Clinophilia (not getting out of bed): characteristics of the symptom and treatment

This symptom is frequent in mental disorders such as depression or bipolar disorder.

When we are sad and tired, as for example when we have a disappointment in love or when we are fired from a job, making the slightest effort can become a world to us. We may not feel like doing anything and even the only thing we do in the first moments is to lie in bed, whether we sleep or not, thinking or just letting time pass.

Generally this is something occasional, but sometimes this type of attitude is much more frequent than usual and even becomes a tendency. This tendency, typical of situations of high emotional discomfort and even medical or psychiatric disorders such as depression, has a specific name: we are talking about clinophilia.

Clinophilia: what is it?

It is understood as clinophilia to the excessive tendency on the part of a subject to remain encamado or lying down, often without desire or forces to make another activity beyond remainingoften without the desire or strength to perform any activity other than remaining in this position. Such permanence is not justified by the presence of an organic cause: i.e., the subject is not bedridden because he/she cannot biologically get up from it. Thus, behind it there is usually some kind of psychological disturbance or discomfort, being frequent the association with suffering.

Clinophilia is not a disorder in itself, but rather a behavioral manifestation that could be indicating the presence of one: i.e., it is a symptom of the existence of a disorder, we are before symptom of the existence of a problem.. It is usually associated with emotional discomfort that we do not know how to avoid.

Symptoms

In this sense and to a large extent, we can consider that clinophilia is associated with the feeling of learned helplessness: continuous exposure to a situation to which we have not found a way out makes us consider that our resources are not sufficient to cope with the aversive situation, inhibiting our action and acquiring a position of passivity in this regard.

Lying down or lying down prevents us from encountering the cause of our pain and allows us to be in a controlled and relatively safe place, in a way that exposure to the direct cause of the discomfort is prevented.. But on the other hand, it prevents us from resolving it, which in the long run tends to generate even greater discomfort.

While clinophilia itself is only this tendency to remain practically immobile and passive in bed, it is often accompanied by apathy, sadness, mental or physical fatigue, irritability and difficulties in finding beauty and pleasure in everyday life.

Depending on the case, crying may appearand it is also possible that a lack of sensitivity and emotion, such as emotional anesthesia, may appear. It is not infrequent that hypersomnia also appears due to the lack of activity, and/or that it is accompanied by nocturnal insomnia with lack of restful sleep.

In terms of consequences, in addition to enhancing the above, it is common to generate in the sufferer a certain feeling of guilt for the lack of action and a decrease in self-esteem.

At the social level, work problems may occur. (for example, unpunctuality or absenteeism), and at the social level can also generate conflicts with the environment (such as the partner or people who cohabit with the subject) and even isolation (both by the absence of desire on the part of the subject to relate to others and by a possible rejection of this attitude).

Causes and problems in which it usually appears.

Clinophilia is a passive attitude that usually occurs as a reaction to a stressful, traumatic or painful situation for the subject. This behavior does not necessarily derive from the suffering of a psychiatric disorder, but can appear as a result of living with a psychiatric disorder.It can appear due to the experience of phenomena such as those described in the introduction, the death of a loved one (it can appear in a mourning process), relationship problems or even the mere lack of vital objectives and self-realization.

In either case, what usually underlies it is a high level of suffering and emotional discomfort that saps the subject's energy.

As regards its occurrence in mental disorders, the disorders most closely linked to clinophilia are major depression and other depressive disorders, anxiety problems, bipolar disorder (in depressive phases) and psychosocial stress over a long period of time.

It is also possible its appearance after the experience of trauma or post-traumatic stress disorder (although in this case there is also (although in this case there is also hypervigilance and restlessness, so that the stay in bed is restless and tense), and in personality disorders such as depressive or borderline.

Another possible association is abulia and alogia in patients with cognitive impairment, as in psychotic patients with negative symptomatology.

However, it should be noted that clinophilia can be both a symptom of a disorder and a response to the diagnosis, course, prognosis, or difficulties generated by it. a response to the diagnosis, course, prognosis, or difficulties generated by the disorder (i.e. it is not the disorder that generates it but a reaction to some aspect of it). Likewise, it can also be a reaction to the diagnosis of medical illnesses such as cancer, HIV-AIDS, Diabetes or heart disease.

Treatment of this behavioral symptom

Treating clinophilia can be much more complicated than it seems. While the treatments may seem relatively simple, one must keep in mind the great suffering and discomfort the great suffering and discomfort caused by the patient being in such a state, understand it and respond to it.and the patient's suffering and discomfort must be understood and addressed. It should also be taken into account that the patient (or his or her environment) has had to overcome his or her resistance to action in order to come for consultation, something that should be valued and reinforced.

The first step would be to discover the reason why the person with clinophilia maintains this behavior, what he considers to be its cause, his emotions and thoughts regarding his lack of action and the interpretation he makes of it (as well as the functionality he can find in it). It is also necessary to assess whether there are disorders such as major depression or bipolar disorder in order to make an appropriate treatment (remember that clinophilia is a symptom of something, whether or not it is a mental disorder, and not a disorder in itself).

Once this is done, the fundamental step is to favor the subject's activation. Establishing psychoeducational guidelines is useful.It is also useful to program pleasant activities or small steps (more or less graduated according to the problem; if a dramatic change is demanded, the patient will probably not accept it) that the subject forces him/herself to do. For example, taking out the garbage or going for a walk around the block. By promoting an activation contrary to the emotional discomfort, the subject will gradually show some behavioral improvement, but this should not be the only thing to be carried out.

It is also necessary to work on the causes of their discomfort. An example in this sense can be found in Beck's cognitive therapy or in cognitive restructuring of the patient's beliefs and biases.. Work on self-esteem and self-concept is also necessary.

An important step is to favor the progressive empowerment of the person. To this end, we can try to remember similar moments that the subject has successfully overcome, explore his or her attitudes, actions and the consequences they had and analyze their applicability to the current case. It is also advisable to the presence of activities in which the subject presents a certain mastery and expertise.The person may be able to see him/herself as valid and capable.

Stress management training can help to become aware of different ways of coping with difficulties, as well as expressive therapies can help to give an outlet for the sufferer's internalized discomfort. In cases where there are sleep problems, appropriate treatment and sleep hygiene will also be required.