Americanitis: A Repetitive Stress Injury From Being Alive
"Modern life is killing us" - Doctors in 1925
Let’s play a quick game. The game goes like this: Think about Americans and what you know about us and then ponder what sort of disease would best incapsulate our general ethos. What might the symptoms be? Thin skin? Inability to think critically? A debilitating lack of empathy?
Unfortunately, that’s not precisely what Americanitis - an actual name for an actual (at the time) psychiatric condition - was when it was being diagnosed and treated. But honestly, it’s not that far off. And when I tell you what Americanitis actually is, you’re going to be curious why there isn’t a current CDC warning about the disease.
The Infection of Industrialization
First things, the term “Americanitis” so named because a whole lot of sad, pathetic Americans were falling ill with it, not because it was a condition whose symptoms were reminiscent of the traits of Americans. The Christian name for this poorly-defined constellation of symptoms was neurasthenia and it was kind of like garden-variety depression except more.
Neurasthenia was first described in 1829 as an actual weakness of the nerves, but it soon came to mean a broader set of problems. At this time, it was mainly a diagnosis applied to children; in England, the new public school system meant young people who were, for the first time, being observed by people other than their parents and being made to do things like sit at a desk.
Writing in a comprehensive 2022 paper, Henry Connor noted that these diagnoses spiked when “Charles Thackrah, a Leeds-based surgeon and pioneer in the field of occupational medicine, wrote of the student’s poor posture and lack of exercise which caused impaired digestion and a congested brain.”
Conditions attributed to overpressure usually included fatigue as a core symptom and others, some of which might now be classified as psychosomatic, such as weariness, lethargy, stress-related headache, insomnia, nightmares, restlessness, irritability, and malaise. They also included myopia, spinal deformity attributed to badly designed desks, and some more serious problems such as hysteria, insanity and suicide, chorea, various types of cerebral inflammation (often referred to as ‘brain fever’), epilepsy, hydrocephalus, and death.
This disease was later used as a political cudgel, much like ADHD has been used for the last 25 years, to fight battles over education, funding, and the benefits of children learning outside of the home. But as this war waged on in the UK, the United States was also seeing an epidemic of bad nerves.
An 1886 medical journal described neurasthenia as the “exhaustion of the nervous system,” as well as a kind of “indefinite phase of nervous exhaustion.” Which like, doesn’t that sort of describe how all of us have felt for the last four to seven years? No? Just me? Fine.
Anyway, neurasthenia was a condition that was appearing more and more as industrialization changed work, the economy, rest, domesticity, school, and just about every other area of life. Its symptoms - including being tired, feeling restless, not really wanting to eat, feeling lethargic, and having high blood pressure - were described as similar to anemia, but doctors found that patients respond to iron supplements.
Around that same time, neurologist S. Weir Michael had been studying neurasthenia and released “Wear and Tear: Or Hints for the Overworked,” a treatise on what he saw to be the causes of this “brain drain.” Here’s part of the updated introduction, added to the publication a few years after its initial release:
The American of the Eastern States and of the comfortable classes is becoming notably more ruddy and more stout. The alteration in women as to these conditions is most striking, and, if I am not mistaken, in England there is a lessening tendency towards that excess of adipose matter which is still a surprise to the American visiting England for the first time.
I should scarcely venture to assert so positively that Americans had obviously taken on flesh within a generation if what I see had not been observed by many others. It would, I think, be interesting to enter at length upon a study of these remarkable changes, but that were scarcely within the scope of this little book.
Yes, literally 150 years ago, people were wringing their hands about how women were getting uglier and men were getting fatter and everything was going to shit and that’s why we’re all so sad. The more things change!
Neurasthenia became a fairly common diagnosis for folks seeking assistance at the turn of the 20th century, mostly because it was a neat way to write off a lot of symptoms and blame an outside force. It wasn’t any kind of actual medical or cognitive issue - it was the stress of the world around you. And who knows? Maybe it was. By the 1900s, it was still a hot topic, though it had now very much become a disease associated with Americans.
Living Feverishly
In the preface to his 1921 book, “Epilepsy, Hysteria, and Neurasthenia: Their Causes, Symptoms, & Treatment” the London-Based Isaac G. Briggs blamed modern life, writing:
“To-day, the need to eat forces even sensible men to live—and die—at a feverish rate. In bygone days the world was a peaceful place, in which our forefathers were denied the chance of combining exercise with amusement dodging murderous taxis.”
He cited the following “exciting factors”, which could turn someone who was only a little predisposed into someone with a full-blown case:
Worry in any form (especially when accompanied by excess of brain-work),
Accident-shock,
Sexual abuse,
Abuse of drink, drugs or tobacco,
Lack of exercise,
Exhausting diseases,
Menopause, and diseases of the womb,
"Society life",
Retirement,
So, just to be clear: both retirement and worry in any form could be all it took to push someone over the edge. Got it! Briggs also wrote that women were less likely to get this disease than men “because of the more active part played by [men] in the struggle for existence.”
Additionally, he viewed neurasthenia as a disease of people living in cities, doing “mental rather than manual” labor, of the "idle rich", and “in races which live feverishly, like the Americans.”
These Americans were pretty used to being told that feeling “run-down” was cause for concern. At this time, Rexall was running ads in just about every paper in the United States, trying to sell their “Americanitis Elixir,” a mix of grain alcohol and chloroform. Which, to be fair, I’m sure is quite effective at making you less stressed because you will, in fact, be dead or unconscious.
A couple of years later, William Samuel Sadler published “Americanitis - Blood Pressure and Nerves,” which further hammered home the point. In it, Sadler - an American himself - describes a lecture he gave in 1905 about the health concerns of modern American life, including high blood pressure and “toxic irritation.” But, said Sadler, people were not powerless over this condition.
Sounding a lot like a white woman purporting to be a YouTube mindfulness “guru,” Sadler explained that many sufferers could alleviate their symptoms on their own.
“These nervous victims of Americanitis, these fussy, irritable, fretting folks who are victims of the high-tension life, could all train themselves to live with much more peace on their inherited nerves than they are used to on average.”
He encouraged people to smoke less, especially as children, and to cut back on caffeine. He also cautioned about the role of opium (he has like, a long chapter trying to convince the reader that opium is not healthful). His prescriptions included (get this): baths, the sun, exercise, and rest.
Which really makes me feel like modern medicine hasn’t progressed a lot in the last 100 years because this is literally what my doctor told me to do about my high blood pressure. And, while I can’t be absolutely certain, I am relatively sure the pace of my American Life is quicker than that of someone who lived before the television set.
So Anyway, Who Here Has Americanitis?
The terms “neurasthenia” and “Americanitis” aren’t used any longer by medical doctors, mostly because “stress” and “anxiety” exist instead. But I do think there’s something to the fact that for 200 years, we’ve been blaming modernity and woefully wishing for some kind of simpler, more peaceful past when, you know, you just died from basic diseases and women were often caught in a cycle of pregnancies from age 16 until finally she was released by the sweet arrival of death.
It kind of seems like there wasn’t a point when humans weren’t anxious, it’s just that we’re anxious about different stuff. It also feels like going outside and, as the kids say, touching grass really is a good way to find a bit of solace.
So if nothing else, the cure for the American Disease of Stress and Medical Nostalgia, seems to be reminding ourselves that life has always been a nightmare in varying degrees, but there have also always been nice things, like a bit of sunshine and a healthy snack.
Hope that helps you feel better! xoxo!