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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.A neurotic reaction characterized by chronic physical fatigue, listlessness, mental sluggishness, and, often, phobias.
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
| ICD-10 | F48.0 |
|---|---|
| ICD-9 | 300.5 |
Neurasthenia was a term first coined by George Miller Beard in 1869. Beard's definition of "neurasthenia" described a condition with symptoms of fatigue, anxiety, headache, impotence, neuralgia and depression.
Americans were supposed to be particularly prone to neurasthenia, which resulted in the nickname "Americanitis" (popularized by William James).
It was explained as being a result of exhaustion of the central nervous system's energy reserves, which Beard attributed to civilization. Physicians in the Beard school of thought associated neurasthenia with the stresses of urbanization and the pressures placed on the intellectual class by the increasingly competitive business environment. Typically, it was associated with upper class individuals in sedentary employment.
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 grasp of the
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." (Townsend, 1996).
In the late 1800s, 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. Virginia Woolf was known to have been forced to undergo rest cures, which she describes in her book On Being Ill. In literature, Charlotte Perkins Gilman's protagonist in The Yellow Wallpaper also rebels against her rest cure. 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.
In 1895, Sigmund Freud reviewed electrotherapy and declared it a "pretense treatment." He highlighted 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,". See also placebo effect.
Nevertheless, neurasthenia was a common diagnosis in World War I - for example, every one of the c.1700 officers processed through the Craiglockhart War Hospital was diagnosed with neurasthenia - but its use declined a decade later.
The modern view holds that the main problem with the neurasthenia diagnosis was that it attempted to group together a wide variety of cases. In recent years, Richard M. Fogoros has posited that perhaps "neurasthenia" was a word that could include some psychiatric conditions, but more importantly, many physiological conditions marginally more understood by the medical community, such as fibromyalgia, chronic fatigue syndrome, and various forms of dysautonomia. He emphasizes that the majority of patients who would have once been diagnosed with neurasthenia have conditions that are "real, honest-to-goodness physiologic (as opposed to psychologic) disorders... and while they can make anybody crazy, they are not caused by craziness." (see reference, below)
This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
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.)
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
العربيه (Arabic)
(الاسم) النوراستينيا : النهك العصبي
עברית (Hebrew)
n. - חולשת עצבים, נויראסתניה, מונח כללי, לא רפואי, לעייפות דאגה ואדישות
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