Putting a Name to an Old Mental Disease

Here's a bit from a NY Times article by Benedict Cary about the evolution of names for and old mental disease: neurasthenia. Oh, OK, I'll give it its more modern name: mental breakdown. Or if I'm really trendy: burnout syndrome. Isn't it wonderful how we label and re-label things?

Decades ago modern medicine all but stamped out the nervous breakdown, hitting it with a combination of new diagnoses, new psychiatric drugs and a strong dose of professional scorn. The phrase was overused and near meaningless, a self-serving term from an era unwilling to talk about mental distress openly.

But like a stubborn virus, the phrase has mutated.

In recent years, psychiatrists in Europe have been diagnosing what they call “burnout syndrome,” the signs of which include “vital exhaustion.” A paper published last year defined three types: “frenetic,” “underchallenged,” and “worn out” (“exasperated” and “bitter” did not make the cut).

This is the latest umbrella term for the kind of emotional collapses that have plagued humanity for ages, stemming at times from severe mental difficulties and more often from mild ones. There have been plenty of others. In the early decades of the 20th century, many people simply referred to a crackup, including “The Crack-Up,” F. Scott Fitzgerald’s 1936 collection of essays describing his own. And before that there was neurasthenia, a widely diagnosed and undefined nerve affliction causing just about any symptom people cared to add.

Yet medical historians say that, for versatility and descriptive power, it may be hard to improve upon the “nervous breakdown.” Coined around 1900, the phrase peaked in usage during the middle of the 20th century and echoes still. One recent study found that 26 percent of respondents to a national survey in 1996 reported that they had experienced an “impending nervous breakdown,” compared with 19 percent from the same survey in 1957.

This bit catches the essence of finding just the right name for a disease:

Through the ages, every generation has attributed its own catchall diagnosis to larger cultural changes. Industrialization. Modernization. The digital age. The 19th-century philosopher William James reportedly called neurasthenia, from which he claimed to suffer himself, “Americanitis,” in part the result of the accelerating pace of American life. So it was with breakdowns. The causes were largely external — and recovery a matter of better managing life’s demands.

As medicine gets "professionalized" we get more specific:

Psychiatrists proceeded to slice problems like depression and anxiety into dozens of categories, and public perceptions shifted, too. In 1976, 26 percent of people admitted seeking professional help, up from 14 percent in 1947, according to Dr. Stearns’s analysis. And “nervous breakdown” began to fade from use.

Read the article. It is fun and interesting.