I think neuroasthenia is relatively rare in psychiatric clinics because it is the mildest of all mental disorders, and most patients go to general hospitals. Personally, I think the difference between neurasthenia and phytodysfunction is still obvious, as a kind of neurosis, neurasthenia still has the basic characteristics of neurosis, that is, it generally has certain personality characteristics, certain psychosocial factors such as life and work stress or physical illness, etc. Its clinical manifestations will generally have insomnia, fatigue, distraction, emotional instability, low energy, memory loss, and even the development of a mental disorder. The clinical manifestations of the disorder include insomnia, fatigue, distress, emotional instability, lack of energy, loss of memory, and even vegetative nerve dysfunction. It is due to various reasons (may be physiological or psychological) resulting in abnormal sympathetic or parasympathetic nerve function, which is manifested in a series of symptoms such as blood pressure, pulse, breathing, intestinal motility, sweat glands, etc. Obviously, the plant nerves belong to a lower level and are not under conscious control. In contrast, the emotional and cognitive symptoms of neurasthenia must involve the cerebral cortex and are largely governed by the consciousness, which I think should be the difference between the two. If the insomnia is only accompanied by mild distress and fatigue, which basically does not affect the patient’s ability to work and live, a diagnosis of neurasthenia is usually made. If there are significant anxiety symptoms, especially when accompanied by a variety of somatization symptoms and more pronounced social dysfunction, then the diagnosis is anxiety disorder. As for the neurasthenia-like symptoms of schizophrenia in its early onset or during its latent period, I think it is possible to distinguish them from the personality traits, psychosocial factors, emotional reactions, self-knowledge, and desire for treatment, etc. And as time goes by, the differential diagnosis will not be a problem when the symptoms of knowledge, emotion, and intention become clearer.