Neurasthenic neurosis: Psychogenic weakness and fatigue

Neurasthenic neurosis may be physical —with weakness and fatigue stemming from chronic overwork brought on by attempts to compensate for low self-esteem and the lack of primary coping techniques; or symbolic —with the somatic symptoms serving as expressions of and excuses for functional helplessness rather than resulting from actual physical exertion. Since functional helplessness results from the lack of effective coping patterns and inhibitions motivated by low self-esteem, the underlying dynamics in both types of neurasthenic neurosis are similar. In either type, helping the patient come to better terms with himself and acquire more adaptive coping patterns provides a practical approach to treatment.