"Nerves": a sociomedical diagnosis ... of sorts

"Nerves" represents a common complaint among individuals from Appalachia. It appears to be a conglomerate term to encompass chronic anxiety without panic, mild depression without despair, neurasthenia without malaise, a smattering hypochondriasis and a surfeit of illness behavior, all superimposed on passive, dependent individuals with borderline normal intelligence and exposed to profound sociocultural deprivation. Definitive treatment of this disorder entails major changes or modifications in almost every aspect of their lives, including family structure, education, vocational training, and basic value systems. This may eliminate "nerves" but will not prevent the development of the more conventional psychiatric disorders to which more educated, middle-class individuals are vulnerable.