Neurasthenia – A Disease For the 20th Century

The years leading up to the Great War were a time of huge upheaval. The dizzying pace of change which preceded the outbreak of hostilities undoubtedly set the stage for that horrible conflict. The turn of the century brought with it rapid technological advancement as well as changes in the roles of women and a blurring of the previous century’s class structure. The world was shifting on its axis and a new feeling of anxiety presented itself during those times.

Neurasthenia was the name given to this new dis-ease, which affected more men than women —a surprise to the establishment, given its similarity to hysteria, which was largely viewed as a female disease. (On a side note, hysteria was an overused, misogynistic diagnosis. Have a bad day? Hysterical. Don’t feel like having sex tonight? Hysterical. A woman could be labeled hysterical for simply disagreeing with her husband’s demands. It was diabolical. Anyway…) The psychiatrists saw this nervous exhaustion as a result of the fast pace of life in the modern world. For example, with the advent of the assembly line, manufacturing was transformed from a system in which one worker saw the building or assembly of the product from start to finish to one in which the product was built or assembled by a team of workers each repetitively performing one task. The faster the process, the more machines built, the more units sold, with lower the cost to the consumer and more profits to the company. The pace could be as frenetic as the work was mind numbing.

The condition was even more common among the professional class: doctors, lawyers, judges and businessmen were finding it difficult to cope with their lives. The pressure to work hard, play hard resulted in irritability, sleep deprivation, depression, various physical pains and eventual breakdown. Those professions in which new technology was being employed suffered the greatest. Telephone operators, typesetters, railway workers, and engineers working on ever faster machines struggled to keep up. All throughout the Western World, the numbers of new diagnoses of neurasthenia rose at a frightening pace. For example, in Germany, just over 40,000 patients were registered in mental hospitals in 1870. By 1900, that number had risen to nearly 116,000 and to 220,000 by 1910. These numbers don’t include those who consulted a doctor without being admitted to hospital or those who spent time in a private sanatorium for respite. One German doctor called the illness ‘the pathological signature of the time in which we are living.’

Imagine a world where the great powers were rapidly developing their economies, competing for dominance in the colonial holdings, embracing new technologies, expanding their military might and simultaneously trying to hold on to the political systems of the past. The working classes were primed for revolution and the professional classes were having nervous breakdowns. It was a recipe for disaster and inevitably culminated in a global catastrophe the world had never seen before.