I first came across the term neurasthenia while reading Recovery: The Lost Art of Convalescence by Gavin Francis. The book’s deep dive into historical healing practices made me realize how much our understanding of mental health has evolved—and how some struggles remain unchanged.

😪 The Birth of “Nervous Exhaustion”

In 1869, American neurologist George Miller Beard coined the term neurasthenia, combining the Greek words neuron (nerve) and asthenia (weakness). He used it to describe what he saw as an epidemic of nervous exhaustion—a condition brought on by the relentless pace of industrial life. Symptoms ranged from fatigue and anxiety to headaches and depression. At the time, doctors believed modern civilization was simply draining people’s nervous energy, leaving them physically and mentally depleted.

Neurasthenia’s Gender-Based “Cures”

The treatments for neurasthenia were as much about enforcing societal roles as they were about healing. Women were often subjected to the infamous “Rest Cure”—weeks of forced bed rest, isolation, and restrictions on reading, writing, or socializing. Ironically, I’ve done something similar myself, believing I was healing. Only later did I realize that this pattern wasn’t just personal—it was something I had absorbed from the women around me. What was once enforced as medical treatment had, in some ways, become a learned form of self-preservation. Though intended to calm overstimulated nerves, the Rest Cure often led to worsening depression and frustration.

The Yellow Wallpaper by Charlotte Perkins Gilman offers a haunting critique of its effects. Men, by contrast, were encouraged to travel, engage in outdoor activities, or undergo experimental treatments like electrical stimulation. Some were even sent on expeditions, with the belief that time in nature or manual labor would restore their vitality. Instead of addressing the root causes of exhaustion, these treatments reinforced outdated ideas—women were expected to submit and rest, while men were expected to push through and reclaim their strength.

Neurasthenia in Modern Mental Health

Over time, neurasthenia faded as a diagnosis, replaced by more precise terms that better reflect the complexities of mental health. Today, many of the symptoms once grouped under neurasthenia are recognized as part of:

• Major Depressive Disorder
• Generalized Anxiety Disorder
• Chronic Fatigue Syndrome
• Somatic Symptom Disorder

Instead of attributing everything on “weak nerves,” modern psychiatry acknowledges the biological, psychological, and social, and environmental factors influencing mental well-being, as documented by the National Institute of Mental Health.

💭 Have things changed much?

Medical understanding has improved, but the feeling of exhaustion—whether from work, social pressures, or simply trying to keep up with life—remains just as pervasive. While we no longer frame it as “nervous exhaustion,” burnout is now a recognized condition, with symptoms strikingly similar to what 19th-century doctors once labeled neurasthenia. The difference today is that we talk about these struggles in the language of psychology, neuroscience, and self-care. We acknowledge the impact of stress, trauma, and overwork.

We study cognitive load, emotional labor, and the long-term effects of chronic fatigue. But does that mean we’ve solved the problem? In some ways, modern life has only intensified what Beard observed in his time. The industrial revolution may have been overwhelming, but the pace of today’s world—constant digital stimulation, economic precarity, the expectation of being available 24/7—presents a different kind of mental strain. Instead of telegraphs and steam engines, we have emails, notifications, and an endless flow of information that can be just as draining.