Although the Rest and West cures involved wildly different therapeutic strategies, both were designed to treat the same medical condition: neurasthenia. First described by American neurologist George Beard in 1869, neurasthenia’s symptoms included depression, insomnia, anxiety and migraines, among other complaints. The malady was not just an illness, he said, but also a mark of American cultural superiority. According to Beard, excessive nervousness was a byproduct of a highly evolved brain and nervous system. A “brain-worker” who excelled in business or the professions might experience nervous breakdowns if he overtaxed his intellect. His highly evolved wife and children could easily succumb to the same malady, particularly if they engaged in excessive study or “brain work.”
While men and women could experience the same neurasthenic symptoms, the different treatments they received reflected cultural stereotypes of the day. The Rest Cure ensured that women remained in their “proper” sphere: the home. Mitchell and his medical peers discouraged female patients from writing, excessive studying or any attempt to enter the professions. Mitchell told Gilman, who underwent the Rest Cure in 1887 during a bout of postpartum depression, to “live as domestic a life as possible” and “never to touch pen, brush or pencil again.”
By contrast, nervous men were encouraged to engage in vigorous physical activity out West, and to write about the experience. These activities would supposedly rehabilitate them for further success in commerce and intellectual pursuits. As Mitchell wrote in his 1871 book “Wear and Tear: Or Hints for the Overworked,” neurasthenic men could strengthen their nervous systems by engaging in “a sturdy contest with Nature.” Such a challenge would allow a man to test his willpower and reinforce his masculinity, which had been weakened by the feminizing effects of nervous illness. (Mitchell elsewhere lamented that under great nervous stress, “The strong man becomes like the average woman.”) The West Cure also promoted physical fitness, allowing patients to attain the manly, muscular build popular at the time.