Nervousness

Nervousness, a general concept lacking strict scientific meaning for designating numerous nervous and psychological phenomena not connected with any specific damage to the central or peripheral nervous system and representing, in essence, reactions of the whole human personality to various stimuli of exogenous and endogenous character. Among the symptoms of N. one can distinguish as the most important excessive excitability (impressionability or irritability), instability of mood, weak will, tendency to tears, lack of self-confidence, hypochondria, indecision, tendency to fears, obsessive thoughts, sleep disorders, etc. Along with these, mainly psychological manifestations of nervousness, a group of nervous-somatic disorders is distinguished: headaches, dizziness, ringing in the ears, general weakness, pain sensations, paresthesias in various parts of the body, trembling, tendency to convulsions, and a whole series of unpleasant sensations from the internal organs - the heart, gastrointestinal tract, sexual sphere, etc. The concept of N. covers a group of phenomena completely different in origin, diagnostic, and prognostic significance. Here one can distinguish the following groups. First, N. as a symptom of general exhaustion on the ground of starvation, severe bleeding, in the postpartum and lactation periods, after exhausting diseases, as a prodromal symptom of acute infections, as a phenomenon accompanying chronic infections (tbc, syphilis), various diseases of internal organs, endocrine apparatuses, and general metabolism. In all these cases one can speak of symptomatic N. This also includes N. developing on the ground of prolonged overexertion and emotional tension, expressed in the so-called neurasthenic syndrome (see Neurasthenia). Second, the concept of N. includes the sum of various inadequate reactions to certain irritations of a social order, reactions conditioned either by congenital underdevelopment of the nervous-psychic apparatus (constitutional inferiority, infantilism) or caused in an average normal person by excessively strong impressions emanating from the environment. Such psychogenic N., belonging to the group of psychotraumatism, besides various effective outbursts, hysteroid attacks, and other irregularities of behavior, is also often expressed by purely somatic signs (pain, anesthesia, paralysis, contractures, and other symptoms of the so-called conversion hysteria). Third, N. is one of the first signs of a psychotic disease: schizophrenia, manic-depressive psychosis, cerebral arteriosclerosis, neurosis (psychic N.), as well as neurological diseases (multiple sclerosis, tabes, brain tumors, etc.). Fourth, N. can serve as a manifestation of a constitutionally-neuropathic personality type (see Neuropathies, Psychopathies), for which the most ordinary life irritants are a reason for inadequate reactions in the form of the so-called explosiveness, impulsiveness, a whole series of antisocial reactions, irresistible craving for alcohol, narcotics, etc. This group includes numerous eccentrics, originals, fantasists, generally psychopaths, representing numerous varieties extremely difficult for scientific classification (schizoids, epileptoids, psychasthenics, degenerative-hysterical personalities, etc.). This is psychopathic nervousness. Much has been said and written about N. as a menacing sign of the time, beginning with the second half of the 19th century, when new production relations and the rapid development of capitalism created favorable conditions for the spread of nervous diseases. Special studies on nervousness were published (Birn's description of neurasthenia, the sensational book Kraft-Ebing's "Our Nervous Age", works of Forel, Möbius, Helphand, Veraguth, etc.). Besides socio-economic factors as a cause of N., further indication was given to the enormous spread of social diseases - syphilis, tbc, and alcoholism. In recent times, universal attention has increasingly concentrated on the study of unfavorable working conditions and occupational hazards as the main causes of N. in the environment of the industrial proletariat and workers of mental labor. Mass examinations of N. among various professional groups (workers in production, teachers, students, doctors, communication workers, etc.) carried out by the State Scientific Institute of Nervous-Psychiatric Prevention have already given a large amount of data establishing a "neuropathopsychological indicator" for a given group (Rosenstein). Similar studies have been undertaken regarding domestic conditions of a material and moral order (housing, family relations, sexual life, domestic alcoholism, etc.). Among pediatricians, pedologists, and child psychopathologists, the question of childhood nervousness is widely posed, its dependence on infections, head injuries, early alcoholism, sexual traumas, incorrectly delivered school lessons, etc. Treatment of N. is entirely conditioned by to which of the above-mentioned groups of N. (symptomatic, psychogenic, psychotic, etc.) the given private case of the general nervous syndrome belongs. Prevention of N. is the main task of Soviet psychoneurology, the guiding ideas of which develop first of all in the direction of social hygiene, introducing active methods of struggle against social diseases, unfavorable working and domestic conditions, reflecting on the nervous-psychic health of the broad masses of workers (struggle against epidemics, tbc, venereal disease, alcoholism, occupational hazards, protection of maternity and infancy, protection of children and adolescents). The methodology of preventing N. is based on the dispensarization of workers, on the creation of special points of medical aid, outpatient clinics, and consultations on all questions of psychog hygiene of labor and domestic life. According to the principles of Soviet medicine, all these measures in the field of prevention of nervousness are carried out with the widest involvement of the workers themselves in the work of their own nervous healing. A great role in the prevention of nervousness plays sanitary enlightenment (spreading psychog hygienic knowledge on enterprises and in schools through lectures, conversations, and popular scientific literature).