Asthenia: what is it and what symptoms does it produce?

Persistent fatigue that never seems to leave us. Why does it happen?

At one time or another, we have all felt a lack of energy.. Not wanting anything except to lie down and rest, exhausted. We feel weak and almost unable to move, needing a break.

This feeling of fatigue will probably pass after a while, after a period of rest. However, due to multiple causes, sometimes this sensation resists to subside and is prolonged in time. This would be a case of asthenia..

Defining the concept of asthenia

We call asthenia to a condition in which there is a reduction in the level of energy a reduction in the level of energy and force in the organism, diminishing also the motivation and producing a sensation of exhaustion. and producing a feeling of exhaustion both physically and mentally.

Although pathologies such as spring asthenia are well known, asthenia is generally catalogued as a symptom, since it is an indicator of a deeper process that causes it, regardless of its etiology.

This alteration may be accompanied by attention and concentration difficulties, sleep and memory disturbances, loss of appetite and sexual desire, bradykinesia or slowness in movement, dizziness, emotional lability, depressive symptoms and even, depending on its cause, it is possible to experience alterations such as fever and hallucinations. In some cases it may cause loss of consciousness, changes in vision or difficulty in speech, in which case medical services should be sought promptly, as it may be a symptom of a serious organic disorder.

This exhaustion produces a series of complications in the life of the person who suffers it.This can affect your life in different areas of life by reducing the amount of behaviors performed and your mood.

Etiology or causes of asthenia

As we have mentioned, asthenia is usually catalogued as a symptom of a medical process or a mental state.There are multiple possible causes for its appearance. Generally speaking, it is observed that together with asthenia there tends to appear a decrease or alteration in the immune system, so that this is considered as a possible explanation of the symptoms.

On a medical level it can be caused by the presence of allergies and autoimmune problems (as for example in the case of spring asthenia or in some cases of patients with HIV). It is also frequent in infectious processes, in the absence of sufficient nutrients in the body as in the case of anemia, as well as in neurological disorders, tumor processes and even as a reaction or side effect of some medications such as benzodiazepines and tranquilizers or antihistamines). Metabolic disorders such as Diabetes mellitus can also cause episodes of asthenia.

In more than half of the cases asthenia is due to purely psychological causes.

This is known as psychogenic or functional asthenia, it often appears in the presence of continuous stress, such as that suffered by burnout patients.such as that suffered by subjects with burnout or in times of exam preparation in the case of students. In these cases the asthenic episode worsens in the mornings, generally appearing together with problems of conciliation or maintenance of sleep. It also appears in cases of dysregulation of circadian rhythms such as that produced by jet lag. Finally, this symptom appears in a large number of disorders that produce emotional exhaustion, being frequently visible in cases of depression, anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorders.

On a more normative level, asthenia is also frequent due to aging, pregnancy or an excessively sedentary lifestyle.

Brain mechanisms involved

Although the specific causes of asthenia can be, as we have seen, many and varied, at the cerebral level, the presence of alterations in the system that governs wakefulness is discussed.the reticular activating system or RAS, located in the brainstem.

These alterations are based on the non-activation of this center, which cause a feeling of tiredness both physically and mentally. In this aspect, the existence of a problem at the level of noradrenaline production in the locus coeruleus or its transmission is suggested.

Treatment

Asthenia is treated at a general level starting from the resolution of the specific cause that has provoked it, there is generally no treatment.In general, there is no specific treatment for this problem.

However, it is very useful to do physical exercise, which, let us remember, helps to reduce stress and to relax, as well as to generate endorphins endogenously.

Cognitive behavioral therapy is also successful in the treatment of asthenia, especially if it occurs chronically, helping to de-dramatize present problems, improve cognitions and behaviors that may influence the onset of asthenia and presenting techniques and planning activities so that the patient is able to better manage stress and present optimal functioning in day-to-day life.

At the pharmacological level, antidepressants or anxiolytics have been used on occasion, as well as multivitamin preparations to increase the level of energy. A drug that is also sometimes prescribed as an antiasthenic is sulbutiamine, especially for sexual symptoms.

Basic difference between asthenia and normal fatigue

Asthenia is often confused with a normal fatigue process. The main difference between asthenia and fatigue is that while fatigue usually reverts with a period of rest, in the case of asthenia it remains and even worsens, and can become chronic, becoming known as chronic fatigue syndrome if the problem persists for more than six months, producing a deterioration in the patient's life at work, social or personal level of more than 50% with respect to his or her baseline level.

Bibliographic references:

• Casanovas, J.M. (2009). From symptom to disease: asthenia. Rev Pediatr Aten Primaria. vol.11, 17, 425-431.

• Feuerstein, C. (1992): Neurophysiological data concerning fatigue. Role of the activating reticular system. Entreteins de Bichat.11-19.

• Price, J.R. & Couper, J. (2000). Cognitive behaviour therapy for adults with chronic fatigue syndrome. Cochrane Database Syst Rev.

• Walkman, K.E.; Morton, A.R.; Goodman, C.; Grove, R. & Guilfoyle, A.M. (2004). Randomised controlled trial of graded exercise in chronic fatigue syndrome. Med J Aust. 180(9):444-8.

• Waynberg, J. (1991). Asthenia and male dysfunction. JAMA (French ed.); 222 (suppl):4-12