What exactly is collective dysthymia? First of all, we know that dysthymia refers to a psychiatric disorder dominated by dissociative symptoms (partial or complete loss of self-identification and memory of the past) and conversion symptoms (unpleasant moods that arise during encounters with unresolvable problems and conflicts that appear as transformations into somatic symptoms) that have no verifiable organic pathological basis. The disorder has a hysterical personality basis, and its onset is often influenced by psychological, environmental, and social factors. Collective dysthymia has been described by psychologists as a “dysthymic epidemic” or “dysthymic contagion,” in which one person has an episode and others around him or her witness the episode, followed by the same or similar episodes, often with predominantly somatic conversion symptoms. So why is there an epidemic or contagion of dysthymia? Unlike individual dysthymia, which mostly has a hysterical personality basis, collective dysthymia has a stronger environmental component, but a common feature of both is that they are highly suggestive. Collective hysteria usually occurs in the same environment, in a group of the same nature, such as students, the military, they live together, have the same psychological state, the same age and cultural background, and are very close to each other, so when a person develops, due to the mutual influence between individuals, that kind of fear is infected with each other, passing, thinking that “he/she I will faint too if I have the same injection/medication as him/her”, so other people will have the same or similar reactions, one person will be nauseous and other people will be nauseous, one person will have chest tightness and other people will have chest tightness, etc., and one person will follow the other, which is actually caused by mutual suggestion, an unconscious imitation formed under suggestion, so the symptoms of collective hysteria are very similar. The symptoms are very similar. Of course, this imitation is not intentional, but the patient himself is not aware of it. In addition, in addition to imitation, when a person has an attack due to a certain drug or injection, the fear of others will also lead to sympathetic excitement, i.e., increased heartbeat, shortness of breath, and increased carbon dioxide exhalation, resulting in dizziness, chest tightness, tingling of the hands and feet, and even limb cramps, which are also common manifestations of mass hysteria. Although mass hysteria is easily contagious, not everyone will develop it. What kind of people are more likely to be contagious? Psychologists believe that feelings of tension and loneliness make people more susceptible to mass hysteria. The cases mentioned above occur mostly among students, because the pressure of studying is often high and the competition is strong, and students are often in a state of tension, competing with each other and coming from only-child families, so students often feel lonely. The more anxious and sensitive or lonely introverts in a group are more likely to pay attention to the abnormal reactions of others, and more likely to attribute the cause to factors related to their own factors, and then consciously look for similar feelings in themselves, that is, gradually fall into the “disease” state. Another example is the girls’ high school in Mexico, which is rumored to have a very strict management model, such as only seeing parents twice a year and not being able to answer letters from parents, which causes a lot of psychological pressure on students and puts them in a state of tension and anxiety for a long time. When they cannot bear this pressure, they will show hysteria. Because being sick somehow means that they can temporarily escape the strict school administration, receive special care, and see their parents. How can we treat a mass hysteria attack? First of all, it is important to identify the presence of organic pathology. When organic lesions are ruled out, then the treatment of dysthymia should be implemented. The treatment of collective hysteria is based on the principle of comprehensive treatment, including environmental therapy, psychotherapy, suggestive therapy and medication, etc. In case of students’ illness, the cooperation of parents should also be obtained. Environmental treatment: Patients should first be removed from the environment where they first developed the disease and isolated from other individuals who did not develop the disease and the individuals who developed the disease should be treated separately in isolation. This can avoid the patient to continue to receive the influence and suggestion of the onset environment, and can also avoid other people to be influenced by the patient or imitate the patient to continue to develop the disease, and can also avoid the patient to influence and imitate each other, because some patients may continue or aggravate the symptoms, while some individuals after isolation because there is no influence of the next onset individual, can quickly quiet down, after the suggestion of treatment symptoms may quickly disappear The symptoms may disappear quickly after suggestion therapy. Psychotherapy: The onset of collective hysteria is often related to the patient’s long-term accumulation of bad emotions that cannot be vented, and when it accumulates to the extreme, hysteria may break out. Therefore, communication and conversation should be used to help patients to vent their discontent or tension. Once the strong emotions can be released in a verbal way, the physical symptoms will be reduced or even disappear. Group psychotherapy can also be carried out after the disappearance of symptoms, using circular questioning, perturbative questioning, cognitive apprehension therapy, relaxation training and other methods of treatment. Suggestion therapy: verbal suggestion is often used, that is, telling the patient that good results will be achieved after treatment, and it can also be combined with acupuncture, intramuscular injection with injectable water or intravenous injection of 10% calcium gluconate, etc. Drug therapy: For patients with emotional outburst or spastic seizures, suggestion therapy is generally not appropriate. Diazepam 5-10mg or Fenazepam 5mg intramuscular injection can be given to relieve the symptoms through its sedative-hypnotic and muscle relaxing effects. Other treatments: For patients with syncope or mydriasis, acupuncture treatment at Renzhong, Hegu, Neiguan and Yongquan acupoints can be used. Patients with hysterical paralysis, contractures, and aphasia can also be treated with direct current induction excitation methods. Prevention of collective hysteria. As already mentioned, the onset of collective hysteria is related to the long-term tension and loneliness of the person concerned, but also to the long-term common life between a group and the same psychological and cultural background. Therefore, an overall relatively relaxed and pleasant environment should be created to reduce the tension and anxiety of each individual in the environment as much as possible. Secondly, expression, communication and exchange should be encouraged to reduce the feeling of isolation, and at the same time, individuals can develop a cheerful personality. Individuals should learn to reject things they do not like and interact with cheerful and optimistic people. Finally, individualization and differentiation should be encouraged, allowing individuals in the group to play different personalities without repression and to engage in different activities and hobbies, so that they can avoid being in a highly uniform psychological state and environmental background, and so that the onset of group hysteria can be avoided.