In a world of stress, frayed nerves and worry, neurasthenia is increasingly common.

When we experience psychological stress, our nervous system and other contingency systems of the body take over to function and deal with these difficulties. However, when we face problems for a prolonged period ? or problems become too enormous ¡Ð our nervous system and other contingency systems can fail to tackle these problems within their normal capacity, often with neurasthenia as a result.

The proper medical term for neurasthenia is "neurosis". Medically speaking, neurasthenia is a psychiatric illness. Sufferers have symptoms of frayed nerves, but without obvious structural pathological changes.

Basically, there are four types of neurasthenia.

Anxiety neurosis is very common. Patients usually suffer from palpitation of the heart and difficulty in breathing and may have trouble with their digestion system exhibiting symptoms such as vomiting, loss of appetite or overeating and diarrhoea. Other symptoms include frequent urination, decline or increase in sexual desire, strained and aching muscles, trembling hands, fatigue, headaches, ringing in the ears and loss of concentration. Patients are more forgetful and restless, and can also suffer from insomnia and sweating.

On the other hand, neurotic depression sufferers are generally emotionally depressed and sometimes suicidal. They often lose interest in everything and cannot concentrate. They get tired easily, suffer from insomnia and constipation, and can have nightmares and poor appetites. In addition, sufferers of neurotic depression often suspect that they are physically ill.

The third type of neurasthenia is obsessive-compulsive neurosis. Those suffering from this psychological disorder exhibit compulsive behaviour - constantly repeating certain conduct or mulling over the same thought in their minds. Though sufferers may realise that such repetitive behaviour or obsessive thinking is counter-productive, harmful, useless and weird, they cannot control themselves. Common manifestations of compulsive behaviour and thoughts are: incessantly washing hands, checking on doors locks, taps and stoves, and counting things. Other symptoms include: mysophobia, bacteria phobia, fear that accidents may happen, and unnecessary dread of loss of personal possessions.

The fourth, and most serious type of neurasthenia is hysteria. Sufferers of hysteria often subconsciously transform ambivalent emotions, restlessness or worries that cannot be resolved into physical or mental symptoms. By doing so, they hope to evade facing the problems or attracting attention. Physical or emotional symptoms of hysteria can be blindness, deafness, complete/partial numbness or paralysis, cramps, spasms, amnesia, dementia, odd gestures, strange sensations or pains in the body, anorexia or overeating, multiple personality, and so on.

The causes of neurasthenia can be analysed from two aspects: flaws in personality and circumstantial stress.

Every one has his or her own strengths and weaknesses in personality. The greater the flaws in one's personality, the more vulnerable one is to neurasthenia in the face of circumstantial stress.

Common weaknesses in personality are: excessive nervousness, extreme pessimism, being overly serious or stubborn, paranoid, emotionally unstable, edgy, lonely or introverted.

Circumstantial stress can be caused from pressures at work and school (facing examinations), from concern for one's health, dire financial situations, and by excessive pressures caused by broken relationships, a death in the family, or the injury/sickness of a relative/friend. Failure in business, overworking, and excessive intimidation can also cause tremendous stress on one's mental well-being.

The prevention and treatment of neurasthenia includes medication, psychological and behavioural therapy, monitoring of environment or minor brain surgery. In any case, sufferers should seek medical treatment as soon as possible.

To effectively prevent symptoms of neurasthenia it is essential to have a stable, balanced lifestyle, a supportive family and friends.

You should also strive to understand your own personality and interests and choose a career that is suitable, while at the same time cultivating a variety of pastimes, seeking rest and relaxation, healthy entertainment and social activities.

Diet and exercise are also important, as is having a regular life pattern as far as possible.

Above all, you should cultivate a healthy attitude towards life.

Q
Due to the nature of my husband's work he eats out very often and as a result consumes a large amount of stimulating foods and alcoholic beverages. What effect will this have on his stomach? Are there certain foods he can eat to maintain a healthier diet?

A
Alcohol can irritate the stomach to produce gastritis. Fatty food can slow down stomach peristalsis, but does not result in injury. Restaurant food in general includes all categories of nutritional elements. If appropriate choices are made, a balanced diet can be achieved. The main problem is excessive calories that may lead to obesity and various associated diseases. The easiest remedy is to follow every restaurant meal with a meal consisting entirely of fruit.

Q
Occasionally I get stomach muscle spasms for no obvious reason. Is it necessary to consult a physician?

A
Stomach aches and cramps may be caused by nervous tension, but can also be caused by gastritis, stomach ulcers, stomach tumours, and even other diseases outside the stomach such as gallstones. Generally speaking, a doctor should be consulted to determine the cause of your stomach muscle spasms.

Q
I like to drink Chinese tea as it speeds up digestion. Can drinking a lot of tea every day be harmful to the stomach? What quantity is considered safe?

A
Theoretically, the tannic acid in tea leaves, if present in high concentrations, is capable of precipitating protein and injuring living tissues. However, drinking tea containing very low concentrations of tannic acid should not harm the stomach. Because tea contains caffeine it is a tonic and can cause insomnia. Constant drinkers of tea, once weaned, may experience a period of lassitude. Like everything else in life, tea should be consumed in moderation.

Information for Health is Wealth is provided by doctors and health care professionals of the Hong Kong Medical Association (co-ordinated by Administration and Support Group, Personnel Services Branch, Hong Kong Police). They look forward to receiving, and will try to answer any questions you have, on neurasthenia and other health issues. Please fax: 2865-4799.