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Neurasthenia was a term first coined by George Miller Beard in 1869. Beard's definition of "neurasthenia" described a condition with symptoms of fatigue, anxiety, headache, impotence, neuralgia and depression. It was explained as being a result of exhaustion of the central nervous system's energy reserves, which Beard attributed to civilization. Physicians of the Beard way of thinking associated neurasthenia with the stresses of urbanization and the pressures placed on the intellectual class by the increasingly competitive business environment. Typically, it was associated with upper class individuals in sedentary employment.

Beard, with his partner A.D. Rockwell, advocated first electrotherapy and then increasingly experimental treatments for people with neurasthenia, a position that was controversial. An 1868 review posited that Beard's and Rockwell's grasp of the scientific method was suspect and did not believe their claims to be warranted.

In the late 1800s, it became a popular diagnosis that began to include such symptoms as weakness, dizziness and fainting, and led to rest cures, especially for women, who were the gender primarily diagnosed with this condition at that time. Virginia Woolf was known to have been forced to undergo rest cures, which she describes in her book On Being Ill. In literature, Charlotte Perkins Gilman's protagonist in The Yellow Wallpaper also rebels against her rest cure. Marcel Proust was said to suffer from neurasthenia.

In 1895, Sigmund Freud reviewed electrotherapy and declared it a "pretense treatment." He highlighted the example of Elizabeth von R's note that "the stronger these were the more they seemed to push her own pains into the background," perhaps a precursor to modern-day biofeedback.

Nevertheless, neurasthenia was a common diagnosis in World War I - every one of the c.1700 officers processed through the Craiglockhart War Hospital was diagnosed with neurasthenia, for example — but its use declined a decade later.

The modern view holds that the main problem of neurasthenia was that it attempted to group together a wide variety of cases. In recent years, Richard M. Fogoros has posited that perhaps neurasthenia was a word that could include some psychiatric conditions, but more importantly, many physiological conditions marginally more understood by the medical community, such as fibromyalgia, chronic fatigue syndrome, and various forms of dysautonomia, among others. He emphasizes that the majority of patients who would have once been diagnosed with neurasthenia have conditions that are "real, honest-to-goodness physiologic (as opposed to psychologic) disorders... and while they can make anybody crazy, they are not caused by craziness."

• Combat stress reaction

• A family of misunderstood disorders, by Richard N Fogoros
• An American Treatment for the 'American Nervousness'
• Chronic fatigue syndrome: a true illness
• Neuraesthenia revisited: ICD-10 and DSM-III-R psychiatric syndromes in chronic fatigue patients and comparison subjects