Nervous exhaustion

Neurasthenia is a term that was first used at least as early as 1829 to label a mechanical weakness of the nerves and would become a major diagnosis in North America during the late nineteenth and early twentieth centuries after neurologist George Miller Beard reintroduced the concept in 1869. Neurasthenia is a term that was first used at least as early as 1829 to label a mechanical weakness of the nerves and would become a major diagnosis in North America during the late nineteenth and early twentieth centuries after neurologist George Miller Beard reintroduced the concept in 1869. As a psychopathological term, the first to publish on neurasthenia was Michigan alienist E. H. Van Deusen of the Kalamazoo asylum in 1869, followed a few months later by New York neurologist George Beard, also in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, heart palpitations, high blood pressure, neuralgia, and depressed mood. Van Deusen associated the condition with farm wives made sick by isolation and a lack of engaging activity, while Beard connected the condition to busy society women and overworked businessmen. Neurasthenia is currently a diagnosis in the World Health Organization's International Classification of Diseases (and the Chinese Society of Psychiatry's Chinese Classification of Mental Disorders). However, it is no longer included as a diagnosis in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Americans were said to be particularly prone to neurasthenia, which resulted in the nickname 'Americanitis' (popularized by William James). Another, rarely used, term for neurasthenia is nervosism. 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 with stress suffered as a result of the increasingly competitive business environment. Typically, it was associated with upper class people and with professionals working in sedentary occupations, but really can apply to anyone who lives within the monetary system. 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 'infrequency of emissions' or the infrequent practice of the higher cultural correlate thereof. Later, Freud formulated that in cases of coitus interruptus as well as in cases of masturbation, there was 'an insufficient libidinal discharge' that had a poisoning effect on the organism, in other words, neurasthenia was the result of (auto‑)intoxication. Eventually he separated it from anxiety neurosis, though he believed that a combination of the two conditions existed in many cases. 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 men, 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 as Gilman herself did. 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. 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.'