An increase in the number of movements is observed in mental and narcological diseases. It is detected in mania, anxiety spectrum disorders, delirium, dementia, alcohol dependence, cocaine addiction and opium addiction. Often combined with psycho-emotional arousal, sometimes with agitation. The cause is established on the basis of complaints, anamnesis data, and the results of special tests. If an organic etiology is suspected, instrumental and laboratory studies are carried out. Treatment - psychotherapy, antidepressants, mood stabilizers, antipsychotics, complex addiction therapy.
general characteristics
An increase in the number of movements, as a rule, occurs against the background of strong experiences. The patient appears fidgety, performing many small, chaotic motor acts. Perhaps a combination with increased talkativeness. More often the provoking factor is fear, anxiety, anxiety. Less commonly, the symptom occurs due to violent joy, excessive enthusiasm, etc.
A certain role in the increase in motor activity is played by the state of the extrapyramidal system, as well as external and internal factors that cause an imbalance of neurotransmitters in the brain. Violation is found in mental and drug problems. In healthy people, it develops briefly during periods of psychological trauma and acute stressful situations.
Why is the number of movements increasing?
affective disorders
The main symptom of affective disorders is a change in the intensity of emotions that become too strong or too weak, unstable, inadequate to the situation. An increase in the number of movements is typical for affective hyperesthesia (intensification of experiences). It can be observed in the following diseases:
- masked depression. Characterized by the absence of obvious emotional fluctuations and an obvious decrease in mood in the presence of a variety of somatic complaints. In the advanced stage, the listed disorders are supplemented by uncertainty, anxiety and restlessness, accompanied by mildly pronounced motor excitation.
- BAR. In the phase of mania, hyperactivity, an excessive increase in mood, acceleration of thinking and speech are found. Excessive optimism, inability to maintain a serious attitude, constant jumping from one topic to another, active gestures, restlessness, and excessive mobility are noted.
- GTR. The clinical picture includes severe non-fixed anxiety, vegetative failures and motor tension. With an increase in the level of anxiety, patients become fussy, make unnecessary movements. Patients are concerned about frequent cephalalgia and constant muscle tension, mainly in the cervical-collar zone.
- organic anxiety disorder. It is provoked by cardiovascular and endocrine diseases, CNS lesions (neuroinfections, injuries, circulatory disorders), hypoglycemia, B12 hypovitaminosis, and taking certain medications. The symptoms are reminiscent of GAD.
- Phobias. Characterized by the emergence of an extremely intense unreasonable fear upon contact with an object (closed or open space, some kind of animal, etc.). An increase in the number of movements is determined at the prospect of a collision with the subject of a phobia, supplemented by vegetative reactions. The patient partially loses control over his behavior. In severe cases, an attack develops at the mere thought of an object.
- Panic attacks. More often they are not an independent disease, but a sign of other somatic and mental pathologies. Occur in NCD, gastric ulcer, coronary artery disease, OCD, GAD, hysterical neurosis, phobic, depressive and hypochondriacal disorders. An increase in motor activity is noted at the initial stage, due to the rapid increase in vegetative manifestations that cause anxiety and anxiety.
restlessness
Delirium
Delirium is a polyetiological condition. Accompanied by emotional and behavioral disorders. Patients partially lose the ability to navigate in place and time, but retain orientation in their own personality. Illusions, hallucinations, delusions are possible. An increase in the number of movements is potentiated by strong experiences. The cause of delirium is:
- Infectious and somatic diseases: cirrhosis of the liver, some hepatitis, kidney failure, rheumatism, malaria, pneumonia.
- CNS lesions: traumatic brain injury, tumors, neuroinfections, deterioration of cerebral circulation.
- Intoxication: withdrawal syndrome in alcoholism and some drug addictions, drug poisoning.
- Postoperative psychosis: develops immediately or within 2 weeks after surgical interventions, more often - major operations for conditions accompanied by hypoxia.
Dementia
Fussiness against the background of excessive experiences can be observed in various types of dementia, including senile dementia and Alzheimer's disease. The number of small movements increases in moments of confusion, when you get into an unusual environment. Along with periodic motor restlessness, a progressive decrease in memory and cognitive functions, emotional changes are determined.
Drug problems
In narcological practice, an increase in the number of movements is detected in such conditions as:
- Alcohol intoxication. The symptom, as a rule, is found during intoxication of moderate severity, provoked by mood swings, transitions from fun to irritation or aggression. A significant role is played by neurological problems arising from the toxic effect of ethanol on the body.
- hangover syndrome. It is formed in the absence of alcoholism or at the initial stage of dependence. Motor excitation develops against the background of anxiety, depression and feelings of guilt. Complemented by a tremor of the hands and a feeling of "internal trembling" in the body. Patients suffer from thirst, nausea, headache, increased blood pressure. The performance is reduced.
- Alcohol withdrawal syndrome. It is revealed at the exit from hard drinking in patients with the second stage of alcoholism. The symptom occurs against the background of irritability, anxiety, agitation, somatic and autonomic disorders, changes in the mental sphere. Perhaps a rapid deterioration of the condition, clouding of consciousness. In severe cases, it turns into delirium tremens.
- Cocaine addiction. Violation is noted in the period of intoxication and in the stage of withdrawal. In the first case, it is due to the stimulating effect of cocaine, in the second - to the withdrawal syndrome. For long-term drug addicts, it becomes permanent, it is formed due to an imbalance of neurotransmitters.
- Opium addiction. Short-term motor restlessness can be determined at the moment of transition of the first stage of drug intoxication to the second. It is also found during the period of withdrawal syndrome, which develops 8-12 hours after the last use. It is combined with anxiety, progressive deterioration of physical condition, pain in the body.
- Abuse of amphetamines. The appearance of a symptom during intoxication is explained by the stimulating effect of psychoactive substances. In case of an overdose, a combination with aggression, anxiety, chest pain, hyperthermia, nausea and vomiting is detected. In addition, as with other drug addictions, restlessness accompanies withdrawal.
Neurological examination
Diagnostics
Diagnostic measures are carried out by a psychiatrist. If you suspect the presence of provoking somatic pathologies, an examination by a therapist, neurologist, endocrinologist is prescribed. If a symptom occurs as a result of taking a psychoactive substance, a consultation with a narcologist is indicated. The survey program includes activities such as:
- Conversation and observation. During the survey, the specialist not only collects information about the clinical picture, anamnesis of life and illness, but also monitors behavior, facial expressions and speech, which may indicate the presence of a particular mental disorder. Establishes the preservation of orientation in place, time and self. If productive contact is impossible, the patient is inadequate, relatives are involved in the survey.
- Tests and questionnaires. Testing is an area of diagnostics that allows you to assess the state of different levels of the psyche, to form a reasonable conclusion regarding cognitive, emotional, personal, social and other aspects. A detailed examination includes psychophysiological tests, projective techniques and various questionnaires (Eysenck's test, SMIL, Beck's questionnaire and others).
- physical methods. Informative for narcological diseases, the organic basis of affective disorders. The doctor evaluates the condition of the skin and mucous membranes, reveals traces of injections, pustular lesions, jaundice. Determines pulse and blood pressure. Examines reflexes, muscle tone, sensitivity, coordination of movements.
- Laboratory tests. They are used to determine the substance that caused intoxication. Preliminary methods include chromatography, immunochromatographic and enzyme immunoassays, polarization fluoroimmunoassay. If the result is positive, gas-liquid and liquid chromatography, chromato-mass spectrometry, thin-layer chromatography are carried out.
In case of delirium and anxiety disorders against the background of somatic, endocrine and neurological diseases, the examination program is drawn up taking into account the nature of the causative pathology. Various laboratory tests (biochemistry of blood and urine, tests for hormones), ultrasonography, CT, MRI can be performed.
Treatment
The therapeutic tactics is determined by the etiology of the increase in the number of movements. Patients with affective disorders are usually observed on an outpatient basis (with the exception of severe cases with psychotic symptoms). With delirium, hospitalization in a psychiatric department is indicated. For chemical addictions, treatment and rehabilitation in the conditions of a narcological dispensary are recommended. The plan is made taking into account the characteristics of the disease:
- affective disorders. To eliminate depressive symptoms, antidepressants are used, to reduce anxiety - anxiolytics, to mitigate the severity of mania - normotimics. With psychosis, neuroleptics are prescribed. Conduct individual and group psychotherapy using CBT, psychodrama and other techniques. Teach patients self-regulation techniques. Carry out mode correction.
- Delirium. Medium therapy is recommended to minimize stress levels. As part of drug treatment, parenteral and then oral administration of antipsychotics is indicated first. To normalize sleep, benzodiazepines are included in the regimen. Measures are taken to correct the underlying pathology. With alcoholic delirium, detoxification is performed, with renal failure - hemodialysis, etc.
- Drug problems. In acute intoxication and withdrawal syndrome, detoxification is indicated using infusion therapy, plasmapheresis, hemosorption, in severe cases - UROD. In the future, methods are used to eliminate dependence. The drug is canceled simultaneously or gradually. Symptomatic remedies are prescribed, nutrition and activity regimen are adjusted. To eliminate the mental component of dependence, individual and group psychotherapy is carried out.