Astral Codex Ten

neurasthenia

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neurasthenia

Article

neurasthenia is a recurring concept in the Astral Codex Ten archive, appearing 3 times across 3 issues between July 15, 2021 and August 05, 2022. The archive places it in contexts such as “history of Japanese mental illness, which focused on neurasthensia”; “most of the lower-class patients weren’t real neurasthenics (hard-working, intelligent, sensitive, admirable), but had a similar condition, imitating the symptoms of neurasthenia”; “state the diagnosis as “neurasthenia"". It most often appears alongside Japan, America, China.

Metadata

  • Category: Concepts
  • Mention count: 3
  • Issue count: 3
  • First seen: July 15, 2021
  • Last seen: August 05, 2022

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Book Review: Crazy Like Us
July 15, 2021 · Original source
Much more fun was the history of Japanese mental illness, which focused on neurasthensia. This was another one of those fully-generic late-1800s diagnoses like hysteria (I assume late-1800s psychiatrists just sort of flipped a coin: heads you were neurasthenic, tails you were hysteric). Around the Meiji Restoration, when everyone was obsessed with how great foreign stuff was, Japanese medical students went to Germany, learned psychiatry, came back to Japan, and told everyone they were neurasthenic. Being neurasthenic became first a fashion, then a class marker. The idea was that neurasthenics were people who were working too hard (good, admirable), and who were so smart and doing so much furious intellectual activity that it was straining their nerves (impressive). Also, they were probably sensitive souls too pure for this world. The most embarrassing extreme of this happened in 1903, when some photogenic Japanese youth carved a poem in a tree, went to a beautiful waterfall, and leapt to his death. Everyone praised him for how sensitive and artistic and neurasthenic this was, and turned him into a posthumous national hero. Meanwhile, “in 1902 an article reported that fully one-third of patients visiting hospitals for consultations were suffering from the new disease.”
Eventually Japanese psychiatrists got fed up, and started announcing that actually neurasthenia sucked and you should not have it. From a 1906 Japanese neurology journal:
These days, young students talk about such stuff as “the philosophy of life”. They confront important and profound problems of life, are defeated, and develop neurasthenia. Those who jump off a waterfall or throw themselves in front of a train are weak-minded. They do not have a strong mental constitution and develop mental illness, dying in the end. How useless they are! Such weak-minded people would only cause harm even if they remained alive.
Highlights From The Comments On "Crazy Like Us"
July 21, 2021 · Original source
Living in Russia, I can say that ADHD (translated as СДВГ) is less recognized by the psychiatry community here because of its unclear aetiology. Doctors usually refuse to treat the patients in the absence of dangerous symptoms, and state the diagnosis as "organic nervous system disorder", "psychoorganic syndrome" or indeed "neurasthenia". Adderall and Ritalin are illegal drugs here. Patients usually get prescribed nootropics (glycine, racetams) and adrenaline reuptake inhibitors (atomoxetine).
Also, I don’t know if things like the giant increase in neurasthenia in Japan after people started glorifying it is like this, or whether it was just a giant increase in neurasthenia, with no benefits or compensations.
Your Book Review: Exhaustion
August 05, 2022 · Original source
I read this book to try to make sense of CFS and its related conditions, and the book in my opinion begins to come together as it moves into the modern conceptions of exhaustion, but it is important to first follow Schaffner as she traces the explanatory models used in science and culture throughout Western history – there are only passing mentions in the book about Eastern conceptions of this condition, although it seems as though it is almost as common in Asian countries as in the West, where versions of neurasthenia are still diagnosed in China (shenjing shuairou; 神经衰弱) and Japan (shinkeisuijaku; 神経衰弱) and elsewhere.
Inline links: almost as common
This led to the development in the 19th century of a new, vaguely defined illness known as neurasthenia. It was, in the conception of the time, an illness of overworked and played out nerves due to their overstimulation at the hands of industrialisation and modern society. A neat rhetorical trick was employed by physicians at the time, who claimed that sensitive and creative people doing brain work were more susceptible than those in the working classes. This is an important change, as it begins the move away from the moralistic conception of exhaustion and produces a blame-free, stigma-free conception of an illness which has a tendency to strike the special and the smart. It is no coincidence that many of the writers and thinkers I mentioned earlier that suffered from exhaustion (James, Woolf, Mann, Wilde et al) are all concentrated in this era – they all were diagnosed with neurasthenia. As Darwin announces and elaborates on the theory of evolution, more attention is paid to the idea of inherited weaknesses in nerves, culminating in cultural accounts like Huysmans’s Á rebours (Against Nature), which described the final, exhausted, idle throes of generations of inbreeding in the person of a decadent, hypersensitive and exhausted noble recluse.
Inline links: Á rebours
If you’re a doctor in this period, the other benefit of the reformulation of exhaustion into neurasthenia is that it manifests in those who are rich enough to pay your fee, and simultaneously makes the physician indispensable. So, we begin to see in the writings of physicians, psychiatrists and novelists the two opposing views of how this condition is to be best treated. On one side, we have rest; the other, activity.