[clarification needed] It became a major diagnosis in North America during the late nineteenth and early twentieth centuries after neurologist George Miller Beard reintroduced the concept in 1869.

[7] Also in 1868, New York neurologist George Beard used the term in an article published in the Boston Medical and Surgical Journal[1] to denote a condition with symptoms of fatigue, anxiety, headache, heart palpitations, high blood pressure, neuralgia, and depressed mood.

[12] The condition was explained as being a result of exhaustion of the central nervous system's energy reserves, which Beard attributed to modern civilization.

Data from this period gleaned from the Annual Reports of Queen Square Hospital, London, indicates that the diagnosis was balanced between the sexes and had a presence within Europe.

[16] To capitalize on this epidemic, the Rexall drug company introduced a medication called "Americanitis Elixir" which claimed to be a soother for any bouts related to neurasthenia.

[24][failed verification] Barbara Ehrenreich, restating James's view, considered that neurasthenia was caused by the Calvinist gloom,[25] and it was helped by the New Thought, through replacing the "puritanical 'demand for perpetual effort and self-examination to the point of self-loathing'"[25] with a more hopeful faith.

This loanword combines shenjing (神經) or shinkei (神経) "nerve(s); nervous" and shuairuo or suijaku (衰弱) "weakness; feebleness; debility; asthenia".

In China, traditional Chinese medicine describes shenjingshuairuo as a depletion of qi "vital energy" and reduction of functioning in the wuzang "five internal organs" (heart, liver, spleen, lungs, kidneys).

[27] Arthur Kleinman described Chinese neurasthenia as a "biculturally patterned illness experience (a special form of somatization), related to depression or other diseases or to culturally sanctioned idioms of distress and psychosocial coping.

"[28] In Japan, shinkei-suijaku is treated with Morita therapy involving mandatory rest and isolation, followed by progressively more difficult work, and a resumption of a previous social role.