What is Neurasthenia?

George Miller Beard was an American neurologist in the 19th century and developed the term neurasthenia in the 1860s. By this term, Beard hoped to provide a descriptive diagnosis of a vague and shadowy condition that could include a variety of symptoms, which were thought due to failure or tiredness of the central nervous system. These included things like pain, numbness, stomach upset, anxiety, depression, fatigue, and even sighing for no reason.

As a diagnosis in Western medicine, neurasthenia has faded out of popularity, and it is no longer used, though it is still a common diagnosis in parts of Asia. In most cases in places like the US, many other diagnoses may take its place depending upon the predominant symptoms, and many of these diagnoses are mental conditions. Alternatively, conditions like chronic fatigue syndrome, which is caused by the Epstein Barr virus, might have been the likely cause of some cases of neurasthenia.

There were many treatments advocated for curing neurasthenia, and a number of them were awful to endure. They included electroshock therapy, which was not at all like the modern methods employed. People were conscious and spasms caused by electrical currents running through the brain were extremely painful.

Another common cure, especially as the diagnosis became popular in the late 19th century, was the rest cure which involved being restrained in bed for the first few weeks and isolated from all family for up to two months. This was often forced on people and women were most likely to undergo it. Power to a demand a rest cure could be abused — any husband could suggest his wife was ill and needed it for neurasthenia or conditions like “hysteria.”

The diagnosis of neurasthenia remained a common one up until shortly after World War I. Advances in medicine created better understanding of mental illness and diseases of the central nervous system, and other diagnoses supplanted it. In truth, diversity of symptoms made it difficult to treat. While electroshock therapy could potentially alleviate depression, it did nothing for pain or numbness that might have other causes. More specificity was required because different treatments were needed to address varying symptoms.

There are countries where neurasthenia is still used as a diagnosis. It is sometimes used in Asia, especially when there are mental disorder symptoms present. Strong stigma exists about mental illness in some Asian cultures, and being diagnosed with neurasthenia avoids this stigma. In some ways the continued use of the term is unfortunate because it can overlook severe mental illness that could be treated with available medicines and/or with therapy.