Treatment of far-reaching forms of neurosis, neurotic development is a very difficult task, therefore, of course, special attention should be paid to the prevention of neurosis. G.K. Ushakov identifies the social, psychological and medical aspects of prevention and sets out a broad program. Among the social activities, he includes improving the training of doctors in the field of psychohygiene and psychoprophylaxis , studying the conditions that ensure mental health and contributing to the emergence of neurosis, and the psychohygienic education of the population. Among the psychological aspects, the leading ones are the streamlining of interpersonal relationships, ensuring group compatibility in the family and the work collective, the scientific organization of labor, psychological training that ensures the neutralization and deactivation of stresses, the development of an adequate level of claims, the development of a sense of collectivism. Medical aspects include women’s health, pregnancy protection, skilled medical care and early diagnosis of neurotic disorders. The issues of widespread prevention go beyond clinical medicine and require the complicity of educators, sociologists, hygienists, etc. The goal of prevention is to reduce the number of adverse, stressful factors, harmonious education of the personality, and the ability to neutralize emerging traumatic situations.
Patients with pre-existing neurotic disorders turn to doctors and psychiatrists and neuropathologists, which sets the tasks: correct and maximally early diagnosis, reducing the degree of painful disorders and rehabilitation. The most appropriate treatment for neurosis is psychotherapy. For this purpose, various methods are used: rational, autogenic training, hypnosis, family psychotherapy, etc. The tasks of psychotherapy are the elimination or deactivation of the existing psycho-traumatic factor, the effect on the essence of psychological conflict. An ideal, but not always realistically feasible factor is the exclusion of a traumatic situation. If this is not possible, then a restructuring of the attitude to the existing situation is necessary. The elimination or neutralization of a psychogenic significant factor is extremely significant, but does not always solve the problem of recovery, since the course and development of a neurosis can “tear itself away” from the cause that caused it and continue after the elimination of the trigger factor. Hence the need and impact on the patient’s personality, a change in the system of his settings, and a correction in the level of claims. Among the psychotherapeutic tasks is the explanation to the patient of the essence of his illness. The leading elements are often autonomic disorders, headaches, sleep disorders. At the same time, the patient not only does not connect them with changes in the emotional sphere, situations of his own life, but also actively resists the doctor’s attempts to determine the right cause-effect relationship. Psychotherapy serves not only the elimination of neurotic manifestations, but also their prevention. In this case, the role of autogenic training, which can become an important psycho-hygienic factor, should be emphasized.
In second place is the proper organization of work and rest. Normalized labor outside the conditions of industrial hazards and interpersonal conflicts is an important protective and therapeutic factor. It is very important that the work is loved and brings a sense of satisfaction. An essential factor is the organization of leisure. Rest should be active, include sufficient physical activity. This is especially true for people engaged in intellectual or inactive labor. Morning exercises, water procedures, long walks should become a habit and a need. The formation and development of any hobbies, interests that switch attention and distract from everyday worries is also essential.
A major role belongs to modern psychopharmacology, the object and target of which are neurotic syndromes. In the presence of disturbing and phobic disorders, tranquilizers are used – diazepam (seduxen), chlordiazepoxide (elenium), oxazepam ( tazepam ). Depressive disorders require the appointment of antidepressants. In case of anxious agitated forms, amitriptyline of apathetic and asthenic conditions is shown – drugs like imizine ( melipramine ). Leading hypochondriacal disorders cause the appointment of teralen , thioridazine ( meleryl ). The dose of the funds used should be sufficient and individually selected.
In the presence of concomitant neurological disorders, complex therapy includes agents that reduce vestibular excitability, antiepileptic drugs, dehydration agents.
A significant place is occupied by symptomatic treatment. In autonomic disorders, B- and a- blockers ( pyroxan , anaprilin – obzidan ), ganglion blockers ( gangleron ), antispasmodics ( platifillin , halidor ) can be used . Sleep disorders, in addition to these general activities, require the selection of minimum doses. sleeping pills. For morning headaches associated with muscle tension in the aponeurosis of the head, muscle relaxants ( scutamyl- C, midocalm ) are prescribed . It is important to emphasize the need for an integrated approach to treatment, including pathogenetic and symptomatic aspects. Patients are shown physiotherapy and spa treatment.