Neurosis (plural: neuroses) is a non-clinical term describing a spectrum of mental disorders that cause significant anxiety or distressing emotional symptoms. These include irrational fears, obsessive thoughts, compulsive acts, or dissociation (disconnection from yourself or the world around you).
Neurosis is not a clinical diagnosis and is no longer included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is largely viewed as an exaggerated, unconscious response to internal conflicts and the anxiety they cause. Most of the disorders that used to be called “neuroses” are now regarded as anxiety disorders, which are included in the DSM-5.
This article describes where the term “neurosis” came from and what it means today. It also explains how neurosis differs from anxiety disorders and psychosis, and how the condition may be treated.
What Are Neuroses?
The term “neurosis” can be confusing because its meaning has changed over the years. In Freudian psychology of the early 20th century, neurosis was used to describe mental disorders triggered by past anxieties that were repressed.
In the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-1) issued in 1952, the condition was referred to as “psychoneurosis” in which a person might experience anxiety, dissociation, phobia, obsessive or compulsive behaviors, and reactive depression.
By the release of the DSM-3 in 1980, the term was abandoned, and a new term, “anxiety disorders,” was used to house many of these mental disorders.
Today, neurosis is no longer considered a clinical diagnosis.
Types of Neurotic Behaviors
Neurosis can be applied to any number of behaviors that are characterized by anxiety and excessive emotional distress. The behaviors are often seen to be exaggerated or disproportionate.
Examples of neurotic behaviors include:
- Anxiety and apprehension
- Excessive worry and guilt
- A tendency toward more negative emotions and reactions
- Irritability and anger
- Low self-esteem and self-consciousness
- Poor response to stress
- An interpretation of everyday situations as threatening
- Emotional instability
While research in this area is lacking, one study in Xi’an, China reported that the estimated lifetime prevalence (the total number of people in a population who have a disease over a lifetime) of 10.8% for any neurotic disorder. Specific phobias (5.7%), obsessive-compulsive disorders (3.8%), and social phobias (1.3%) were among the most prevalent subtypes.
Neurosis and Mental Health
Although neurosis is not a clinical diagnosis, it infers distress. This is important to note because a great many mental disorders are characterized by distress that negatively impacts a person’s relationships and quality of life.
As such, being called “neurotic” and having neurosis can mean entirely different things. If your neurotic behaviors are undermining your well-being and quality of life, you may have an anxiety disorder that would benefit from treatment.
Neurosis broadly refers to a spectrum of mental disorders, most of which fall under the umbrella of anxiety disorders. The distinction is important because there are specific guidelines for the treatment of anxiety disorders, but not for neurosis.
While anxiety is a normal reaction to everyday stress, an anxiety disorder involves excessive fear or anxiety that a person cannot control.
Examples of anxiety disorders include:
In the same way that there is a difference between having a neurosis and “being neurotic,” there is a difference between having psychosis and “being psychotic.” One term infers a mental disorder, while the other is used in everyday language to describe unusual behaviors.
Neurosis and psychosis differ in severely different ways. Chief among these is the fact that neurosis is an unofficial term, while psychosis is an official term included in the DSM-5.
In the DSM-5, psychosis occurs when a person cannot tell what is real and what is not, often manifesting with hallucinations and delusions. Psychosis can occur with many mental illnesses such as schizophrenia, bipolar disorder, and severe depression as well as with sleep deprivation, major trauma, and drugs such as alcohol, hallucinogens, and stimulants.
By contrast, a person with neurosis knows what is real even though they may have the inability to control their behavior.
Neurosis as Personality Trait
The terms “neurosis” and “neuroticism” are sometimes used synonymously, but there are subtle differences in their definitions.
Neuroticism describes the state of being prone to neuroses. As such, it is regarded as a personality trait, while neurosis infers the presence of a mental disorder.
In psychology theory, neuroticism is classified as one of the Big Five personality traits alongside conscientiousness, agreeableness, extraversion, and openness. The theory, first established during the 1980s, suggests that all personalities are comprised of the absence or presence of these five traits.
Neuroticism can manifest with the following personality traits:
- Constantly needing reassurance (even on small matters and things you’ve previously validated)
- Being overly dependent on others or codependent in relationships
- Making their dissatisfaction well-known to you
- Conflicts with others due to a lack of emotional resilience or ability to bounce back
- Perfectionist tendencies or obsessing about getting things right
- Flying off the handle whenever you try to have a serious conversation
Even though these behaviors are characteristic of neuroticism, they don’t necessarily mean that someone has neurosis or an anxiety disorder.
Left untreated, neurosis can grow into bigger health concerns for you and your relationships. This is because being neurotic takes a toll on your mental health and ability to function in everyday life.
Physical complications over time may include:
Neurosis can also lead to other health complications, including:
- Marital dissatisfaction
- Decreased work performance
- Increased vulnerability to eating disorders, mood disorders, and substance use disorders
Researchers have identified factors that are believed to contribute to neuroticism. They may do so on their own or work in tandem to undermine a person’s emotional stability.
Having a family history of neuroticism increases your risk of the same. Family and twins studies suggest that neuroticism as a personality trait is linked to specific genetic variations in 48% of cases. Many of these genetic variations are also seen in people with anxiety disorders and specific phobias.
A 2015 review of studies suggests that environment also contributes to neuroticism. This is evidenced by twins studies in which nonshared environments (such as classrooms or workplaces where the twins are separated) can cause stresses that manifest with neuroticism in one twin but not the other.
Within these nonshared environments, an individual might experience interpersonal stress, conflict, or major events that are typically undesirable, unpredictable, or occur earlier in life than expected (such as becoming a teenage mother).
Neuroticism is thought to be linked to experiences that suddenly and unexpectedly disrupt a person’s sense of identity and status. Examples include changes in relationship status (marriage vs. divorce) or work status (promotion vs. job loss).
If neurotic behavior is becoming a problem, talk to your healthcare provider. The provider will likely conduct a physical exam and lab work to determine if the cause of your symptoms is physical.
In the absence of a physical cause, you may be referred to a mental health professional to determine if you have a mental health disorder. This is one in which behaviors are causing you severe distress and relationship issues.
If your neurosis stems from an underlying mental health disorder, one or several treatments may be prescribed.
A physician or psychiatrist can prescribe medications when needed to reduce symptoms of neuroticism, associated with disorders like anxiety disorders or depression. These include:
- Anti-anxiety medications: These work to reduce anxiety and associated symptoms like nervousness or restlessness. One commonly prescribed drug is benzodiazepine, which is fast-acting but can lead to addiction if overused.
- Antidepressants. Drugs like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can be used to manage symptoms of depression.
Various forms of talk therapy, including cognitive behavioral therapy (CBT), can help address negative thought patterns and help a person change those behaviors to better cope with stress. CBT can also help you identify neurotic behaviors and how those behaviors are contributing to other problems at home or work.
Coping with your own neurotic behaviors can be tiring. Practicing self-awareness and recognizing what can trigger those behaviors are essential to managing neuroticism.
You can do this by:
- Keeping a journal: Journaling helps you better articulate and organize your thoughts whenever you are stressed. It may also help you identify triggers (including people, places, or events) that trigger stress so that you can avoid them.
- Getting ample sleep: Anxiety can lead to irregular sleep patterns that, in turn, contribute to sleep deprivation and daytime anxiety. By improving your sleep hygiene (with regular sleep hours and other practices), you can better manage stresses that contribute to neuroticism.
- Practicing deep breathing: Deep breathing exercises used in yoga help relieve stress by focusing your concentration on breathing patterns rather than succumbing to racing thoughts that arise from anxiety.
- Using a meditation or sleep story app: These can help guide you through stressful times and promote better sleep. Use apps that let you track mindfulness, write notes, or document moods so that you can see your progress over time.
Neurosis is a historical, non-clinical term that describes certain mental disorders that cause persistent anxiety or emotional distress symptoms, including compulsive acts, obsessive thoughts, irrational fears, and dissociation. Most of these mental disorders are today classified as anxiety disorders, which can be diagnosed and treated.
Neuroticism is not a mental disorder but a personality trait. It’s characterized by obsessive thinking and anxiety. You can’t really cure a personality trait, but you can learn to manage it by becoming aware of what triggers your behavior, such as high-stress environments.