Is hysteria simply a mental disorder?

Author: Wang Changhong, Chief Physician of the Second Affiliated Hospital of Xinxiang Medical College

Gao Chang, Associate Professor, Jining Medical College

Reviewer: Pan Miao, deputy chief physician of the Second Affiliated Hospital of Xinxiang Medical College

Jingjing is an 18-year-old female college student who is introverted, quiet and unsociable. Half a year ago, her father thought the skirt she wore was ugly, and she gradually developed symptoms such as poor appetite and vomiting. She was diagnosed with depression by a psychiatrist at a local hospital.

But Jingjing had another conflict with her father during the treatment. This time, Jingjing suddenly couldn't turn over, couldn't walk normally, and finally even had symptoms of "paralysis" of both lower limbs. She could only squat and move forward by pulling her legs with her hands. But after the doctor performed an electromyography on Jingjing's lower limbs, no abnormalities were found.

Finally, Jingjing was diagnosed with "hysteria".

Why does hysteria make Jingjing "paralyzed"?

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1. Causes of hysteria

Hysteria is a common mental disorder, and its etiology is generally related to psychological factors. Patients often have certain personality traits, such as being self-centered, competitive, emotional, and performative.

Some patients are highly suggestible, which means that their thoughts, words and deeds are often influenced by the people around them. People with this kind of personality foundation are prone to illness when they experience stressful events or inner conflicts that cannot be resolved for a long time.

Jingjing's symptoms are due to her caring too much about her father's thoughts. When Jingjing was young, she had a breast surgery, which left scars. She has been inferior since she was a child and dared not wear skirts. In addition, her relationship with her parents is not very close, so Jingjing always rushes to do the heavy work at home, wanting to show her value in her contribution to the family.

But when Jingjing mustered up the courage to try to wear a skirt, she was scolded by her father, which made Jingjing realize that she was ugly and unacceptable. Jingjing's psychological trauma had nowhere to be released, and then it turned into physical discomfort, manifested as vomiting, difficulty eating, and even "paralysis" of both lower limbs and inability to walk.

2. Manifestations of hysteria

Hysterical patients often have emotional abnormalities, common manifestations include hoarseness, wailing, beating the chest and stamping the feet, etc.

In addition to emotional abnormalities, patients may also feel abnormal about their identity and the environment around them. For example, some patients experience possession, some patients often think they are no longer themselves, and some patients do not recognize the people around them and do not know where they are. In addition, some patients do not have these abnormal manifestations, but have physical problems, such as sudden convulsions or inability to walk or talk, but clinical examinations show no problems, and the patient's physical symptoms cannot be diagnosed with related diseases.

No matter what symptoms the patient shows, he or she should be sent to the hospital for treatment in time to understand the psychological factors behind these symptoms. Only by resolving the patient's inner conflicts can the patient get rid of the troubles as soon as possible.

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3. Treatment of hysteria

There are many treatments for hysteria, such as suggestion therapy, behavioral therapy, physical therapy, drug therapy, etc.

When performing suggestive therapy, the surrounding environment should be quiet and all irrelevant people should leave the scene to avoid the panic or attention of onlookers, which may bring greater psychological pressure to the patient and increase the difficulty of treatment. When the patient's emotions are stable, the doctor will listen to the patient's complaints in a hidden way, allowing the patient to vent negative emotions, and then use language suggestion to eliminate the patient's nervousness. Language suggestion is generally positive language with a benign effect, which helps to enhance the patient's confidence in overcoming the disease.

Behavioral therapy generally uses systematic desensitization therapy. First, we need to understand the causes (stressors) of the patient's abnormal behavior, then gradually give the patient corresponding stimuli, and teach the patient how to deal with these stimuli, so that the patient's established conditioned reflexes gradually disappear.

Physical therapy involves acupuncture, electroacupuncture, etc. This method is more effective for patients with functional disorders such as hysterical paralysis, deafness, blindness, and inability to speak.

Drug treatment is an emergency treatment method for hysterical attacks or sudden passionate excitement, tics, and convulsions. Generally, some antipsychotic drugs can be used.

The onset of hysteria is related to the individual's emotional experience. As long as the patient realizes the relationship between certain personality traits and the onset of the disease, he will understand that only by "losing weight" on his mind can he get rid of the troubles of hysteria. When you feel stressed, you can consciously divert your attention and do something else, or you can temporarily leave the current environment and find a safe and comfortable place to change your mood. Doing so can stabilize the condition and prevent the onset of hysteria.

References

【1】Deng Hui. Research on the application value of psychological nursing for hysteria among college students[J]. Famous Doctors, 2021, 16: 105-106.

【2】Zhang Jin. Clinical analysis of 40 cases of hysterical emergency in college students[J]. Practical Clinical Medicine, 2022, 23(2): 20-21, 28.