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 in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood.[footnotes 1] It is currently a diagnosis in the World Health Organization'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" (popularized by William James). Today, the condition is still commonly diagnosed in Asia.
The condition 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. In common with some other people of the time, he believed this condition to be due to "non-completed coitus" or the non-completion of the higher cultural correlate thereof or to arise "spontaneously due to the infrequency of emissions" or the infrequent practice of the higher cultural correlate thereof. Eventually he separated it from anxiety neurosis though he believed that a combination of the two conditions coexisted in many cases.
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."
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. 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.
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."
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. The ICD-10 system of the World Health Organization categorizes neurasthenia under "F48 - Other neurotic disorders".
Barbara Ehrenreich considers that neurasthenia was caused by the Calvinist gloom, and it was healed by the New Thought, through replacing the "puritanical 'demand for perpetual effort and self-examination to the point of self-loathing'" with a more hopeful faith.
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 sometimes used as a disguise for serious mental illnesses such as schizophrenia and mood disorders. In China the condition is known as shenjingshuairuo (the Japanese term shinkeisuijaku is written with the same kanji characters), 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.
- Combat stress reaction
- Placebo effect
- ^ Beard, G (1869). "Neurasthenia, or nervous exhaustion". The Boston Medical and Surgical Journal: 217–221.
- ^ 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.
- ^ 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.
- ^ Townsend, Kim (1996). Manhood at Harvard: William James and others. New York: W.W. Norton. ISBN 0-393-03939-0.
- ^ 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 (6): 550–557. doi:10.1192/bjp.179.6.550.
- ^ 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.
- ^ WHO (Version 2007). "Chapter V Mental and behavioural disorders (F00-F99)". http://apps.who.int/classifications/apps/icd/icd10online/index.htm?gf40.htm+. Retrieved 2009-10-09
- ^ 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.
- ^ a b c Jenni Murray, Smile or Die: How Positive Thinking Fooled America and the World by Barbara Ehrenreich. Jenni Murray salutes a long-overdue demolition of the suggestion that positive thinking is the answer to all our problems. The Observer, 10 January 2010 at guardian.co.uk.
- ^ a b Schwartz, Pamela Yew (September 2002). "Why is neurasthenia important in Asian cultures?". West. J. Med. 176 (4): 257–8. PMC 1071745. PMID 12208833. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1071745. Retrieved 2008-09-11.
- Brown, EM (1980). "An American Treatment for the 'American Nervousness'". American Association of the History of Medicine. http://bms.brown.edu/HistoryofPsychiatry/Beard.html. Retrieved 2008-09-11.
- Gijswijt-Hofstra, Marijke (2001). Cultures of Neurasthenia: From Beard to the First World War (Clio Medica 63) (Clio Medica). Rodopi Bv Editions. ISBN 90-420-0931-4.
- Gosling, F. G. Before Freud: Neurasthenia and the American Medical Community, 1870-1910. Urbana: University of Illinois Press, 1987.
- Weir Mitchell, S (1884). Fat and Blood: an essay on the treatment of certain types of Neurasthenia and hysteria. Philadelphia: J. D. Lippincott & Co.. http://www.gutenberg.org/files/16230/16230-h/16230-h.htm. Retrieved 2008-09-11.
- Farmer A, Jones I, Hillier J, Llewelyn M, Borysiewicz L, Smith A (October 1995). "Neuraesthenia revisited: ICD-10 and DSM-III-R psychiatric syndromes in chronic fatigue patients and comparison subjects". Br J Psychiatry 167 (4): 503–6. doi:10.1192/bjp.167.4.503. PMID 8829720. http://bjp.rcpsych.org/cgi/content/abstract/167/4/503.
Mental and behavioral disorders (F 290–319) Neurological/symptomaticOther Psychoactive substances, substance abuse, drug abuse and substance-related disorders Schizophrenia, schizotypal and delusional Psychosis Schizophrenia Mood (affective) Neurotic, stress-related and somatoformOther Physiological/physical behavioralNonorganic
- Postpartum depression
- Postnatal psychosis
Adult personality and behaviorOther Mental disorders diagnosed in childhood
- X-Linked mental retardation
- (Lujan-Fryns syndrome)
Symptoms and uncategorized
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Neurasthenia — Neu*ras the*ni a, n. [NL., fr. Gr. ney^ron nerve + ? weakness.] (Med.) A condition of nervous debility supposed to be dependent upon impairment in the functions of the spinal cord. [1913 Webster] … The Collaborative International Dictionary of English
neurasthenia — (n.) nervous exhaustion, 1854, medical Latin, from neur (form of NEURO (Cf. neuro ) before a vowel) + asthenia, from Gk. aisthesis feeling, from PIE root *au to perceive (see AUDIENCE (Cf. audience)). Related: Neurasthenic … Etymology dictionary
neurasthenia — [noor΄əs thē′nē ə, nyoor΄əs thē nē ə] n. [ModL: see NEURO & ASTHENIA] a former category of mental disorder, including such symptoms as irritability, fatigue, weakness, anxiety, and localized pains without apparent physical causes, thought to… … English World dictionary
neurasthenia — A nervous condition characterized by depression, worry, and pains having no apparent cause. Colorado Springs & I. R. Co. v Nichols, 41 Colo 272, 92 P 691. See traumatic neurasthenia … Ballentine's law dictionary
neurasthenia — noun Etymology: New Latin Date: circa 1856 a psychological disorder marked especially by easy fatigability and often by lack of motivation, feelings of inadequacy, and psychosomatic symptoms compare chronic fatigue syndrome • neurasthenic… … New Collegiate Dictionary
neurasthenia — /noor euhs thee nee euh, nyoor /, n. Psychiatry. (not in technical use) nervous debility and exhaustion occurring in the absence of objective causes or lesions; nervous exhaustion. [1855 60; NEUR + ASTHENIA] * * * … Universalium
neurasthenia — noun An ill defined medical condition characterized by lassitude, fatigue, headache, and irritability, associated chiefly with emotional disturbance … Wiktionary
neurasthenia — An ill defined condition, commonly accompanying or following depression, characterized by vague fatigue believed to be brought on by psychological factors. [neur + G. astheneia, weakness] angiopathic n., angioparalytic n. an obsolete term for a… … Medical dictionary
neurasthenia — Chronic lethargy … Bryson’s dictionary for writers and editors
neurasthenia — n. weakness or exhaustion of the nervous system; constant mental and physical weariness (Pathology)neuÂ·rasÂ·theÂ·niÂ·a || â€šnÊŠrÉ™s Î¸ÉªËnÉªÉ™ /â€šnjÊŠÉ™ … English contemporary dictionary