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Diagnoses such as neurasthenia, nervous breakdown and hysteria were eclipsed in the early 1900s by the broad category of neurosis (or the neuroses). This was largely thanks to the prestige of German medicine. Neurosis let physicians suspend judgment about whether the root of nervous disease was in the body or the mind. It was also a basis for separating types of mental illness. In general, those illnesses considered less severe were classed as neurosis; those considered more severe were classed as psychosis.

The search for the physical cause of neurosis was never successful. An alternative understanding, based on the ideas of Viennese neurologist Sigmund Freud, became dominant after the First World War. Freud‘s clinical work focused on patients with neurosis. He argued it was caused by unconscious desires, not degenerate nerves. Treating neurosis became the exlusive domain of psychoanalysts and psychiatrists by the 1930s and 1940s. This was especially true in the United States, where many of Freud’s followers exiled from Nazi Germany ended up.

Psychoanalysis declined and psychiatric medications became the dominant focus of research and treatment in the late 20th century. Gradually, and particularly in the 1980 revision of the Diagnostic and Statistical Manual (DSM), neurosis became eclipsed by diagnoses such as depression and PTSD.


M Gijswijt-Hofstra and R Porter (eds), Cultures of Neurasthenia from Beard to the First World War (Amsterdam: Rodopi, 2001)

E Green Musselman, Nervous Conditions: Science and the Body Politic in Early Industrial Britain (Albany: State University of New York Press, 2006)

J Oppenheim, ‘Shattered Nerves’: Doctors, Patients, and Depression in Victorian England (Oxford: Oxford University Press, 1991)


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