Vegetovascular Dystonia In Children As Psychosomatics - Is It Normal Or Not?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The other day, I was asked to write a commentary regarding panic attacks in adolescents and their possible connection with suicide. After the publication, I wanted to reveal this topic in more detail, because in our time anxiety disorders make themselves felt more and more often, and often their roots go back to childhood and the notorious diagnosis of VSD. I have broken this article into 2 parts. The first is a light version that the VSD is not always something terrible, and how best to act so as not to form the position of "terminally ill" in the child. The second article is about what is important to know when there is more than a simple vegetative crisis behind the diagnosis of VSD.

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Diagnosis which is not … It does not matter how we formulate the diagnosis of VSD, so that it fits under the ICD - vegetative vascular dystonia, neurocirculatory dystonia, psychovegetative syndrome or even somatoform dysfunction of the autonomic nervous system, etc. What matters is what this diagnosis describes psychosomatic disorder - a disease that doesn't really exist … And as you probably guessed, since there is no disease here, it is impossible to cure it. At the same time, as with any psychosomatic disorder, symptoms experienced by the client-patient, in this case the child, absolutely real … Then the child who was diagnosed with a similar VSD falls into a vicious circle, and the task of the psychologist-psychotherapist is to open it.

What is happening and why … What we call "VSD" can manifest itself in different ways, and accordingly the reason will also be different. In some, the pressure drops sharply, in others it rises, unlike adults, children often have abdominal pain, and pain in the heart or neck may occur. Therefore, in order to find out for sure what is happening specifically with this child, you need to discuss specifically his symptoms. And of course we need to start with doctors, as you probably guessed - a cardiologist, orthopedist, gastroenterologist, endocrinologist and neurologist. When each of them makes his own diagnosis and realizes that there is no disease here, he will either explain what is happening and give recommendations for correcting his lifestyle, or diagnose VSD and prescribe symptomatic treatment or placebo drugs. And let's be honest, the second option is often chosen by the parents themselves. And again for a revelation - often this option works, because the psychosomatic symptom received attention, the care and care of which the child lacked, and went home.

But such a recipe does not always help and the thirst for attention is not always hidden behind the child's psychosomatics. Physiologically speaking, the symptoms that are called vegetative dystonia are often associated with:

- conditionally normal vegetative reactions - functional pain (in a growing body, the heart and blood vessels can develop unevenly, therefore, excessive activity or physical exertion can cause cardiac symptoms); hormonal changes in a growing body (which often happens in adolescents); constitutional features (it happened so, some have poor vision, and some have weak blood vessels, this cannot be changed, but can be corrected and controlled). By and large, in a constantly growing and developing organism, there are always some physical changes. Our brain can react to any of them as "danger", producing adrenaline or norepinephrine, and then the main thing is not to focus the child's attention on these symptoms, since soon the brain will recognize this new situation as normal and everything will calm down by itself.

- we will refer to more unnatural - the wrong way of life (let's start with a long sitting at the gadgets when the muscles are tense, the blood vessels are pinched, but the plot of the game excites and makes the heart pump blood stronger, we end up with a banal lack of oxygen and a violation of the sleep regime (the norm is 9-10 hours)); the consequences of other diseases (including when a child who is not strong after an illness enters the regime of heavy loads); various chemistry (both vapes and energy drinks, and chaotic vitaminization, well, about chips and soda, and so it is clear); dietary condition (both due to eating disorders and due to diets initiated by the idea of "something you began to get better, live without carbohydrates for now"); sports microtrauma or excessive stress on the developing spine, including prolonged sitting / standing; excessive intellectual load. Here we are already holding the situation, the brain reacts not to a novelty, but to constant physical stress, trying to mitigate it with the help of the production of the stress hormone cortisol. What are these hormones doing?

One way or another, in each of these stories there are 2 basic principles of self-regulation or self-defense of the body from stress (both physical, listed above, and mental, described below). These are adaptive reactions of the body that helped to survive in danger - having smelled a predator, you need to pretend to be dead (paralyzing fear - weakness, dizziness appears, sometimes "stomach is grabbed") or attack and attack (mobilizing fear - muscles tone up, heartbeat and breathing quicken, blood rushes). That is, in a situation that the brain perceives as a threat, our body releases hormones into the bloodstream, which either mobilize us to fight or become uninteresting. As soon as the brain realized that there is no real "danger" and everything is within the permissible limits - it produces another hormone and after a while the weakness and tremor go away, everything is restored. In general, both of these reactions are absolutely normal and the problem is more that the child is frightened of this very state, and then worries and listens to his body, expecting a repetition, which creates a new autonomic reaction (after all, anxiety = stress). But getting hung up on this situation is the subject of another article.

What to do with it all … As I already wrote, first of all, we are examined by specialized specialists in order to understand that we are dealing with VSD, i.e. a non-existent disease with real symptoms. Then we need to explain to the child what is happening to him and focus on the fact that this is not a disease or pathology, it is normal guard reaction organism, which does not always happen on time, but always very soon passes, if you do not fear. You can do the following with it:

During the crisis itself:

1. According to the hypotonic type (reaction to pretend to be "dead"), if possible, do everything that tones the vessels: take a contrast shower if the child is at home; walk arm in arm with someone (to the medical center, to the toilet, to the corridor, it doesn't matter, the movement itself revives), breathing deeply; if the child is in class, rub the palms or ears well, massage the neck and back of the head; eat something stored in advance and, if possible, drink strong tea or cola (it is harmful, but the most affordable for the child is caffeine + glucose); peel the orange (i.e. if we know that this happens to the child, the orange and the carbohydrate bar can be put in the pocket of the knapsack in advance).

2. According to the hypertensive type (reaction of rage "hit-and-run"), do what calms the heart: relax and take 10 long deep breaths with a pause on exhalation; wash your hands and face with cool water; think about something pleasant, switch attention from the situation that angered or discuss its solution with someone senior here and now; drink clean water and suck on the mint candy.

Remember that this is a hormone release reaction, so soon it will calm down by itselfunless supported by fear. Tremors and weakness are side effects, residual effects.

In general terms:

1. Revise the child's lifestyle and eliminate the existing gaps in sleep and rest, ventilate the premises well and give the opportunity to walk in any weather, making the vessels more resistant to physical changes.

2. Reconsider the mode of physical and intellectual activity, everything is good in moderation and each child has its own.

3. To organize a balanced diet, if necessary, in the diet, products should not be excluded, but replaced.

4. Eliminate chemistry (vape, energy) if it is present, including not taking any medication without indications, including psychostimulants and sedatives.

5. To teach to respond adequately to symptoms and not to discuss VSD as an incurable disease. The child is essentially healthy.

In terms of correction

Remember that VSD is a psychosomatic disorder and, in addition to physical factors, it will be precisely psychological … We often read on the net that the psychological cause of children's VSD is stress and conflict. Most parents start thinking globally, about major quarrels at school, about how someone at home yelling at a child, or maybe he was scared by a car / dog / dark staircase, etc. This can all be, but much more often it becomes a reason it is chronic stress - less noticeable, but more dangerous for the body. That is why we often cannot associate the symptoms of VSD with any specific event, and they appear on a regular basis, as if out of the blue.

Unlike adults, children are very sensitive to much greater subtleties of interaction with the outside world. Many things that are natural and normal for us look intimidating to children. Due to their little life experience and lack of information, they tend to come up with surprisingly strange explanations for various events. Therefore, for them stress can become not only what we clearly interpret as a load or threat, but also what they did not understand, mistakenly interpreted as bad, perceived as punishment, inadequately connected the situation and were afraid to discuss, exaggerated the meaning of our words or understood literally (after all, even jokes are perceived differently by children (!), not to mention the phrases "who will beat whom when he finds out"). Moreover, often children, due to emotional immaturity, may experience negativity, but do not know how to demonstrate it, how to indicate what they feel, how to say that it is not like it, when everyone around seems to be “good”, etc. …

That is, in fact, hundreds of situations can be stressful for them, which we do every day, but do not notice that something is wrong with them. A child psychologist will help to deal with this, and as is usually the case in working with child psychosomatics, the question of involving the family in therapy, and not just the child himself, will always arise. And often in order for change to occur to him, the parents must be the first to start changing. And this is important, because, as we have already discussed, there are no cures for VSD, but the child's physical suffering is real. If the situation is ignored and nothing is changed, over the years it turns into more complex psychological disorders.

What is the forecast for this whole story?

Will outgrow … For children and adolescents, many different dysfunctions are allowed due to physiological immaturity. Naturally, when the body grows, matures and fully forms, there will no longer be those physical stresses that provoked vegetative crises. Therefore, in an environment where physical stress is "over", and the child has dealt with psychological stress, has learned to cope and cope, we will forget about VSD very soon.

Will not outgrow … Not all children outgrow psychological distress. It depends on many factors, from heredity to unresolved psychological problems, trauma, etc. In the next article, we will discuss exactly the moment when "VSD" becomes a major psychological disorder and what is important for parents to pay attention to.