Old Name, Same Game
What's in a name? In the olden days they called it vapors, melancholia, neurasthenia,
neuralgic disease, nervous prostration. Indeed, the medical profession originally thought
that it was a disease of the peripheral nerves only later deciding that perhaps it
was a disease of the mind. What's the difference? We all know one when we see one: it's a
Today's nomenclature includes any of a number of clinical diagnoses found in the DSM-IV
(psychiatric classification system): psychotic break, schizophrenic episode, manic break,
post-traumatic stress disorder, panic attack and (most commonly) major depressive episode.
Although the mental health profession doesn't use the term at all, the ordinary folk call
it a nervous breakdown.
What Is It?
A nervous breakdown, officially a symptom of one of the psychiatric diagnoses listed
above, includes some sort of disintegration of personality usually temporary. It's
as if the "circuits are overloaded." When associated with stress, it has been
described as a "snapping under extreme pressure." (Interestingly, surveys show
that one third of Americans have felt on the verge of a nervous breakdown at some point in
A breakdown can manifest as an inability to function (to fulfill obligations at work or
home or school). It may involve severe weakness, exhaustion or even catatonic posturing
(inability to move). In breakdowns of the depressive type, there may be uncontrollable
crying, loss of pleasure in all activities, dramatic weight loss or weight gain, sleep
disruption or extreme sleepiness, confusion, disorientation, extreme feelings of
worthlessness, guilt and despair.
In breakdowns involving psychosis, there will be a loss of contact with reality that
can take many forms:
- · having visions, hearing voices or feeling sensations that have no basis in fact (i.e.
feeling like there is something crawling on the skin when there isn't; hearing someone say
something when there is no one present)
- · obsessing about doing something harmful (i.e. in post-partum psychosis, having
thoughts of harming one's baby)
- · feelings of being victimized or persecuted by others (when this isn't happening)
- · feelings of extreme guilt or excessive grandiosity or unwarranted intense jealousy
- · strange speech patterns (not comprehensible because it is strangely organized and
- · strange behaviours (bizarre behaviour such as odd body movements or disrobing in
In breakdowns that are actually bi-polar (manic) episodes, there may be racy behaviour,
lack of sleep with high energy, very poor judgment resulting in excessive spending and
socially inappropriate behaviours, increased talkativeness, and exaggerated self-esteem.
In breakdowns that are manifestations of some sort of anxiety disorder, there may be
panic attacks and incapacitating fears that affect daytime performance (perhaps
interfering with ability to work, study or run a home) and disrupting night time sleep
The common factor in all types of nervous breakdowns is that the sufferer steps out of
his/her normal, functional lifestyle and into a place of emotional chaos that erodes
Who Gets A Nervous Breakdown?
Some people have a nervous breakdown after exposure to extreme or unremitting
overwhelming stress. They may have been "normal" beforehand. For example, a
young man may come back from battle with a nervous breakdown (post-traumatic stress
disorder), whereas he entered the battle "normal." Similarly, a woman may have
functioned normally until she was violently assaulted. Or, a woman may have been perfectly
normal until she gave birth, after which she experienced some type of post-partum
depression. Theoretically, anybody could have a nervous breakdown.
Some people have breakdowns that were "waiting to happen." These are
disintegrations that result from genetically based disorders such as schizophrenia or
bi-polar depression. The genetic sensitivity, combined with life stress, can result in a
"breakdown." Breakdowns that are episodes of major depression also stem from a
combination of inborn and environmental factors (for example, having a family history of
depression and then experiencing serious loss, frustration or failure in one's own life).
How Are Nervous Breakdowns Treated?
Appropriate types of psychotropic medications, therapeutic interventions and rest are
used to treat breakdowns. Normally people are restored to previous levels of functioning
(or even better, depending on the type of breakdown); in some cases of mental illness,
healthy functioning is never completely restored. In the vast majority of breakdowns,
however, proper treatment leads to recovery and prevention of further collapse.
For example, an episode of major depression ("a nervous breakdown"), can
bring a person to psychotherapy for the first time. Psychotherapy (which may or may not
require the addition of medication, depending on the severity of symptoms), can help the
person come "back to himself" and it can also help him learn powerful ways of
monitoring stress levels in the future, so as to prevent further breakdowns. In addition,
psychotherapy may help him to achieve a higher level of functioning (mentally, emotionally
and spiritually) than he ever had before. In other words, a nervous breakdown can actually
be a gift! Indeed, many people have experienced a breakdown as a pivotal turning point in
their lives, a situation that forced them to take stock, dismantle harmful mental,
physical and emotional habits and revamp their lifestyles. Like many crises, the nervous
breakdown can be an opportunity for growth. Nonetheless, most of us would prefer not to
Preventing Nervous Breakdowns
In many cases, a total collapse can be prevented by responding promptly to early
symptoms. Don't wait until you crack up seek professional psychological help when
feeling very stressed or when mood is dropping and not picking up quickly. Self-management
can include taking a break from work, taking alternative remedies and treatments (see your
naturopath, herbalist or homeopath); exercising more, allowing more time for sleep,
increasing actual fun and laughter, doing some deep relaxation or meditation daily,
improving food choices and de-stressing your lifestyle wherever possible. Take care of
yourself! Not all breakdowns can be prevented, but many can. Increase your chance of
staying physically and mentally healthy by being proactive in your approach.