abandoned as a medical diagnosis. The ICD-10 system of the World Health Organization categorizes neurasthenia under "F48 – Other neurotic disorders". Under "F48.0 Neurasthenia", there are notable differences in characteristics of the disorder among various cultures. Two main overlapping forms of symptoms can be present: Increased fatigue after mental exertion can be associated with a reduction in cognitive function. Minimal physical effort might be felt as extreme fatigue along with pain and anxiety. Many other symptoms of bodily discomfort may be felt with either form. Excluded from this disorder are: asthenia NOS (R53), burn-out (Z73.0), malaise and fatigue (R53), postviral fatigue syndrome (includes Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)) (G93.3) and psychasthenia (F48.8). One modern opinion of neurasthenia is that it was actually dysautonomia, an "imbalance" of the autonomic nervous system. Barbara Ehrenreich, restating James's view, considered that neurasthenia was caused by the Calvinist gloom, and it was helped by the New Thought, through replacing the "puritanical 'demand for perpetual effort and self-examination to the point of self-loathing'" with a more hopeful faith. In Asia The medical term neurasthenia is translated as Chinese shenjing shuairuo () or Japanese shinkei-suijaku (神経衰弱), both of which also translate the common term nervous breakdown. This loanword combines shenjing (神經) or shinkei (神経) "nerve(s); nervous" and shuairuo or suijaku (衰弱) "weakness; feebleness; debility; asthenia". Despite being omitted by the American Psychiatric Association's DSM in 1980, neurasthenia is listed in an appendix as the culture-bound syndrome shenjing shuairuo as well as appearing in the ICD-10. The condition is thought to persist in Asia as a culturally acceptable diagnosis that avoids the social stigma of a diagnosis of mental disorder. In Japan, shinkei-suijaku is treated with Morita therapy involving mandatory rest and isolation, followed by progressively more difficult work, and a resumption of a previous social role. The diagnosis is sometimes used as a disguise for serious mental illnesses such as schizophrenia and mood disorders. In China, traditional Chinese medicine describes shenjingshuairuo as a depletion of qi "vital energy" and reduction of functioning in the wuzang "five internal organs" (heart, liver, spleen, lungs, kidneys). The modern CCMD classifies it as a persistent mental disorder diagnosed with three of these five symptoms: "'weakness' symptoms, 'emotional' symptoms, 'excitement' symptoms, tension-induced pain, and sleep disturbances" not caused by other conditions. Arthur Kleinman described Chinese neurasthenia as a "biculturally patterned illness experience (a special form of somatization), related to depression or other