The World Health Organization’s International Classification of Diseases still recognises neurasthenia as a diagnosis. Symptoms of this modern life condition include fatigue, dyspepsia, irritability, headaches, impotence, insomnia, lethargy, premature baldness, depression and many more. The name, neurasthenia, was originally coined in 1869. A physician, E. Van Deusen, and a neurologist, George Beard, both independently came up with the name. Van Deusen coined the term slightly before Beard. However, Beard was practicing in New York while Van Deusen worked in Kalamazoo, Michigan – which led Beard to be recognised for naming the ailment.
In the late 19th and early 20th century, the United States was booming. A combination of immigration and technology saw swathes of people moving to cities to make their fortunes. As industrialisation took hold, the world was teeming with new inventions; cars, airplanes, telephones, daily newspapers, air-conditioning and even vitamins all came into existence within the space of 20 years.
It shouldn’t come as a surprise, that during this time the leading theory around how the body functions wasn’t dissimilar to how a machine works. The body was seen to run on ‘nervous energy’ and with too much work and with too many things to worry about it was believed possible to deplete the body’s reserves of this energy, which inevitably led to a diagnosis of neurasthenia. To put it another way, neurasthenia was the illness brought on by living in the modern world.
The cure for neurasthenia
For a modern illness, the cures for neurasthenia hankered more to Victorian times than the ways of the new modern world. Shocking patients was seen as an effective way to replenish nervous energy. There were even electropathic belts one could use in the comfort of your own home that delivered the desired shocks to replenish one’s nervous energy. And for those who deemed electrical shocks unpleasant, another option was a ‘rest cure’.
A rest cure was prescribed predominantly to women, however, many men also endured this cruel treatment. A rest cure involved lying in bed for 4 – 6 weeks while not doing anything. During this time, patients had to engage in as little activity as possible. Reading and writing were prohibited, it was expected that patients use bedpans so they didn’t have to get out of bed to take care of business, and being spoon-fed milk or soup by a nurse or a doctor were all part of the treatment.
Both Virginia Woolf and Charlotte Perkins Gilman were prescribed rest cures. Virginia Woolf underwent several rest cures and wrote scathing accounts of her experience. Gilman wrote the feminist classic; The Yellow Wallpaper, a novel based on her own experience of undergoing a rest cure. In the novel, the protagonist is confined to a bedroom as she slowly loses her mind.
For men, especially in the United States, a West cure was advised. This involved getting out of the cities and engaging in manual labour, usually working as a cattle hand, or game hunting. Theodore Roosevelt developed his macho persona while on a West cure. Before being treated for his neurasthenia he was considered quite the dandy and referred to by some as the ‘American Oscar Wilde’.
Neurasthenia’s unexpected legacy for the modern life
Neurasthenia was widespread and a common diagnosis on both sides of the Atlantic in the early 20th century. This New York Times article claims that ‘just about anyone in the upper classes whose occupation demanded “brain-work” was likely to fall prey to this nervous disorder that afflicted both body and spirit.’ The prevalence of this nervous disorder gave rise to the concept of the rest cure, but also several other concepts that still exist today.
In schools it was feared modernity and sitting in class all day would be bad for children’s nervous systems. Thus, both recess and physical education were introduced into schools to combat the nervous disorders likely to come about from the modern schooling system.
Similarly, national parks in the US were created so that neurasthenics had somewhere to go for their cures. The concepts of travelling for holidays, exercising for mental health, bicycling and sports leagues were all introduced to address the impact modern life had on people’s states of mind.
What neurasthenia can teach us
It is strange to think that an ailment that was this widespread could have faded into such obscurity. Today, neurasthenia is likely to be diagnosed as one of several other, better defined, neurological, physical or psychological maladies and is for the most part forgotten. Virginia Woolf, for instance, is likely today to be diagnosed with bipolar disorder.
Since I discovered the existence of this diagnosis, and having given the ailment more thought, I have come to the conclusion that neurasthenia has given us more than rest cures, exercise and outdoor recreational spaces. It also shows us that over a century ago people recognised something in the way the world was changing. They understood that the nature and the speed of change was and would pose a psychological challenge to us all. While we equally laugh and are horrified by the remedies introduced to address these challenges, there is no ambiguity about the seriousness with which they viewed the impact this new world would have on us.
Despite the advancements in psychology, medicine and psychiatry over the past 100 years, are we really that much better today at understanding the impact modern life has on us? From what I can see we have been offered meditation, mindfulness, and psychotherapy to address the anxiety we experience in our day-to-day lives. While, culturally, we have stigmatised and played down the mental and emotional load our technological societies place on us.
Despite us genuinely feeling that something is amiss, most of us choose to ignore the disquiet we experience during our most intimate moments. Personally, I’m a big fan of meditation, mindfulness and psychotherapy, but I believe we will all, collectively, lead better lives if we acknowledge the impact this new, ever changing world has on our psyche.
And if we start taking our anxiety and stress as seriously as people took neurasthenia at the turn of the 20th century, if nothing else, we might get more national parks and more free time for our efforts.