Are all diseases caused by nerves? Is it possible to get sick due to “bad” emotions? What is a psychosomatic disorder? These and many other questions from the Challenger magazine are answered by Anton Rodionov, Candidate of Medical Sciences, cardiologist of the highest category, Associate Professor of the Department of Faculty Therapy of the Faculty of Medicine of the Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov.
— In the 80-90s of the last century, a very famous psychologist, Professor Yu. M. Orlov, worked at our institute (First Moscow State Medical University named after I.M. Sechenov. - Ed.). He belonged to the theory of “sanogenic thinking”. Its meaning boiled down to the fact that if you think correctly, cultivate good emotions and fight bad ones, you can prevent many diseases. It must be admitted that for the fragile minds of young doctors, his theory looked very convincing...
Can emotions affect health? Definitely yes. To be a reason - no. Negative emotions activate the sympathetic nervous system, which in turn leads to increased blood pressure, increased heart rate and vasospasm. Everyone knows the stories when, against the background of, for example, fear or anger, people suffered heart attacks and strokes. I repeat: emotion in this case is not the cause of the disease, but only a provoking factor, a trigger.
In some cases, a negative emotion, of course, can become a cause of illness. For example, if you hit a wall with your fist out of anger, you can break your arm. Here is a very clear cause-and-effect relationship. By the way, we must not forget about the existence of an inverse relationship. Often the cause of negative emotions is chronic physical suffering. Remember Baba Yaga with a bone leg - perhaps she would have been a very sweet old lady if not for chronic pain in the hip joint...
“All diseases are caused by nerves” – a myth?
It's not even a myth, it's just an old student joke. The full quote is: “ All diseases are from nerves, and only five are from love ” (referring to the five classic venereal diseases). However, chronic stress is indeed a proven risk factor for the development of at least cardiovascular diseases. Several years ago, using positron emission tomography (a high-precision study that allows one to study metabolic processes in various tissues), scientists identified mechanisms that transform stress into chronic inflammation, which, in turn, serves as a key mechanism for the development of atherosclerosis.
“However, I repeat again and again: stress is not the cause of disease, but one of the risk factors that works only in conjunction with other factors, primarily genetic.
What situations provoke the appearance of rheumatoid arthritis?
Of course, everyone has different events unfolding in their lives. But the most common are:
— Reasons related to the man (husband).
For example, when the husband cheated; when the husband left and without him a feeling of insecurity came; when the man for whom there was hope disappointed; if the husband was initially soft and pliable, and then became self-confident and began to pay less attention.
Let us especially focus on disappointment with our man. Disappointment is always associated with expectations, and they, in turn, are the problem of the woman herself, not the husband. Because you can “expect” anything, and the other half will never fulfill it.
This is how girls develop unconstructive grievances (at what has not been done), manipulation - this is what is later called “difficult character.”
All this is connected with immaturity, infantilism, the desire to throw off responsibility and shift it onto someone else’s shoulders, and even indicate how the husband “should” fulfill all this.
Always in these cases, our clients become acquainted with their own egoism, which is a serious step on the path to recovery.
- Events in life, because of which feelings of hostility and guilt that have been “dormant” in the psyche come to the surface.
For example, in childhood, when a younger brother (or sister) is born, a feeling of competition arises (which creates hostility). Guilt is activated when there is no opportunity to sacrifice oneself or serve.
- Experiences of a sexual nature.
When a woman does not want to take on the imposed female role (she likes to be like a man, to compete with him, to be the first in a relationship).
The disease itself has stages of remission and relapse. And, if you follow, these stages coincide in time with the occurrence of difficult life situations or stress.
Consequently, the essence of arthritis is constant aggressive impulses “stuck” in the soul. And this causes chronic increased muscle tension.
Psychosomatic disorders: what are the causes and mechanisms of their occurrence?
Psychosomatic diseases are a group of diseases that are manifested by bodily suffering (that is, symptoms of diseases of the internal organs), but their main cause still lies in problems with the nervous system. These include a whole range of gastrointestinal disorders (functional gastric dyspepsia and irritable bowel syndrome), fibromyalgia (a specific pain syndrome in the projection of the joints), hyperventilation syndrome (a feeling of lack of oxygen and the need for rapid breathing) and much more.
I will explain how mental suffering and somatic symptoms are related to each other using the example of the most common complaint with which patients come to a cardiologist - a feeling of rapid heartbeat. Tachycardia (fast pulse) normally occurs when you need to respond to an external stimulus, for example, to run away from danger. In this situation, the muscles need more blood, therefore, the heart must increase its contraction frequency. But when the danger passes, the pulse returns to normal. A patient with a neurotic disorder is outwardly calm, no one is chasing him, he does not need to catch up with anyone, but the brain gives a signal: “You are in danger, run away!” As a result, the sympathetic nervous system is activated, blood pressure rises and heart rate increases. The patient feels unwell... In this case, treating tachycardia as a separate symptom is at least absurd - it is necessary to treat the neurotic disease itself, and such patients should be treated not by a cardiologist, but by a psychiatrist or psychotherapist.
As for child psychosomatics, I’ll tell you another story. Recently a young woman came to an appointment. She looked very worried and kept trying to ask me about her husband’s health, although, in my opinion, her husband could well have come to the appointment himself. During the conversation, it turned out that the husband (a man who works hard and earns well) constantly yells at his wife and child at home, while still successfully manipulating his high blood pressure, but does not want to be treated. At the end of our meeting, the woman asked if I knew of a good neurologist, a specialist in childhood tics... Should I continue the story? In my opinion, you don’t have to be Dr. House to understand a simple thing: most transient neurological and neurotic symptoms in children are a problem with the parents.
What is the “Chicago Seven” and how relevant is such a classification today?
I don’t really need classifications of psychosomatic disorders in my daily work, and I first learned about the “Chicago Seven” thanks to this question. I read it and was horrified. Can anyone really seriously consider them in the 21st century as “diseases of unreacted emotions”! I will list these seven diseases indicating their true causes:
- Arterial hypertension is a disease based on a genetic predisposition, which is caused by dozens of additional factors (smoking, excess weight, salt abuse, physical inactivity, increased sugar and cholesterol levels, and so on). Stress is only one of the risk factors, but far from the main one.
- Peptic ulcer of the stomach and duodenum is a disease whose cause was well studied at the end of the 20th century. This is a microorganism called Helicobacter Pylori. Yes, acute “stress” ulcers have been described, but that’s a completely different story.
- Inflammatory bowel diseases (ulcerative colitis and Crohn's disease) are a group of inflammatory autoimmune diseases with a genetic predisposition.
- Neurodermatitis (atopic dermatitis) is a disease that has a genetic predisposition. A stress factor can only in some cases cause an exacerbation.
- Bronchial asthma is a chronic inflammatory disease with a clear genetic predisposition. Sometimes stress can contribute to an exacerbation, and sometimes vice versa - stimulation of the sympathetic nervous system leads to dilation of the bronchi.
- Thyrotoxicosis (hyperfunction of the thyroid gland) is a classic autoimmune disease, which is based on the production of antibodies to the tissues of the thyroid gland. Here, would-be psychologists generally confuse cause and effect. Thyrotoxicosis greatly changes a person's character - he becomes whiny, hot-tempered, and nervous. After thyrotoxicosis is cured, mental manifestations completely disappear.
- Rheumatoid arthritis is a disease of unknown nature (the connection between genetic and infectious factors is being discussed). However, stress definitely has nothing to do with it.
How are psychosomatic disorders diagnosed?
Patients with psychosomatic disorders can visit doctors of any specialty. For some, illnesses manifest as unmotivated shortness of breath and palpitations, for others, nausea, vomiting and diarrhea, and for others, pain syndromes.
— The main diagnostic criterion is examination, often repeated, which does not detect any signs of an organic disease. It is this fact that should suggest the need for consultation with a psychiatrist or psychotherapist.
The basis of diagnosis is a conversation with the patient. Just based on how the patient presents his complaints, one can think about the presence of psychosomatic disorders. If the doctor has sufficient time to clarify the circumstances associated with the onset or exacerbation of the disease, if he finds accurate words to clarify psychotraumatic situations, then the picture of the disease will begin to emerge. As I already said, the dissociation between complaints and the absence of organic pathology is an important argument in favor of “psychosomatics”. Of course, a reasonable amount of additional examination is always necessary, but it should not be excessive.
Let me give you an example of one of the classic psychosomatic diseases - irritable bowel syndrome (IBS). In Russia, they believe that in order to establish a diagnosis, it is necessary to do a colonoscopy - a difficult and expensive endoscopic examination of the large intestine. All over the world they think differently. If long-term symptoms of intestinal discomfort (diarrhea or constipation, bloating, etc.) are not accompanied by the presence of so-called “red flags” (weight loss, blood in the stool, inflammatory changes in blood tests, late age of onset of the disease and the presence of cancer in close relatives ), then there is no point in tormenting the patient with such a difficult procedure as a colonoscopy - the diagnosis of IBS is very likely. How many years pass from a patient presenting with a psychosomatic disorder to receiving a correct diagnosis? It's not always the same. It seems to me that if you build communication with the patient correctly, it is not at all difficult. But we are well trained for this. The fact is that our now deceased teacher, former director of the First Medical Faculty Therapy Clinic (now Sechenov University), Professor V.I. Makolkin, paid great attention to the study of psychosomatic pathology, as a result of which a small psychosomatic center was actually created on the basis of the clinic. The clinic staff are quite well versed in this kind of pathology, in addition, we are supported by a team of several psychiatrists. Sometimes it happens that years pass from the onset of the disease to receiving professional help. It's difficult to say what this is connected with. Most likely, because colleagues “do not see” psychosomatics or are embarrassed to send patients to a psychiatrist, fearing that the patients will misunderstand them.
Traditional medicine recipes for polyatritis
- Take the roots of marsh cinquefoil , chop them into 1-2 cm pieces, rinse thoroughly. Fill in half a half-liter jar. Fill the rest of the dishes with high-quality vodka. Leave for 21 days in a warm, dark place. Then strain through cheesecloth. Use 1 tbsp. 5 times a day 15-30 minutes before meals. Start with small doses and monitor the condition, as the herb is poisonous. The tincture can also be rubbed into sore joints.
- Drink a glass of freshly squeezed carrot juice a day.
- Brew tea from currant leaves and oats .
- Apply hay dust compresses .
- Wrap joints in blue clay 4-6 times a day.
How to treat psychosomatics?
It all depends on the situation; The concept of “psychosomatic disorders” is too broad. In mild cases, specific treatment is not required at all; a detailed conversation between the doctor and the patient and an explanation of the essence of what is happening is sufficient. The fact is that sometimes the patient is worried not so much by the symptoms themselves as by the unknown and suspicion of serious organic diseases. If you explain that behind the “feeling of incomplete inspiration” or “tingling in the heart” there are no organic diseases of the heart and lungs, this will be quite satisfactory for many patients.
In some cases, an internist (therapist, cardiologist, gastroenterologist and others) can independently prescribe psychotropic therapy, if, of course, he knows how to do this. For example, a qualified gastroenterologist can and should himself prescribe antidepressants to patients with functional diseases of the gastrointestinal tract, without resorting to the help of psychiatrists. Why do gastroenterology patients need antidepressants? They are needed to break the pathological connection between signals in the brain and symptoms from the gastrointestinal tract. By the way, antidepressants have long ceased to be specific drugs for the treatment of depression. They are also successfully used in the treatment of certain pain syndromes.
If the internist feels that the patient needs serious combination therapy, then it is better to involve a psychiatrist in the treatment, since psychopharmacology is quite complex and the arsenal of drugs is diverse. It is advisable to consult not just with a psychiatrist from the district dispensary, but with a specialist who has experience working specifically with psychosomatic patients.
Psychotherapy (that is, talking therapy) can be very helpful for many patients with psychosomatic disorders. There are only two disadvantages: it is expensive and takes a long time. A contraindication to psychotherapy is symptoms of a “major” mental illness (delusional disorders, hallucinations), however, this already goes beyond the scope of the “psychosomatics” topic.
But what the patient definitely does not need is the appearance of treatment using dummies: vitamins, “restorative”, “metabolic”, “vascular” drugs and so on.
What is mental hygiene and how can it help?
Perhaps mental hygiene can be a way to prevent such disorders, although it is not so simple. Here again it is appropriate to recall the theory of “sanogenic thinking” by Yu. M. Orlov. On my own behalf, I will add four positions that I try to follow myself (more about this in my book “Heart and Vascular Health”):
- limit negative information flow. Don't let the TV run in the background. It’s better to play recorded music or favorite movies;
- separate work from home. Get two phone numbers - for home and for work calls, turn off your work mobile phone at home, on weekends and on vacation;
- think about the most difficult event in your life. Maybe everything else isn't worth going crazy?
- The best way to get rid of accumulated fatigue and irritation is physical activity.
And one last thing. If you feel that something in life is going completely wrong and you can’t get out on your own, do not hesitate to contact specialists in the field of psychiatry and psychotherapy. Modern psychiatry has come a long way compared to the classic image of it in the movie One Flew Over the Cuckoo's Nest.
If you want to competently use all the possibilities of modern medicine, and also not become a victim of questionable treatment and excessive diagnostics, books from the course of the “Dr. Rodionov Academy” will help you. All the authors of the series are not only practicing doctors and specialists, but also our permanent experts (for which we thank them very much).
Photo: shutterstock.com
Link to publication: the-challenger.ru
Psychology of diseases: Rheumatoid arthritis
ARTHRITIS - (Liz Burbo)
Physical blockage
This is a rheumatic disease of the joints, which is inflammatory in nature and is accompanied by all the characteristic signs of inflammation (swelling, redness, temperature, pain), which can appear in one or more joints. With arthritis, pain is felt both during movement and at rest, so the patient suffers both day and night. So, if you experience joint pain and inflammation at night, it's most likely arthritis. This disease reduces joint mobility, significantly limiting the patient's physical capabilities.
Emotional blockage
In medicine, there are several types of arthritis. The severity of this disease indicates the severity of the emotional, mental and spiritual blockages.
As a rule, arthritis occurs in a person who is too strict with himself, does not allow himself to stop or relax, and does not know how to express his desires and needs. He believes that others know him well enough to offer him everything he may need. When others do not meet his expectations, he experiences disappointment, bitterness and resentment. He may also have a desire for revenge, although he feels powerless to do anything. This makes him angry, which he hides deep inside. Such a person has a very well developed “inner critic”.
The place where arthritis occurs indicates the area of life in which the source of all problems should be sought. So, if arthritis affects the joints of the hands, a person should reconsider his attitude to what he does with his hands. If he needs help, he should ask for it, and not wait for others to read his mind or guess that he needs help.
People suffering from arthritis usually appear very submissive and quiet, but in reality they suppress the anger that they really want to express. Emotions are paralyzing, just like arthritis. A person with arthritis must stop accumulating these paralyzing emotions.
Mental block
If you suffer from arthritis, think about why it is so difficult for you to express your needs and desires. Perhaps it seems to you that if you satisfy your desires, you will not be able to stop in time and will turn into an egoist. Check it out and you will see that you were wrong. Also, check your definition of the word egoist.
Allow yourself to say “no” when you don’t want to do something, but if you decide to do something, do it with pleasure and don’t criticize yourself.
If you don't give yourself a break because you want to gain recognition, recognize this and understand that you are doing it for yourself, and not because someone is forcing you. Give yourself the right to seek recognition from others by helping them, working for their benefit. If you work with joy and pleasure, and not under the pressure of internal criticism, life will seem more pleasant to you, you will become more flexible and energetic. (See also “ features of inflammatory diseases
».)
RHEUMATIC ARTHRITIS - (Louise Hay)
Causes of the disease
Extremely critical attitude towards the manifestation of strength. The feeling that too much is being put on you.
A Possible Solution to Promote Healing
My strength is me. I love and approve of myself. Life is Beautiful.
RHEUMATOID ARTHRITIS - (V. Zhikarentsev)
Causes of the disease
Strong criticism of authority. The feeling of being very burdened, deceived.
A Possible Solution to Promote Healing
I am my own authority. I love and approve of myself. Life is good.
