Vegetative dystonia

Vegetative dystonia: description

A vegetative dystonia literally means a “dysregulated tension (dystonus) of the autonomic nervous system”. This coordinates many important bodily functions that deliberately hardly or not at all can influence – such as the heartbeat, breathing or digestion. Accordingly, various symptoms can be summarized under the umbrella term of vegetative dystonia – from cardiovascular complaints and headaches to trembling hands and diarrhea.

While the diagnosis of “vegetative dystonia” was a mass phenomenon in the 1950s, it has since been partially superseded by various synonyms. Examples are neurovegetative disorder, autonomic neurosis and autonomic dysregulation. In general, when patients suffer from symptoms for which no physical causes can be found, physicians generally speak of somatoform disorders or functional syndromes. However, the vegetative dystonia is not to be confused with the dystonia; This is a collective term for various movement disorders, such as a crooked head posture or cramps in different parts of the body (for example, fingers, the musicians’ cramp).

What is the autonomic nervous system?

The autonomic dystonia concerns the autonomous or also autonomic nervous system, This system controls all automatic body functions: it regulates the blood pressure, activates the sweat glands on hot days and narrows the pupils in glaring light. However, when a person consciously decides to move or to have a perception, it is somatic nervous system active. Most of the time, both systems work closely together.

The autonomic nervous system is divided into two functional antagonists:

• the sympathetic nervous system (sympathetic)
• the parasympathetic nervous system (parasympathetic)

While the sympathetic nervous system tightens people, accelerates heartbeat and respiration, and sets the whole body in a fight-or-flight response, the parasympathetic nervous system is primarily responsible for processes of relaxation and regeneration. If the interaction between the sympathetic and parasympathetic nerves does not work properly, the symptoms are sometimes classified as vegetative dystonia.

The complaints depend on whether the tension has shifted in favor of the sympathetic or the parasympathetic: People with an increased sympathetic activity (sympatheticotonia) are therefore prone to nervousness, palpitations, increased blood pressure and diarrhea. If, on the other hand, the parasympathetic nervous system is dominant (vagotonia), it may be associated with low blood pressure, cold hands and feet, listlessness and constipation. However, the vegetative dystonia as a diagnosis is controversial; Critics call it an “embarrassment diagnosis” that is made when the doctor no longer knows what to do.

Vegetative dystonia: symptoms

A vegetative dystonia can be associated with very different symptoms. The complaints are often difficult to classify.

Possible symptoms of vegetative dystonia are:

• a headache
• dizziness
• diarrhea
• constipation
• sleep disorders
• cramps
• increased sweating
• increased or decreased pulse rate
• slight trembling of the hands

In a broader sense, vegetative dystonia includes various symptom complexes. They often occur together and are sometimes treated as independent diseases of unknown cause. An example is this hyperkinetic heart syndrome, which is associated with frequent palpitations and large blood pressure fluctuations. Of a irritable bowel One speaks of chronic indigestion, which is often associated with abdominal pain and flatulence. A overactive bladder (Irritable bladder) can lead to constant urination and frequent urination. Symptom complexes of this type are also called functional syndromes. Also chronic pain of unclear cause belong to this complex of topics, for example fibromyalgia; However, these are usually not classified under the term autonomic dystonia.

Vegetative dystonia: causes and risk factors

The vegetative dystonia often has no clear cause. Not infrequently, several physical, mental and social circumstances play a role. So it is difficult to find a specific trigger for the vegetative dystonia.

If a purely physical cause for the respective symptoms can be excluded after all necessary medical examinations, one must psychosomatic causes consider. Body and psyche are in constant interaction with each other. And so it is not uncommon that severe mental stress is also reflected in various bodily functions. These include, for example, permanent stress, grief, worries and fears. For example, a person who has lost a loved one or feels very unhappy at work can develop long-term physical symptoms such as headaches, sleep disturbances, or frequent tremors. These symptoms could possibly be considered by the doctor as vegetative dystonia.

But that does not mean that the complaints are conceited or “not genuine”! The vegetative dystonia can sometimes bring frightening symptoms (such as tachycardia) with it and can be a great burden in the long run. Somatoform disorders are therefore just as serious as those that have physical causes. Both require a careful diagnosis.

Vegetative dystonia: examinations and diagnosis

The vegetative dystonia is not a diagnosis in the sense of a specific disease, but includes an uncharacteristic condition, in which obviously different functions of the autonomic nervous system are disturbed. First, the doctor inquires about the medical history (medical history). So he asks what pre-existing conditions exist, whether the person takes medication, since when the symptoms exist, in which situations they occur and if there are other distressing symptoms. The respective life situation as well as the alcohol and drug consumption of the patient can provide important information.

Then follow various examinations to knock off and rule out possible physical causes of the discomfort:

• A physical examination can already provide information about some symptoms. For example, in a patient with frequent gastrointestinal problems, the doctor scans the abdominal wall. If there are complaints in the heart area, he listens to the heart sounds with a stethoscope.
• A Pulse and blood pressure measurement is particularly informative for circulatory problems. The patient may be able to check for fluctuations during the day with a manual sphygmomanometer.
• With a blood test For example, it is possible to check whether inflammatory processes are taking place in the body, whether there are various nutrient deficiencies, or whether there is an excess or lack of specific hormones. Thus, possible physical causes such as thyroid dysfunction or iron deficiency can be ruled out.
• If a physical illness can not be ruled out and the symptoms persist for a long time, depending on the symptoms – special investigations consequences. Examples are an electrocardiogram (ECG), a stool or urine examination or imaging procedures such as ultrasound and X-ray examination. However, the doctor usually tries to avoid unnecessary and possibly stressful examinations.

A vegetative dystonia is ultimately diagnostically not reliably detectable, but also difficult to refute. The doctors usually make the diagnosis when there are no physical causes.

Vegetative dystonia: treatment

The best way to treat a vegetative dystonia depends on its respective trigger and severity. If the physical diagnosis remains without result, physicians often advise to wait and to observe the course of the symptoms – somatoform disorders often recur after a while on their own.

If this is not the case, the doctor usually recommends one psychotherapy, This does not mean that he does not take the patient’s complaints seriously. Often, physical symptoms have their roots in the psyche. It is therefore best to treat vegetative dystonia with psychotherapeutic measures. They promise the greatest chance of complaint. Some psychotherapists specialize in somatoform disorders or autonomic dystonia. With this support, the person concerned can learn to classify his complaints better and to deal with them in everyday life – this happens, for example, in the context of a cognitive behavioral therapy.

It is especially helpful to work through the causes and feelings behind the symptoms. If stressful feelings such as stress, worry or grief can be eliminated or processed differently, the physical symptoms usually improve in the long run. Many sufferers are also in a kind of “vicious circle of avoidance”. They always avoid situations in which their symptoms increase. Ultimately, they increase the suffering that comes with the vegetative dystonia. A psychotherapist can help break this behavior.

Physical activity has a positive influence on some somatoform disorders, such as sports or walks. Some people also benefit from relaxation exercises such as progressive muscle relaxation, autogenic training, tai chi or yoga.

Vegetative dystonia – drugs in therapy?

These measures often reduce the symptoms over time and thus help against the vegetative dystonia. Medication is not necessary in most cases, but it can be used to treat the symptoms if there is great suffering. These include, for example, painkillers, but also various modern antidepressants. The doctor discusses the procedure exactly with his patient and adjusts the medication individually to each case. As a rule, the vegetative dystonia is not permanently, but only temporarily treated with medication.

Vegetative dystonia: course and prognosis

How the vegetative dystonia works depends on various circumstances. In general, the prognosis is good, A vegetative dystonia does not limit life expectancy. In 50 to 75 percent of cases, somatoform disorders are mild and symptoms improve over time. In patients with a very anxious and negative view of their discomfort, severe avoidance behavior, and parallel mental illnesses (such as depression or anxiety disorders), the prognosis is worse. This also applies to strong psychosocial burdens that can not be resolved. It also appears to have a negative impact on the progression if the person leaves the profession for more than a month or withdraws from friends and family.

A “severe course” vegetative dystonia means that the symptoms become more severe over time and persist (chronic). However, this does not mean that the symptoms persist forever just because they can not be successfully treated at first. There is always the possibility that the vegetative dystonia developed backwards.