At some point in our lives all or most of us have felt tired, exhausted and saturated. It is likely that at some point our strength was not enough, and we even had a headache from the fatigue.

Fortunately, this situation has been for the majority something temporary 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 such a state on a continuous basis: we have no strength at all, we cannot think, our head and back hurt and we cannot even sleep. This is what happens to people who suffer from neurasthenia, a problem we will talk about throughout this article .

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What is neurasthenia?

The concept of neurasthenia refers to a type of disorder characterized by the presence of deep exhaustion and physical and mental weakness that occurs at minimal exertion. 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 are alterations such as the presence of an irritability that often leads to kerulant behavior or even direct hostility, loss of appetite, problems in falling and staying asleep, depersonalization or a feeling of strangeness to oneself.

It is also common to have problems with concentration and mental slowness, as well as anxiety and multiple worries. Neurasthenia appears with a fundamentally depressive clinical type, 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 despair. Libido tends to decrease greatly, and a decrease in work performance and an increase in isolation are usually observed.

Symptoms

It is possible that during this picture, alterations at a physiological level 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, back pain and possible scalp hypersensitivity are also common and some authors included them among the possible symptoms.

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

A concept currently in disuse

This concept is currently in disuse and it is more common to talk about it as a symptom than as a disorder in itself , given that the set of symptoms it involves 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 before) 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 include it among the two main real neuroses, together with that of anguish. It was considered one of the main diagnostic categories at that time, being the label that identified depression.

Over time, however, the concept gradually lost popularity, to the point that in 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

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

In the beginning it was considered a product of the exhaustion generated by the high social demand, and with time the idea has been added 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 a depression or an anxiety-related disorder (also including obsessive-type disorders).

Likewise, pictures of neurasthenia have also been identified that appear in a context of medical illness, such as certain infections, drug or toxic product intoxications, 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 lack of sufficient rest on a daily basis are other possible causes.

Treatment

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

In addition, from the field of pharmacology, people with neurasthenia can benefit from the use of benzodiazepines and/or antidepressants that help them to reduce their level of discomfort in such a way as to facilitate behavioural changes at a psychological level.

Training in stress management and the practice of enjoyable activities and relaxation techniques, as well as working on life motivations, can also be helpful.

Bibliographic references:

  • Arias Parra, G. (1957). Current concept of neurasthenia. Lecture given at “Seminario Médico”. Jaén, Spain.

  • Beard, G.M. (1889). A Practical Treatise on Nervous Exhaustion (Neurasthenia). Its Symptoms, Nature, Sequences, Treatment. New York: E. B. Treat.

  • Martínez Jiménez, M. (2017). Neurasthenia and fibromyalgia: the link between the nervous system and culture in complex clinical entities. En-keys of thought, 11 (22). Mexico.