Forest
Beloved Grand Eagle
I find it fascinating to learn about the various mindbody conditions. As I've read more, one condition that comes up periodically is Neurasthenia, and I've always been curious to learn more. I looked into it yesterday and thought I'd share what I found.
It looks like Neurasthenia was a diagnosis popularized by American doctor, George Beard, starting in the 1869. In the paper in which he coins the term, he explains that the word roots of the term imply having not enough "strength in the nerve." Specifically, the word roots in neur-a-sthenia are correspond to nerves-not-strong. He compares his term to the better known term a-nemia, meaning not enough blood, where the word roots correspond to no-blood. Comparing the two diagnoses, he writes, "The one means want of blood; the other, want of nervous force." I bring the word roots up because the idea of neurasthenia is that the actual physical nerves are "broken" in that they are underperforming.
Later, on the same page, he writes, "Both anemia and neurasthenia are most frequently met with in civilized, intellectual communities. They are part of the compensation for our progress and refinement." [Repressed rage, anyone?]
The original page can be found here:
http://www.nejm.org/doi/full/10.1056/NEJM186904290801301
In Beard's view, neurasthenia caused everything that today we might associate with a psychological or psychosomatic condition. Basically, he lumped all of these diagnoses together and explained it in terms of "exhausted nerves." The resulting diagnosis isn't far from TMS.
The diagnosis became quite fashionable among the elite in the US, during the go-go period as the US was just rising to power. A recent article in the New Yorker, referring to Beard's 1881 magnum opus, connected the circumstances during this period to the rapid rise to power of China, one of the few places where the diagnosis is still made:
In 1881, at the height of the American industrial revolution, New York doctor George Beard published “American Nervousness,” about the fraying effects of modern life. Every person was born with a limited supply of nervous energy, Beard wrote, and depleting it in the hustle of modern civilization led to “neurasthenia,” a mix of fatigue and confusion named after the Greek for “tired nerves.” Neurasthenia rapidly became a household word in America, a fashionable affliction that carried the air of sophistication and striving. Its famous sufferers included Theodore Roosevelt, Jane Addams, and William James, who popularized its nickname, “Americanitis.” In 1925, a doctor estimated that a quarter of a million people were dying before the age of fifty every year because of “the hurry, bustle and incessant drive of the American temperament.” The Rexall drug company patented “Americanitis Elixir” for the “man of business, weakened by the strain of your duties.”
Click on the picture to read
the label. It's pretty hilarious.Neurasthenia eventually lost favor among American psychiatrists—Sigmund Freud, among others, redirected the study of the mind toward the inner workings, not the outer pressures—and it was ultimately sidelined from American diagnostic manuals. But one of the only places in the world where Americanitis maintained a foothold well into the nineteen-nineties was China. It was an easy fit for China because it echoed traditional medical concepts of qi, the vital life force, and it allowed patients to avoid the stigma of mental illness by describing their symptoms as fatigue, headache, or other physical sensations. When Arthur Kleinman, the Harvard psychiatrist and China expert, studied a hospital in Hunan province in the early eighties—the first frantic moments of China’s economic rise—he found that the most common diagnosis at the hospital was none other than neurasthenia. China, in other words, had come down with an acute case of Americanitis.
These days, Americanitis has fallen out of use again; Chinese doctors are far more likely to apply more familiar diagnoses, such as depression and chronic fatigue syndrome.
the label. It's pretty hilarious.Neurasthenia eventually lost favor among American psychiatrists—Sigmund Freud, among others, redirected the study of the mind toward the inner workings, not the outer pressures—and it was ultimately sidelined from American diagnostic manuals. But one of the only places in the world where Americanitis maintained a foothold well into the nineteen-nineties was China. It was an easy fit for China because it echoed traditional medical concepts of qi, the vital life force, and it allowed patients to avoid the stigma of mental illness by describing their symptoms as fatigue, headache, or other physical sensations. When Arthur Kleinman, the Harvard psychiatrist and China expert, studied a hospital in Hunan province in the early eighties—the first frantic moments of China’s economic rise—he found that the most common diagnosis at the hospital was none other than neurasthenia. China, in other words, had come down with an acute case of Americanitis.
These days, Americanitis has fallen out of use again; Chinese doctors are far more likely to apply more familiar diagnoses, such as depression and chronic fatigue syndrome.
What fascinates me about the diagnosis is the way that it more or less disappeared in the early 20th century in the west. I'm fascinated by how that might have happened. For example, one of the main symptoms of neurasthenia was chronic fatigue. Did people just stop getting this symptom? What happened?
Any thoughts?
), Dr. Sarno also mentions neurasthenia before the clip you've quoted above. I can't remember exactly what he said, but he compared one of the modern day TMS epidemics (may have been fibromyalgia) to the epidemic of neurasthenia in the prior century. 