Treatment for neuroses

Disorders that are considered a neurosis or neurotic disorder are treatable to various degrees of success. In general, the sooner that the symptoms of neuroses are recognized and treated, the more effective treatment will be. The most effective treatment plans generally include a multifaceted approach and may include medications and psychotherapy.

Disorders that are considered a neurosis are treated with an individualized combination that may include medications, cognitive therapy and anxiety management. Psychotherapy, sometimes known as " talk therapy", may also be prescribed. In psychotherapy, a psychotherapist builds a relationship with a client, establishing trust and helping the client to address the neurosis through such techniques as communication and behaviour therapy.

Cognitive-behavioral therapy, or CBT, is the standard psychotherapy for treating neurotic disorders. It helps sufferers to identify, understand, and change faulty thinking and behaviour patterns, thus allowing neurotic people to learn how to control their worry. The cognitive part of CBT helps by changing the thinking patterns that create and support fears; the behavioral part helps with changing the way sufferers react to anxiety-provoking situations.

A part of cognitive-behavioral therapy can include learning relaxation techniques. In addition to medication and psychotherapy, your doctor or therapist might suggest activities such as meditation, yoga or other types of physical exercise.

Medication can keep the symptoms of neuroses under control while the patient receives psychotherapy. Medications used for treating neurotic disorders include antidepressants, anti-anxiety drugs, and beta-blockers.

Warnings. Never try any medication without prescription from a doctor. Seek the advice of a neurological specialist before starting a new medication since most clinical doctors are not experts in the field of neurology.

Only you can recognize if a medication is right for you after it has been prescribed. Many doctors are quick to prescribe anti-depressants to the neurotic patients. Keep in mind, however, that many of anti-depressant companies have a lot of money for promotion. As a result, never feel guilty for telling a doctor to take you off of a medication that you don't think is working (especially if it is for a child).

Exercise 5. Answer the questions to the text:

1. When will the treatment for neuroses be more effective?

2. What includes treatment for neuroses?

3. What is psychotherapy?

4. What does the abbreviation CBT mean?

5. How are neuroses treated with the help of CBT?

6. What types of drugs can treat neuroses?

7. What should you know before starting drug therapy?

8. What should one do if the administered drugs do not help?

Exercise 6. Read, open the brackets, and discuss the case history:

Mr. T. K (Patient Reference Number-4285) (to bring) to the clinic with anxiety disorder. He (to suffer) from severe anxiety for last 4-6 months. He (to be) a software engineer with increased work related stress.

He (not can) express his anger. When he (to be) alone he (to get) thoughts of quitting from the job but (not to have) the courage to do so. He (to have) a nervous temperament with lack of confidence. Frequently he (to experience) sensation of itching on his palms and feet, along with repetitive movement of his legs. Due to all of these complaints his sex life (to affect), along with it his relations with other family members also (to affect). His appetite (to increase) when he (to depress). His sleep (to disturb). He often (to suffer) from neck and lower back pains. All of these (to identify) as stress related concerns. Dr. Shah (to study) his case in detail and (to prescribe) him research based medicine for anxiety neurosis.

In 8 weeks Mr. T.K. (to report) to the clinic, he (to feel) better. His body pains (to reduce) and his sleep (to improve). His medication (to continue). In next 8 weeks he (to report) the anxiety to have reduced by 50 %. He said he (not to experience) such relief since quite long time. He (to feel) calmer and relaxed. The itching on his palms and soles (to reduce) considerably.

Exercise 7. Open the brackets put the verbs into the appropriate tense:

1. The term neurosis (to coin) by the Scottish doctor William Cullen.

2. Cullen (to use) the term to describe various nervous disorders and symptoms.

3. Neurosis (may, to define) as a " poor ability to adapt to one's environment".

4. This patient (to treat) with antidepressants.

5. Neuroses (must, to distinguish) from psychoses.

6. Conflicts (to create) anxiety which leads to symptom formation.

7. If these antidepressants (not to help) you, you (should, to change) them to other ones.

8. Relaxation (to treat) this case of neurosis in several weeks.

Exercise 8. Put questions to the underlined words:

1. Phobias are initiated by classical conditioning of fear to a stimulus.

2. Psychoanalitic treatment requires a detailed interpretation of specific events and their meaning for a person.

3. Neuroses can disrupt the life of both patient and family.

4. Specific anxiety also occurs in obsessive-compulsive disorder.

5. During the last century serious attempts were made to find out the aetiology of neuroses.

6. Neuritic cases resemble one another to a certain extent.

7. Approximately 90 % of population are I'll with neuroses.

8. Obsessive-compulsive disorder often runs throughout the individual's life.

Exercise 9. Translate into English using:

a) Complex Subject (Nominative Infinitive Construction)

1. Відомо, що люди із слабким типом нервової діяльності більш схильні до нервових розладів.

2. Вважають, що когнітивно-поведінкова терапія є одним із основних методів лікування неврозів.

3. Ліки при неврозах, без сумніву, призначаються лише спеціалістом у неврології.

4. Повідомили, що болі у спині та шиї у цього хворого мають невротичне походження.

5. Відомо, що люди, які страждають на істерію, відчувають постійний страх і втрачають самоконтроль.

b) Complex Object (Objective Infinitive Construction)

1. Пацієнт помітив, що свербіж з’являється в ситуації стресу, розумової чи фізичної напруги.

2. Лікар побачив, що зіниці хворого розширені.

3. Численні фобії змушують Вуді Аллена боятися висоти, замкненого простору та комах.

4. Лікар дозволив хворому припинити прийом антидепресантів.

5. Гіппократ вважав, що істерія спричинена порушенням кровообігу.

Exercise 10. Describe the term “neuroses” according to the table:

Завдання для самостійної роботи студентів (СРС)

Test

1. Neuroses are ….

a) organic diseases

b) mild mental illnesses

c) caused by organic disease

d) diseases of reproductive system

e) diseases of endocrine system.

2. Physical symptoms of anxiety include ….

a) nausea, palpitations, chest pains, and breathlessness

b) shortness of breath, cough, fever, elevated blood pressure

c) sweating and radical loss of touch with reality

d) vomiting, loss of consciousness

e) fatigue, decreased blood pressure.

3. The most characteristic symptom of phobias is ….

a) fatigue

b) fixation on fire

c) unreasonable fears of smth or smb

d) increased blood pressure

e) palpitation

4. In … a person suffers from intrusive, repetitive, and disturbing thoughts.

a) common neuroses

b) obsessive-compulsive disorder

c) anxiety d) phobias e) pyromania

5. Conversion neuroses are also called …..

a) obsessive-compulsive disorders

b) hysterical neuroses

c) phobias d) anxiety e) pyromania

6. Somatoform disorders manifest themselves in physical symptoms, such as … that are not caused by organic disease.

a) blindness, paralysis, or deafness

b) pale skin, dilated pupils, and trembling

c) behaviour including rituals such as repetitive hand washing or door locking

d) shortness of breath, cough, fever, elevated blood pressure

e) nausea, palpitations, chest pains, and breathlessness

7. Medications used for treating neurotic disorders include ….

a) antidepressants, anti-anxiety drugs, and beta-blockers

b) sedatives, statins, and anticonvulsants

c) anti-anxiety drugs, tonics, and beta-blockers

d) tranquilizers, statins and beta-blockers

e) antidepressants, stimulants and analgesics

8. Seek the advice of … before starting a new anti-depression therapy.

a) you family doctor

b) a neurological specialist

c) any practicing physician

d) psechologist

e) therapuitist

9. Meditation, yoga, and special physical exercises are considered to be … for neuroses.

a) a first-line treatment

b) a part of “talk therapy”

c) an additional treatment

d) a part of behavioral therapy

e) a part of cognitive therapy

10. He said he … such restlessness since quite long time.

a) hasn’t experienced

b) hadn’t experienced

c) didn’t experience

d) wasn’t experienced

e) doesn’t experience

11. The anti-anxiety medications … by the end of the next month.

a) will take

b) will be taken

c) will have been taken d) are going to be taken e) shall be taken

12. These disturbances … as stress related concerns.

a) were identified

b) identified

c) had identified d) are identified e) will be identified.

13. Some of common phobias are fear of heights, … spaces and insects.

a) enclosed

b) enclosing

c) enclose d) encloses e) are enclosed

14. The patient noted headache … after mental exertion.

a) occur b) to occur c) occurs

d) is occurred d) occurred

15. People with a weak type of the nervous system … predisposed to neuroses.

a) are seemed to be b) seem to be c) seem to

d) seem e) seemed to be.

16. Cognitive-behavioral therapy … one of the most effective methods for treating neurotic disorders.

a) is believed to be b) believed to be c) believes to be

d) are believed to be e) believe to be

17. … some anxiety is normal in certain situations, such as when sad, angry, or afraid of a specific situation, people with neurosis may experience anxiety for no known reason.

a) until b) while c) unless d) despite e) in spite of

18. Only you can recognize … a medication is right for you after it has been prescribed.

a) when b) until c) if d) as e) which

19. Never feel guilty … telling a doctor to take you off of a medication that you don't think is working.

a) for b) of c) from d) by e) with

20. CBT helps … changing the thinking patterns that create and support fears.

a) with b) by c) as d) to e) from

Exercise 1. Topic Vocabulary:

Exercise 2. Read the word combinations and sentences with the new words and translate them into Ukrainian:

Accident: cerebrovascular accident; car accident. She died in an accident. Try to avoid having an accident. We never planned to have a third child – it was a happy accident.

Damage: neurological damage; cartilage damage from a sports injury. The storm did considerable damage to the crops. Taking regular doses of antimalarial drugs can have long-term side effects such as hearing loss and liver and kidney damage.

Factor: risk factors; lifestyle factors; environmental factors; factor of time; factor of safety.

Hemorrhage: subarachnoid hemorrhage; hemorrhagic stroke; hemorrhagic shock; internal hemorrhage.

Consciousness: loss of consciousness; nature of human consciousness. The word is a thing in our consciousness.

Exercise 3. Complete the table with the missing words (you may need a dictionary):

Exercise 4.Translate the following word combinations into Ukrainian:

Rapid loss of brain function, disturbance in the blood supply to the brain, inability to move one or more limbs, altered taste, inability to understand or formulate speech, an inability to see one side of the visual field, the most important modifiable risk factor of stroke, interruption of the blood supply, to result from rupture of a blood vessel, the increased intracranial pressure, the leaking blood compressing the brain, an embolic stroke.

Exercise 5. Do you know that:

a) Statins are a class of drugs used to lower cholesterol levels.

b) Anti-platelet drugs are intended to prevent and/or reverse platelet aggregation in arterial thrombosis, most prominently in myocardial infarction and ischemic stroke.

c) Clot busting medications break up blood clots. During a heart attack or stroke, clot busters, also called thrombolytics, dissolve the blood clot that is blocking the artery and help to restore blood flow. These medications are injected into the arm through an intravenous (IV) line.

d) Carotid endarterectomy (CEA) is a surgical procedure used to prevent stroke, by correcting stenosis (narrowing) in the common carotid artery. Endarterectomy is the removal of material on the inside (end-) of an artery.

Exercise 6. Read and translate the text:

STROKE

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage. As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body (paralysis), inability to understand or formulate speech (aphasia), an inability to see one side of the visual field, or altered taste, smell, hearing.

A stroke is a medical emergency and can cause permanent neurological damage and death. Risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.

An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a " clot buster"), and some hemorrhagic strokes benefit from neurosurgery. Prevention of recurrence may involve the administration of anti-platelet drugs such as aspirin and dipyridamole, control and reduction of high blood pressure, and the use of statins. Selected patients may benefit from carotid endarterectomy and the use of anticoagulants.

Strokes can be classified into two major categories: ischemic and hemorrhagic. Ischemic strokes are those that are caused by interruption of the blood supply, while hemorrhagic strokes are the ones which result from rupture of a blood vessel or an abnormal vascular structure. About 87% of strokes are caused by ischemia, and the remainder by hemorrhage. Some hemorrhages develop inside areas of ischemia (" hemorrhagic transformation"). It is unknown how many hemorrhages actually start as ischemic stroke.

Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of brain affected, the more functions that are likely to be lost.

Loss of consciousness, headache, and vomiting usually occurs more often in hemorrhagic stroke than in thrombosis because of the increased intracranial pressure from the leaking blood compressing the brain.

If symptoms are maximal at onset, the cause is more likely to be a subarachnoid hemorrhage or an embolic stroke.

Exercise 7. Answer the questions:

1) What is the cause of a stroke?

2) What does the abbreviation CVA mean?

3) What is ischemia?

4) What are the manifestations of CVA?

5) How can the the blood supply to the brain be damaged?

6) What are the risk factors for stroke?

7) What medication can be administered in stroke?

8) What kind of surgery may some CVA patients undergo?

9) What is “hemorrhagic transformation”?

10) How do stroke symptoms start?

11) How does the onset of hemorrhagic stroke differ from that of the ischemic one?

Exercise 8. Match the following English word combinations with Russian ones:

Exercise 9. Match the words with their definitions:

Exercise 10. Put questions to the underlined words:

1) Clot busting medications dissolve the blood clot that is blocking the artery.

2) Symptoms of a small stroke may be confused with those of other conditions that cause similar symptoms.

3) The anterior circulation of the brain that controls most motor activity, sensation, thought, speech, and emotion is supplied by the carotid arteries.

4) The patient’s condition improved gradually within 2 weeks of treatment.

5) When blood flow stops, brain cells do not receive the oxygen and glucose they require to function.

6) Two weeks after antibiotic treatment was discontinued, the patient experienced a frontal headache.

7) A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor.

8) He had developed hypertension over the last 10 years.

9) Because there was occasional low-grade fever, intravenous penicillin was given for 2 weeks.

10) On day 4 of hospitalization, she developed fever (38°C), chills, and dysuria.

Exercise 11. Open the brackets:

1) She (to lose) consciousness and (to transfer) to our hospital on the same day.

2) Quick action by a doctor sometimes (to reduce) the damage or (to prevent) more damages.

3) In both patients, brain abscess (to develop) at the stroke lesion site after they (to have) an infectious complication.

4) Most strokes (to happen) suddenly and (to damage) the brain within minutes.

5) If the stroke already (to happen) blood clotting drugs are not effective.

6) The ischemic infarction (to demonstrate) by computer assisted tomography and angiography.

7) After the patient (to develop) the left hemiparesis, he (to admit) to our hospital.

8) Because of the progressive multifocal cerebral manifestations in the patient, we (to decide) to perform a brain biopsy of the right parietal lobe ten days after admission.

9) As soon as a doctor (to gather) all information he (to make) a diagnosis of a suspected ischemic stroke.

10) Occlusion of small brain arteries very rarely (to cause) by the malignant intravascular lymphoma, which first (to describe) in 1959.

Exercise 12. Translate into Russian paying attention to the translation of the Infinitives:

1. To identify the virus causing human influenza serologic tests are made.

2. The tumor to be removed is benign.

3. It is difficult to do it in such a short period of time.

4. Please close the window so as not to catch cold.

5. I had nothing to give him for his headache.

6. To treat advances cases of malignant tumours is very difficult.

7. His aim was to master English.

8. I stopped there in order to rest a little.

Exercise 13. Translate the sentences using Infinitive:

1. Щоб виписати цього хворого, ми повиннi мати всi аналiзи.

2. Лiкар приписав судинорозширювальнi препарати, щоб знизити тиск.

3. Медсестра зробила пацieнту iн’екцiю знеболюваного, щоб вiн змiг заснути.

4. Молодому лiкарю було важко поставити дiагноз.

5. Вiдомо, що у нього вражена значна частина мозкy в результатi iнсульту.

6. Вiн не мiг рухати кiнцiвками правоi сторони два мiсяцi тому.

7. Антитромбоцитарнi лiки назначають, щоб запобiгти повторного iнсульту.

8. Хворий не мiг говорити i формулювати мову у зв’язку з дисфункцieю мозку.

Exercise 14. Read the case and its study based upon the patient’s symptoms. answer the questions below:

A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor. Her daughter called an ambulance and the woman was taken to the emergency room. She had suffered a stroke, and slowly regained consciousness over the next two days. However, when she woke up, she had the following signs and symptoms paralysis of the right face and arm- loss of sensation to touch on the skin of the right face and arm; inability to answer questions but ability to understand what was said to her; ability to write down her thoughts more easily than to speak them.

Solving the clinical problem

Based upon the patient's symptoms, which cerebral artery was blocked?

The loss of all sensation on the right face and arm, coupled with the paralysis of muscles in these regions suggests that this woman suffered damage to the lateral portions of her left frontal and parietal lobes. Specifically, damage to the face and arm regions of the left somatosensory and primary motor cortices would cause these deficits. Damage on the left side of her brain causes right-sided symptoms since the motor and sensory tracts cross the mid-line as they travel between the cerebrum and the spinal cord. The language disorder that this patient has is called Broca's (expressive) aphasia, and it may result from damage to the dominant Broca's motor speech area, a control center that sits just anterior to the face portion of the primary motor cortex in the left frontal lobe. The artery that supplies blood to these regions is the superior division of the left middle cerebral artery. Blockage of this artery by a thrombus or embolism could cause all of this patient's signs and symptoms.

1) Which lobe of the brain, the right or the left one, was damaged? What symptoms indicate that?

2) Damage to what portion of the left lobe caused the language disorder? How is the area responsible for the language function called?

3) What artery was blocked?

Завдання для самостійної роботи студентів (СРС)

Test

1. Stroke can be due to ….

a) cerebral ischemia b) paralysis

c) inability to see one side of the visual field

d) dizziness e) thirst

2. A stroke is ….

a) a chronic brain disease b) a medical emergency

c) paralysis of limbs d) neoplasm e) ulcer

3. Strokes can be divided into two types: ….

a) acute and chronic b) acute and hemorrhagic

c) ischemic and hemorrhagic

d) primary and secondary e) hereditary and nonhereditary

4. The most common predisposed factors for stroke are ….

a) hypertension, diabetes, smoking b) atrial fibrillation, hypotension, vomiting

c) hemiparesis, old age, aphasia d) tenderness, rupture, malaise

e) numbness, fever, constipation

5. Loss of consciousness, headache, and vomiting usually occurs more often in … because of the increased intracranial pressure from the leaking blood compressing the brain.

a) cerebral thrombosis b) cerebral ischemia c) cerebral hemorrhage

d) cerebral tumour e) hemiparesis

6. A 75-year-old woman (to wash up) in the kitchen when she (to fall down) onto the floor.

a) washes up …. falls down b) was washing up …. fell down

c) was washing up …. was falling down d) washed up … had fallen down

e) is washing up … has fallen down

7. The doctor asked the patient ….

a) whether she had taken all prescribed remedies

b) she took all prescribed remedies

c) if she was taken all prescribed remedies

d) if she takes all prescribed remedies

e) whether she will take all prescribed remedies

8. He asked ….

a) how is the affected area of the brain called

b) how was the affected area of the brain called

c) how the affected area of the brain was called

d) how will the affected area of the brain be called

e) how the affected area of the brain had been called

9. The language disorder may result … damage to the dominant Broca's motor speech area.

a) of b) to c) from d) at e) in

10. Damage … Broca's motor speech area leads to aphasia.

a) on b) of c) to d) from e) at

Exercise 1. Learn the following words:

Exercise 2. Match the words with their translation:

Exercise 3. Match the medical terms with their definitions:

Exercise 4. Translate the following word combinations:

Recurrent seizure, sudden onset, structural damage, partial and generalized seizures, to fall to the ground, result in cyanosis, urinary incontinence, to cease movements, state of confusion, brief spells of unconsciousness, bisynchronous spike and wave discharges, intermittent photic stimulation, clouded awareness, temporal lobe, focal lesions.