~ Neurocirculatory asthenia is also called anxiety neurosis and effort syndrome.

~ It is characterized by difficulty doing muscular effort and handling emotional situations. It also includes physical symptoms such as poor appetite and nervous urinary frequency.

~ Display symptoms similar to panic attacks and agoraphobia.

~ The condition is hereditary and onset is between 18 and 35 years of age.
Typically occurs after trauma.

Neurocirculatory asthenia is a disorder characterized by the appearance of many symptoms but few signs. It has been given many names including anxiety neurosis, neurasthenia and effort syndrome. Patients chiefly complain of difficulty doing hard work (i.e., muscular work) and  handling emotion-provoking situations.


Some of the common symptoms are similar to those of a panic attack and involve pain in the chest, smothering spells, subjective feelings of choking, and nervousness. Often patients complain about breathing difficulties, which, according to the study authors, are expressed as: “I can’t get in enough air”; “I have to fight for my deep breath”; “I don’t seem to get in enough oxygen.” Those symptoms are also accompanied with sighing that may have been ongoing since childhood, and taken together may resemble a diagnosis of panic disorder.

Other recurrent symptoms in anxiety neurosis are also found in agoraphobia, such as avoidance of crowded places due to the fear of having a panic attack. Patients often experience dizzy spells and giddy sensations while walking or standing which brings on feelings of insecurity and the need to hold on to things. Similarly, they may experience an acute attack of choking, palpitation, hyperventilation, and chest discomfort, which elicits the fear of dying and subsequently avoidance of certain places.


Anxiety neurosis includes other physical symptoms as well such as poor appetite, nervous urinary frequency, and constipation. In addition, general irritability is predominant making everyday tasks even more difficult to handle. Typical of this disorder is the inability to complete tasks that require muscular effort, and for example running on a treadmill for five minutes result in poor oxygen consumption (i.e., high oxygen consumption during exercise is a sign of efficient aerobic metabolism) and high lactate concentration, suggesting abnormal aerobic metabolism and high anaerobic metabolism.  In addition, the study authors reckon that patients also show abnormal responses to painful stimuli (i.e., carbon dioxide, temperature, noise, and flashes).

The onset of anxiety neurosis is typically observed after 18 years of age and no later than 35 year-old, and it has a high familial incidence, suggesting that it could be hereditary. However, according to the patients’ reports collected by the authors, the onset and exacerbations of the illness occurred in situations involving father’s cruelty, infectious illnesses, marital problems, warning about health, poverty, trouble at school, malnutrition, which correspond to high emotion-provoking situations. Finally, time and reassurance appear to have a higher positive outcome than any form of therapy.


COHEN ME, WHITE PD. Life situations, emotions, and neurocirculatory asthenia (anxiety neurosis, neurasthenia, effort syndrome). Psychosom Med. 1951 Nov-Dec;13(6):335-57. doi: 10.1097/00006842-195111000-00001. PMID: 14892184.


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