But in the land of the Protestant work ethic, relaxing’s for chumps, anyway. “Neurasthenia did not simply denote the presence of sickness,” Schuster writes, “Beard argued it indicated the presence of an active mind, a competitive character, a lover of liberty—in short, the quintessential American.” Many characters in fiction of the day were neurasthenic, and portrayed positively.
This attitude made the diagnosis desirable and some patients sought it out. Because American medicine was still trying to establish itself as a respected profession, doctors were motivated to give the patients what they wanted. Medicine manufacturers also did a booming business selling bottled treatments of dubious composition directly to patients through newspapers and other periodicals, giving people the opportunity to self-diagnose—and, in the process, to assign themselves a label that said more about them than just their health. Tom Lutz, the author of American Nervousness: 1903, and a professor of creative writing at the University of California, Riverside, writes that people sometimes used “claims to sickness as claims to privilege.”
And this was an illness of the privileged—the white, Protestant, Northern privileged, mostly. Mental activity was thought to use more energy than physical activity, a belief that allowed Beard to offer racist explanations for why blacks and Native Americans didn’t get neurasthenia—because they didn’t overuse their minds, he thought, or didn’t have the mental capacities to overuse in the first place. Catholics just did whatever the church told them, in Beard’s view, so that relieved some of their mental burden, and the South wasn’t as modernized as the North.
It was thought that “if you were lower class, and you weren't educated and you weren’t Anglo Saxon, you wouldn’t get neurasthenic because you just didn't have what it took to be damaged by modernity,” Lutz says.
In reality, members of the upper and middle classes were the ones who could afford to see a neurologist and get the diagnosis in the first place. They could afford tonics from advertisements, and afford the expensive, time-consuming treatments. But even within this more well-off population, there was a sharp divide between how the disease was conceptualized and treated for men and for women.
The underlying notion of neurasthenia—that nervous energy gets depleted because people’s bodies weren’t built for modern life—provided an easy way to reinforce traditional gender roles. When men spent too much time indoors, when they couldn’t keep up with the pace of their work, or had money problems, they were susceptible to neurasthenia. Women were susceptible when they were too socially active, or spent too much time outside the home.
For men, the frontier held the cure. Doctors would often send male neurasthenics westward to ride horses, rope cattle, do pushups, and slap each others’ butts until the sheer manliness of it all restored their nervous energy. None other than the 26th president of the United States, Teddy Roosevelt, received such a “West cure” for his neurasthenia. Before his cure, when he was a New York state legislator, Roosevelt had a reputation as a dandy, and people called him names like “Young Squirt” and “Punkin-Lily,” Lutz writes. Some called him an American Oscar Wilde. His neurasthenia was seen as an “effeminizing sickness” that the West cure got rid of, making him buff and tough enough to be elected president. Such were the times.