Everything about Neurasthenia totally explained
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Neurasthenia was first used by
George Miller Beard in
1869 to label 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).
Symptoms
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.
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 grasp of the
scientific method was suspect and didn't 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." (Townsend, 1996).
Diagnosis
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.
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 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.
Today
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
irritable bowel syndrome, that according to Fogoros have one factor in common:
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're not caused by craziness." (see reference, below)
Further Information
Get more info on 'Neurasthenia'.
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