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Neurasthenia is a borderline neurotic disorder caused by overwork or chronic stress. Neurasthenia is much more common than one might think – and not in the weak and melancholic, but in the most active and committed young men and women.            

The disease of hyperresponsible people and perfectionists 

The average age of a neurotic patient is from twenty-five to fifty years. As a rule, this is a resident of a big city who works hard, leads an active social life and, as they say, always succeeds in everything. When psychologists say “burnout,” psychiatrists often refer to neurasthenia.   

Typical personality traits that become favorable factors for the development of the disease: asthenic type (“nervous weakness”, exhaustion), increased anxiety, suspiciousness and perfectionism. Such people are very responsible, they are very worried about their obligations, they try to do everything at the highest possible level. They are never late, they are very worried if they cannot keep their promise.       

When psychologists say “burnout,” psychiatrists often refer to neurasthenia.

It also happens in another way: difficult life circumstances fall on a person – a serious illness of a relative, alcoholism or betrayal of a partner, household and financial difficulties. In a word, an unfavorable environment, overexertion and pressure, which lead to constant stress and frequent overwork.       

Types of neurasthenia

According to the international classification of diseases, revision 10 (ICD-10), the types of neurasthenia are represented by two types.  

The first type is increased fatigue after mental work. The person complains that they are less successful at work or in everyday activities due to distracting associations, memories, problems with attention. Mental exhaustion is more pronounced.     

The second type is general weakness after minor physical exertion (not going to the gym, but something ordinary) with a feeling of pain in the muscles. Also, the person says that he cannot relax.        

In other classifications, there is hypersthenic and hyposthenic neurasthenia – these are rather phases (stages) of the disorder, which will be discussed later.    

Symptoms and signs of neurasthenia: from irritability to deep fatigue   

A person can suspect neurasthenia on the following grounds:  

• became more irritable;
• gets very tired in the evening; 
• reacts sharply to insignificant stimuli (“everything pisses me off”); 
• began to swear with colleagues and loved ones more often , “snap back”;  
• has always been calm, and now he loses his composure, raises his voice or cries for no serious reason. 

The disease develops in three phases. Signs of neurasthenia at different stages are slightly different.  

1 The first (hypersthenic) phase is expressed in increased excitability, irritability and sleep disturbance. A person is “on edge” all the time , a sharp sound or sudden bright light causes pain in him. Disturbed by dizziness, headache, throws in a fever or chills, excitement is accompanied by attacks of palpitations.       

2 The second (hyposthenic) phase is an increase in weakness. The nervous system is depleted, a person has to strain in order to maintain a habitual way of life. It becomes difficult to get out of bed in the morning and do housework: “I can’t bring myself to do it,” “I don’t have the strength to leave the house,” the ability to “think quickly” is lost.        

3 Phase of exhaustion – symptoms of neurasthenia are complemented by a deep feeling of weakness. There is tearfulness, conflict, general lethargy. I don’t want anything, nothing motivates. The disease has completely taken over a person’s life.    

Neurasthenia and depression 

If neurasthenia is not treated for a long time , it leads to changes in the body: the resource is depleted, immunity decreases. There is a decrease in the production of neurotransmitters in the brain (serotonin, dopamine), which can lead to an even more serious pathology – depression.      

In psychiatry, there is a term “disorder of adaptive reactions.” So they say when, for example, depression develops as a reaction to prolonged neurasthenia.   

In pure depression there are some differences: 

• mood noticeably worse for more than two weeks;
• there are long-term sleep and appetite disturbances ; 
• worried about pain not associated with a disease of internal organs (pain in the abdomen, in the pelvic region);    
• mood and well-being fluctuates during the day (worse in the morning).  

Treatment of neurasthenia

In each case, the treatment of neurasthenia should begin with the elimination of the traumatic situation and the activity that is overwhelming. If you cannot get away from stress (go to another department, change jobs, part with your partner), then you need to learn how to cope with it through meditation, auto-training or psychotherapy.          

I always recommend that patients start by resting, rethinking their lifestyle and maintaining a healthy regimen, but, unfortunately, it is not always possible to solve the problem without therapy . If the symptoms do not go away within a month after the start of the recovery regimen, you need to make an appointment with a psychiatrist.        

If the symptoms do not go away within a month after the start of the recovery regimen, you need to make an appointment with a doctor. A psychiatrist or a psychotherapist (not a psychologist) will tell you how to treat neurasthenia .    

The diagnosis is made on the basis of complaints and the patient’s story about the disease. Additional methods are prescribed to rule out other diseases. For the treatment of neurasthenia, a psychiatrist prescribes modern antidepressants – SSRIs (selective serotonin reuptake inhibitors) or similar drugs.    

In addition to meditations, which help a person restore the balance of the body’s work, I also recommend sessions of restorative hypnosis to patients. Hypnotic techniques are highly effective treatments for neurasthenia.   

The prognosis for neurasthenia is good – it can be cured of it.  

Once again, I emphasize that depression can be hidden behind the symptoms of neurasthenia. Although we and describe their differences higher urge: Do not put yourself diagnoses themselves. It also happens that even psychiatrists put neurasthenia where a more serious condition is observed. To such patients come to me. They assume they have chronic fatigue syndrome, the diagnosis is “neurasthenia”, and I see a classic case of recurrent depression. If a patient is depressed, he definitely needs the help of a doctor.