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Old wine in new bottles: neurasthenia and ‘ME’

Published online by Cambridge University Press: 09 July 2009

Simon Wessely*
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr Simon Wessely,Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.

Synopsis

The history of neurasthenia is discussed in the light of current interest in chronic fatigue, and in particular the illness called myalgic encephalomyelitis (‘ ME ’). A comparison is made of the symptoms, presumed aetiologies and treatment of both illnesses, as well as their social setting. It is shown that neurasthenia remained popular as long as it was viewed as a non-psychiatric, neurological illness caused by environmental factors which affected successful people and for which the cure was rest. The decline in neurasthenia was related to the changes which occurred in each of these views. It is argued that similar factors are associated with the current interest in myalgic encephalomyelitis. It is further argued that neither neurasthenia nor ‘ ME ’ can be fully understood within a single medical or psychiatric model. Instead both have arisen in the context of contemporary explanations and attitudes involving mental illness. Future understanding, treatment and prevention of these and related illnesses will depend upon both psychosocial and neurobiological explanations of physical and mental fatigability.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1990

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