Neurasthenia: what it is, causes, symptoms and treatment

A disorder that causes almost inexplicable mental and physical exhaustion.

At some point in our lives all or most of us have felt tired, exhausted and saturated. It is likely that at some time our strength was exhausted, and that we even had a headache due to fatigue.

Fortunately, for most of us this situation has been 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 this state continuously: we have no strength at all, we cannot think, our head and back ache, and we cannot even sleep. This is what happens to people suffering from neurasthenia, a problem that we are going to talk about in this article..

What is neurasthenia?

The concept of neurasthenia refers to a type of disorder characterized by the presence of a profound physical and mental exhaustion and weakness and mental weakness that occurs at the slightest 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.

These include alterations such as the presence of irritability that often leads to querulous behavior or even direct hostility, loss of appetite, problems in falling and staying asleep, depersonalization or a feeling of strangeness towards oneself.

It is usual that in addition there are problems of concentration and mental slowing down, as well as anxiety and multiple worries. Neurasthenia appears with a fundamentally depressive clinical picture, appearing in addition to the above mentioned sadness, high emotionalityThe patient may suffer from anhedonia or inability to feel pleasure, outbursts of crying and/or anger, passivity, apathy and sometimes hopelessness. Libido is often greatly diminished, and decreased work performance and increased isolation are often observed.

Symptoms

It is possible that during this picture appear alterations at physiological level, such as hypotension, fainting, various pains in the body (usually headaches) and Gastrointestinal problems such as nausea, gas and heartburn after eating. Constipation and back pain are also common, and some authors have included a possible hypersensitivity of the scalp among the possible symptoms.

It is a problem that as such is more frequent 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 to 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 of those who suffer from it.

A concept currently in disuse

This concept is currently in disuse and nowadays it is more common to speak of it as a symptom than as a disorder in itself.The term "neurasthenia" is now in disuse and is more commonly used as a symptom than as a disorder in itself, since the set of symptoms it implies can usually be included in other disorders. However, the term neurasthenia also has its history, and was once 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 clinical level (although the concept already existed before) as an irritating weakness of probably functional causes.

In addition to this author, neurasthenia would be accepted and investigated by currents such as psychoanalysis. Freud would come to include it among the two main real neuroses, together with that of anguish. During that time it was considered one of the main diagnostic categories, being the label that at that time identified depression.

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

Causes

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 continuous experience of a situation of suffering, discomfort and/or stress that is exhausting for the subject.

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

Neurasthenia has also been identified in the context of a medical illness, such as certain infections, intoxication with drugs or toxic products, neurological diseases and some tumors. Dysfunctions in the immune systems or at the 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 daily rest are other possible causes.

Treatment

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

In addition, from the pharmacological point of view, 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 that it facilitates the realization of behavioral changes at a psychological level, beliefs, expectations and self-demands that the person may be maintaining can be worked on, with strategies such as cognitive restructuring to modify them.

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

Bibliographical 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-claves del pensamiento, 11 (22). Mexico.