Neurosis is a group of mental illnesses, but the behaviour of the individual remains within "socially acceptable” norms. There is no aggressive behaviour or withdrawal, which are signs of mental illness. Hence, the mental sickness of a person suffering from neurosis may remain undetected and untreated, as it may not be recognised as an illness.
ALSO READ: Early alcohol, cannabis use linked to teen mental health struggles in Rwanda
People with overt mental illness, like psychosis, are easily identified. But due to a lack of awareness among the public regarding neurosis, many times the diagnosis, and hence, treatment is often delayed. When the condition becomes severe, family members may turn to traditional or ‘magic’ healers in search of treatment.
ALSO READ: From one psychiatrist in 1995, Rwanda's mental healthcare comes of age
There are many kinds of neurotic disorders. Anxiety neurosis is one of them. One may suffer from undue anxiety, lop-sided to the situation at hand. Then, there may be fear without any reason or excess fear in a small situation, known technically as phobias. These are of various kinds, fear of open spaces, of heights, of crowds, of speaking in front of people, of flying, infections, and so on. The person may go to great lengths to avoid the situation that induces the fear. Post-Traumatic Stress Syndrome (PTSS) is also categorised as neurosis, where a person has persistent anxiety or fear after facing or witnessing a stressful situation.
Obsessive neurosis is a kind of neurosis where one is obsessed with something beyond reason. This can be an obsession for cleanliness, for security, orderliness, etc. But the limit to which the person becomes particular about something often goes beyond rationality. Unknowingly, these people become targets for jokes or pity.
Therefore, people need to know about neurosis and help a person suffering from it. The cause of these various kinds of neurosis is mental and situational. One may develop it after being exposed to a fearsome or stressful situation, like PTSD. Some tend to develop it even if they have a friend or family member in a stressful situation. A feeling of insecurity during childhood is said to result in some type of neurosis after growing up.
It can be an outward manifestation of an inner conflict within an individual or an inappropriate stress response.
Dryness of the mouth, palpitations, sweating, restlessness, depression, inability to speak, sleep disorders, etc., are physical manifestations of different types of neurosis. Along with it, there may be undue fear or depression, etc., depending on the type of neurosis. A person may have more than one type of problem at the same time. Use of alcohol and drugs tends to aggravate the symptoms of neurosis.
Neurosis, as a disorder, is diagnosed by excluding a physical cause for the problem by means of appropriate tests.
The management needs a lot of patience on the part of family members and the treating physician alike. Conditioning of the mind by creating an appropriate situation is very helpful in caring for a person suffering from neurosis. For example, a person with a phobia of heights can be taken to a high place many times and shown that there is nothing to fear. Similarly, one with undue anxiety has to be counselled many times and told that there is nothing to worry about.
Tranquilisers and anxiety relief drugs like alprazolam, diazepam are beneficial for these patients. They help reduce mental stress and induce a sense of tranquillity in the individual. But these drugs are not safe for long-term use, as one tends to get physically and emotionally dependent on them. Moreover, in people who take alcohol, they are not effective.
Collective efforts of family members and counsellors can ensure that people suffering from neurosis get over their problem and become mentally healthy again.
Dr Rachna Pande is a specialist in internal medicine.