Neurasthenia, Symptoms and Treatment

At some point in our lives, all or most of us have felt tired, exhausted and saturated. It is probable that on some occasion our forces did not allow for more, and that even our head ached with fatigue.

Fortunately, this situation has been something temporary for most of us and in a short time and maybe with some rest we have been able to get out of it. Imagine, however, that we are in that state continuously: we have no strength at all, we can not think, our head and back hurts and we can not even sleep. That is what happens to people suffering from neurasthenia, a problem that we are going to talk about throughout this article.

What is neurasthenia?

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

This fatigue, which is the characteristic and most defining symptom of this alteration, 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 an irritability that often leads to querulous behavior or even direct hostility, loss of appetite, problems to reconcile and maintain sleep, depersonalization or feeling of strangeness for oneself.

It is usual that there are also problems of concentration and mental slowness, as well as anxiety and multiple concerns. The neurasthenia appears with a clinic of mainly depressing type, appearing in addition to the above sadness, high emotionality, anhedonia or inability to feel pleasure, bursts of crying and / or anger, passivity, apathy and sometimes despair. Libido tends to decrease to a great extent, and there is usually a decrease in work performance and an increase in isolation.


It is possible that during this picture alterations appear at a physiological level, such as hypotension, fainting, various pains in the body (usually headaches) and gastrointestinal problems such as nausea, gas and burning after eating. It is also common constipation, back pain and some authors included a possible hypersensitivity in the scalp between 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 inheritors of 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 that maintain those who suffer it.

A concept currently in disuse

This concept is currently in disuse and nowadays it is more usual to speak of it as a symptom than as a disorder itself, since the set of symptoms that it implies 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 the clinical level (although the concept already existed previously) as an irritant weakness of probably functional causes.

In addition to this author, neurasthenia would be welcomed and researched by currents such as psychoanalysis. Freud would come to include it between the two main real neuroses, next to that of anguish. One of the main diagnostic categories was considered during that time, 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 in it. Despite this, even today some highly popular diagnostic manuals such as ICD-10 include it.


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

In its beginnings it was considered a product of the exhaustion generated due to the high social demand, 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 on an affective level.

  • In this sense, neurasthenia can occur in the context of a depression.
  • It is not linked to anxiety (including also obsessive-type disorders).
  • Likewise, neurasthenia plaques have also been identified that appear in a context of medical illness, such as, for example, certain infections, drug or toxic poisoning, 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 the absence of sufficient rest in day to day are other possible motivators.


The treatment of neurasthenia depends to a great extent on the causes that its appearance may have. In the case of those cases that appear due to medical / biological causes, the treatment of this condition will depend to a large extent on the disease that generates it: treating its origin will improve the person’s condition.

In addition, from the field of pharmacology the person 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 facilitates the realization of behavioral changes at a psychological level, expectations and self-demands that the person may be maintaining, 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 vital motivations.