The term neurasthenia used to be a common name for a range of nervous complaints. In modern medicine, it has been largely replaced by the term chronic fatigue syndrome.
What is neurasthenia?
The term neurasthenia denotes a weakness of the nerves, an overstimulation of the nerves. It was one of the most common diagnoses in the 19th and early 20th centuries when no organic cause could be found for physical problems. Because no organic damage can be detected, neurasthenia is now considered more of a mental disorder or neurosis, although whether the causes are more psychological or physical has not yet been thoroughly researched. The various signs of neurasthenia can occur after long illnesses, strong mental tensions, periods of sustained high concentration or emotional problems. Affected persons then suffer from exhaustion and chronic fatigue even during minor physical or mental exertion. The term “neurasthenia” was coined by the New York neurologist George M. Beard, who saw the overstimulation of the nerves as a reaction to the electrical revolution of his time. Modern medicine refers to it as chronic fatigue syndrome or burnout syndrome.
Causes
Neurasthenia is usually the result of prolonged mental tension, prolonged stressful situations, or illness. People often get the diagnosis in rehab treatments, especially if they are also under a lot of pressure at work. The permanent pressure at work leads to pressure to perform, which makes working people feel more and more under pressure to only have to function and not be allowed to act independently. People with personal characteristics such as ambition, a tendency toward perfectionism, inadequate stress management skills, a helper syndrome or the inability to say no sometimes are particularly at risk. Excessive demands, which they can no longer live up to, cause them to burn out internally. Unlike neuropathy, neurasthenia does not involve organic damage to the nerves. Different causes were seen at different times. Sigmund Freud saw it in the accumulation of sexual energy, other researchers saw it as a narcissistic disorder due to self-esteem problems or a failed conflict behavior. Currently, the majority of causes are seen in stimulus overload due to external influences or physical and mental overwork.
Symptoms, complaints and signs
Neurasthenia can present with a variety of symptoms. Common signs are exhaustion and frequent fatigue, anxiety, cardiac neuroses as well as neuralgia. But also headaches, concentration problems, irritability and melancholy are among the signs. Sometimes the disease manifests itself in sexual unwillingness or sexual disorders. The symptoms can be favored by external stimuli, but can also result from too much monotony. Even minor physical and mental stress causes sufferers to take longer to recover than healthy people. This clinical picture has been known since the end of the 19th century. The Austrian writer Robert Musil, for example, is known to have visited a neurologist in 1913 because of palpitations with an increased pulse, twitching when falling asleep, digestive disorders, depressive moods and mental fatigue. He was working as a librarian at the Technical University at the time and suffered from the dullness of this work.
Diagnosis and course of the disease
Because of the wide range of symptoms, neurasthenia is not easy to diagnose. Affected persons usually suffer subjectively very strongly from their symptoms, even if no organic cause can be found for them. In addition, the course of the disease is usually gradual. Before a diagnosis is made, it can often take years. Often the physical complaints are first examined for a long time and treated if necessary. Early diagnosis is most favorable because most sufferers anxiously observe their complaints, which stirs up new fears that can intensify the symptoms. Often, several doctors are visited to finally find a cause. In most cases, the diagnosis is made through in-depth discussions with the patient about the symptoms after physical causes have been ruled out.
Complications
In neurasthenia, the affected person usually suffers from chronic fatigue. This has a very negative effect on the patient’s quality of life and can lead to serious complications or discomfort in the long run. As a rule, this disease also causes confusion and anxiety. Disturbances in concentration may also occur, which have a very negative effect on the deforestation of the child. Furthermore, the affected persons suffer from sexual unwillingness and also from irritability or depression. Neurasthenia also leads to digestive problems or an increased pulse rate in the further course. Sleep disturbances and muscle twitching may also occur. As a rule, neurasthenia can be treated well. Only in severe cases is treatment with the help of medication necessary. Antidepressants have various side effects that could occur. Furthermore, the affected person must reduce stress in order to avoid the symptoms of neurasthenia. As a rule, the course of the disease is positive if neurasthenia is diagnosed and treated early enough. A healthy lifestyle has a very positive effect on the disease.
When should you go to the doctor?
Persistent stress and emotional strain lead to severe health impairments. If the affected person suffers from sleep disturbances, an inner restlessness or apathy over a longer period of time, a doctor should be consulted. Irritability, mood swings or behavioral problems are signs of an irregularity and should be examined and clarified. Attention deficits, a decrease in mental performance as well as disturbances in concentration are further indications of an existing problem. A visit to the doctor is necessary as soon as everyday or professional requirements can no longer be adequately perceived and fulfilled. In case of a depressive mood, a loss of well-being as well as joy of life, this should be reported to a doctor. If there is a decreased libido, in women irregularities of the menstrual cycle, a general feeling of malaise and headaches, a doctor is needed. Anxiety, rapid exhaustion, as well as digestive disorders occur when a health condition is present. A doctor should be consulted as soon as the complaints persist unabated, they increase in intensity or other symptoms develop. Changes in food intake, weight problems, a dissatisfaction and twitching of the eye as well as the limbs should be presented to a doctor. Heart palpitations, elevated blood pressure, and a loss of participation in social and community life are cause for concern. A visit to the physician is necessary so that a causal investigation can be initiated.
Treatment and therapy
The nervous symptoms that occur with neurasthenia are a sign that the body’s self-healing powers have been weakened by external demands. For this reason, those affected should first of all shift down a gear and take periods of relaxation in order to regenerate. Individually tailored behavioral therapy is recommended to replace behavioral patterns that may have promoted the disorder with new, health-promoting ones. Light physical training is best carried out in parallel in order to reduce the tendency to rest that sufferers display as a result of their complaints. It is important to allow the body to do as much as possible while at the same time providing as much rest as necessary. Since neurasthenia is considered a systemic disease in which it is not clear whether the causes lie more in the soul or in the body, lifestyle should be adjusted in parallel with behavioral therapy. If depression and anxiety symptoms occur, antidepressants can be prescribed concomitantly. It is helpful and important that those affected learn to reduce stress again in a healthy way.
Outlook and prognosis
The prognosis for neurasthenia depends on several factors and varies from case to case. The prospects of recovery are significantly influenced by the patient’s personality structure. In people who put a lot of pressure on themselves and are constantly subject to high expectations, neurasthenia can develop into a long-term burden.To defeat the disease, fundamental rethinking and lifestyle adjustment is necessary, which often only leads to lasting success under psychotherapeutic guidance. The sooner therapy begins, the greater the chances of recovery. If the symptoms have already existed for a long time, it is difficult to change or completely discard certain automated behaviors. In addition, untreated neurasthenia can lead to depression, which requires longer and more intensive treatment. The prognosis improves if the sufferer is insightful and willing to identify stressors that are typical for him or her and to develop new strategies for coping with stress. Strengthening self-confidence through solvable challenges and cultivating social contacts also contributes to coping with the disease. For neurasthenia to be cured in the long term, the triggers must be found and eliminated as best as possible. A relapse into old behaviors can result in the recurrence of symptomatology at any time.
Prevention
A good prevention of nervous disorders is a good balance between stress and rest. Those who frequently work under high pressure should shift down a gear. Sometimes it helps to simply take more breaks and prioritize sitting. If there is too much monotony, variety helps, and if nerves are overstimulated, minimizing stressors helps.
Aftercare
As a rule, only very limited or very few measures of direct aftercare are available to the person affected by neurasthenia, so the patient should ideally see a doctor very early in this disease. This is the only way to prevent or limit further complications and discomfort, as it is not possible for the condition to heal itself. The earlier a doctor is consulted, the better the further course of the disease usually is. Often, those affected by neurasthenia are dependent on therapy with a psychologist. The help of one’s own family or relatives is also very important in order to prevent depression and other psychological upsets. Contact with other patients with neurasthenia can also have a positive effect on the further course of the disease, as it leads to an exchange of information, which can make everyday life much easier. When taking medication, the patient should always follow the doctor’s instructions and consult him or her if there are any questions or side effects. It is also important to ensure that the correct dosage is taken and that the medication is taken regularly. In this regard, neurasthenia does not usually reduce the patient’s life expectancy.
What you can do yourself
In accordance with the many different symptomatologies that can be manifested in the presence of neurasthenia, the options for self-help are also diverse. Basically, they all aim to alleviate stress factors and create space for recovery. Those affected can, for example, develop rituals that keep them focused and calm. Morning rituals in particular can give a lot of strength for the next few hours. This can be supplemented by relaxation techniques, exercise, a healthy diet and the firm scheduling of breaks. For example, people with neurasthenia need to be able to specifically opt out of situations. Creating these spaces is therefore a valuable form of self-help. In addition, spaces for retreat (for example, in the form of hobbies) can also prove valuable. Against many physical symptoms of the condition (dizziness, nausea, etc.), it sometimes helps to put the body down and take a drink of water. If the physical symptoms are noticed early by the sufferer, they can usually be overcome well. It is important to leave the (supposedly) triggering situation. The self-help measures for neurasthenia are still supplemented by techniques, which the affected person may be taught by a therapist. They are all to be considered only as a supplement to psychotherapy.
