Neurasthenia: What It Is, Causes, Symptoms And Treatment


At some point in our lives all or most of us have felt tired, exhausted and saturated. It is likely that on some occasion our strength was no longer enough, and that our heads even ached due to fatigue.

Fortunately, this situation has been temporary for most of us and in a short time and perhaps with some rest we have been able to get out of it. Let us imagine, however, that we are in this state continuously: we have no strength at all, we cannot think, our head and back hurt, and we cannot even sleep. That is what happens to people who suffer from neurasthenia, a problem that we are going to talk about throughout this article.

Neurasthenia, also known as nervous exhaustion or nervous breakdown, is a psychological disorder characterized by chronic fatigue, physical and mental exhaustion, and a range of somatic symptoms. While neurasthenia was once a common diagnosis, it is now less frequently used in modern psychiatric classification systems. Nonetheless, it remains a relevant concept in understanding certain forms of mental and physical distress. In this article, we explore the symptoms, causes, and treatment options for neurasthenia.

What is neurasthenia?

The concept of neurasthenia refers to a type of disorder characterized by the presence of profound physical and mental exhaustion and weakness that occurs with minimal effort. This fatigue, which is the characteristic and most defining symptom of this disorder, tends to go hand in hand with an inability to relax and the presence of other possible symptoms.

Among them, alterations stand out such as the presence of irritability that usually leads to querulous behavior or even direct hostility, loss of appetite, problems falling and staying asleep, depersonalization or a feeling of strangeness towards oneself.

It is common for there to also be problems with concentration and mental slowing, as well as anxiety and multiple worries. Neurasthenia appears with a fundamentally depressive type of symptoms, appearing in addition to the above, sadness, high emotionality, anhedonia or inability to feel pleasure, explosions of crying and/or anger, passivity, apathy and sometimes hopelessness. Libido usually decreases greatly, and a drop in work performance and an increase in isolation is usually observed.

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Symptoms of Neurasthenia

It is possible that during this condition physiological alterations may appear, such as hypotension, fainting, various pains in the body (generally headaches) and gastrointestinal problems such as nausea, gas and burning after eating. Constipation and back pain are also common, and some authors included a possible hypersensitivity of the scalp among the possible symptoms.

It is a problem that, as such, is more common in adult men up to fifty years of age. However, it should be noted that medical syndromes such as fibromyalgia or chronic fatigue are heirs of this concept, and in these cases it is more common in women. Currently it would be classified as a type of somatoform disorder, since the main symptom is the great fatigue and low physical energy that those who suffer from it maintain.

Neurasthenia is associated with a variety of symptoms, which may vary in severity and duration. Common symptoms include:

  • Persistent fatigue and weakness, even after rest
  • Difficulty concentrating or thinking clearly
  • Irritability, anxiety, or mood swings
  • Sleep disturbances, such as insomnia or hypersomnia
  • Muscle aches, headaches, and other physical complaints
  • Digestive problems, such as nausea or indigestion
  • Sensitivity to light, noise, or other environmental stimuli
  • Reduced tolerance for stress or physical exertion

A concept currently out of use

This concept is currently out of use and it is currently more common to talk about it as a symptom than as a disorder itself, given that the set of symptoms it implies can usually be included in other disorders. However, the term neurasthenia also has its history, and at the time it was considered one of the main types of neurotic disorders.

It would be in 1880 when the American neurologist George Miller Beard would describe the neurasthenia syndrome at a clinical level (although the concept already existed previously) as an irritating weakness of probably functional causes.

In addition to this author, neurasthenia would be welcomed and investigated by currents such as psychoanalysis. Freud would go so far as to include it among the two main real neuroses, along with anxiety. It was considered during that time one of the main diagnostic categories, being the label that identified depression at that time.

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As time went by, however, the concept gradually lost popularity, to the point that in the DSM-II it disappeared from the set of disorders identified in it. Despite this, even today some highly popular diagnostic manuals such as the ICD-10 include it.

Causes of Neurasthenia

The causes of neurasthenia can be multiple, and different theories have different hypotheses about it. It is generally considered to have a psychogenic and functional origin, linked to the continued experience of a situation of suffering, discomfort and/or exhausting stress for the subject.

In the beginning it was considered a product of exhaustion generated due to high social demand, and over time the idea has been added to this consideration that one of the factors that generate its appearance is the presence of conflicts at an emotional level. In this sense, neurasthenia can occur in the context of depression or a disorder linked to anxiety (also including obsessive-type disorders).

Likewise, neurasthenia symptoms that appear in the context of a medical illness have also been identified, such as certain infections, drug poisoning or poisoning with toxic products, neurological diseases and some tumors. Dysfunctions in the immune systems or at a hormonal or metabolic level, such as hyper/hypothyroidism or diabetes, can also be contexts in which neurasthenia occurs. Finally, extreme hunger, anemia or the lack of sufficient rest on a daily basis are other possible motivators.

The exact causes of neurasthenia are not fully understood, but it is believed to result from a combination of biological, psychological, and environmental factors. Possible contributors to neurasthenia include:

  • Chronic stress or overwork: Prolonged exposure to stressful situations or excessive demands may deplete physical and mental resources, leading to exhaustion and burnout.
  • Genetic predisposition: Some individuals may have a genetic susceptibility to neurasthenia or related conditions, such as anxiety disorders or mood disorders.
  • Lifestyle factors: Poor sleep habits, inadequate nutrition, lack of exercise, and other lifestyle factors can contribute to fatigue and physical malaise.
  • Underlying medical conditions: Neurasthenia may co-occur with medical conditions such as chronic fatigue syndrome, fibromyalgia, or thyroid disorders, which can exacerbate symptoms of fatigue and weakness.
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Treatment of Neurasthenia

The treatment of neurasthenia depends largely on the causes of its appearance. In the case of those conditions that appear due to medical/biological causes, The treatment of this condition will depend largely on the disease that causes it: treating its origin will improve the person’s condition

In addition, from the field of pharmacology, people with neurasthenia can benefit from the use of benzodiazepines and/or antidepressants that help them reduce their level of discomfort in such a way that it is easier to make behavioral changes at a psychological level. Beliefs can be worked on. , expectations and self-demands that the person may be maintaining, with strategies such as cognitive restructuring to modify them.

Training in stress management and practicing pleasant activities and relaxation techniques can also be useful, as well as working on vital motivations.

Treatment for neurasthenia typically involves a multidisciplinary approach addressing both physical and psychological aspects of the condition. Common treatment strategies include:

  • Psychotherapy: Cognitive-behavioral therapy (CBT), mindfulness-based therapy, and stress management techniques can help individuals develop coping strategies, reduce anxiety, and improve resilience.
  • Medication: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), may be prescribed to alleviate symptoms of depression or anxiety.
  • Lifestyle modifications: Adopting healthy habits such as regular exercise, balanced nutrition, adequate sleep, and relaxation techniques can help manage stress and improve overall well-being.
  • Supportive interventions: Support groups, peer counseling, and social support networks can provide emotional validation, encouragement, and practical assistance to individuals coping with neurasthenia.

Neurasthenia is a complex and multifaceted condition characterized by chronic fatigue, physical discomfort, and psychological distress. While the diagnosis of neurasthenia is less common today, the symptoms and challenges associated with this condition are still relevant and may require comprehensive treatment and support. By understanding the symptoms, causes, and treatment options for neurasthenia, individuals and healthcare professionals can work together to address this condition and improve quality of life.