease that is not in one way or another connected with mental manifestations or characteristics of personal response.

The clarity and intelligibility of psychosomatics does not at all mean its practical acceptance in the clinic. No great physician could move away from the idea that essentially all medicine is psychosomatic. But in current “evidence-based medicine”, focused on pharmacotherapy, the psychosomatic component of the disease is often remembered only when it has borderline manifestations. In addition, psycho is also closely intertwined with socio, as well as with somatics. Hence the inevitable conclusion that saving drowning people is the work of the drowning people themselves. But maybe this is not a wall, but a way out?!

Let's take the simplest option: blood pressure, ulcers, diabetes, asthma, myocardial ischemia, etc. are already making themselves felt. Therapy - strict or occasionally - is already being carried out. Is recovery possible? And here I will not say anything more banal than: “You need to change yourself!” The phrase is banal, but the truth is eternal.

Myocardial ischemia, even against the background of angina attacks, can be compensated by long-term dynamic physical activity (jogging, swimming, even regular squats, long brisk walking), naturally with a slow gradual increase in the load and without interruptions due to bad weather, mood, etc.

What about a heart attack or stroke? Yes, maybe, I saw it with my own eyes and am obliged to refer those who are planning to change their life to a doctor. And it’s even better, for example, to do a coronary angiography first.

But I have already described the doctor-patient relationship within the framework of prescriptions and their real result. It's up to you to choose. Humanity has not yet come up with a better remedy for a heart attack than jogging.

I was once struck by the memories of a marathon runner who came to running through severe angina pectoris in the 60s. He simply couldn't run. Doctor's recommendation - a spoonful of vodka (vasodilation) - jogging: there was nothing to lose. And so, drunk, staggering from tree to tree, the man ran away from death.

There are facts of a different kind. For several years I ran in the forest along the paths of a cardiac rehabilitation sanatorium. I was running all alone...

I’ve also seen people in a coma after their first run...

Hypertension. This is where the field remains unplowed for pharmacotherapy. As a friend of mine puts it: “I take pills by the handful!” The disease is stressful, but multifactorial. Leading a calm lifestyle does not mean there is no high blood pressure. My grandmother died at 86 years old. For approximately 40 years she lived with blood pressure of 180 and 100 mmHg. Art., taking reserpine. She considered stress to be the onset of the disease when she saw me, 2 years old, at the site of a 36-meter-deep well. She never worked (in production), lived in the countryside, without experiencing material and moral problems.

Here in front of me are two [70,100] of numerous publications on the treatment of hypertension. The cause of the disease was determined by the group of authors under the scientific guidance of academician. N. Agadzhanyan sees a decrease in the content of carbon dioxide in the arterial blood (hypocapnia) due to stress, which leads to a spasm of the huge capillary bloodstream with a persistent increase in blood pressure.

There are a lot of publications of this kind as advertisements in periodicals: tsiganap, amber, blueberry preparations and so on, so on... The point is different. Pranayama is the oldest Indian system of prana (energy) control; it is a practical guide to breathing control, in which a small place is given to the “expansion” and deepening of breathing (bhastrika). The basis of pranayama is the breath-holding exercise. Inhaled - held your breath - exhaled - held it. Just to the point of rejection. There are no contraindications, no special conditions. Try it - and you will quickly get the hang of it if you have the patience to practice pranayama for 10 minutes for 2-3 months. Twice a day.

Diabetes is a disease of physical inactivity and improper, or rather, abundant nutrition. The development of diabetes in childhood and youth, which is most likely of an antigenic nature, does not prevail in the general structure of patients with diabetes.

So, F. Chaliapin, in the era of the absence of replacement therapy, was recommended to chop wood before eating. And the great singer himself writes that delicious, plentiful food accompanied by good wine was important in life. Now recommendations for the treatment of diabetes are completely subject to diet - good. But physical activity - running, swimming, even squatting - is an equally significant factor, helping not only to cure type 2 diabetes, but to “get off” insulin.

Bronchial asthma. Numerous theories of the origin of bronchial asthma, from inflammatory-antigenic to overirritation of the trachea and bronchi with “hard” air due to disturbances in the aerodynamics of the nasal passages, each have a basis. But here is the practical implementation in treatment...

Hypercapnic therapy (Buteyko-Strelnikova, Frolov, Malakhov method), which relieves bronchospasm, has real results in treating the disease. It’s easier to take antibiotics and bronchodilators... One of my friends, the owner of a restaurant chain, having heard from me about breathing exercises for his rather mild asthma, stopped consulting with me. He is being treated at the Pulmonology Center. Twice a year he takes courses of pharmacotherapy. Strange? No, it’s real and ordinary, to the point of toothache.

Interesting fact: many outstanding athletes are diagnosed with bronchial asthma. One explanation is that such a diagnosis allows you to take stimulants. Well, it's quite possible. But, in my opinion, this is a natural reaction to many hours of hypocapnia, like the world marathon champion Englishwoman Cartfield. What could be more unnatural than jogging 25 km every day?

I will not repeat myself about obesity and atherosclerosis.

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Symptoms of pathologies of psychostasis

Psychosomatic diseases are replete with variety. Patients describe both individual painful manifestations and present multisystem complaints.

The most common:

• Painful sensations. Patients complain of chest pain, muscle-joint pain, and headaches. Often they indicate a projection from their point of view: “ache in the heart”, “bursts in the stomach”, “stabs in the liver”, “shoots in the kidneys”, etc. Often, suffering people note a psychogenic factor at the onset of a painful attack. The ongoing diagnostics do not reveal any pathological changes.
• Weakness, fatigue, dizziness, feeling of heaviness in the body or individual limbs.
• Cardiopalmus.

• Shortness of breath with hot flashes or vice versa, chills, psychosomatic cough.
• Difficulty in nasal breathing.
• Nausea, vomiting, heartburn, constipation.
• Sexual disorders: decreased libido, problems with erection, ejaculation.
• “Loss of function” (more often in women). We are talking about spasmodic conditions, paralysis, loss of sensitivity, vision, hearing, and difficulty speaking.

These symptoms occur more often in adults.
Children are characterized by disorders that manifest themselves:

• Pre-neurotic complaints of poor sleep, screaming and crying for no reason, enuresis, convulsive twitching, tics.
• Vegetovascular problems: fainting, excessive sweating, dizziness, palpitations.
• Psychosomatics with thirst, nausea, skin rashes, itching, respiratory manifestations.

Joints and activity

Forced inactivity also affects the joints, which derive their strength from the satisfaction of movement. The joints of the legs are nourished by the power of prana - the joyful movement of prana makes them healthy. The joints of the hands are more connected with the activity of the mind and they need joyful mental activity.

When a person with a grudge in his heart does some kind of physical work, he develops inflammatory processes in his joints. This gradually leads to polyarthritis of the joints of the lower extremities. When some mental work is done with resentment, the joints of the hands suffer. A trivial case of working in a state of resentment is working after yet another reprimand. Often a resentful state occurs when wages are not given for a long time. If we realize that all losses occur because we tried to acquire something in a fraudulent way in the past, then all resentments immediately leave the mind. Exactly how much we took in excess, we will lose. The person who is the cause of our suffering is just a puppet in the hands of fate. However, if he really acted unfairly, then fate will do the same to him. Therefore, in any case, a person who understands the law of karma and tries to understand everything in accordance with the Vedas will not be offended by those who, due to weakness of character, cause him trouble. Sometimes punishment comes from decent people. If it is your duty to punish a person who has acted badly, this must be done without hatred or resentment, but out of a sense of duty. For example, sometimes in class students make jokes about their teachers. It is the teacher's duty to punish his students. If you do this in a state of resentment, then, firstly, this punishment will not change the situation for the better, and secondly, such activity is not favorable and can lead to joint disease.

Consequences of lack of therapy

If patients do not receive adequate care, they develop classic somatopathology over time. It is accompanied by changes in the structure of organs, revealed during examination. In this case, specialized clinics should already be involved in the treatment. On this basis, you should promptly contact a psychiatrist to avoid the consequences and complications of PSD.

What to do to be less nervous

To prevent the development of psychosomatics, you need to learn to relax. There are techniques that can help with this:

• breathing exercises;
• relaxation;
• self-hypnosis. A positive internal monologue will help you believe in yourself;
• analysis of the current situation, attempts to find a rational explanation for it and the search for arguments confirming one’s own rightness;
• self-affirmation techniques will help you get out of a stressful situation with minimal losses;
• autogenic training and much more.

Try not to deny yourself small joys, take time to relax, walk in the fresh air and do what you love. For some, going to the theater will help them overcome stress, while others like to care for indoor plants or spend time with their pets. You can embroider, draw, read books, play chess. Yoga, dancing or various sports will help normalize your mental state. It is important to find something to do that brings you joy.

But overcoming stress is not always the solution to the existing problem. To maintain mental and physical health, you need to identify and understand the cause of your experiences, and then develop a new strategy of behavior. And here you can’t do without the help of specialists.

Clinical diagnosis

Establishing an accurate diagnosis can take a long time. The problem is that patients get to the doctor late. They go to specialized specialists, and often in circles until they get to a psychiatrist. Uncertainty can last for months and even years.

In the client clinic:

• They carefully question and listen to complaints.
• They examine.
• Investigated by physical, laboratory and instrumental methods.
• They are referred to specialists for clarification.

Psychologists are involved in the diagnostic process, prescribing:

• Carrying out tests.
• Application of questionnaires.
• Projective techniques.

Only after a final diagnosis has been established is a treatment plan selected.

Joints and criticism

The tendency to criticize arises from hatred or envy. Both of these problems are a product of pride - the desire to put oneself above other people. Criticism itself acts directly on the mind and is one of its most serious diseases. Criticism completely destroys any possibility of spiritual progress. Having a spiritual nature and deprived of spiritual activity, a person gradually plunges into a state of despair and resentment, which also has a bad effect on the joints. It is especially dangerous to criticize people who selflessly serve God and spiritual progress. Among them, a special position is occupied by those who have achieved perfection along this path. We have already listed the qualities of such a person above. Even the slightest criticism of such a holy person destroys any possibility of moving forward on the path to happiness. Only by sincerely asking the saint for forgiveness can we cure ourselves of further degradation of the mind. A critical person is unable to have real friends. In addition, his immunity is greatly reduced, which leads to frequent infectious diseases of many organs, including joints. Whatever he does, gradually all activity is surrounded by an atmosphere of hatred and as a result of such an attitude, resentment towards fate and despair sets in. Any activity in a state of despair again leads to joint disease.

Treatment of psychosomatic diseases

The main task of the doctor is to eliminate the cause of PSD. It is important to identify the primary traumatic factor: stress, conflict, subconscious and hidden experiences. Psychotherapy is used to eliminate it.

Treatment of psychosomatic disorders is carried out:

• Individual psychocorrection.
• Group assistance sessions.
• Hypnosis.
• Methods of neurolinguistic programming.
• Cognitive-behavioral and family correction.
• Body-oriented techniques.
• Gestalt therapy.
• Automotive training.
• Aesthetic therapy.

Pharmacotherapy is no less important.

The list of drugs used includes:

• Antidepressants.
• Sedatives.
• Anxiolytics that suppress anxiety.
• Psychostimulants.
• Psychocorrectors.
• Symptomatic remedies.
• Vitamin therapy.

Treatment of psychosomatic pain requires a comprehensive application of therapeutic techniques.
It is important to eliminate negative feelings at the very beginning of therapy. Often, for these purposes, along with medication, placebo therapy is used, which helps not only in relieving pain, but also in clarifying the diagnosis. At the end of all therapeutic measures, rehabilitation may be necessary. It includes both outpatient sessions with a psychotherapist and a stay in a specialized center using recovery programs. The rehabilitation period may require a long time. After complete recovery, it is necessary to periodically see a doctor for preventive purposes. These meetings will help prevent a possible relapse of the disease.

Joints and disappointment

Without a true goal in life, directing his mind to temporary benefits, a person actively works and waits for when he will be happy, but happiness does not come. Happiness is a power that has a spiritual nature. The spiritual cannot be found in the material. Let's say you can sincerely respect a good person. But if someone has the idea that having a lot of money can achieve sincere, disinterested respect, then this is simply absurd. How can you sell your sincerity and respect for money. A person, having a lot of money, becomes respected by all those who need his money, position, power. However, this type of respect does not bring real happiness, but only its shadow. On the contrary, any beggar who has the ability to honestly and selflessly fulfill his duties to God and the people around him is naturally deeply respected by everyone. Thus, understanding the spiritual nature of happiness, he becomes happy for free. When we achieve greater and greater material success and become more and more immersed in an atmosphere of artificial, formal happiness, the result of such a life is always disappointment. Frustration leads to a lack of incentives for activity and, ultimately, to the degradation of organs that support the active ability to work, including joints. So the joints begin to undergo rapid destruction, which ultimately leads to complete immobility of the person.

Literature:

1. Psychosomatic diseases: Full. reference / [E.V. Bochanova and others; Ed. Yu.Yu. Eliseeva]. - M.: EKSMO, 2003 (N. Novgorod: GIPP Nizhpoligraf). – 602 s.
2. Psychosomatic diseases: theory and practical research / [D. N. Efremova, O. I. Kayasheva]. - Moscow: URAO; St. Petersburg: Scientific Research Center ART, 2015. - 100 p.
3. Mortality of the Moscow population from mental and psychosomatic diseases: Monograph / S. P. Ermakov, Yu. P. Boyko. - M.: Publishing house Ros. Peoples' Friendship University, 2002 (Type. IPK RUDN). – 108 s.

The text was checked by medical experts: Head of the socio-psychological service of the Alkoklinik MC, psychiatrist-narcologist L.A. Serova.

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Joints and despair

When we think: I won’t have time, I won’t finish it, or I’ll work very hard - work does not bring joy, but only gives tension, and despair appears as the last link in this chain - no one understands me. A person should live for happiness, and not for self-torture. Joints contain the force of dynamic tension, and they give us the ability to act. Therefore, when everyday activity brings only suffering, a person becomes immobilized. This is how the body, under the guidance of the mind, expresses its protest against an erroneous position in life. If a person works only out of fear of being left without means of subsistence and suffers from joyless work, he should know that the time will soon come when it will become very difficult for him to move. Despair from joyless work leads to the first signs of joint disease, which is expressed in their pain and increased sensitivity. When despair turns into disappointment, destructive changes in the joints will begin.

The Vedas say that we receive the amount of material resources as a result of those pious deeds that we performed in past lives. Greedy labor does not add piety to a person’s destiny, but on the contrary makes him more and more unhappy. Therefore, we must learn to work with love, stop acting as a slave to our material plans and despair when we see how difficult it is to implement them. The Vedas say that when you live honestly, and this means according to the laws of the sacred scriptures, it becomes easy to understand how to correctly fulfill your duties to society and God. Only in this case, knowledge hidden from all other people is revealed - how you can be happy without overexerting yourself in joyless work and without immersing your mind in material problems. The Vedas assert that if a person unselfishly fulfills his duties to God, then, simply by doing his useful work, he will have everything necessary for life. And if you completely free yourself from selfish desires and fulfill your duty with love for God, then you can gradually become the happiest and most successful of people.