Neurasthenia

Neurasthenia is an old (19th Century) name for weakness of the physical nerves. It was first used in 1829 to be a mechanical weakness of the actual nerves. In 1869, an American neurologist, George Miller Beard, started using the term to mean metaphorical nerves, i.e., anxiousness, stress, or depression. In 1871, an American physician, S. Weir Mitchell, wrote the book, Wear and Tear, or Hints for the Overworked, detailing his belief that the condition was a result of the demands of modern life in the industrial era. The term began to transition out of use in medical pathophysiology to being used in psychopathology.

When used in psychology, the term describes a vague disorder marked by chronic abnormal fatigability, moderate depression, inability to concentrate, loss of appetite, insomnia, and other symptoms. The secondary symptoms were ill-defined and abundant, including headaches, muscle aches and pain, dizziness, weight loss, irritability, inability to relax, anxiety, impotence, “a lack of ambition,” lethargy, insomnia or hypersomnia, "racing heart", and excessive sweating.

It became a catch-all for nearly any kind of discomfort or unhappiness that couldn't be explained with a known medical condition. Since ME/CFS presents with similar symptoms, many patients with ME/CFS were given the psychological diagnosis of neurasthenia.

Simon Wessely has written about neurasthenia and ME. In the essay, Old wine in new bottles: neurasthenia and 'ME', he wrote: "'Evidence is presented of the striking  resonances  between neurasthenia and  ME. A simple explanation  is that  clinicians in  both  the  modern  and  Victorian  periods  are describing  a  similar  neurobiological  syndrome, of  excessive  fatigability:  supported  by  the  similarity   of   the   clinical   case   histories.    Current medical  research  into the relationship  of viruses to fatigue  states (Yousef et al. 1988), which  is of undeniable  importance,  may  therefore  be  seen as an  renewed  effort  to  solve a clinical  problem common  to  both  contemporary  and  nineteenth century medicine. Such work attempts to answer the  question  posed  by  Wechsler  (1930):  'The suspicion is justified that 'true' neurasthenia  is an   organic   disease  in  the   sense  that   as  yet undemonstrable   pathologic   changes   are   the cause  of  the  symptom  and  not  the  result  of psychogenic processes. How much truth there is in  such  a  view  only  further   studies  will  determine.' However, further  studies have failed to fully  answer  the  question,  and  will  continue  to fail as neither neurasthenia nor ME fits into such a  simple  medical  model.'"

The term, neurasthenia, has been retired as a diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, however, it is still used as a diagnosis in the 2016 version of the World Health Organization's International Classification of Diseases(ICD-10) under the diagnostic code F48.0.

Learn more

 * Wikipedia - Neurasthenia
 * 2016, ‘Americanitis’: The Disease of Living Too Fast