What is cerebral asthenia. Manifestation of asthenia. What we can do ourselves to treat asthenia in women

Among persons whose professional activities are associated with irregular work schedules, night shifts, symptoms of this condition, to one degree or another, are found in 90% of cases.

Asthenia worsens the quality of life of patients, and severe forms of the disorder can completely deprive patients of working capacity.

Research in the field of the causes of the onset of pathology, the mechanism of its development, measures for diagnosis and treatment continues today, although scientists and physicians around the world have already made great strides in understanding why this syndrome occurs.

The causes of the disease

Asthenia (from the Greek asthenia - "powerlessness") is a general pathological reaction of the body to any stimulus that threatens to decrease energy resources. According to ICD-10, this state has the code R53.53

Pathology often develops in women of young, working age, but it can occur in men, children, and elderly people (senile type of asthenia).

The etiology of the syndrome is very wide. This condition can occur for the following reasons:

• Mental and psychophysiological problems. Asthenic syndrome can be triggered by overload and exhaustion of the nervous system: triggers - stress, increased preparation for exams, competitions, hard work requiring constant concentration, unresolved psychological conflicts.
• Brain lesions of organic genesis: TBI, contusion, concussion, tumors and cysts.
• Vascular cerebral changes. Strokes, heart attacks and other vascular accidents, age-related seals, atherosclerosis,
• Intoxication of the body with psychoactive substances, alcohol.
• Somatic diseases. Chronic diseases (stomach and duodenal ulcers, bronchial asthma, diabetes, arterial hypertension) and long-term persistent infections, oncological pathology, diseases of the blood and connective tissue.

The causes of the onset of the disease in childhood are more often acute respiratory diseases, which are frequent and severe, as well as suppressed, unexpressed emotions of anger, resentment, fear, traumatic situations in the family.

The above conditions or their combination are triggers that trigger complex neuropsychological processes leading to the development of asthenic syndrome.

Development mechanism

Normally, the body of a healthy person responds to any stimulus in the form of a reaction peak, which has a certain period of extinction. The more powerful the stimulus, the larger the peak and the longer the extinction period. From such peaks and periods, a "working background" and normal performance are formed.

But what happens when the body experiences an asthenic state?

Even the most insignificant stimulus produces a maximum peak, after which the recovery period is disrupted. This is due to the fact that the patient's nervous system is exhausted, weakened under the influence of certain causal factors.

Such an excessive response to any trigger leads to the fact that the nervous system is in constant, chronic stress, the body does not relax, and there is no adequate recovery period.

Asthenic state includes increased excitability, and at the same time - excessive exhaustion of nervous processes with a corresponding clinical picture.

Disease symptoms

The clinical picture of asthenic disorder is diverse. Patients often complain about:

• Constant fatigue that does not disappear after good rest and sleep.
• Lethargy, feeling of weakness.
• Permanent feeling of sleepiness.
• Sleep disorders: difficulty falling asleep, shallow sleep. After awakening, strength in asthenic syndrome is not restored, unlike ordinary fatigue, there is no feeling of vigor and energy.
• Increased anxiety.
• Labile mood (characterized by sharp changes in it).
• Emotional instability: tearfulness, episodes of overwhelming aggression.

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Not only psycho-emotional reactions suffer, but also volitional qualities of the individual. Patients may experience restlessness, an inability to bring the matter to its logical conclusion. Memory is impaired, absent-mindedness appears, the impossibility of concentration, the ability for prolonged mental work is lost.

With asthenia, symptoms of a vegetative nature are frequent, and they have a "volatile" character: the patient is worried about "one thing or the other", there are a lot of complaints, a person literally every day either has new symptoms or the old ones disappear. However, when examining a patient, organic disorders of the functioning of internal organs are not observed.

Vegetative manifestations of asthenic syndrome may include the following subjective signs on the part of disorders in the work of internal organs:

• subfebrile body temperature (37-37.5 C);
• chills or a feeling of heat throughout the body ("hot flashes");
• feeling short of breath;
• palpitations;
• unpleasant sensations in the area of \u200b\u200bthe heart (patients describe it as "whining", "tingling", "pressing");
• a feeling of discomfort along the digestive tract;
• instability of the stool, such as constipation or diarrhea;
• muscle pain.

During laboratory and instrumental examination about the patient's complaints from the studied systems, pathological abnormalities are not observed.

Very often, against the background of the patient's depleted nervous system, numerous vegetative signs of the disease, a person develops a depressive syndrome: depressed mood, apathy, and gloomy suicidal thoughts prevail.

In different patients, the severity of the syndrome may differ individually. Asthenic manifestations can manifest themselves in a mild degree: a person lives with an illness, somewhat losing the quality of life, but maintaining efficiency, socialization. In another case, the patient's psychological state may be severe and requiring qualified medical care. Any signs of this condition that bother a person for more than 2 months are a reason to consult a doctor.

Forms of the disease

Depending on what reason lies at the heart of the pathology, varieties of asthenic syndrome are distinguished, each of which has its own specific features of the clinical picture. The main forms of the syndrome are:

1. Psychogenic. It occurs if the basis of the disease is traumatic situations (conflicts, stresses). Neuro-emotional stress inappropriate to the traumatic situation arises, it depletes the patient's body.
2. Vascular... It often develops in the elderly due to vascular changes in the brain. Distinctive clinical symptoms are tearfulness, forgetfulness, absent-mindedness, excessive sentimentality. Tears in this case are the maximum manifestation of emotional involvement, they appear at any insignificant events, "trifling" reasons for a healthy person.
3. Traumatic. It occurs as a result of trauma suffered: TBI, contusion. It is characterized by the fact that a person reacts to a minor irritant with an excessive aggressive reaction: verbal or even physical. After a burst of aggression, the patient feels an extreme degree of physical and psycho-emotional exhaustion and loss of strength.

In practice, erased or combined forms with a mixed, variable clinic are often found.

There is another classification of asthenia, according to which it happens:

• Primary. This is an independent disease due to psychogenic and constitutional characteristics. Patients, as a rule, have a thin physique, tall stature, poorly tolerate physical, emotional stress, stressful situations.
• Secondary. Symptoms of the disease occur against the background of somatic, infectious diseases, trauma. Clinical signs of asthenia can be the result of the use of drugs (antidepressants, hypnotics, diuretics), alcohol intoxication, occupational hazards.

How to treat pathology?

Before starting treatment for the manifestations of asthenia, the doctor should exclude all possible somatic diseases that have similar clinical symptoms. Only after making sure that the patient does not have organic lesions of the internal organs, "guilty" of the patient's complaints, the doctor develops a comprehensive therapy program.

Do I have signs of asthenia?
Signs of asthenia, is it a disease?

Asthenia can be a normal variant?

Asthenia, is it a temporary and reversible condition?
Do I need a doctor's help if there are signs of asthenia?
Can the disease be avoided?
The answers to these questions have been prepared for you by our doctors.

What is asthenia

Primary signs of asthenia

Asthenia is a symptom complex, that is, a set of symptoms.
What symptoms fall into this category?
We give in the order of diagnostic significance:

• Fatigue, weakness
• Irritability, feeling dissatisfied with others
• Reduced well-being
• Various sexual disorders, breakdowns, etc.
• Depleted attention with over-specification
• Tearfulness, increased sentimentality.
• Sleep disturbances (insomnia at night, sleepiness during the day).
• Poor tolerance for loud sounds, bright light, strong odors.
• Headaches.
• Nervousness.
• Feeling of inner trembling.
• Poor appetite.
• Excessive worry on irrelevant reasons.
• Difficulty making decisions.
• Thought is easily lost, it is difficult to concentrate.
• Vegetative symptoms: palpitations, sweating, feeling short of breath, trembling, trembling sensations.
• Unpleasant sensations in different parts of the body that can change and "migrate".

It should also be added that in order to ascertain the state of asthenia, one must see that these symptoms are directly related to any psychophysical overloads and they do not pass or do not subside after quality rest.

That is, based on this list, one can assume that one has an asthenic state. But, to determine exactly whether there is asthenia or not, only a doctor at a full-time appointment can.

In the reference book on psychiatry, classic for Russian psychiatry, edited by A.V. Snezhnevsky 1985, asthenia is briefly characterized as a state of increased fatigue with frequent mood swings, irritable weakness, exhaustion, hyperesthesia (increased susceptibility to common stimuli), tearfulness, autonomic disturbances and sleep disorders.

Asthenia

Asthenia can proceed in the form of attacks, with full recovery in the interictal period, but more often the asthenic state is characterized by a constant (often intensified in the evening), "as a background" and a long course.

Asthenia synonyms

In their practice, experts often use a large number of synonyms for asthenia:

• Asthenic syndrome
• Asthenic condition
• astheno-neurotic syndrome
• asthenic-depressive syndrome
• Neurasthenia
• Cerebroasthenia
• Psychasthenia
• "Manager's syndrome"
• The syndrome of "transcendental inhibition"
• Irritable weakness syndrome

Is asthenia a disease or a normal (i.e. healthy) response to overload? Let's figure it out.

On the one hand, asthenia is a familiar state of overwork, fatigue. On the other hand, many modern scientists attribute asthenia to a mild, reversible, initial stage in the development of a more severe disorder - psychoorganic syndrome. Both statements are correct. Thus, asthenia can be talked about as a borderline state between the norm and the disease. In the event of the development of the disease, asthenia becomes heavier and will "grow" with other, more gross symptoms, in a normal (healthy) situation, the temporary reaction of the nervous system will not transform asthenia into anything.

It is very important that the doctor can correctly distinguish asthenia as a norm from asthenia as a manifestation of the disease. Accordingly, in the first case, asthenia is not required to be treated, in the second it is necessary.

Prevention of asthenia

Can asthenia be avoided? The answer is simple: you don't need to avoid it. Asthenia is one of the defense mechanisms that keeps our central nervous system from destruction. When the number of external stimuli begins to reach a certain limit, an innate protective reflex of the so-called "transcendental inhibition" is activated, which is manifested by asthenic symptoms.

Asthenia can occur at any age, but most often it manifests itself in:

• children in primary school
• graduates of schools, colleges, institutes
• people with high psycho-physical activity

The Brain Clinic offers complete diagnostics, treatment and rehabilitation of asthenic conditions of any origin.

Asthenic syndrome, or asthenia (translated from Greek means "lack of strength", "powerlessness") is a symptom complex, indicating that the body's reserves are depleted, and it works with its last strength. This is a very common pathology: according to different authors, the incidence rate of it ranges from 3 to 45% in the population. Why asthenia occurs, what are the symptoms, principles of diagnosis and treatment of this condition, and will be discussed in our article.

What is asthenia

Asthenia is a psychopathological disorder that develops against the background of diseases and conditions that in one way or another deplete the body. Some scientists believe that asthenic syndrome is a harbinger of other, very serious, diseases of the nervous system and mental sphere.

For some reason, many ordinary people think that asthenia and ordinary fatigue are one and the same condition, named differently. They are wrong. Natural fatigue is a physiological condition that develops as a result of exposure to the body of physical or mental overload, is short-term, completely disappears after a good rest. Asthenia is pathological fatigue. At the same time, the body does not experience any acute overloads, but it experiences chronic loads due to one pathology or another.

Asthenia does not develop overnight. This term applies to people who have symptoms of asthenic syndrome for a long time. Symptoms gradually increase, the patient's quality of life decreases significantly over time. Good rest alone is not enough to eliminate the symptoms of asthenia: complex treatment by a neuropathologist is necessary.

Causes of asthenia

Asthenia develops when, under the influence of a number of factors, the mechanisms of energy formation in the body are depleted. Overstrain, depletion of structures responsible for higher nervous activity, in combination with a deficiency of vitamins, trace elements and other important nutrients in food and disorders in the metabolic system form the basis of asthenic syndrome.

We list the diseases and conditions against which asthenia usually develops:

• infectious diseases (influenza and other acute respiratory viral infections, tuberculosis, hepatitis, foodborne diseases, brucellosis);
• diseases of the digestive tract (peptic ulcer, severe dyspepsia, acute and chronic gastritis, pancreatitis, enteritis, colitis and others);
• diseases of the heart and blood vessels (essential hypertension, atherosclerosis, arrhythmias, ischemic heart disease, in particular, myocardial infarction);
• respiratory system diseases (chronic obstructive pulmonary disease, pneumonia, bronchial asthma);
• kidney disease (chronic pyelo- and glomerulonephritis);
• endocrine system diseases (diabetes mellitus, hypo- and hyperthyroidism);
• blood diseases (especially anemia);
• neoplastic processes (all kinds of tumors, especially malignant);
• pathology of the nervous system (, and others);
• mental illness (depression, schizophrenia);
• postpartum period;
• postoperative period;
• pregnancy, especially multiple pregnancies;
• lactation period;
• psycho-emotional stress;
• taking certain medications (mainly psychotropic), drugs;
• in children - an unfavorable situation in the family, difficulties in communicating with peers, excessive exactingness of teachers and parents.

It is worth noting that prolonged monotonous work, especially with artificial lighting in a confined space (for example, submariners), frequent night shifts, work that requires processing a large amount of new information in a short time, can play a role in the development of asthenic syndrome. Sometimes it occurs even when a person moves to a new job.

The mechanism of development, or pathogenesis, asthenia

Asthenia is the reaction of the human body to conditions that threaten the depletion of its energy resources. In this disease, first of all, the activity of the reticular formation changes: the structure located in the region of the brain stem, which is responsible for motivation, perception, the level of attention, which provides sleep and wakefulness, autonomic regulation, muscle work and the activity of the body as a whole.

There are also changes in the work of the hypothalamic-pituitary-adrenal system, which plays a leading role in the implementation of stress.

Numerous studies have shown that immunological mechanisms also play a role in the mechanism of development of asthenia: certain immunological disorders have been identified in persons suffering from this pathology. However, the viruses known to date do not have a direct role in the development of this syndrome.

Classification of asthenic syndrome

Depending on the cause of asthenia, the disease is divided into functional and organic. Both of these forms occur with approximately the same frequency - 55 and 45%, respectively.

Functional asthenia is a temporary, reversible condition. It is a consequence of psycho-emotional or post-traumatic stress, acute infectious diseases or increased physical exertion. This is a peculiar reaction of the body to the above factors, therefore the second name for functional asthenia is reactive.

Organic asthenia is associated with certain chronic diseases that occur in a particular patient. Diseases that can result in asthenia are listed above in the "causes" section.

According to another classification, according to the etiological factor, asthenia is:

• somatogenic;
• post-infectious;
• postpartum;
• post-traumatic.

Depending on how long asthenic syndrome has existed, it is divided into acute and chronic. Acute asthenia occurs after a recent acute infectious disease or severe stress and, in fact, is functional. Chronic is based on some kind of chronic organic pathology and proceeds for a long time. Separately, neurasthenia is distinguished: asthenia arising from the depletion of structures responsible for higher nervous activity.

Depending on the clinical manifestations, there are 3 forms of asthenic syndrome, which are also three consecutive stages:

• hypersthenic (the initial stage of the disease; its symptoms are impatience, irritability, erratic emotionality, an increased reaction to light, sound and tactile stimuli);
• a form of irritability and weakness (there is increased excitability, however, the patient feels weak, exhausted; the person's mood changes sharply from good to bad and vice versa, physical activity also ranges from increased to complete reluctance to do anything);
• hyposthenic (this is the last, most severe form of asthenia, characterized by reduced performance to a minimum, weakness, fatigue, constant sleepiness, complete unwillingness to do something and the absence of any emotions; there is also no interest in the environment).

Asthenia symptoms

Patients suffering from this pathology present a wide variety of complaints. First of all, they are worried about weakness, they constantly feel tired, there is no motivation for any activity, memory and intelligence are impaired. They cannot focus their attention on something specific, are absent-minded, are constantly distracted, cry. For a long time they cannot remember a familiar surname, a word, the desired date. They read mechanically, not understanding or remembering the material read.

Also, patients are worried about symptoms from the autonomic system: increased sweating, hyperhidrosis of the palms (they are constantly wet and cool to the touch), a feeling of lack of air, shortness of breath, pulse lability, surges in blood pressure.

Some patients also note various pain disorders: pain in the heart, in the back, abdomen, muscles.

On the part of the emotional sphere, it is worth noting the feeling of anxiety, internal tension, frequent mood swings, fears.

Many patients are worried about decreased appetite up to its complete absence, weight loss, decreased sex drive, menstrual irregularities, pronounced symptoms of premenstrual syndrome, increased sensitivity to light, sound, touch.

Sleep disturbances include heavy falling asleep, frequent awakenings at night, and nightmares. After sleep, the patient does not feel rested, but, on the contrary, feels tired and weak again. As a result of this, a person's well-being worsens, which means that working capacity decreases.

A person becomes excitable, irritable, impatient, emotionally unstable (his mood deteriorates sharply at the slightest failure or in case of difficulty in performing any action), communication with people tires him, and the tasks that have been set seem to be impossible.

In many persons with asthenia, an increase in temperature to subfebrile values, sore throat, increased certain groups of peripheral lymph nodes, in particular, cervical, occipital, axillary, painfulness on palpation, pain in muscles and joints are determined. That is, there is an infectious process and insufficiency of immune functions.

The patient's condition worsens significantly in the evening, which is manifested by an increase in the severity of all or some of the above symptoms.

In addition to all these symptoms, directly related to asthenia, a person is worried about the clinical manifestations of the underlying disease, the one against which asthenic syndrome developed.

Depending on the cause of asthenia, its course has some peculiarities.

• Asthenic syndrome accompanying neurosis is manifested by the tension of the striated muscles and an increase in muscle tone. Patients complain of constant fatigue: both during movement and at rest.
• In case of chronic circulatory failure in the brain, the patient's motor activity, on the contrary, decreases. Muscle tone is reduced, the person is lethargic, does not feel like moving. The patient is experiencing the so-called "emotional incontinence" - seemingly crying for no reason. In addition, there is difficulty and slowing down of thinking.
• With brain tumors and intoxication, the patient feels pronounced weakness, powerlessness, unwillingness to move and do any, even previously loved, things. Its muscle tone is reduced. A symptom complex similar to myasthenia gravis may develop. Mental weakness, irritability, hypochondriacal and anxious-fearful moods, as well as sleep disorders are typical. These violations are usually persistent.
• Asthenia, which has arisen after injuries, can be both functional - traumatic cerebrosthenia, and be organic - traumatic encephalopathy. Symptoms of encephalopathy, as a rule, are pronounced: the patient experiences constant weakness, notes impairment of memory; his circle of interests gradually decreases, lability of emotions takes place - a person can be irritable, "explode" over trifles, but suddenly becomes lethargic, indifferent to what is happening. New skills are hard to learn. The signs of dysfunction of the autonomic nervous system are determined. Cerebrosthenia symptoms are not so pronounced, but it can last for a long time, for months. If a person leads a correct, sparing, lifestyle, eats rationally, protects himself from stress, the symptoms of cerebrosthenia become almost invisible, however, against the background of physical or psychoemotional overload, during ARVI or other acute diseases, cerebrosthenia is exacerbated.
• Postinfluenza asthenia and asthenia after other acute respiratory viral infections are initially hypersthenic in nature. The patient is nervous, irritable, and experiences a constant feeling of internal discomfort. In the case of severe infections, a hyposthenic form of asthenia develops: the patient's activity is reduced, he constantly feels sleepy, irritated over trifles. Muscle strength, sex drive, motivation decrease. These symptoms persist for more than 1 month and become less pronounced over time, and a decrease in working capacity, unwillingness to perform physical and mental work comes to the fore. Over time, the pathological process takes on a protracted course, in which symptoms of vestibular disorder, memory impairment, inability to concentrate and perceive new information appear.

Diagnosis of asthenia

Often, patients believe that the symptoms they are experiencing are not terrible, and everything will work out by itself, as soon as you get enough sleep. But after sleep, the symptoms do not go away, and over time they only get worse and can provoke the development of very serious neurological and psychiatric diseases. To prevent this from happening, do not underestimate asthenia, but if symptoms of this disease occur, you should consult a doctor who will make an accurate diagnosis and tell you what measures to take to eliminate it.

Diagnosis of asthenic syndrome is based mainly on complaints and data from the anamnesis of the disease and life. The doctor will ask you how long ago certain symptoms appeared; whether you are engaged in heavy physical or mental work, have you recently experienced overload associated with it; whether you associate the occurrence of symptoms with psycho-emotional stress; do not suffer from chronic diseases (which - see above, in the section "causes").

Then the doctor will conduct an objective examination of the patient to detect changes in the structure or functions of his organs.

Based on the data received, in order to confirm or deny a particular disease, the doctor will prescribe a number of laboratory and instrumental studies to the patient:

• general blood analysis;
• general urine analysis;
• biochemical blood test (glucose, cholesterol, electrolytes, kidney, liver function tests and other indicators required by the doctor);
• blood test for hormones;
• PCR diagnostics;
• coprogram;
• ECG (electrocardiography);
• Ultrasound of the heart (echocardiography);
• Ultrasound of the abdominal cavity, retroperitoneal space and small pelvis;
• fibrogastroduodenoscopy (FGDS);
• chest x-ray;
• Ultrasound of the vessels of the brain;
• computed or magnetic resonance imaging;
• consultations of related specialists (gastroenterologist, cardiologist, pulmonologist, nephrologist, endocrinologist, neuropathologist, psychiatrist and others).

Asthenia treatment

The main direction of treatment is the therapy of the underlying disease, the one against which asthenic syndrome arose.

Lifestyle

Lifestyle modification is also important:

• optimal work and rest mode;
• night sleep lasting 7-8 hours;
• avoiding night shifts at work;
• calm atmosphere at work and at home;
• minimizing stress;
• daily physical activity.

Often, the patient benefits from a change of scenery in the form of a tourist trip or rest in a sanatorium.

The diet of persons suffering from asthenia should be rich in protein (lean meat, legumes, eggs), vitamins of group B (eggs, green vegetables), C (sorrel, citrus fruits), tryptophan amino acid (wholemeal bread, bananas, hard cheese) and other nutrients. Alcohol should be excluded from the diet.

Pharmacotherapy

Medication for asthenia may include drugs of the following groups:

• adaptogens (extract of Eleutherococcus, ginseng, lemongrass, Rhodiola rosea);
• nootropics (aminalon, pantogam, gingko biloba, nootropil, cavinton);
• sedatives (novo-passit, sedasen and others);
• procholinergic drugs (enerion);
• (azafen, imipramine, clomipramine, fluoxetine);
• tranquilizers (phenibut, clonazepam, atarax and others);
• (eglonil, teralen);
• b vitamins (neurobion, milgamma, magne-B6);
• complexes containing vitamins and microelements (multitabs, duovit, berokka).

As it became clear from the list above, there are a lot of drugs that can be used to treat asthenia. However, this does not mean that the entire list will be assigned to one patient. Treatment of asthenia is mainly symptomatic, that is, the drugs prescribed depend on the predominance of certain symptoms in a particular patient. Therapy begins with the use of the lowest possible doses, which, with normal tolerance, can subsequently be increased.

Non-drug treatments

Along with pharmacotherapy, a person suffering from asthenia can receive the following treatments:

1. The use of infusions and decoctions of soothing herbs (valerian root, motherwort).
2. Psychotherapy. It can be carried out in three directions:
   • impact on the general condition of the patient and on individual, diagnosed in him, neurotic syndromes (group or individual auto-training, self-hypnosis, suggestion, hypnosis); techniques allow you to strengthen motivation for recovery, reduce anxiety, and increase emotional mood;
   • therapy that affects the mechanisms of pathogenesis of asthenia (conditioned reflex techniques, neuro-linguistic programming, cognitive-behavioral therapy);
   • techniques affecting the causative factor: gestalt therapy, psychodynamic therapy, family psychotherapy; the purpose of using these methods is the patient's awareness of the connection between the onset of asthenia syndrome and any personality problems; during the sessions, children's conflicts or traits inherent in the personality in adulthood, contributing to the development of asthenic syndrome, are revealed.
3. Physiotherapy:
   • Exercise therapy;
   • massage;
   • hydrotherapy (Charcot shower, contrast shower, swimming and others);
   • acupuncture;
   • phototherapy;
   • stay in a special capsule under the influence of heat, light, aromatic and musical influences.

At the end of the article, I would like to repeat that asthenia cannot be ignored, one cannot hope for "it will pass by itself, just get enough sleep." This pathology can develop into other, much more serious neuropsychiatric diseases. With timely diagnosis, it is quite simple to deal with it in most cases. Self-medication is also unacceptable: illiterately prescribed drugs can not only not give the desired effect, but also harm the patient's health. Therefore, if you find yourself with symptoms similar to those described above, please seek help from a specialist, in this way you will significantly bring the day of your recovery closer.

Today, there are many drugs used to treat vegetative pathologies. Various approaches allow you to quickly and effectively eliminate the disease. Since the ailment is associated with the consumption of vital and mental forces, the patient needs good rest, a change in the environment and type of activity. This will allow the body to rest and store energy. But sometimes these recommendations, for one reason or another, are impracticable. Therefore, they resort to drug therapy.

• Nootropic or neurometabolic drugs are safe and affordable medications for treating psychopathological disorders. However, their clinical efficacy remains unproven, as not all symptoms of malaise can be controlled. Because of this, this category of drugs is used with varying intensity in different countries. They are widely used in Ukraine, but rarely in America and Western Europe.
• Antidepressants are serotonin reuptake inhibitors used to treat asthenic symptoms and signs of depression.
• Atypical antipsychotics or antipsychotics are effective in vital and asthenic conditions.
• Psychostimulants - this category of medications is prescribed by a psychiatrist with appropriate indications for use. These include pro-cholinergic agents.
• NMDA receptor blockers - help with cognitive impairment due to cerebral atherosclerosis and other pathologies that cause impairment of cognitive functions.
• Adaptogens are plant-based products. Most often, patients are prescribed ginseng, Chinese magnolia vine, pantocrine, Rhodiola rosea and Eleutherococcus.
• B vitamins - this method of therapy is popular in the United States, but is limited in use due to the high risk of allergic reactions. Therefore, optimal vitamin therapy is used, which includes vitamins of group B, C and PP.

All of the above products require appropriate indications for use. Moreover, in general medical practice, their use is limited.

Stimol for asthenia

Stimol is an oral solution with an active ingredient - citrulline malate. The active ingredient activates the generation of energy at the cellular level. The mechanism of action is based on an increase in the level of ATP, a decrease in the level of lactate in blood plasma and tissue, and the prevention of metabolic acidosis. It stimulates the excretion of metabolic products from the body, eliminates emotional lability and a feeling of fatigue, and increases efficiency.

• It is used to treat asthenia of various origins, including senile, sexual, post-infectious, physical. Helps with weakness, drowsiness, emotional lability, increased fatigue. It can be used by patients with vegetative-vascular dystonia of hypotonic type and with withdrawal symptoms.
• It is taken orally, well absorbed in the intestines. The maximum plasma concentration occurs 45 minutes after administration. It is excreted within 5-6 hours. Before use, the powder must be dissolved in ½ glass of water. The dosage and duration of treatment are determined by the attending physician. But, as a rule, adults and adolescent patients are prescribed 1 sachet (10 ml) 3 times a day. For patients under 15 years of age, 10 ml 2 times a day.
• Of the side effects, only discomfort in the stomach is possible. It is not recommended to use in case of intolerance to the active substance and other components. Not indicated for patients with peptic ulcers of the stomach and duodenum, pregnant women and patients under 6 years of age.

Phenibut for asthenia

Phenibut is a nootropic agent, gamma-amino-beta-phenylbutyric acid hydrochloride. It has a tranquilizing, psychostimulating and antioxidant effect, facilitates the transmission of nerve impulses to the central nervous system. Improves cerebral circulation, reduces feelings of anxiety, fear, anxiety. Helps normalize sleep and has an anticonvulsant effect.

• After oral administration, it is rapidly absorbed, penetrates into all tissues of the body. It is evenly distributed in the kidneys and liver, metabolized in the liver by 80-90%. Does not cumulate, metabolites are pharmacologically inactive. It is excreted by the kidneys 3-4 hours after ingestion, but a high concentration in the brain tissues lasts for 6 hours. 5% of the substance is excreted unchanged by the kidneys and part with bile.
• It is prescribed for the treatment of anxiety-neurotic states, asthenia, anxiety, fear, obsessive states, psychopathy. Helps in the treatment of bedwetting and stuttering in children and insomnia in elderly patients. The medicine is effective for dysfunctions of the vestibular analyzer, as well as for motion sickness. It can be used as a complex therapy for alcoholism.
• The tablets are taken orally, regardless of the meal. The dosage and duration of treatment depend on the indications, the individual characteristics of the patient's body and his age. A single dosage for adults is 20-750 mg, and for children 20-250 mg.
• It is contraindicated to use in case of hypersensitivity to active substances. With extreme caution, appoint patients with hepatic failure, erosive and ulcerative lesions of the gastrointestinal tract. Long-term use requires monitoring indicators of liver function and peripheral blood. During pregnancy and lactation, it is used with appropriate medical indications.
• Side effects cause increased irritability, anxiety, headaches and dizziness, drowsiness. Attacks of nausea and allergic reactions on the skin are possible. When used simultaneously with hypnotics, analgesics, antipsychotic and antiepileptic drugs, it enhances their effect.

Grandaxin for asthenia

Grandaxin is a tranquilizer with the active ingredient tofisopam. The drug belongs to the group of benzodiazepine derivatives. It has an anxiolytic effect, but is not accompanied by a sedative, anticonvulsant effect. The psychovegetative regulator eliminates vegetative disorders, has a moderate stimulating activity.

• After oral administration, it is rapidly and almost completely absorbed from the gastrointestinal tract. The maximum concentration in blood plasma is maintained for two hours after ingestion and decreases monoexponentially. The active ingredient does not accumulate in the body, metabolites do not have pharmacological activity. Excreted by the kidneys 60-80% in the urine and about 30% in the feces.
• It is used to treat neuroses, apathy, depression, obsessive experiences, post-traumatic stress disorders, climacteric syndrome, myopathy, premenstrual tension syndrome and alcohol withdrawal.
• The dosage is individual for each patient and depends on the clinical form of vegetative disease. Adults are prescribed 50-100 mg 1-3 times a day, the maximum daily dose should not exceed 300 mg. For patients with renal insufficiency, the dose is halved.
• Overdose causes suppression of the function of the central nervous system, vomiting, coma, epileptic seizures, confusion and respiratory depression appear. Treatment is symptomatic. Side effects provoke insomnia, seizures, headaches, problems with the gastrointestinal tract, various allergic reactions, pain in muscles and joints.
• It is contraindicated to use in case of respiratory failure and respiratory arrest during sleep, with pronounced psychomotor agitation and with deep depression. Do not use in the first trimester of pregnancy and lactation, with galactose intolerance, hypersensitivity to benzodiazepines. Use with extreme caution in organic brain lesions, glaucoma, epilepsy.

Teraligen for asthenia

Teraligen is an antipsychotic, neuroleptic agent. It has a moderate antispasmodic, antihistamine effect. The active ingredient is alimemazine, which has an antipsychotic effect. Due to the blockade of adrenergic receptors, a sedative effect occurs.

• After oral administration, the active ingredient is rapidly and completely absorbed in the digestive tract. The maximum concentration in blood plasma is maintained for 1-2 hours. Protein binding at the level of 30%. It is excreted by the kidneys as a metabolite, the half-life is 3-4 hours, about 70% is excreted within 48 hours.
• It is used for the treatment of neuroses, asthenia, increased anxiety, apathy, psychopathy, phobic, senestopathic and hypochondriacal ailments. Helps with sleep disorders, can be used as a symptomatic therapy for allergic reactions.
• The tablets are taken whole without chewing, drinking plenty of water. For the treatment of psychotic conditions, adults are prescribed 50-100 mg, children 15 mg 2-4 times a day. The maximum daily dosage for adults is 400 mg, for children 60 mg.
• Side effects occur from the nervous system, causing increased drowsiness and confusion. In addition, visual acuity, tinnitus, dryness of the oral mucosa, constipation, irregular heart rhythms, bladder retention and allergic reactions are possible.
• Contraindicated for patients with individual sensitivity to the active substance and additional ingredients. Do not appoint patients with glucose-galactose malabsorption syndrome and lactase deficiency. It is forbidden to use in patients taking monoamine oxidase inhibitors. With extreme caution, it is prescribed to patients with chronic alcoholism, epilepsy, jaundice, arterial hypotension and bone marrow suppression. Not used during pregnancy and lactation.

Cytoflavin for asthenia

Cytoflavin is a drug that affects the processes of tissue metabolism. Refers to metabolic agents with cytoprotective properties. It activates the formation of energy and respiration in cells, restores the antioxidant defense of the body, stimulates protein synthesis in cells, and participates in the rapid utilization of fatty acids. These effects restore the intellectual and mnestic properties of the brain, improve coronary and cerebral blood flow.

• The medication is released in the form of tablets and solution for infusion. The medicine contains several active ingredients: succinic acid, nicotinamide, riboflavin mononucleotide and inosine. After application, it is quickly distributed in all tissues, penetrates the placenta and into breast milk. It is metabolized in the myocardium, liver and kidneys.
• It is prescribed as part of complex therapy to eliminate acute disorders of cerebral circulation, chronic ischemia of brain tissue, vascular encephalopathy, fatigue and asthenic disease.
• The solution is used only intravenously drip, diluting with 0.9% sodium chloride solution or glucose solution. Tablets are taken in the morning and evening, 30 minutes before meals, 2 times a day, 2 pieces. The course of treatment is 25-30 days.
• Side effects cause a sensation of heat, flushing of the skin, sore throat, bitterness and dry mouth. Exacerbation of gout is possible. In rare cases, there is discomfort in the epigastric region, short-term pain in the chest, nausea, headaches, allergic reactions. Contraindicated for use with breastfeeding, lowering the partial pressure. With regard to use during pregnancy, if a woman does not have allergic reactions to the components of the product, then it can be used.

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Vitamins for asthenia

Vitamin therapy for asthenic syndrome is carried out regardless of the form of the disease and its clinical features. Vitamins of group B are used for medicinal purposes, as they restore vital resources and energy reserves of the body.

Let's take a closer look at each of the vitamins in this group:

• B1 - thiamine synthesizes bioactive amines, influences metabolic processes, participates in the breakdown of glucose, that is, it helps to convert food into energy. It is necessary for the normal functioning of the body, its deficiency affects the work of all organs and systems, and especially the central nervous system. It is not synthesized in the body, therefore it must be taken with food.
• B6 - pyridoxine hydrochloride, is involved in the metabolic process. Synthesizes mediators of the nervous system, which are needed for the transmission of nerve impulses and the synthesis of hemoglobin. This substance stimulates the work of bone marrow, antibodies and blood cells, and affects the condition of the skin. Its regular use prevents the development of paresthesias and seizures. It is synthesized in small quantities by the intestinal microflora.
• B12 - cyanocobalamin, is involved in the metabolism of carbohydrates, proteins and fats. Regulates the nervous and digestive systems.

A lack of vitamins can be the cause of the development of a psychopathological syndrome. With a deficiency of nutrients, there is increased nervousness, sleep disorders, decreased performance, fatigue, digestive system disorders and asthenia. The use of vitamins is included in the complex of treatment and measures to restore the normal functioning of the body.

Folk remedies for asthenia

Along with traditional methods of treating asthenia, folk remedies are also used. Such therapy is based on the use of herbal ingredients to restore the normal functioning of all organs and systems.

Effective and simple remedies for vegetative ailments, nervous exhaustion and neuroses:

• Grind 300 g of walnuts, two heads of garlic (boiled) and 50 g of dill. Mix all the ingredients well, pour 1 liter of honey and let it brew in a cool dark place. The tool is taken 1 spoon 1-2 times daily before meals.
• Grind walnuts and pine nuts to a flour state, mix with honey (linden, buckwheat) 1: 4. Take 1 spoon 2-3 times a day.
• Mix a spoonful of flax seeds with 20 g of chamomile officinalis, pour 500 ml of boiling water and let it brew for 2-3 hours. After the remedy has been infused into it, you must add a spoonful of honey and take 100 ml 3 times a day before meals.
• Chop dates, almonds and pistachios in a 1: 1: 1 ratio. Use the resulting mixture 2 times a day for 20 g.
• Warm baths with essential oils have regenerating properties. Add a couple of drops of cloves, lemon oil, cinnamon, ginger or rosemary to the water. This will help you relax and fall asleep quickly.
• Grind 250 g of rose hips, 20 g of flowers of St. John's wort and calendula. Mix all ingredients thoroughly and add 500 ml of honey. The agent should be infused for 24 hours, take one spoonful 3-5 times a day.
• Herbal collection of motherwort, mint, oregano and hawthorn will help to cope with irritability and bouts of anger. All ingredients are taken in equal proportions, 250 ml of boiling water are poured in and infused. Take 1/3 cup 3-4 times a day.
• Prepare 100-150 ml of freshly squeezed carrot juice and add a spoonful of honey to it. The drink helps with a breakdown and fatigue.
• Take thyme herb, Rhodiola rosea and Leuzea root in equal proportions, mix and pour 250 ml of boiling water. Insist for 1-2 hours, strain, add a spoonful of honey and 5 g of ginger powder. Take ¼ cup 3-4 times a day.

In addition to taking the above funds, spend more time in the fresh air, get enough sleep, rest and do not forget about a fully healthy diet.

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Herbs for asthenia

Herbs for the treatment of neurological and asthenic diseases are included in the category of folk remedies. The advantage of using herbal ingredients is naturalness, a minimum of side effects and contraindications.

Effective herbs for psychopathologies:

• Aralia Manchu

An alcoholic setting is prepared from the roots of the plant, which stimulates the work of the heart muscle. To prepare the product, the crushed roots of the plant are poured with 70% alcohol in a ratio of 1: 6 and insisted for two weeks in a warm place. The medicine must be drained and taken 30 drops 2-3 times a day, the course of treatment is a month.

• Eleutherococcus spiny

Effectively stimulates the central nervous system, improves mental and physical performance, accelerates metabolism, increases visual acuity. The plant increases appetite, lowers blood sugar. Helps in the treatment of pathologies of the nervous system, with depression and hypochondriacal conditions. To prepare the tincture, take 200 g of plant roots per 1 liter of vodka. The mixture is infused in a dark, warm place for 2 weeks, shaking constantly. Strain the tincture and take 30 drops in the morning and evening.

• Schisandra chinensis

A tonic and stimulating agent for the nervous system. Perfectly increases physical and mental performance, protects the body from the adverse effects of the external environment. Helps with psychosthenia, reactive depression. The medicine is prepared from the seeds or fruits of the plant. Take 10 g of dried lemongrass fruit and pour 200 ml of boiling water. Take the infusion 1 spoon 1-2 times a day.

• Rhodiola rosea

Preparations from this plant improve performance, restore strength, help with neuroses and neurotic pathologies. Their daily use reduces irritability, improves attention and memory. The tincture is prepared from rhodiola root. Pour 20 g of chopped root with 200 ml of vodka, leave for 2 weeks in a dry, warm place. Therapeutic dose is 25 drops 2-3 times a day.

• Leuzea safflower

Stimulates the central nervous system, helps with hypochondria, vegetative diseases, impotence. It has a tonic and tonic effect, relieves fatigue and weakness. The infusion is taken 40 drops, diluted in 30 ml of water 1-2 times a day.

Natural stimulant of the central nervous system, relieves the feeling of fatigue and drowsiness, improves heart function, increases efficiency, relieves muscle fatigue. Caffeine abuse can lead to hypertension and even myocardial infarction. Contraindicated in patients with heart defects, hypertensive patients, angina pectoris and heart failure.

Homeopathy for asthenia

Homeopathic therapy involves the use of small doses of substances that, in large doses, cause pathological symptoms. Treatment with this method is based on the elimination of the primary disease that caused the signs of a nervous disorder. Malaise is characterized by increased fatigue, decreased performance, rapid exhaustion, both physical and mental.

Traditional medicine uses psychostimulants and sedatives to eliminate the disease. Homeopathy involves the use of harmless medications that are not addictive or have side effects. Such drugs do not regulate, but do not suppress the functions of the brain and central nervous system. The drug should be selected by the doctor, indicating the dosage and duration of therapy. The most commonly used agents are: ignacia, Nux vomica, thuja, gelsemium, acteracemosis, platinum, cocculus, and others. The preparation of ginseng Ginseng has proven itself well. It relieves fatigue, tones, betrays strength and energy. Helps with fatigue of a traumatic nature, increased weakness in elderly patients. Eliminates hand shake and muscle strain.

Homeopathy is used in combination with other methods such as acupuncture, hirudotherapy and color therapy. An integrated approach is more effective, as it helps to quickly eliminate the symptoms of the syndrome. But the main advantage of the method is the ability to lead a normal life.

Psychostimulants for asthenia

Psychostimulants are drugs that temporarily improve physical and mental performance. The positive effect is achieved due to the mobilization of the reserve capabilities of the body, but prolonged use of pills depletes them. Unlike drugs that depress the central nervous system, psychostimulants are devoid of selectivity of action, since after stimulation the nervous system is suppressed.

This group of funds quickly eliminates fatigue, weakness, helps to fight irritability and emotional lability. They can be considered a kind of doping for the nervous system, which temporarily removes asthenic symptoms.

Classification of psychostimulants:

1. Drugs affecting the central nervous system:

• Stimulating the cerebral cortex - Meridol, Phenamine, Methylphenamine, Xanthine alkaloids.
• Spinal cord stimulants - Strychnine.
• Stimulating oblong can - Carbon dioxide, Bemegrid, Camphor, Cordiamin.

1. Reflexively acting on the nervous system - Lobelin, Nicotine, Veratrum.

The above classification is considered conditional, since if drugs are prescribed in large doses, they stimulate the central nervous system completely. The medicine is prescribed by the attending physician, since such drugs require a prescription.

Psychotherapy for asthenia

Psychotherapy in the treatment of asthenic conditions refers to additional methods, since the main emphasis is on drug therapy. It is a system of psychological impact on the patient's body. It eliminates the symptoms and the traumatic circumstances that caused them, that is, minimizes the negative impact of psychotraumatic factors. It can be used as a method of rehabilitation and psychoprophylaxis.

To draw up a treatment program, the doctor conducts psychological diagnostics and draws up a plan. Therapy can be group and individual. The success of its application lies in close contact of the patient with a psychotherapist or psychologist. But to improve health, you need to adhere to the daily regimen, take vitamins and good nutrition. Regular consultations with a psychologist will allow you to understand and eliminate the true causes of the disease.

Treatment of asthenia after influenza

In order to cure the increased weakness and unreasonable fatigue after the flu, the body's metabolic balance must be restored. Stimol has proven itself well in treatment. It improves well-being in a short time. In addition, patients are prescribed vitamin therapy (vitamins of group B, C, PP), good nutrition and rest, frequent walks in the fresh air, a minimum of stress and more positive emotions.

The term asthenia in medicine is usually used to denote a complex of disorders manifested by increased fatigue, sleep disturbances, mood instability, indifference to food, and loss of interest in life.

Asthenic syndrome can occur after illness or against their background, as a result of prolonged stress.

A thorough questioning of the patient helps to correctly diagnose; after a course of treatment, in most cases, asthenia disappears.

Causes of occurrence

Asthenia is a psychopathological condition, many doctors believe that asthenic disorders should be attributed to the initial stage of development of serious mental and neurological diseases.

Asthenia is necessary be able to separate from ordinary fatigue or weakness after illness.

The main distinguishing criterion is the fact that after illness and fatigue, the body gradually returns to normal on its own after a good rest, good nutrition and sleep. Asthenia, on the contrary, without complex therapy can last for months, and in severe cases for years.

Common characteristic causes asthenia:

• overstrain of higher nervous activity;
• lack of supply of essential trace elements and nutrients;
• pathological disorder of metabolic processes.

All these factors in different age periods in most cases arise in the life of every person, but they do not always lead to the development of asthenic disorders.

Provoke development asthenia can be somatic diseases, injuries and disturbances in the work of the nervous system. Moreover, the symptoms of asthenia can be observed both before the disease itself, and in the midst of the disease and during the recovery period.

An extremely rare mental disorder has many different facets and problems.

The most dangerous disease hepatic encephalopathy provokes a whole complex of problems in the body, which is not so easy to cope with. What to conquer disease?

Among the diseases leading to asthenia, there are several groups:

1. Infection - SARS, food poisoning, tuberculosis, viral hepatitis.
2. Diseases of the gastrointestinal tract - ulcers, gastritis, pancreatitis, enterocolitis, severe dyspeptic disorders.
3. Diseases of the cardiovascular system - heart attack, arrhythmias, hypertension.
4. Renal pathologies - glomerulonephritis, chronic pyelonephritis.
5. Diseases of the bronchopulmonary system - pneumonia, chronic bronchitis.
6. Trauma, postoperative period.
7. Neurological disorders.

Asthenic disorders often develop in people who do not think of their life without work and therefore do not get enough sleep and deny themselves rest. Signs of asthenia also appear when you change your place of residence, work, after troubles or serious worries.

Asthenia classification

Asthenia is usually classified in medical practice according to many criteria, it is necessary for the choice of treatment tactics.

For reasons of origin, it is customary to subdivide asthenia on the:

1. Organicdeveloping after infectious and somatic diseases, after trauma, degenerative changes in the brain. Organic asthenia is determined in almost 45% of cases.
2. Functional Asthenia is a reversible condition that develops as a protective response to stress, depression, excessive mental and physical exertion.

By the duration of the course of the disease, it is customary to subdivide asthenia on the:

• sharp;
• chronic.

As a rule, acute asthenia is most often functional. The chronic course of the disease is due to organic disorders.

According to clinical signs, asthenia is divided into on the:

• hypersthenic form, characterized by increased irritability and excitability of a person;
• hyposthenic form, manifested by a reduced response to any external stimuli.

For reasons of occurrence, asthenic syndrome is subdivided on the:

• post-infectious;
• postpartum;
• somatogenic;
• post-traumatic.

The correct classification of the disease helps the doctor to correctly determine the tactics of treatment.

Clinical picture

Asthenia has characteristic symptoms, which are divided into three main groups:

The main signs of asthenia are accepted consider:

1. Fatigue. With asthenia, fatigue does not go away even after a long rest, it does not allow a person to concentrate on work, leads to distraction and to a complete lack of desire for any activity. Even one's own control and efforts do not help a person return to the desired mode of life.
2. Autonomic disorders. The development of asthenia almost always leads to jumps in blood pressure, an increase in the pulse rate, interruptions in the work of the heart, to a decrease in appetite, headaches and dizziness, to a feeling of heat or, on the contrary, chills throughout the body. Disorder of sexual function is observed.
3. Sleep disturbance. With asthenia, a person cannot fall asleep for a long time, wakes up in the middle of the night or wakes up early. Restless sleep, does not bring the necessary rest.

A person experiencing the influence of asthenic disorders realizes that something is wrong with him and begins to react differently to his condition.

There are outbursts of rudeness, aggression, sudden mood swings are observed, and self-control is often lost. A long course of asthenia leads to the development of depression and neurasthenia.

A characteristic sign of asthenia is the condition in which the patient feels good in the morning, and after about lunchtime, all the symptoms and signs of the disease begin to increase.

By evening, asthenic disorder usually reaches its maximum. With asthenia, there is also an increased sensitivity to bright light sources, harsh sounds.

Asthenic disorders affect people of all ages, often signs of the disease are detected in children and adolescents. In modern boys and girls, asthenia is often associated with the intake of psychogenic and narcotic drugs.

Asthenia must be taken very seriously, it is not just a manifestation of ordinary fatigue, but a serious illness that can lead to serious consequences in the absence of therapy.

Diagnostic income

Asthenic disorders can be suspected in a patient by a doctor of any specialty.

To clarify the patient's diagnosis, it is necessary to inquire in detail about disturbing symptoms, learn about behavior, sleep quality, attitude to work and to the life around.

Assessment of neurological and psycho-emotional state performed by a neurologist.

In order to find out the underlying cause of the development of asthenia, it is necessary to determine the presence of pathological disorders in the body.

The patient needs consultation cardiologist, therapist, nephrologist, gastroenterologist, pulmonologist.

Appoint blood tests, according to indications of ultrasound of internal organs, MRI of the brain, gastroscopy, radiography of the lungs.

Only on the basis of all the data obtained during a comprehensive examination, a decision is made on the choice of a therapy regimen. Most often, functional asthenia with timely access to a medical facility is eliminated in a few weeks.

Syndrome treatment

Treatment of asthenia occurs depending on the predominant symptoms and on the identified provoking disease.

First you need to do therapy of identified disorders, in order to prevent their further negative impact on the psychoemotional sphere.

A certain scheme has been developed, which most doctors try to apply in practice in the treatment of asthenia. Stages of asthenic disorder treatment are considered:

A full course of treatment of the underlying disease and asthenic disorder leads to the normalization of the general well-being of a person.

It must be remembered that some people are prone to psychopathological disorders and therefore asthenia can become chronic for them.

Carrying out preventive treatment, avoiding the influence of stress and observing the daily regimen, it will be possible to minimize the risk of re-development of asthenia.

Forecast and consequences

Asthenia in the absence of treatment can lead to the development of neurasthenia, depression, hysteria.

Chronic asthenic disorders lead to impaired concentration, to absent-mindedness and therefore many people cannot work with complex equipment. In this case, the EEC commission establishes the degree of disability and recommends another job.

The success of the treatment of asthenia depends on the mood of the patient himself. The more optimistic about the possibility of recovery, the more real that asthenic disorders will pass completely.

Asthenia can occur in each of us, you should not be afraid. The main thing to remember is that a timely visit to the doctor will help you return to your usual life in the shortest possible time.