Neurosis (anxiety disorder)-like conditions

Overview of mood disorders (mania and depression)

Manic depression was traditionally considered one of the two major psychiatric illnesses, along with schizophrenia. However, since manic depression is characterized by emotional disturbance and mood swings, the condition has for some time been classified as a mood disorder or emotional disorder, rather than a psychosis. Recent research suggests that imbalances in brain neurotransmitters, particularly noradrenaline and serotonin, may be a cause.

While the specific causal factors in mood disorders are not well known, it appears that genetic influences play some role in terms of susceptibility to its symptoms. The magnitude of the genetic effect is particularly high in bipolar disorder, discussed below. In addition, certain personality characteristics may predispose individuals to mood disorders, and certain circumstances may trigger them.

Depression may be broadly classified into two types. In unipolar depression (major depressive disorder), a person experiences only depressive episodes. Bipolar disorder, meanwhile, is characterized by recurrent mood swings between manic (or “high mood”) states and depressive (or “low mood”) states. Both types of depression show high comorbidity rates with neurotic disorders.

Unipolar depression (major depressive order)

Unipolar or major depression is more predominant in females than males, with roughly twice as many women thought to have the disorder. Middle age, from the early thirties to late fifties, appears to be the peak period of onset. The condition always features a low mood (depressed state with negative emotions such as intense sadness or sorrow) and/or a loss of interest or pleasure in the activities of life. Depressive episodes are persistent, lasting for at least two weeks. In the majority of cases, individuals exhibit symptoms which may include sleep or appetite disturbances, low energy, impatience, fatigability, lethargy or listlessness, thoughts of worthlessness or excessive guilt, decreased ability to concentrate, and suicidal ideation. Unipolar depression is also characterized by a marked decrease in mental energy, causing a variety of psychological and physical symptoms.

Bipolar disorder

Men and women are almost equally likely to be affected by bipolar disorder. The age of onset is relatively young, often occurring between late adolescence and the early thirties. Bipolar disorder is characterized by the following depressive-phase and manic-phase symptoms.

≪Symptoms during the depressive phase≫

• Poor concentration and impaired decision-making
• Negative/pessimistic outlook; self-loathing (self-directed aggression); feelings of worthlessness
• Down/depressed mood; sadness; feelings of hopelessness; anxiety
• Unwillingness or reluctance to do things; speaking less; social withdrawal (disinclination to leave the room or home)
• Insomnia (tendency to awaken in the middle of the night or early morning)
• Decreased appetite and libido
• Headache; stiff and/or painful neck; dry mouth; stomach distress; total body fatigue; constipation; weariness/tendency to tire easily

≪Symptoms during the manic phase≫

• Inflated self-esteem (grandiosity)
• Becoming more talkative, speaking more emphatically or in a louder voice than usual, and/or talking nonstop to passing acquaintances.
• Unrestrained spending sprees (spending money on unaffordable and/or unnecessary things)
• Racing thoughts
• Wider than normal variety of activity, characterized by highly animated and active behavior that becomes reckless or out of control
• Decreased need for sleep
• Increased appetite and libido
• Distractibility (attention easily drawn to unimportant or irrelevant things)

Sleep disorders

The most common sleep disorder, insomnia, may be caused by a variety of factors, some of which are physical or physiological, while others are psychological. Examples of physical causes include conditions where pain is present, or respiratory distress associated with asthma. Insomnia that occurs when a person travels overseas is considered physiological, caused by a disruption of the individual’s daily activity pattern. Meanwhile, stress and worry are examples of the psychological causes of insomnia.

Because these psychological factors are also seen in neurotic disorders, insomnia quite often exists in close association with neuroticism. Thus, nervous, anxiety-prone personalities may suffer insomnia as a symptom of a neurotic condition.

Since there are so many potential causative factors in sleeplessness, correctly identifying the precise cause is a key first step in diagnosing an individual’s condition.

Psychosomatic disorders

A psychosomatic disorder is defined as “a physical disorder that is closely related to psychosocial factors that affect the onset and/or course of the disease. It is a condition of organic or functional damage, the symptoms of which are not explained by neurosis, depression or other psychological disorder.” Simply put, then, a psychosomatic disorder can be considered as an organic or functional disorder whose major causative factor is psychosocial stress. While neuroses bear some similarities to psychosomatic disorders, the fact that neurotic conditions are not associated with physical, structural damage is a significant point of departure.