SYMPTOMS

What is neurasthenia?

Neurasthenia is a common clinical neurotic disorder, frequently observed in young and middle-aged adults, particularly among mental workers. It manifests as fatigue, weakness, depression, sleep disturbances, mental excitability, and mental exhaustion, often accompanied by significant emotional distress and psychological or physiological symptoms such as forgetfulness and dizziness^[1-5].

However, with advances in medicine, the diagnosis of neurasthenia has gradually been phased out. Instead, symptoms are now classified under conditions like depression or anxiety disorders based on clinical presentation.

What are the symptoms of neurasthenia?

Neurasthenia primarily involves a decline in various abilities and heightened sensitivity to external stimuli. Its complex manifestations are often summarized into the following seven major symptoms^[1-5].

• Weakness symptoms: The fundamental feature, including mental lethargy, lack of interest, low mood, insufficient energy, slow reactions, poor concentration, and memory decline. Even brief periods of work or study may induce exhaustion, with little relief from rest, leading to inefficiency and impaired daily functioning.
• Excitability symptoms: Mental overexcitement, such as involuntary recollection of past events or excessive imagination, especially before sleep, disrupting rest. Some may exhibit heightened sensitivity to sounds or light, even experiencing headaches or irritability from minor stimuli like TV noise.
• Emotional symptoms: Reduced self-control, impatience, irritability, and mood swings. Minor life conflicts may trigger frustration, with tasks feeling overwhelming and problems unsolvable.
• Headaches: Often tension-type, with sensations of pressure, tightness, or dull pain. The discomfort may be persistent or episodic, unrelated to physical exertion but linked to emotions, and unrelieved by rest.
• Muscle tension pain: Including soreness or aches in limbs.
• Sleep disturbances: Difficulty falling or staying asleep, light sleep, frequent nightmares, easy awakening, and short deep-sleep phases. Hypersensitivity to environmental factors like light leads to daytime grogginess and anxiety about nighttime rest.
• Psychophysiological symptoms: Non-specific issues like dizziness, blurred vision, palpitations, chest tightness, shortness of breath, excessive sweating, indigestion, or menstrual irregularities.

How is neurasthenia diagnosed? Does feeling weak or sluggish mean neurasthenia?

Strict diagnostic criteria must be met:

• Chronic duration of at least 3 months.
• Significant weakness or persistent fatigue unrelieved by rest, with no underlying organic disease detected.
• Presence of two or more excitability symptoms, impairing daily life and work, while ruling out other psychiatric disorders^[1].

Thus, mere physical weakness or sluggishness does not confirm neurasthenia.

TREATMENT

How to relieve symptoms of neurasthenia?

Psychological adjustment therapy is the main approach, supplemented by medication, physical therapy, or other treatments when necessary. Listen to soothing music or watch light entertainment programs to relax, engage in self-psychological adjustment, and allow the nervous system to rest and unwind. Seek professional psychological intervention from a psychiatrist or counselor^[2].

For patients whose symptoms cannot be effectively relieved by psychological adjustment alone, medication (such as anti-anxiety drugs for anxiety symptoms or sleeping pills for insomnia) can be combined with high-voltage low-frequency electrotherapy and alternating electromagnetic field therapy^[2].

Can neurasthenia be completely cured?

Most cases can be cured within six months to two years with proper treatment^[1].

How to prevent recurrence of neurasthenia?

• Identify triggers and reduce risk factors: Fully understand the nature of neurasthenia, identify disease triggers such as overwork, excessive stress, or noisy environments, and learn self-regulation. Adjust your mindset in a timely manner, balance work and rest, improve living conditions, adopt a correct attitude toward the disease, and enhance psychological resilience. Open up and confide in trusted individuals to cultivate a positive and optimistic outlook. Regular physical exercise and outdoor activities can also help regulate mental state^[5].
• Know yourself: Be clear about your capabilities and adjust your mindset when facing tasks beyond your capacity, avoiding excessive self-pressure.
• Adhere to psychological and drug treatments: This is the most effective measure to prevent recurrence.
• Schedule regular follow-ups and seek medical attention when needed: Attend follow-up appointments, report recent mental conditions to your doctor, and adjust treatment plans based on symptom changes.

DIAGNOSIS

Which department should I see for neurasthenia?

Psychiatry or Neurology.

How to distinguish between neurasthenia and autonomic nervous dysfunction?

They are fundamentally different. Neurasthenia is mostly caused by excessive fatigue, while autonomic nervous dysfunction is a syndrome caused by an imbalance in the autonomic nervous system^[6]. The main clinical manifestations of neurasthenia are mental excitability and mental fatigue, whereas autonomic nervous dysfunction often presents with symptoms of dysfunction in multiple visceral systems^[6].

How to differentiate between neurasthenia and depression?

With the development of medicine, the diagnosis of neurasthenia has gradually been abandoned^[7]. Patients with related symptoms are generally classified under depression or anxiety disorders based on their condition during consultation^[6].

What tests are needed for diagnosing neurasthenia?

Neurasthenia requires the exclusion of other organic diseases and psychiatric disorders.

Common tests include routine blood tests, electrocardiograms, etc. For headaches, a cranial CT or MRI, electroencephalogram, or transcranial Doppler may be needed. For fatigue, liver function tests and abdominal ultrasounds may be required. If psychiatric symptoms are prominent, relevant scales at a psychiatric clinic should be used to rule out other mental disorders. These test results typically show no significant abnormalities^[1].

What is a neurasthenia self-assessment form?

Currently, there is no self-rating scale for neurasthenia in China. Patients can self-assess based on the characteristics of neurasthenia.

POTENTIAL DISEASES

Why does neurasthenia occur?

There are many causes of neurasthenia, primarily related to social environment and psychological stress. Generally, human brain nerve cells have evolved over a long period to possess strong tolerance, making neurasthenia rare. However, prolonged high-intensity stimulation can easily trigger abnormalities^[1-5].

• Social environment: Prolonged exposure to contradictory or tense environments can lead to sustained nervous tension. Examples include highly competitive settings, excessive fatigue, irregular lifestyles, lack of rest, or intense work/study pressure and prolonged mental exertion.
• Psychological stress: Excessive fatigue and overwhelming psychological pressure can also keep the nervous system in a state of high tension. Continuous stress without adequate rest may cause persistent nervous tension, eventually exceeding the body's tolerance threshold and leading to symptoms.

What diseases can cause neurasthenia?

Generally, neurasthenia is associated with overwork, high stress, and mental tension, with no clear link to other diseases. However, chronic conditions such as infectious diseases, chronic poisoning, metabolic disorders, nutritional deficiency disorders, or head injuries may weaken resistance. Patients in prolonged states of caution, tension, or anxiety are also prone to developing psychological burdens that may trigger neurasthenia.

Is neurasthenia a disease?

Strictly speaking, neurasthenia is a syndrome of neurosis. The third edition of the American Diagnostic and Statistical Manual of Mental Disorders (DSM-III) already removed the diagnostic definition of neurasthenia. The latest diagnostic standards no longer include neurasthenia as a standalone diagnosis, instead classifying it under neurological or mental disorders^[7-9].