neurasthenia

Neurasthenia is a historical medical diagnosis describing a state of chronic mental and physical exhaustion. It featured fatigue, weakness, irritability, headaches, sleep disturbances, memory or concentration problems, and a general sense of debility that could not be explained by other illnesses. The term implies a depletion of “nerve energy,” a concept popular in late 19th-century neurology and psychiatry.

The diagnosis was popularized in the United States by George M. Beard in 1869 and spread to Europe. It was often linked to the stresses and changes of modern life—urbanization, industrial work, and intellectual demands—though its exact causes were debated. Some clinicians attributed neurasthenia to metabolic or nutritional factors, others to long-term psychological stress or constitutional weakness. It was treated with rest, improved diet, physical activity, and sometimes rest cures or spa-based therapies. Over time, many of the symptoms described would now be categorized under depression, anxiety disorders, or chronic fatigue-related syndromes.

In modern classification, neurasthenia is rarely diagnosed and is largely considered obsolete in many countries. The ICD-10 retains a neurasthenia entry (F48.0), though it is not widely used in contemporary practice. The DSM-5 does not recognize neurasthenia as a distinct disorder; similar symptom patterns are typically approached as mood or anxiety disorders, somatic symptom disorders, or, in some cases, chronic fatigue syndrome, depending on the clinical picture.

The term remains of historical interest for the fields of psychiatry and the social history of medicine, illustrating how cultural factors, medical theory, and concepts of “nervous energy” shaped the understanding of fatigue and distress in the modern era.