Hysteria during school examinations.

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By Metron Siziba

Learners in primary and secondary schools sometimes experience hysteria attacks, forcing authorities to suspend lessons due to the students` violent behaviours. Without the involvement of parents and other stakeholders to find solutions, school authorities can find it difficult to handle the hysteric situation.

What exactly is hysteria?

Hysteria is a term often used to describe emotionally charged behaviour that seems excessive and out of control. It is at type of mental disorder in which a wide variety of sensory, motor, or psychic disturbances may occur. Cherry (2022) defines hysteria as a feature of some conditions that involve people experiencing physical symptoms that have a psychological cause. When someone responds in a way that seems disproportionately emotional for the situation, they are often described as being “hysterical.” In other words, hysteria can be defined as a feature of some conditions that involve people experiencing physical symptoms that have a psychological cause.

In schools, children discharge nervousness marked by excitability of the emotions. Hysterical fits are most usual in adolescent girls and young women. The attack may consist of jerking limbs with closed eyes and apparent unconsciousness, or a drop attack with no convulsions. To understand the effects Hysteria had on women and medical care, it is important to understand what exactly the condition entailed. Hysteria was classified by many different symptoms and behaviors. Basically, anything a woman did that wasn’t viewed as acceptable behavior was considered hysteria and needed treatment.

Symptoms of Hysteria

Symptoms that are considered characteristic of “hysteria” include blindness, emotional outbursts, hallucinations, histrionic behavior (being overly dramatic or excitable), increased suggestibility and loss of sensation. Additional symptoms often associated with being in a hysterical state have varied, but include: being in a sort of trance, developing amnesia, experiencing paralysis, fainting or passing out (syncope), having epileptic-like seizures, increased pain sensations and rigid or spasming muscles.

Diagnosis of Hysteria

In 1980, the American Psychological Association (APA) changed the diagnosis of “hysterical neurosis, conversion type” to “conversion disorder.” Today, someone might be diagnosed with different types of disorders that were historically known as hysteria, including dissociative and somatic disorders.

Dissociative Disorders

Dissociative disorders are psychological disorders that involve an interruption in aspects of consciousness, including those related to identity and memory. Disorders in this category include:

Dissociative amnesia, which involves forgetting personal information or not being able to recall certain events.

Dissociative fugue, which involves forgetting personal information, combined with changing physical locations and sometimes creating a new identity in the process.

Dissociative identity disorder, which involves having two or more distinct personalities, each with no memory of what the other has done.

Somatic Symptom Disorder in the DSM-5, symptoms that once existed under the broad umbrella of “hysteria” now fit under what is referred to as somatic symptom disorder. Somatic symptom disorder involves having a significant focus on physical symptoms such as weakness, pain, or shortness of breath. This preoccupation with symptoms results in significant distress and difficulties with normal functioning. With somatic symptom disorder, the person may or may not have a medical condition. It is important to note that the disorder does not involve faking an illness—whether the person is sick or not, they believe that they are ill.

Causes of Hysteria

When fear is fed with enough fuel it can become hysteria – excessive out-of-control fear that can be contagious, and obviously dangerous. A human exposed to a fire outbreak in a nightclub is an example of hysteria where the instinct for one’s own survival trumps the instinct to help others or flee, such that one loses control.

Over time, the theories about what causes hysteria have changed. Although they originally focused on the uterus, we now know that the causes of both dissociative and somatic disorders are often psychological in nature. Dissociative disorders are generally caused by experiencing some type of trauma. This might include being exposed to childhood abuse that is physical, sexual, or emotional. Being in a natural disaster or being involved in combat can also lead to a dissociative disorder. Somatic symptom disorder can also be a result of childhood abuse or parental neglect but is also sometimes caused by having extreme anxiety about bodily processes and illness combined with a low threshold for pain.

A phenomenon known as hysterical contagion, a form of social contagion, can also lead groups of people to experience symptoms often associated with hysteria. This phenomenon involves groups of individuals having symptoms of illness that are attributed to a physical or contagious source, but that, in reality, stem from social and psychological influences.

Management of Hysteria

Treating hysteria-like symptoms associated with dissociative and somatic symptoms disorders typically includes some type of psychotherapy. Common treatment approaches for these conditions include Cognitive behavioral therapy (CBT), supportive psychotherapy, Dialectical behavioral therapy (DBT), Eye movement desensitization and reprocessing (EMDR) and Mindfulness-based therapy. In some cases, medications may also be used to help reduce symptoms. For example, amitriptyline, selective serotonin reuptake inhibitors (SSRIs), and St. John’s wort are known for effectively treating somatic symptom disorder.

If someone becomes hysterical in a school setup, the primary focus should be of calming the person down. If it’s a bystander becoming hysterical, move them away from the patient so as not to upset them. The teacher needs to keep their voice down and instructions clear, patiently working with them to calm the person down. The patient and other learners who witnessed the attack should be referred for counselling. 

Copying With Hysteria

If you or a loved one experiences symptoms associated with hysteria—such as having emotional outbursts, losing sensation, or having hallucinations—seeking the help of a mental health professional is a good step.

In the meantime, here are a few tips to help you better cope:

Practice mindfulness- concentrate on the present instead of focusing on yesterday or tomorrow. This can help you stay grounded.

Engage in breathing exercises- relax your feelings of anxiety by breathing in and out in specific patterns.

Write in a journal- get your feelings out and on paper. Put the sources of your stress in black and white, and then let them go.

Get physically active- go for a walk or hike, or take your bike for a ride around the neighborhood. Physical activity helps boost mental health while promoting physical health at the same time.

Develop a consistent sleep schedule- give your body the rest it needs to help it better deal with the symptoms and emotions you are experiencing.

Metron Siziba is a Masters in Counselling Psychology student at Great Zimbabwe University.

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