Overholser, James C, Beale, Eleanor E · The Journal of nervous and mental disease · 2019 · DOI
This article looks back at a condition called neurasthenia that doctors diagnosed frequently between 1869 and 1930, then largely abandoned. The authors found that many symptoms people with neurasthenia experienced—like exhaustion, mental fog, and physical weakness—are still seen today in conditions like chronic fatigue syndrome (ME/CFS) and fibromyalgia. By understanding neurasthenia's history, modern doctors may better recognize and treat these conditions and improve how they listen to their patients.
Understanding neurasthenia's historical trajectory helps contextualize modern ME/CFS within broader patterns of how medicine recognizes and legitimizes conditions characterized by fatigue and functional impairment. This perspective may help reduce diagnostic skepticism and improve clinical validation for ME/CFS patients who face similar physician dismissal that neurasthenia patients once experienced.
This review does not establish whether neurasthenia and ME/CFS are the same condition or different manifestations of a common underlying mechanism. It does not provide empirical evidence of causation or direct biological links between historical and modern diagnoses, nor does it offer new clinical or laboratory findings to inform ME/CFS diagnosis and treatment.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Overholser, James C & Beale, Eleanor E (2019). Neurasthenia: Modern Malady or Historical Relic?. The Journal of nervous and mental disease. https://doi.org/10.1097/NMD.0000000000000943
BibTeX
@article{mecfsatlas-overholser-2019-neurasthenia-modern,
author = {Overholser, James C and Beale, Eleanor E},
title = {Neurasthenia: Modern Malady or Historical Relic?},
journal = {The Journal of nervous and mental disease},
year = {2019},
doi = {10.1097/NMD.0000000000000943},
note = {PubMed: 31464984},
url = {https://www.mecfsatlas.com/evidence/overholser-2019-neurasthenia-modern},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/overholser-2019-neurasthenia-modern
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