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Neurasthenia vs Adrenal Fatigue

The symptoms of Neurasthenia seem identical to Adrenal Fatigue
The lack of acceptance Neurasthenia is also similar to AF

In 1869, the term Neurasthenia was introduced by the American neurologist George Miller Beard.

Page Contents:

Neurasthenia Symptoms

Chronic Stress as a cause?

Lack of Acceptance

Same as Chronic Fatigue Syndrome?

Most doctors do not think adrenal fatigue is real. And Neurasthenia eventually suffered the same fate.

Neurasthenia was dropped from the American Diagnostic and Statistical Manual (DSM) in 1980, but it's usage as a diagnosis dropped off sharply in the early 1930s.

We will cover Neurasthenia Symptoms, and show how they are essentially the same as adrenal fatigue symptoms, as well other conditions.

Neurasthenia has a wide range range of symptoms. It seems to be a multi-system condition, similar to chronic fatigue syndrome, and of course adrenal fatigue.

Neurasthenia is still popular in Asia, since it does not carry with it the stigma of a psychiatric diagnosis². A Neurasthenia diagnosis does imply that It is all in your head.

Neurasthenia Symptoms

The following list of symptoms comes from references 2, 3, 4 and 6:

sensation of pain or of numbness in various parts of the body
chronic fatigue. excessive physical and mental fatigue
muscle weakness
anxiety
inability to relax
insomnia
lack of concentration
depression
irritability
fainting
rapid intense heartbeat that may be irregular (palpitations, tachycardia)
cold, clammy hands and feet
abnormally rapid breathing (hyperventilating)
dizziness or faintness
periodic sighing (another symptoms of hyperventilation)
sweating for no apparent reason
dilated pupils
fear of everything
hopelessness
general or local itching

And similar to Chronic Fatigue Syndrome, symptoms must be chronic.

To make the diagnosis (of Neurasthenia), it must be a persistent illness.²

If you have spent time around adrenal fatigue forums, these symptoms will seem very familiar to you.

Eventually, some psychological symptoms were used to rule out Neurasthenia.

Exclusion criteria include the presence of mood, panic, or generalized anxiety disorders.²

That is because anxiety, panic, and mood issues such as depression became their own diagnosis, with the implication that these symptoms were coming from your mind ..... and if you had them, all of the other physical symptoms must be in your head as well...... sigh.

This lack of acceptance of Neurasthenia is covered in more detail later in the article.

Chronic Stress as a Cause

Neurasthenia is such an old condition that there are no studies linking it to abnormalities of the HPA Axis, such as an over active stress response, or abnormal levels of stress hormones, etc.

However, from the observations and writings at the time, it is clear what type of person would develop Neurasthenia.

It was observed that Neurasthenia tended to affect over-achievers

....it is a disease of bright intellects, its victims are leaders and masters of men, each one a captain of industry (Pritchard, 1905) ⁴

Many a brilliant student or vigorous athlete has been thus wrecked, perhaps for life - especially among women (Allbutt & Rolleston, 1905-1911)⁴.

This next one is a little funny. Political correctness didn't really exist to a great extent. The implication is that people who do manual labor know when to rest and are not subject to as much emotional stress.

I still urge with Beard that it [neurasthenia] is seldom found among those who live below the upper crust of the social world. The manual laborers of the world, however little they may know, generally know enough to rest when they are tired, and they have the advantages of fewer superheated and poorly ventilated homes, besides their muscular development holds down their emotional centers to a safe level (Journal of the American Medical Association, 1894). ⁶

Symptoms of Stress

Some of the symptoms listed above for Neurasthenia are also classic signs of someone stuck in a state of stress, or having a dominant sympathetic nervous system:

inability to relax
irritability
abnormally rapid breathing (hyperventilating) - Chronic stress can lead to hyperventilation.
Dilated pupils - This can be caused by over-activation of the sympathetic nervous system (the stressed side)⁹

So ... some of the symptoms, as well as observations from doctors at the time provide some pretty good hints that chronic stress was a big part of Neurasthenia.

Lack of Acceptance of Neurasthenia

Neurasthenia was supposed to be the result of a weak and tired nervous system
However, many doctors did not believe this theory

As proposed by Dr. Beard, Neurasthenia was a physical problem, not a mental problem. It was thought to be a problem with the nervous system

A neurasthenic simply has a narrow margin of nerve force. Neurasthenia was a physical condition, and, most importantly, was not the fault of the neurasthenic. ⁶

However, the idea that so many strange and varied symptoms of Neurasthenia could be the cause of something that was physically wrong was hard for many doctors to accept⁴.

Neurasthenia was never accepted by the Medical Establishment, the giants of the profession (neurology), such as Gowers, Gordon Holmes, Ferrier, Buzzard and Kinnier-Wilson based at the National Hospital for Nervous Diseases, declared themselves in various ways against an organic view of neurasthenia⁴

The development of theories about psychogenic mechanisms began to take its toll on the notion of neurasthenia as a functional physical illness.⁴

Psychogenic means physical symptoms that are coming from the mind .... i.e. it is all in your head.

So that is another similarity between Neurasthenia and Adrenal Fatigue, the belief by many doctors that the symptoms are coming only from the mind.

...there is no more justification for regarding neurasthenia as a definite malady.... (Growes, 1893)⁴

Similar to Chronic Fatigue?

Some researchers and clinicians have connected the dots between Neurasthenia and Chronic Fatigue (CFS).

The symptom profile certainly overlaps.

Many clinicians in the United States see the symptom complex of neurasthenia as similar to that of chronic fatigue syndrome (CFS). Characterized by pervasive fatigue with a diffuse constellation of somatic, cognitive, and emotional symptoms, CFS is thought by some experts to be a contemporary revival of neurasthenia. ...... The symptoms cited in the 1994 Centers for Disease Control criteria for CFS do overlap with those of neurasthenia. Fatigue is the essential symptom for both diagnoses; others that overlap include muscle pain, headaches, inability to concentrate, irritability, and sleep disturbance. .....²

Summary

It is unfortunate that Neurasthenia was superseded by various psychological disorders.

This is not to say that there is no such thing as psychological disorders. But what causes previously productive people to suddenly develop a long list of physical and mental symptoms?

Neurasthenia is similar to Adrenal Fatigue, but it is also similar to Burnout Syndrome, General Adaptation Syndrome and Post Traumatic Stress Disorder.

Chronic Stress is implicated in all of these conditions. See the article Is Adrenal Fatigue Real? for more details.