The term neurasthenia used to be a common term for a range of nervous disorders. In modern medicine, it has largely been superseded by the term chronic fatigue syndrome.


What is neurasthenia?

The term neurasthenia denotes nerve weakness, 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 regarded more as a mental disorder or neurosis, even if it has not yet been precisely researched whether the causes are more psychological or physical. See percomputer for Hypercoagulability Explanation.

The various signs of nervous weakness can appear after a long illness, severe mental tension, periods of sustained high concentration or emotional problems. Those affected then suffer from exhaustion and chronic tiredness even with little physical or mental exertion. The term “neurasthenia” was coined by New York neurologist George M. Beard, who saw nerve overstimulation as a reaction to the electrical revolution of his day. Modern medicine speaks of chronic fatigue syndrome or burnout syndrome.


Neurasthenia is usually the result of prolonged mental tension, prolonged stressful situations or illnesses. Often people in rehabilitation treatments get the diagnosis, especially if they are also under a lot of pressure professionally. The permanent work pressure leads to a pressure to perform, which means that workers feel more and more pressure to only have to function and no longer be allowed to act independently.

People with personal characteristics such as ambition, a tendency towards perfectionism, insufficient stress management skills, a helper syndrome or the inability to say no are particularly at risk. Excessive demands that they can no longer meet cause them to burn out internally. In contrast to neuropathy, there is no organic damage to the nerves in neurasthenia. Different causes were seen at different times.

Sigmund Freud saw her as a pent-up of sexual energy, other researchers saw her as a narcissistic disorder due to self-esteem problems or unsuccessful conflict behavior. At the moment, the majority of the causes are seen as sensory overload caused by external influences or physical and mental overexertion.

Symptoms, Ailments & Signs

Neurasthenia can present with a variety of symptoms. Common signs are exhaustion and frequent tiredness, anxiety, cardiac neuroses and neuralgia. But headaches, concentration problems, irritability and melancholy are also among the signs. Sometimes the disease manifests itself in sexual reluctance or sexual disorders.

The symptoms can be favored by external stimuli, but can also arise from too much monotony. Even slight physical and mental stress means that those affected have to recover longer than healthy people. This clinical picture has been known since the end of the 19th century.

It is known, for example, that the Austrian writer Robert Musil consulted a neurologist in 1913 because of heart palpitations with an increased heart rate, twitching when falling asleep, indigestion, depressive moods and mental fatigue. At the time he was working as a librarian at the Technical University and suffered from the dullness of this work.

Diagnosis & course of disease

Because of the variety of symptoms, neurasthenia is not easy to diagnose. Affected people mostly suffer subjectively from their symptoms, even if no organic cause can be found for them. In addition, the course is usually insidious. Years can often pass before a diagnosis is made. The physical symptoms are often examined over a longer period of time and treated if necessary.

Early diagnosis is best because most sufferers become anxious about their symptoms, fueling new fears that can worsen symptoms. Often several doctors are consulted to finally find a cause. In most cases, the diagnosis is made through detailed discussions with the patient about the symptoms, after physical causes have been ruled out.


Those affected by neurasthenia usually suffer from chronic exhaustion. This has a very negative effect on the patient’s quality of life and can lead to serious complications or complaints in the long term. There is also usually confusion and anxiety associated with this condition. Concentration disorders can also occur, which have a very negative effect on the child’s deforestation.

Furthermore, those affected suffer from sexual reluctance and also from irritability or depression. The neurasthenia also leads to digestive problems or an increased heart rate as the disease progresses. It can also cause insomnia and muscle twitching. As a rule, neurasthenia can be treated well. Only in severe cases is treatment with 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 the 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 strains lead to severe health impairments. If the person concerned suffers from insomnia, inner restlessness or apathy over a longer period of time, a doctor should be consulted. Irritability, mood swings or abnormal behavior are signs of an irregularity and should be investigated and clarified. Attention deficits, a decrease in mental performance and concentration disorders are further indications of an existing problem.

A doctor’s visit is necessary as soon as everyday or professional requirements can no longer be adequately perceived and fulfilled. In the event of a depressive mood, a loss of well-being and a loss of zest for life, this must be reported to a doctor. If there is a decrease in libido, irregularities in the menstrual cycle in women, general malaise and headaches, a doctor is needed. Anxiety, rapid exhaustion and digestive disorders arise when there is a health impairment.

A doctor should be consulted as soon as the symptoms persist, increase in intensity or develop other symptoms. Changes in diet, weight problems, dissatisfaction, and twitching of the eye and limbs should be reported to a doctor. Rapid heartbeat, increased blood pressure and loss of participation in social and community life are causes for concern. A doctor’s visit is necessary so that the cause can be investigated.

Treatment & Therapy

The nervous symptoms that occur with neurasthenia are a sign that the body’s self-healing powers have been weakened by external demands. Therefore, those affected should first of all shift down a gear and insert relaxation phases in order to regenerate again. An individually tailored behavioral therapy is recommended in order to replace behavioral patterns that could have promoted the disorder with new, health-promoting ones.

It is best to do light physical training at the same time in order to reduce the tendency to rest that those affected show due to their symptoms. It is important to expect as much as possible from the body and at the same time to ensure as much protection 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, concomitant antidepressants may be prescribed. It is helpful and important for those affected to learn how to reduce stress in a healthy way.

Outlook & Forecast

The prognosis in neurasthenia depends on several factors and varies from case to case. The prospects of recovery are significantly influenced by the personality structure of the patient. Neurasthenia can develop into a long-term burden in people who put a lot of pressure on themselves and are constantly subject to high expectations.

In order to defeat the disease, fundamental rethinking and an adjustment of lifestyle are 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 been present for a long time, it is difficult to change or completely abandon certain automated behaviors. In addition, untreated neurasthenia can lead to depression, which requires longer and more intensive treatment.

The prognosis improves when the patient is insightful and willing to identify typical stressors and to develop new strategies for coping with stress. Strengthening self-confidence through solvable challenges and maintaining social contacts also contributes to overcoming the disease.

In order for neurasthenia to be cured in the long term, the triggers must be found and eliminated as far as possible. A relapse into old behaviors can result in the recurrence of the symptoms at any time.


Good prevention of nervous disorders is a good balance between stress and relaxation. Anyone who often works under high pressure should shift down a gear. Sometimes it helps to just take more breaks and set priorities. If there is too much monotony, variety helps and if the nerves are overstimulated, minimizing stress factors.


As a rule, the affected person with neurasthenia has only very limited or very few direct follow-up measures available, so that the patient with this disease should ideally see a doctor very early on. Only further complications and complaints can be prevented or limited, since self-healing cannot occur.

The sooner a doctor is consulted, the better the further course of the disease. Those affected by neurasthenia often need therapy from a psychologist. The help of one’s own family or relatives is also very important in order to prevent depression and other mental upsets.

Contact with other patients with neurasthenia can also have a positive effect on the further course, since this leads to an exchange of information, which can make everyday life much easier. When taking medication, the person concerned should always follow the doctor’s instructions and consult them if they have any questions or experience side effects. It is also important to ensure that the dosage is correct and that it is taken regularly. The neurasthenia usually does not reduce the life expectancy of the patient.

You can do that yourself

According to the many different symptoms that can appear when neurasthenia is present, there are also various possibilities for self-help. Basically, they all aim to relieve stress factors and create space for relaxation.

Those affected can develop rituals that keep them focused and calm. Morning rituals in particular can give you a lot of strength for the next few hours. This can be supplemented by relaxation techniques, sport, a healthy diet and the fixed planning of breaks. It is necessary for people with neurasthenia to be able to deliberately disengage from situations. Creating these spaces is therefore a valuable form of self-help. In addition, retreats (e.g. in the form of hobbies) can also prove to be valuable.

For many of the physical symptoms of the condition (dizziness, nausea, etc.), it sometimes helps to lie down and drink a sip of water. If the physical symptoms are noticed early on by those affected, they can usually be overcome easily. It is important that the (supposedly) triggering situation is abandoned.

The self-help measures in the case of neurasthenia are supplemented by techniques that the affected person may receive from a therapist. They are all only to be considered as a supplement to psychotherapy.