Neurosis is an older psychiatric term that was used to describe a range of mental health conditions characterised by excessive anxiety, emotional distress, or dysfunctional behaviours, without loss of contact with reality (as distinct from psychosis). The category included what are now separately classified as anxiety disorders, phobias, obsessive-compulsive disorder (OCD), and certain depressive and somatic conditions. The term neurosis was removed from the main classification systems (DSM and ICD) several decades ago in favour of more specific diagnostic categories, but it continues to appear in older medical literature and everyday conversation.
In modern psychiatry, the clinical presentations formerly grouped under neurosis are now diagnosed with more precise terms. Anxiety disorders include generalised anxiety disorder (GAD), panic disorder, social anxiety disorder, and specific phobias. OCD, health anxiety (illness anxiety disorder), and somatic symptom disorder are related but separately classified. Each has its own evidence-based treatment pathway, including psychological therapies such as CBT and, where indicated, medication.
After cardiac arrest, a number of mental health difficulties that would previously have been described as neurotic presentations are common. Survivors frequently experience anxiety about recurrence, health-related anxiety around physical symptoms, intrusive thoughts about the arrest, hypervigilance, and avoidance behaviours. These presentations may meet criteria for anxiety disorders, PTSD, or adjustment disorder, all of which respond to evidence-based psychological treatment.
If someone who has experienced cardiac arrest is struggling with persistent anxiety, worry, or fear that is interfering with daily life, they should speak to their GP or cardiac team. Referral to NHS Talking Therapies (formerly IAPT) or a cardiac psychology service can provide access to cognitive behavioural therapy (CBT) or EMDR.
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