Tag Archives: neurasthenia

Another Kind of Asylum

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Certainly Not a Madhouse!

Certainly Not a Madhouse!

Words carry power, and the terminology used in psychiatric care is no exception. When asylums were first gaining popularity, the word meant a place of peace, recuperation, and sanctuary to most laypeople. The word “lunatic” or “insane” in front of it simply denoted the type of resident.

In the early years of American asylums, patients were often referred to as “unfortunates” or in other similarly sympathetic terms, but doctors soon realized that a stigma was growing around these institutions. They urged the use of words like “hospital” as more appropriate: asylums were simply places for sick minds to get well.

Going even further, sanitariums became popular as genteel places where people with nerve issues could get relief. These were many times small hospitals run by physicians . . . for the wealthy. They were private, luxurious, and generally voluntary, and patients were not burdened by the hopelessness sometimes associated with insanity. Nervousness, weak nerves, and neurasthenia were comfortable names that did not embarrass the rich.

Caregivers Outside the Adams-Nervine Asylum in Massachusetts, courtesy Historic New England

Caregivers Outside the Adams-Nervine Asylum in Massachusetts, courtesy Historic New England

One institution that bucked this trend of catering only to the wealthy was the Adams-Nervine Asylum in West Roxbury, Massachusetts. The founder, Seth Adams, provided in his will that the institution should be “for the benefit of the indigent, debilitated nervous people who are not insane, inhabitants of the Commonwealth of Massachusetts, as may be in need of the benefits of a curative institution.”  (Its charter did allow it to accept paying patients as well.)

Even a Modern Stove Required Almost 300 Pounds of Coal a Week and Produced 27 Pounds of Ash to be Sifted, courtesy Conner Prairie.org

Even a Modern Stove Required Almost 300 Pounds of Coal a Week and Produced 27 Pounds of Ash to be Sifted, courtesy Conner Prairie.org

The asylum must have been a boon to the admittedly small number of women able to go there. A Boston Globe article offered the information that “the statistics of the asylum show that of those admitted, unmarried women are in a great majority. Chiefest among the causes mentioned by the doctor as giving rise to this state of things is the fact that many of these women have worn themselves out working for and waiting upon others – daughters upon whom have devolved the weight of household cares and the nursing of invalid parents or relatives, and who have no one to fall back upon when their own strength fails.”

Teddy Roosevelt’s Nerves

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Young Theodore Roosevelt

Young Theodore Roosevelt

“Nervous disease” or more generally, neurasthenia (see last post), was a uniquely American disease of the 20th century. It affected mainly high achievers and the wealthy who exhausted themselves by the stress of their pursuits.

Teddy Roosevelt (born in 1858) was from a wealthy family whose mother could not cope with domestic responsibilities and developed neurasthenia. Roosevelt himself was a sickly child who managed to heal through a rigorous exercise program that included boxing. However, his father’s death gave him an emotional and mental blow that was hard to overcome. Roosevelt became depressed, endured drastic mood swings, and fell into heavy drinking at college; he recovered after falling in love with and marrying Alice Hathaway Lee. However, on February 14, 1883, both his wife and his mother died within a few hours of each other.

Roosevelt as a Cowboy in Dakota Territory, courtesy Theodore Roosevelt Collection, Harvard College Libray

Roosevelt as a Cowboy in Dakota Territory, courtesy Theodore Roosevelt Collection, Harvard College Library

Only 25, Roosevelt was devastated and again developed symptoms of neurasthenia. Physician Silas Weir Mitchell typically put women to bed for a rest cure when they developed neurasthenia, but he sent men to the West where they could rope cattle, hunt, explore rugged terrain and ride horses. Roosevelt followed Weir’s protocol and went to Dakota Territory, spending the next two years working cattle and working as a sheriff.

Col. Theodore Roosevelt, of the Rough Riders, 1898, courtesy Underwood & Underwood

Col. Theodore Roosevelt, of the Rough Riders, 1898, courtesy Underwood & Underwood

Roosevelt’s encounters with cattle thieves and lawless gangs–along with developing the skills needed to break and ride wild horses–changed both his body and mental condition. When he returned East, he married his childhood sweetheart and became the politician and conservationist remembered today. Roosevelt considered physical exercise so important to his well-being that he even brought in a professional sparring partner so he could box at the White House after becoming president.

The American Disease

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Chart From American Nervousness, Its Causes and Consequences, 1881

Chart From American Nervousness, Its Causes and Consequences, 1881

“Nervous” diseases became prevalent toward the end of the 1800s; most manifestations were lumped under the term neurasthenia. Some public commentators believed the condition was entirely manufactured, since it seemed to affect only the wealthier people in the country. Others were convinced it was a real condition brought on by the stresses of modern life and the burdens of business. Almost all agreed that it was a peculiarly American disease.

Writers tended to mock “nervous” women who went to rest homes, sanitariums, or cruises to recover from neurasthenia, but seemed to find the condition more credible in men. “Americans who make money or achieve marked success generally have neurasthenia at some time in their lives,” said the Fort Wayne Sentinel in 1890. Nervous strain was a natural part of these successful lives, and eventually, the body succumbed to “nervous exhaustion.” Doctors often compared neurasthenia in men to the mental aberration called hysteria in women.

Nerve Medicine Aimed at Men

Nerve Medicine Aimed at Men

Symptoms of neurasthenia included fatigue, anxiety, headache, heart palpitations, and depression. Treatment in general terms emphasized rest, a change of scenery, and freedom from responsibility and care. Specifically, treatments could include massage, ocean bathing, electrical stimulation, and hypnosis. Of course, nerve tonics became popular as well. These “secret” formulas often included strychnine, morphine, cocaine, and opium among other questionable ingredients.

This Elixer Said It All

This Elixer Said It All

The term neurasthenia has faded, but its symptoms live on as chronic fatigue syndrome, “burn-out”, and similar terms that denote high stress and its effects.