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neurasthenia

 
Dictionary: neu·ras·the·ni·a   (nʊr'əs-thē'nē-ə, nyʊr'-) pronunciation
n.
A psychological disorder characterized by chronic fatigue and weakness, loss of memory, and generalized aches and pains, formerly thought to result from exhaustion of the nervous system. No longer in scientific use.

neurasthenic neu'ras·then'ic (-thĕn'ĭk) adj. & n.
neurasthenically neu'ras·then'i·cal·ly adv.

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Dental Dictionary: neurasthenia
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(nyōō′rəsthē′nē ə)
n

A neurotic reaction characterized by chronic physical fatigue, listlessness, mental sluggishness, and, often, phobias.

 
Columbia Encyclopedia: neurasthenia
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neurasthenia (nyʊr'əsthē'nēa), condition characterized by general lassitude, irritability, lack of concentration, worry, and hypochondria. The term was introduced into psychiatry in 1869 by G. M. Beard, an American neurologist. Used by Freud to describe a fundamental disorder in mental functioning, the term was incorrectly applied to almost any psychoneurosis and has been largely abandoned.


Psychoanalysis: Neurasthenia
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The term neurasthenia was coined in English by the American psychiatrist George Beard (1839-1883) to describe an illness characterized by its etiology and its clinical manifestations; it appeared in Beard's Neurasthenia As a Cause of Inebriety (1879) and Sexual Neurasthenia (Nervous Exhaustion), Its Hygiene, Causes, Symptoms and Treatment (1884). Sigmund Freud retained the word, although he gave it a more limited meaning, and included it among the defense neuroses, alongside anxiety neurosis and, later, hypochondria.

In Beard's work, neurasthenia is characterized by the appearance, in subjects who had no family or personal history suggesting mental degeneration, and who, men and women alike, had previously lived the active life of "managers" peculiar to the feverish lifestyle of the New World, of a chronic symptomatology that was both somatic and mental. Somatic symptoms included fatigue that is not alleviated by rest, cephalgias with constriction, back pains, dyspepsia, flatulence, constipation, and dysurea; mental symptoms included insomnia, sadness, lack of interest, anhedonia, impoverishment of sexual activity that had previously been satisfying, and morosity. He attributed this neurasthenia to an excess of activity by those who, in the brutal world of business, must expend an excessive daily energy, and he thus contrasted it to the spleen and melancholia of idlers. As early as 1879, Beard stigmatized alcohol use as a fallacious remedy to this condition, and one that could lead to a secondary pathology.

In Freud's view, expressed in "On the Grounds for Detaching a Particular Syndrome from Neurasthenia under the Description 'Anxiety Neurosis,"' Beard's clinical description was too general and the etiology was imprecise, but it was appropriate to keep the term in medical terminology, on the condition that its semiology be restricted and its origins specified. He retained physical fatigue, somatic disorders, and the impoverishment of sexual life (in particular masturbation that fails to resolve libidinal tension) as neurasthenic symptoms, but he excluded chronic states of anxious expectation and acute anxiety attacks (some-times with a substantial somatic component), which he held to be typical of "anxiety neurosis." From an etiological point of view, neurasthenia is a defense neurosis whose symptomatology is not a symbolic and overdetermined expression, and whose etiology must be sought not in childhood conflicts, but rather in a present frustration.

Bibliography

Beard, George. (1879). Neurasthenia as a cause of inebriety. New York: E. B. Treat.

——. (1881). American nervousness: Its causes and consequences. New York: E. B. Treat.

——. (1884). Sexual neurasthenia (nervous exhaustion), its hygiene, causes, symptoms and treatment. New York: E. B. Treat.

Freud, Sigmund. (1895b [1894]). On the grounds for detaching a particular syndrome from neurasthenia under the description "anxiety neurosis." SE, 3: 85-115.

Pichot, Pierre. (1994). La neurasthénie. Encéphale, 20 (3), 540-550.

—GEORGES LANTÉRI-LAURA

Wikipedia: Neurasthenia
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Neurasthenia
Classification and external resources
ICD-10 F48.0
ICD-9 300.5
MeSH D009440

Neurasthenia is a psycho-pathological term first used by George Miller Beard[1] in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood.[footnotes 1][citation needed] It is currently a diagnosis in the World Health Organisation's International Classification of Diseases (and in the Chinese Classification of Mental Disorders, translated as 神经衰弱). However, it is no longer included as a diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

Americans were supposed to be particularly prone to neurasthenia, which resulted in the nickname "Americanitis"[2] (popularized by William James).

Contents

Symptoms

It was explained as being a result of exhaustion of the central nervous system's energy reserves, which Beard attributed to modern civilization. Physicians in the Beard school of thought associated neurasthenia with the stresses of urbanization and the stress suffered as a result of the increasingly competitive business environment. Typically, it was associated with upper class people or professionals with sedentary employment.

Freud included a variety of physical symptoms in this category, including fatigue, dyspepsia with flatulence, and indications of intra-cranial pressure and spinal irritation.[3] In common with some other people of the time, he believed this condition to be due to "excessive masturbation" or to arise "spontaneously from frequent emissions".[3] Eventually he separated it from anxiety neurosis though he believed that a combination of the two conditions coexisted in many cases.[3]

Treatment

Beard, with his partner A.D. Rockwell, advocated first electrotherapy and then increasingly experimental treatments for people with neurasthenia, a position that was controversial. An 1868 review posited that Beard's and Rockwell's knowledge of the scientific method was suspect and did not believe their claims to be warranted.

William James was diagnosed with neurasthenia, and was quoted as saying, "I take it that no man is educated who has never dallied with the thought of suicide."[4]

Diagnosis

From 1869, neurasthenia became a "popular" diagnosis, expanding to include such symptoms as weakness, dizziness and fainting, and a common treatment was the rest cure, especially for women, who were the gender primarily diagnosed with this condition at that time. Recent analysis, however, of data from this period gleaned from the Annual Reports of Queen Square Hospital, London, indicates that the diagnosis was more evenly balanced between the sexes than is commonly thought.[5] Virginia Woolf was known to have been forced to have rest cures, which she describes in her book On Being Ill. Charlotte Perkins Gilman's protagonist in The Yellow Wallpaper also suffers under the auspices of rest cure doctors, much like Gilman herself. Marcel Proust was said to suffer from neurasthenia. To capitalize on this epidemic, the Rexall drug company introduced a medication called 'Americanitis Elixir' which claimed to be a soother for any bouts related to Neurasthenia.

Skepticism

In 1895, Sigmund Freud reviewed electrotherapy and declared it a "pretense treatment". He emphasized the example of Elizabeth von R's note that "the stronger these were the more they seemed to push her own pains into the background."

Nevertheless, neurasthenia was a common diagnosis during World War I, but its use declined a decade later.[citation needed]

Contemporary opinion

This concept remained popular well into the 20th century, eventually coming to be seen as a behavioural rather than physical condition, with a diagnosis that excluded postviral syndromes. Neurasthenia has largely been abandoned as a medical diagnosis.[6] The ICD-10 system of the World Health Organization categorizes neurasthenia under "F48 - Other neurotic disorders".[7]

One contemporary opinion of neurasthenia is that it was actually dysautonomia, an "imbalance" of the autonomic nervous system.[8]

In Asia

Despite being omitted by the American Psychiatric Association's DSM in 1980, neurasthenia is listed in an appendix as the culture-bound syndrome shenjing shuairuo [神经衰弱] as well as appearing in the ICD-10. The condition is thought to persist in Asia as a culturally acceptable diagnosis that avoids the social stigma of a diagnosis of mental disorder. In Japan the condition is known as shinkeisuijaku, which translates as "nervousness or nervous disposition", and is treated with Morita therapy involving mandatory rest and isolation followed by progressively more difficult work and a resumption of a previous social role. The diagnosis is now being used as a disguise for serious mental illnesses such as schizophrenia and mood disorders. In China the condition is known as shenjingshuairuo (written with the same characters as shinkeisuijaku in Japanese), translated as "weakness of nerves", and is believed caused by a depletion of "qi" and is classified as a mental disorder diagnosed with three of five "'weakness' symptoms,'emotional' symptoms, 'excitement' symptoms, tension-induced pain, and sleep disturbances" not caused by other conditions.[9]

See also

Notes

  1. ^ The term had been used at least as early as 1829 to label a mechanical weakness of the actual nerves, rather than the more metaphorical "nerves" referred to by Beard in 1869.[citation needed]

References

  1. ^ Beard, G (1869). "Neurasthenia, or nervous exhaustion". The Boston Medical and Surgical Journal: 217–221. 
  2. ^ Marcus, G (1998-01-26). "One Step Back; Where Are the Elixirs of Yesteryear When We Hurt?". The New York Times. http://query.nytimes.com/gst/fullpage.html?res=9A05E1DB133BF935A15752C0A96E958260. Retrieved 2008-09-11. 
  3. ^ a b c Sandler, Joseph; Holder, Alex; Dare, Christopher; Dreher, Anna Ursula (1997). Freud's Models of the Mind. Karnac Books. p. 52. ISBN 1 85575 167 4. 
  4. ^ Townsend, Kim (1996). Manhood at Harvard: William James and others. New York: W.W. Norton. ISBN 0-393-03939-0. 
  5. ^ Taylor, Ruth E (2001). "Death of neurasthenia and its psychological reincarnation. A study of neurasthenia at the National Hospital for the Relief and Cure of the Paralysed and Epileptic, Queen Square, London, 1870-1932". British Jnl of Psychiatry 179: 550-557. 
  6. ^ Evangard B, Schacterie R.S., Komaroff A. L. (1999). "Chronic fatigue syndrome: new insights and old ignorance". Journal of Internal Medicine Nov;246 (5): 455–469. doi:10.1046/j.1365-2796.1999.00513.x. PMID 10583715. http://www3.interscience.wiley.com/cgi-bin/fulltext/119095441/PDFSTART. Retrieved 2009-06-25. 
  7. ^ Chapter V Mental and behavioural disorders (F00-F99), Version 2007, http://apps.who.int/classifications/apps/icd/icd10online/index.htm?gf40.htm+, retrieved 2009-10-09 
  8. ^ Fogoros, R (2006-05-29). "A family of misunderstood disorders". About.com. http://heartdisease.about.com/cs/womensissues/a/dysautonomia.htm. Retrieved 2008-09-11. 
  9. ^ Schwartz, Pamela Yew (September 2002). "Why is neurasthenia important in Asian cultures?". West. J. Med. 176 (4): 257–8. PMID 12208833. PMC 1071745. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1071745. Retrieved 2008-09-11. 

Further reading


Translations: Neurasthenia
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Dansk (Danish)
n. - neurasteni, nervesvækkelse

Nederlands (Dutch)
neurasthenie (zenuwzwakte)

Français (French)
n. - neurasthénie

Deutsch (German)
n. - Neurasthenie, Nervenschwäche

Ελληνική (Greek)
n. - (παθολ.) νευρασθένεια

Italiano (Italian)
nevrastenia

Português (Portuguese)
n. - neurastenia (f) (Med.)

Русский (Russian)
неврастения

Español (Spanish)
n. - neurastenia

Svenska (Swedish)
n. - nervklenhet, neurasteni

中文(简体)(Chinese (Simplified))
神经衰弱症

中文(繁體)(Chinese (Traditional))
n. - 神經衰弱症

한국어 (Korean)
n. - 신경쇠약(증)

日本語 (Japanese)
n. - 神経衰弱

العربيه (Arabic)
‏(الاسم) النوراستينيا : النهك العصبي‏

עברית (Hebrew)
n. - ‮חולשת עצבים, נויראסתניה, מונח כללי, לא רפואי, לעייפות דאגה ואדישות‬


 
 

 

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Psychoanalysis. International Dictionary of Psychoanalysis. Copyright © 2005 by The Gale Group, Inc. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Neurasthenia" Read more
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