Neurasthenia in children is a transient mental disorder from the group of neuroses. At the heart of neurasthenia are two symptoms - weakness and irritability, but the clinical picture may be supplemented by other signs, for example, sleep disturbance or nocturnal uncontrolled urination.
Pediatric neurasthenia develops due to such reasons:
- Long-term traumatic factors. Most often, these include social factors: parents' alcoholism, poor relationship between father and mother, negative family atmosphere, low standard of living or malnutrition. Children are extremely sensitive to negative emotions, so they easily catch the “cold” between their parents and reflect it through their mental and somatic state.
- Excessive demands on the part of parents. The provoking factors are hyper-care and high demands, exceeding the child’s abilities. Children are born with their own limitations and capabilities: one child can easily have mathematics, another - music or drawing. Parents demand that the musical kid thoroughly study algebra, and the "mathematical" - the humanities. Due to the inconsistency of the capabilities and requirements of the child, neurasthenia occurs.
- Congenital somatic weakness. Children who often suffer somatic pathologies such as respiratory tract infections, gastrointestinal disorders or frequent joint injuries become ill with neurasthenia. Due to persistent diseases the body is depleted, neurasthenia occurs.
- Overloading school and elective classes.
Modern parents load the child on “all fronts”: in the morning - school, in the afternoon - foreign language lessons, in the afternoon - the sports section, in the evening - homework. Parents do not understand that such a schedule loads the psyche. The kid is exhausted physically and intellectually.
It is rarely the case that the danger arises only on one side - a school load or a hyper-care. Most often this is a combination of several factors: parents quarrel, a child is strained at school, in winter he is ill, and grandmother and grandfather demand the impossible.
The mechanisms of neurasthenia formation were studied by I. Pavlov and his assistants. The physiologist claimed that people with a weak or unstable temperament are susceptible to asthenic neurosis, which are joined by the weakness of mental processes after intellectual or physical exhaustion.
Physiologically, asthenic neurosis develops gradually:
- the weakness of one of the processes in the central nervous system increases, for example, the weakness of the process of inhibition →
- weakness of the first joins the weakness of the second, the process of excitation →
- the weakness of both physiological processes, there is transcendental inhibition in the cortex and subcortex of the brain.
Unlike adults, in children the central nervous system is imperfect. Therefore, the clinical picture of asthenic neurosis is fully developed in them, while in adults individual signs are compensated by the maturity of the cerebral cortex.
Clinical signs in children:
- Irritable weakness. It is two-sided. On the one hand, irritable weakness is manifested by flashes of aggression, impulsiveness, difficulty controlling emotions, anger, and discontent. On the other hand, irritable weakness is manifested by rapid exhaustion, which turns into crying or deep sleep. Children with neurasthenia in this state can not withstand physical or intellectual stress, so try to avoid them.
- Vegetative disturbances. Manifest sweating, dizziness, incontinence, shortness of breath, palpitations, nausea, poor appetite and superficial sleep. It is easy to wake up children with neurasthenia: the slightest rustle will disturb their sleep. Pressure fluctuations can cause orthostatic collapse - the child will lose consciousness.
- Mood. Outbreaks of discontent, aggression and anger most often occur against a background of low mood.
Diagnosis and treatment
For the diagnosis of asthenic neurosis, doctors use the method of clinical conversation. He speaks with parents and child. It is important for the physician to determine the cause of the neurosis - the treatment depends on it. The most common cause is excessive demands from the child or hyper care. In this case, family psychotherapy sessions are prescribed.
For a detailed diagnosis, the doctor uses pathopsychological methods: a thematic apperceptive test, a technique of unfinished sentences, or a Luscher test. Psychological methods help to establish the true attitude of the child to the parents, to identify his experiences or to predict the further management of the patient.
Treatment of neurasthenia in children is a correction of the lifestyle of family members raising a child. For this, sessions are assigned to a psychologist or psychotherapist. Antidepressants, anxiolytics or sedatives are used to normalize the mental state. Improves mood, sleep and overall adaptation of the body to negative factors.
Why do neuroses occur?
Both preschool children and schoolchildren, teenagers have a particularly vulnerable nervous system due to the fact that it is not yet fully formed and immature, they have little life experience in stressful situations, they cannot adequately and accurately express their emotions.
Some parents, because of employment and other factors, often do not pay attention to the manifestations of nervous disorders in children, writing off changes in behavior to age characteristics or moods.
But if the neurosis does not help the child in time, the situation may be delayed, affect the physical health and problems in communicating with others, developing into a neurotic state in a teenager. As a result, the neurosis will be the cause of the already irreversible psychological changes in the warehouse of the individual.
The most significant factor in the increase in neurosis in children today is the increase in the number of pathologies of pregnancy and childbirth, in which there is hypoxia in the nervous tissue of the fetus (see the effects of fetal hypoxia).
Predisposing factors for the development of neurosis are:
- predisposition to problems of the nervous system inherited from parents
- traumatic situations, disasters, stress
The trigger mechanism of neurosis can be:
- past illnesses
- frequent sleep deprivation, physical or mental stress
- difficult family relationships
The course of the disease and its severity depends on:
- gender and age of the child
- features of education
- type of constitution (asthenics, hyper- and normosteniki)
- temperament features (choleric, phlegmatic, etc.)
Psychotrauma is a change in the child’s consciousness because of any events that greatly disturb, suppress or oppress, and are extremely negatively affected. These can be both long-term situations in which the child cannot adapt without problems, or acute, severe mental trauma. Often, the traumas received in childhood, even if the neurosis has passed, leave their mark on adult life in the form of phobias (fear of confined spaces, heights, etc.).
- Neurosis can be formed under the influence of one unfavorable traumatic fact: fire, war, abrupt moving, accident, parents divorce, etc.
- Sometimes the development of neurosis is caused simultaneously by several factors.
Children, due to their temperament and personality traits, react differently to events; for some, a dog barking on the street will be just a sound stimulus, and in a child predisposed to neurosis, it can become a trigger for the formation of neurosis. And already repeated meetings with dogs after the first jolt that launched the neurosis will gradually aggravate the situation and deepen the neurosis.
The type of psychotrauma that can provoke neurosis in children depends on the age of the child.
- At the age of 2, children can give neuroses when they are separated from their parents or when they begin to visit children's groups.
- For older children, there may be a more serious factor - parental divorce, physical punishment when raising children, and strong fear.
Crisis ages in the development of neurosis are the age of three and seven years - when the age-related so-called “three-year crisis” and “seven-year-old” occur. During these periods, the formation of the “I” and the overestimation of attitudes towards oneself occur, and during these periods children are most vulnerable to stress factors.
One of the main provocative causes of children's neuroses are the actions of adults, parental educational errors, which give neurotic reactions, and later the formation of psychological instability of the personality is already an adult. Particularly negative models of education will be:
- model of rejection, subconscious reluctance to raise a child, in the case when, for example, they wanted a boy, and a girl was born
- model of hyper-care with the development of unwillingness to teach a child independence and building relationships in a team
- authoritarian model with the requirements of constant submission to elders, making decisions instead of the child, and not taking into account his opinions
- a model of permissiveness with the complete deprivation of the child of control or help from the parents, with the absence of any norms and order within the family and the collective.
- different approaches to parenting
- excessive parental stiffness
- Conflicts in the family - family problems, divorces, quarrels.
They fall on the “fertile soil” of the immaturity of the nervous system of children, while the child experiences this, since in reality he cannot influence the situation and change it.
- Changes in the habitual way of life - moving from city to village, to an unusual locality, to another country
- visiting a new children's team - starting a kindergarten, changing a kindergarten, starting a school, changing a school, as well as conflicts in a kindergarten or school group
- changes within the family - the birth of a child, a foster child, the appearance of a stepfather or stepmother, the divorce of parents.
Most often, neuroses are formed by the combined effect of several factors at once, and the children's neurosis is unlikely to develop in a child from a prosperous family, even after a strong fear or fright. Parents in this situation usually help to quickly deal with the problem without disturbing the nervous system.
The nature of the child
Children with pronounced emotionality, sensitivity - they especially need the love and attention of loved ones, the manifestation of emotions in relation to them. If children do not receive these emotions from relatives, they experience fears that they are not loved, they do not express emotions towards them.
Children with leadership qualities are also difficult with children independent and actively expressing their own opinion, leadership qualities. Such children have a pronounced arrogance in actions or actions, their own view of all events. They are difficult to tolerate restrictions in their actions and parental dictatorship, they are too heavy to take care of and to restrict independence from an early age. Children try to protest such parental actions, to stubbornly, for which they receive restrictions and penalties from their parents. This will contribute to the development of neurosis.
Weakened, often ill children - children at risk of neurosis, often ill and weak, are often referred to as a “crystal vase”, protecting them from all the above measures. Such children form a feeling of their own helplessness and weakness.
Children from dysfunctional families also suffer from neuroses in difficult life situations: in asocial families, in boarding schools and orphanages.
General manifestations of neurosis
- behavior change children
- appearance of new character traits
- increased sensitivity, frequent tears, even without visible reason
- sharp reactions to minor psychotrauma in the form of despair or aggression
- anxiety, vulnerability.
Changes also occur at the level of children's somatic health:
- tachycardia and changes in blood pressure
- respiratory disorders, sweating
- digestive disorders for stress - "bearish disease"
- concentration disturbance
- memory loss
- children react poorly to loud noises and bright light
- sleep badly, sleep is disturbing and poor in the morning they are difficult to wake.
Games to strengthen breathing.
In a glass of water we drop a straw and give the child a little bubble. The main thing to follow to exhale was long. We use all sorts of whistles, pipes, tubes, which can blow and cause some kind of sound. Your assistants and "trainers" - soap bubbles, dandelions and balloons
What is neurasthenia? How to recognize its symptoms in a child? And why, it would seem, the adult disease is increasingly being diagnosed in childhood? In this article we will try to find answers to questions that are relevant for many parents.
Neurasthenia is also called asthenic neurosis, and it is a chronic overwork in the central nervous system. This means that the central nervous system is constantly experiencing overload for a long time, because of which its functions "overgrow" temporary disturbances. The key word here is “temporary”, since with due attention to the disease, disorders of the nervous system are completely reversible.
Anxiety or Neurosis of Fear
It can manifest itself in the form of bouts of fear, which often occur when falling asleep or alone, can sometimes be accompanied by visions. Fears in children at different ages can be different:
- fears of leaving one in the house, fear of the dark, characters of scary cartoons or films, programs are common among preschoolers. Often the fears are cultivated by the parents themselves, scaring the children for educational purposes with frightening characters - Baba, an evil witch, a policeman.
- younger students can have fears of school or poor grades, a strict teacher, or older students. Often these children skip lessons because of fears.
Manifestations of this neurosis can give a bad mood, unwillingness to remain alone, changes in behavior, in difficult cases urinary incontinence joins. Often, such neurosis occurs in sensitive home children who have had little contact with their peers at preschool age.
How does child neurasthenia arise?
A child from birth is in constant interaction with reality, the world, satisfied with a large number of people, their behavior, reactions to various situations. Everything related to the child, his life seems to him significant. At the same time, it does not matter at all what will be especially significant for him (each person himself defines this “significance”).
But when a person is not ready to face the “imperfection” of the world or simply considers this task to be initially unsolvable, then a conflict arises that negatively affects the child’s personality. This unsolvability of conflict "undermines" the nervous system. The child is trying to hide this problem deeper. He begins to perceive it as a personal failure, gradually convincing himself of its insolubility. Voltage is growing more and more.
Not the situation itself in this case is pathogenic, but the fact that the child is unable to cope with the proposed task. He feels that it is impossible to satisfy his needs, mental and physical disorganization increases. As a result, a nervous strain occurs.
If we proceed from this point of view, it turns out that there must be a certain tendency toward neurasthenia.Each person has his own adaptation resource, with its exhaustion, inability to solve problems, astheno-neurotic syndrome may occur.
At the same time, there is a tough discrepancy between the capabilities of the child’s personality and the requirements of a constantly changing reality. After all, if roughly the same irritant from the external environment acts on different children, then not everyone will have an astheno-neurotic syndrome. The situation can only contribute to the development of neurasthenia, but not be a direct cause of occurrence. As stated in the monograph of the child psychiatrist B.V. Voronkova "Without personal readiness, even with very serious life difficulties, neurosis will not form."
Of course, this is not the only theory about the nature of the occurrence of the neurasthenic state. There are also others. One of them is the theory of psychoanalysts, first of all, Z. Freud. Following this point of view, neurosis (or neurasthenia as a form of neurosis) is formed due to forbidden attraction and psychological defense. The onset of neurosis stems from early childhood. Following the tenets of another theory, the main role in the occurrence of neurotic disorders lies in hereditary predisposition (F. Raymond, F. Kehrer).
Psychotic symptoms are not characteristic of neurasthenia, since the patient remains critical to his condition and self-identity. As an independent form of neurosis, neurasthenia in children is formed starting from school age. In preschool children, it manifests itself as psychogenic asthenic reactions in response to a traumatic situation.
The first 3-4 years of life
During this period, it is especially important for the baby to maintain a harmonious relationship in the “mother and child” system. It is during this period that the worldview is formed through the relationship with the mother. If the mother loves and unconditionally accepts her child, then the world around her seems to the child to be equally accepting, not hostile.
In the case when constant tension is observed, the mother rejects her child, constantly screams at him and does not show love and tenderness towards him, then the world around him will seem to the child as hostile and evil. Neurotic reactions can manifest in excessive tearfulness, aggressiveness, nausea, vomiting, enuresis, encopresis. At the birth of younger brothers or sisters, anxiety increases, jealousy, jealousy form, a feeling of uselessness arises.
Neurasthenia in preschool age
In the preschool period, for a child a psycho-traumatic situation for the occurrence of neurasthenia, various emotional upheavals occur when meeting with unfamiliar animals or acquaintances, but before which fear could be formed by adults themselves. How often we hear from adults the phrase “do not go there, there is an evil big dog, she will eat you”, “do not come near this cat, she will scratch you or bite you”.
All these words are spoken most often from concern for the child’s life and health, but they can be said in a completely different way, for example, “be careful, you don’t know this dog, it’s you, too, when dogs are afraid or worried, they start defending themselves” . We should not “program” a child to fail with direct phrases “you will fall”, “you will break”, etc., since adults only form the fears of the child themselves, they only need to honestly warn about possible consequences and declare their concern. At this age, children are extremely susceptible to the words of adults, shouting, swearing, frightening behavior - all this can negatively affect children and form an undisturbed anxiety and various fears, even phobias.
Children who are excessively centered on the mother, with a drastic change in the system of relationships (marriage, hospitalization without a mother, etc.) can cause neurasthenia, children begin to feel sick for no apparent reason, sleep is disturbed, etc.
At about 5-6 years old, the character of the child is already more clearly defined, self-esteem is formed, so now they are able to fully feel their inferiority and helplessness, they can easily develop for various reasons a sense of guilt and a sense of their own insignificance. This is facilitated by conflicting relationships with peers and excessive demands from parents. A child may feel that he is not at all what his parents want to see. Often, the parents themselves contribute a lot to this, often scolding the child and constantly telling him “no”, introducing a rigid system of rules and permanent bans.
This period included pre-adolescence and adolescence. In primary school children have difficulty mastering the program, open and incessant hostility with peers, lack of friends, forced loneliness can cause neurasthenia. Closer to adolescence, the personality of the child, his self-esteem, the relationship between “I want” and “I can” are subjected to harsh testing.
Adolescents are often afraid of being rejected, their desire for grouping is well developed, the fear of not meeting the generally accepted standards in a group of adolescents forms an anxiety that lasts for a long time. The psychological conflict during this period, especially if the teenager wants something, but cannot realize it (or even the goal seems initially unattainable to him), moves to the apogee, at critical moments only one minor detail is enough to create neurasthenia. The cause of neurasthenia is often a failure to achieve a subjectively significant goal. Overwork at the same time plays a subordinate role, because even a long rest does not bring significant relief.
The clinical picture of neurasthenia (symptoms and behavioral features)
With neurasthenia, pronounced fatigue and irritability prevail. In adolescents, neurasthenia usually manifests itself in two variations: hypersthenic and hypostenic.
- Hypersthenic. In adolescents, short-term violent affective reactions are observed, but quickly fading. There may be on the most insignificant occasions. Such children do not tolerate bright light or harsh sounds. They complain that they are tired, they do not have the strength and desires, they perceive any criticism as extremely painful and acute. Periods of activity and desire to do something with them are short-term. Especially clearly their irritability manifests itself with loved ones, in the family. They often have restless sleep, in the mornings they often have a headache. At school, they become extremely scattered and inattentive, memory deteriorates.
- Hypostenic. In this case, adolescents complain of constant fatigue, they quickly tire, become inactive, lethargic, constantly want to sleep. And even a long rest or sleep does not give a feeling of cheerfulness. Often they complain that they have a headache, stomach ache, heart, etc. There may be symptoms of various diseases that occur due to nervous overstrain.
In both cases, adolescents have palpitations, pressure is uneven, dizzy, can feel sick, frequent intestinal cramps and other symptoms of somatic disorders. Asteno-neurotic syndrome can last for months and even years, the longer it lasts, the more difficult the treatment will be.
Even simple actions (mental or physical) are difficult for children with neurasthenia, they are constantly accompanied by increased anxiety, they are not able to relax or even take a break for a while. Most other neurasthenia prone children with heightened emotional sensitivity, lack of self-confidence, vulnerable, anxious, suspicious. Being constantly "under the pressure" of parental authority.
They constantly try to avoid the risk of failure, they strive not to fulfill the goal, but simply to avoid mistakes, they are afraid of competition. In the lesson, even knowing the correct answer, they sit and are afraid to speak. They have serious problems with self-esteem. They avoid emotional and mental stress. In addition to personality traits, residual-organic failure of the brain and somatic (physical) weakness are also referred to as internal prerequisites for the occurrence of neurasthenia. Among the neurosogenic factors in adolescents, the situation in the family plays an important role.
Risk to the formation of neurasthenia can be alcoholism of parents, their antisocial behavior, diseases of loved ones with the threat of death. Children who are constantly forced to “appease” their parents experience powerful nervous overloads, they have a feeling of hopelessness and constant dissatisfaction with themselves. Over-care is also not good at raising children, it forms in them passivity, infantilism, inability to adapt and, as a result of all this, the astheno-neurotic syndrome or other neurotic disorders.
Before starting treatment, the doctor needs to find the basic prerequisite for neurasthenia. That is, find out exactly what triggered neurasthenia. In most patients, only one traumatic circumstance due to subjective significance is a neurogenic factor. Often inexperienced or insensitive doctors are prone to projecting their installations or their experience on the current situation in a teenager or child, assessing only the outward signs of the disease.
Sometimes even the drunkenness of a father or the death of a close relative is not at all the cause of neurasthenia. It is possible that the child is indifferent to these phenomena from the point of view of particular significance. And the reason may be different. The treatment of such patients should be carried out by a pediatrician (therapist), together with a psychologist or psychotherapist, or else with a psychiatrist.
Therapy and treatment include somatopsychic and socio-personal correction, it is sometimes possible to prescribe medications, you also need a lifestyle change, the establishment of a microclimate in the family. Family psychotherapy is very effective in this case. The main thing in treatment is the resolution of personal conflict. Neurasthenia is a reversible process and can be treated successfully.
How to eliminate neurasthenia in children?
In some cases, to clarify the diagnosis, the doctor prescribes a survey of all organs and systems of the sick child by laboratory, electrophysiological methods. In the process of treatment, the main task is to eliminate the causes and reduce mental and physical exertion.
During the recovery period, it is necessary to change the intensive mode of study and to devote more time to rest. Any activity should cause positive emotions in a child. Welcome walks in the fresh air before bedtime, autogenic training.
You need to take care of a balanced diet rich in vitamins. If possible, it is best to change the situation, for example, with the family to spend a few days in nature. It is useful to apply psychotherapeutic methods that contribute to the normalization of the nervous system, acting soothing.
For example, you can watch beautiful, colorful fish in an aquarium and listen to a melodic piece of music. Parents are obliged to create a calm atmosphere in the house, to restrain their emotions. For this there are many ways, you need patience and compliance with the recommendations of specialists.
Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner
Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.
Sensory integration as a method of treating developmental disorders in a child
Neurosis of obsessive states in children
It can occur as a neurosis of obsessive actions (obsessions) or phobic neurosis, as well as with the presence of both phobias and obsessive actions at the same time.
Obsessive actions - involuntary movements that occur during emotional stress, contrary to the wishes of the child, he can:
- purse nose
- tap foot
- to cough
- to sniff
Nervous tic - involuntary twitching, occurs more often in boys, starting both with psychological factors and with the presence of certain diseases. Initially justified actions against unfavorable background are then fixed as obsessions:
- In case of eye diseases, habits of blinking, blinking, rubbing the eyes can be fixed.
- With frequent colds and inflammation of the upper respiratory tract, sniffing or coughing may become fixed.
They usually appear in the period after 5 years. Such tics affect the facial muscles, neck, upper limbs, can be from the respiratory system, combined with urinary incontinence or stuttering. Such repetitive actions of the same type can bring discomfort to the child, but more often they become habitual, he does not notice them. Read more about the causes and treatment of nervous tics in children.
As a rule, the tendency to neurosis is laid from an early age, when stressful habitual pathological actions are formed and fixed:
- nail biting or thumb sucking
- touching the genitals
- swinging trunk or limbs
- twisting hair on fingers or pulling them out.
If such actions are not eliminated at an early age, they contribute to neurosis in the face of stress in older children.
Phobic manifestations are usually expressed as a particular phobia:
- fear of death or illness
- closed spaces
- various items of dirt.
Often, children form particular thoughts or ideas that are contrary to the principles of upbringing and morality, and these thoughts create anxieties and feelings and fears in them.
For babies, they are not typical, usually children at school age are prone to them, especially during puberty. The child tends to be alone, detached from others, constantly in a depressed mood with tearfulness and reduced self-esteem. Physical activity may also decrease, insomnia arises, appetite worsens, expressionless expression, quiet and scanty speech, constantly feeling sad on the face. This condition requires special attention, as it can lead to serious consequences.
Preschoolers are inclined towards them, if the desired is true. They usually give falls with shouts and screams on the floor or surfaces, beats of limbs and head against hard objects. Affection attacks may occur with imaginary suffocation or hysterical coughing, vomiting, if the child is punished or is not doing what he wants. Older children may experience hysteria analogues in the form of hysterical blindness, skin sensitivity disorders, and respiratory disorders.
It is also called asthenic neurosis, occurs in students as a result of excessive loads of the school itself or an excess of additional circles. Often occurs against the background of the general weakness of children due to frequent illnesses or physical lack of fitness. Such children are disheveled and restless, they quickly get tired, irritable and often cry, can sleep and eat poorly.
Neurotic logoneurosis - stuttering
Stuttering or neurotic logonerosis is more characteristic of boys under five years of age during the active development of speech, the formation of phrasal conversation. Arises against the background of psychological trauma against the background of family scandals, separation from loved ones, acute psychological trauma or fear, fright. There may also be reasons for information overload and forcing parents to develop speech and general development. The child's speech becomes intermittent with pauses, repetition of syllables and the inability to pronounce words.
Somnambulism - sleepwalking, speaking
Neurotic sleep disorders can occur in the form of a long and difficult falling asleep, restless and disturbing sleep with frequent waking up, nightmares and night terrors, talking in a dream and walking at night. Sleepwalking and dreaming are associated with the characteristics of dreams and the work of the nervous system. Often in children is from the age of 4-5 years. Children in the morning may not remember that they walked or talked at night. Read more about sleepwalking in children and adolescents.
Disturbance of appetite in childhood is common in preschoolers and adolescents. Usually the causes are overfeeding or force-feeding, the coincidence of meals with scandals and quarrels in the family, strong stress. At the same time, the child can refuse any food or some of its types, he chews for a long time and does not swallow food, is extremely suspicious of the contents of the plate, up to the gag reflex. At the same time, on the background of poor nutrition, mood changes, moods at the table, crying and tantrums are expressed.
Separate variants of neurosis are:
- pediatric neurotic enuresis (urinary incontinence)
- encopresis (fecal incontinence).
They arise against the background of hereditary predisposition and possibly diseases. Requires a special approach to treatment, and the mechanisms are not yet fully understood.
How to make a diagnosis?
First of all, it is worth going to an appointment with a pediatrician or a neurologist, talk with an experienced psychologist and psychotherapist. Doctors examine and remove the organic causes of disorders, diseases that could lead to such. Neuroses are diagnosed in several stages:
- Dialogue with parents conducts a detailed analysis of the psychological situation in the family, and here it is important to frankly tell the specialist all the details: the family relationship between the parents and the child, the parents themselves, as well as the relationship between the child and peers, relatives.
- Surveys of parents and close relatives who are directly involved in raising a child, studying the psychological climate of a family with errors in behavior and education.
- Conversations with the child - a cycle of conversations with the child in the process of playing and communicating on pre-designed questions.
- Observation of the child - a detailed observation of the child's play activity, which occurs spontaneously or is organized in advance.
- Drawing and detailed analysis of drawings, from which one can often understand the feelings and feelings of a child, his desires and emotional state.
Based on all this, a conclusion is made about the presence and type of neurosis, then a detailed treatment plan is developed. Usually, psychotherapists or psychologists deal with the therapy; the treatment is carried out on an outpatient basis and at home; you do not need to put the child with neurosis in the hospital.
Neurosis treatment methods
In the treatment of neurosis in children, psychotherapy is the main method. It is important for parents to understand that on their own, with the help of books, the Internet or toys, they will achieve little, and sometimes they can also do harm, aggravating the course of neurosis. Psychotherapy is a complex systemic effect on the psyche of the child and the characteristics of his character, in the treatment of neuroses, it has several directions:
- group and individual therapy for the study and correction of the psychological climate of the family
- role-playing games with the participation of the child, helping him learn to overcome difficult situations
- use of art therapy (drawing) and drawing up a psychological portrait of a child’s drawings, tracking the dynamics of drawing changes
- hypnosis - suggestion (autogenic training)
- treatment by communicating with animals - Canistherapy (dogs), feline therapy (cats), hippotherapy (horses), dolphin therapy.
Psychotherapy is aimed at normalizing or significantly improving the intra-family environment and relationships, correcting upbringing. Additionally for the correction of psychosomatic background and achieving baboutDrug therapy, reflexotherapy and physiotherapy are also used to achieve greater success in psychotherapy. An individual treatment plan is developed only by a specialist for each child separately, and if necessary for family members.
Use as a group, and individual or family psychotherapy. Of particular importance in the treatment of neurosis is the family form of psychotherapy. During the sessions, the doctor directly identifies the problems of the life of the child and his family, helps in resolving emotional problems, normalizes the system of relationships and corrects the style of education. Work in the family with preschool children will be especially effective when its effect is maximum and it is easiest to eliminate the negative influence of the main mistakes in upbringing.
It is carried out in several successive stages:
- Stage 1 - a family survey is conducted and the so-called “family diagnosis” is made in the overall set of personal, social and psychological characteristics, deviations in any areas of the relationship with the child.
- Stage 2 - a family discussion of the problems with parents and relatives is conducted, all their problems are noted. When conversations emphasize the role in the education of parents, the need for cooperation with a specialist and determined the perspective in the pedagogical approach.
- Stage 3 - then follow the lessons with the child in a special equipped game room, where there are toys, stationery and other items. Initially, the child is given time for independent games, reading, or classes, as emotional contact is established, the conversation will be held in a playful way.
- Stage 4 - joint psychotherapy of the child and parents. Preschoolers have a joint activity with subject games, buildings or drawing, schoolchildren introduce subject games and discussions on various topics. The specialist evaluates the usual conflicts and emotional reactions in the interaction of children and parents. Then the focus is switched to role-playing games that express the communication of children in life - games in a family or school. Scenarios are used that are played by parents and children who are swapped, and the psychotherapist in the process of these games will demonstrate the most optimal models in family relationships. This gradually creates conditions for rebuilding family relationships and eliminating conflict.
Conducted using numerous techniques that have a complex effect on the child. It uses techniques:
Explaining therapy, the doctor conducts by successive stages. In an accessible form for the child, after establishing a confidential and emotional contact with him, he tells us why and what happens to the child. Then, in the form of a game or in the form of a conversation in the next stage, he tries to determine the sources of the child’s experiences. The next stage will be a kind of “homework” - this is the end of a story or fairy tale started by a doctor, where examining different options in the end of a story, attempts are made to resolve difficult situations, conflicts, or by the child himself, or with the help and advice of a doctor. Even very small successes in the possession of situations, with the approval of a physician, can further improve relations and correct pathological traits in character.
Art therapy in the form of drawing or sculpting can sometimes give much more information about the child than all other methods. When drawing, the child begins to understand his fears and experiences, and observing him in the process can give a lot of necessary information in terms of character, sociability, imagination and potential. It will be informative to draw on the themes of the family, reflections of fears, experiences. Sometimes they use molding or paper appliqués instead. Often, according to the pictures you can get a lot of hidden information, as well as the story of the figure to work with the child of his fear.
It is used in children up to 10-12 years old when they have a need for games, but at the same time the games are organized according to a special plan and emotional participation in them by the psychotherapist, taking into account the ability of children to reincarnate. Can be used as spontaneous games-observation, as directed, without improvisation. In games, you can work out the skills of communication, motor and emotional expression, relieve tension and eliminate fear. The doctor during the game creates situations of stress, dispute, fear, accusations and gives the child the possibility of self-exit or with his help. Especially good neurosis treated with this method in the age of 7 years.
A variant of play therapy is fairy-tale therapy, in which fairy tales are invented and told with the manufacture of special characters, puppets or dolls. Special therapeutic tales can be heard in the form of meditation, with calm music in a supine position. There can also be psycho-dynamic meditations-tales with the reincarnation of the child in animals and the implementation of exercises.
Treatment with autogenic training is carried out in adolescents - this is a method of muscle relaxation, especially effective for systemic neuroses with stuttering, tics, urinary incontinence. Creating a positive attitude by speaking and acting by a doctor (for example, presenting yourself in the most pleasant place) leads to muscle relaxation, a decrease or even complete disappearance of the manifestations. As the sessions this state is fixed in the subconscious, the belief is increased that it is quite possible to recover.
- Suggestive (method of suggestion) psychotherapy
This suggestion to the child in the waking state, under hypnosis or indirect suggestion of certain attitudes. Children often get an indirect suggestion well - for example, taking a placebo will give them a cure. At the same time, they will think that they are taking an especially effective drug. Especially good method for hypochondria, in school and adolescence.
Hypnotherapy is used only in particularly difficult cases in order to mobilize the psychological and physiological resources of the body. It quickly eliminates certain symptoms. But the method has many contraindications and in children is used sparingly.
Shown in special cases of neurosis, it includes:
- a long course of neurosis with adverse personality changes - an increased level of self-requirements, self-centeredness
- communication difficulties and related disorders - constraint, timidity, shyness, suspiciousness
- in difficult family conflicts need to resolve them.
Groups are formed according to individual therapy by age, children in the group are few:
- under 5 years old - no more than 4 people
- from 6 to 10 years old - no more than 6 people
- at the age of 11-14 years old - up to 8 people.
Classes last up to 45 minutes for preschoolers and up to one and a half hours for schoolchildren. This allows you to play complex scenes and involve all the members of the group. Grouped children visit exhibitions and museums, read interesting books, discuss all this, share their hobbies. Thus, relieving the child’s tension is achieved, the children open up and begin to communicate, share painful experiences.
In comparison with the individual, the effect of group training is greater. Spontaneous and guided games are introduced gradually, the training of mental functions begins, adolescents are trained in self-control. As homework they use various kinds of tests with pictures, which are further discussed in the group.
In the classroom relaxation and suggestion of positive personal qualities acquired in class are held. At the end of the course, there is a general discussion and consolidation of the results, which helps the child to work independently on himself in the future.
Drug therapy in the treatment of neurosis is of secondary importance, while it affects those or other symptoms. The drugs relieve tension, excessive irritability or depression, reduce the manifestations of asthenia. Medications are usually preceded by psychotherapy, but complex treatment is also possible when psychotherapy is carried out in conjunction with physiotherapy and medications. Especially important drug treatment of neurosis in the background of encephalopathy, asthenia, neuropathy:
- fortifying drugs - vitamin C, group B
- dehydration phytotherapy - diuretic fees, kidney tea
- nootropic drugs - nootropil, piracetam
- drugs that reduce asthenia - depending on the cause and type of doctor will choose
- herbal medicine (see sedatives for children), herbal tinctures can be prescribed for up to one and a half months. Most drugs have a sedative effect - motherwort, valerian.
With asthenic manifestations, a tonic and restorative treatment is recommended: calcium preparations, vitamins, Chinese magnolia vinegar or zamaniha tincture, lipocerbine, nootropic (nootropil, pantogam).
When subdepressive manifestations can be shown tinctures of ginseng, aralia, Eleutherococcus.
With irritability and weakness, Pavlov’s mixture and motherwort and Valerian tinctures have a good effect, they use pine baths, physiotherapy in the form of electrophoresis with calcium and magnesium preparations, and electrosleep.
It will be more difficult with antidepressants and tranquilizers, they can make psychotherapy difficult. They are used for hyperactivity and disinhibition based on the characteristics of the child and the diagnosis:
- Hypersthenic syndrome - drugs with a sedative effect (eunoctin, Elenium)
- with hypotenia - drugs tranquilizers with an activating effect (trioxazin or seduksen).
- with subthreshold depressions, small doses of antidepressants may be prescribed: amitriptyline, melipramine.
- with strong excitability, sonopax can be used.
All drugs are prescribed exclusively by a doctor, and are used strictly under his control.