Mental

breakdown

A mental breakdown (also

known as a nervous
breakdown) is an acute, time-
limited mental disorder that
manifests primarily as severe
stress-induced depression,
anxiety, or dissociation in a
previously functional
individual, to the extent that
they are no longer able to
function on a day-to-day basis
until the disorder is resolved. A
nervous breakdown is dened
by its temporary nature, and
often closely tied to
psychological burnout, severe
overwork, sleep deprivation,
and similar stressors, which
may combine to temporarily
overwhelm an individual with
otherwise sound mental
functions.
 Nervous breakdown
Specialty Psychiatry

Denition
The terms "nervous
breakdown" and "mental
breakdown" have not been
formally dened through a
medical diagnostic system
such as the DSM-5 or ICD-10,
and are nearly absent from
current scientic literature
regarding mental illness.[1][2]
Although "nervous breakdown"
is not rigorously dened,
surveys of laypersons suggest
that the term refers to a
specic acute time-limited
reactive disorder, involving
symptoms such as anxiety or
depression, usually
precipitated by external
stressors.[1] Many health
experts today refer to a
nervous breakdown as a
"modern mental health
crisis."[3]

Specic cases are sometimes

described as a "breakdown"
only after the emotional and
physical demands[2] on a
person's life are so great as to
prevent him or her from
performing activities of daily
living or, less strictly, only
when those demands prevent
him/her from performing
his/her familial or occupational
duties.[4]

Nervous breakdowns are often

caused by serious ongoing
mental health disorders.[2]

Controversy

In How Everyone Became

Depressed: The Rise and Fall of
the Nervous Breakdown
(2013), Edward Shorter, a
professor of psychiatry and the
history of medicine, argues for
a return to the old-fashioned
concept of nervous illness:

About half of them are

depressed. Or at least that
is the diagnosis that they
got when they were put on
antidepressants. ... They go
to work but they are
unhappy and
uncomfortable; they are
somewhat anxious; they
are tired; they have
various physical pains
and they tend to obsess
about the whole business.
There is a term for what
they have, and it is a good
old-fashioned term that
has gone out of use. They
have nerves or a nervous
illness. It is an illness not
just of mind or brain, but a
disorder of the entire body.
... We have a package here
of ve symptomsmild
depression, some anxiety,
fatigue, somatic pains, and
obsessive thinking. ... We
have had nervous illness
for centuries. When you
are too nervous to function
... it is a nervous
breakdown. But that term
has vanished from
medicine, although not
from the way we speak. ...
The nervous patients of
yesteryear are the
depressives of today. That
is the bad news. ... There is
a deeper illness that drives
depression and the
symptoms of mood. We
can call this deeper illness
something else, or invent a
neologism, but we need to
get the discussion o
depression and onto this
deeper disorder in the
brain and body. That is the
point.

Edward Shorter,
Faculty of Medicine,
University of Toronto.[5]
"In eliminating the nervous
breakdown, psychiatry has
come close to having its
own nervous breakdown."

David Healy, MD,

FRCPsych, Professor of
Psychiatry, University of
Cardi, Wales.[6]

"Nerves stand at the core

of common mental illness,
no matter how much we
try to forget them."

Peter J. Tyrer, FMedSci,

Professor of Community
Psychiatry, Imperial
College, London[7]

"Nervous breakdown" is a
pseudo-medical term to
describe a wealth of stress-
related feelings and they
are often made worse by
the belief that there is a
real phenomenom called
 "nervous breakdown."

Richard E. Vatz, co-

author of explication of
views of Thomas Szasz in
/Thomas Szasz: "Primary
Values and Major
Contentions."

Signs and symptoms

One major symptom of a
mental breakdown is
depression. When someone is
depressed they may
experience weight loss or gain
(often due to changes in
appetite), suicidal thoughts,
loss of interest in social, family
or work life, insomnia or
hypersomnia, exhaustion or
fatigue and feelings of
hopelessness or
worthlessness. Another
symptom of a breakdown is
anxiety, which can produce an
increase in blood pressure,
dizziness, trembling, or feeling
sick to the stomach. Panic
attacks are very similar to
mental breakdowns, but can
also be a symptom in some
cases. Diculty with breathing
and extreme fear, alongside
rapid heartbeat may occur in
those who are experiencing a
panic attack. In more severe
cases of mental breakdown, a
person may experience mood
swings, hallucinations,
paranoia, and ashbacks. In
each of these more severe
cases there can be a more
serious underlying problem
that caused the mental
breakdown. Hallucinations may
suggest schizophrenia or other
disorders involving psychosis,
mood swings may suggest
bipolar disorder or other mood
disorders (or personality
disorders such as BPD), and
ashbacks may suggest
posttraumatic stress disorder.
The severity of each of these
disorders and symptoms may
vary based upon the person
and their background.[8]

Causes
Causes of such breakdowns
are varied. A 1996 study found
that problems with intimate
relationships, such as divorce
or marital separation,
contributed to 24% of nervous
breakdowns.[9] Problems at
work and school accounted for
17% of cases, and nancial
problems for 11%. Surveys
suggest that in the United
States, health problems have
decreased in importance as a
contributor to nervous
breakdowns. Health problems
accounted for 28% of nervous
breakdowns in 1957, 12% in
1976, and only 5.6% in
1996.[9]
A nervous breakdown is very
similar to a panic attack.
Stress is a major cause in both
cases and they are both
temporary. During a nervous
breakdown, a person's
emotional state of being shifts
from an ability to cope with life
stresses to a state of being
totally overwhelmed to a point
that normal functioning is
disrupted. Excessive worry,
nervousness, fear, anxiety are
symptomatic. These states of
being are accompanied by a
variety of uncomfortable
feelings often summarized as
bad or sad. If these feelings
become so intense they are
perceived as life-threatening,
the defense system blocks
awareness. These mechanisms
while protective can also be
limiting to successful living.
Overwhelming stress,
therefore, is causative.
Whether that stress is self-
created or external requires
dierent approaches and has
dierent implications to the
individual.
A nervous breakdown is not
limited to any one type of
person: anyone can have this
breakdown, but if someone is
under a lot of stress and has a
family background of mental
disorders, they can be more
likely to have one.[10]

Treatment
The medication that may be
prescribed to someone who
has a mental breakdown is
based upon the underlying
causes, which are sometimes
more serious mental disorders.
Antidepressants are given to
treat depression. Anxiolytics
are used for those with anxiety
disorders. Antipsychotics are
used for schizophrenia and
mood stabilizers help with
bipolar disorder. Depending
upon what caused a persons
mental breakdown, any of
these treatments can be
helpful for them.

There are several dierent

kinds of therapy that a patient
can receive. The most common
type of therapy is counseling.
This is where the patient is
able to talk about whatever is
on their mind without worrying
about any judgments.
Psychotherapy is a very
common type of therapy that
addresses the current
problems in someones life and
helps them to deal with them.
Past experiences may also be
explored in this type of
therapy. In psychoanalysis
therapy, the main focus is a
patients past experiences so
that they can confront these
issues and prevent breakdowns
in the future. Cognitive
behavioral therapy explores
how a person behaves and
what they are thinking and
feeling. If there is anything
negative in these three
dierent categories, then this
therapy will try to turn them
around into positives.
Hypnotherapy is where
hypnosis is performed and
used to help the patient relax.
Hypnosis can also be used to
gure out why a person acts or
feels a certain way, by
examining past events that
may have caused the
breakdown. Expressive therapy
focuses on how the patient is
able to express their feelings.
If the patient has a hard time
doing this, expression through
the arts is highly
recommended. There is also
aromatherapy, which consists
of herbs to help the patient
relax and to try to relieve
stress. Yoga and massage may
also be included in this therapy
that will help the muscles to
relax. Meditation is also often
recommended. All of these
therapies help a person to
relax and de-stress and also
help to prevent future
breakdowns.

Similar disorders
Rapport, Todd, Lumley, and
Fisicaro suggest that the
closest DSM-IV diagnostic
category to nervous
breakdown is Adjustment
Disorder with Mixed Anxiety
and Depressed Mood
(Acute).[1] Adjustment
disorders and nervous
breakdowns are both acute
reactions to stress that resolve
after removal of the stressor.
However, DSM-IV excludes
from adjustment disorders
cases secondary to
bereavement, which
contributes to approximately
68% of nervous
breakdowns.[1]

Nervous breakdowns may

share some features of acute
stress disorder and post-
traumatic stress disorder, in
that these each occur in
response to an external
stressor, and may be marked
with sleep disturbance,
diminished concentration, and
mood lability. However, the
symptoms of nervous
breakdown do not include the
constellation of re-experienced
trauma, dissociation,
avoidance, and numbing of
general responsiveness that
are associated with the other
two disorders, and the types of
stressors linked to a nervous
breakdown are generally less
extreme.[1]

Nervous breakdowns may

share many features of mixed
anxiety-depressive disorder
(MADD). However, the
denition of MADD suggests a
chronic condition, in contrast
to the acute, short-term nature
of a nervous breakdown.[1]

See also
Adjustment disorder
Breaking point (psychology)
Causes of mental disorders
 Fugue state
Grieving
Mental health
Metanoia
Neurasthenia
Panic attack
Psychosis
Psychotic break
Self-medication

References
1. Rapport, L. J.; Todd, R. M.;
Lumley, M. A.; Fisicaro, S. A.
(1998). "The diagnostic
meaning of 'nervous
breakdown' among lay
populations". J Pers Assess. 71
(2): 242252.
doi:10.1207/s15327752jpa71
02_11 .
2. Mayo Clinic Mental
Breakdown
3. SymptomFind Signs and
Symptoms of Nervous
Breakdown
4. Hallowell, Edward M & John
Ratey. 2005. Delivered from
Distraction: Getting the Most
out of Life with Attention Decit
Disorder. Ballantine Books.
ISBN 0-345-44231-8
5. Edward Shorter (2013) How
Everyone Became Depressed:
The Rise and Fall of the
Nervous Breakdown, Oxford
University Press
ISBN 978-0-19-994808-6
6. David Healy (2013)
Pharmageddon, University of
California Press
ISBN 978-0520275768
7. Peter Tyrer (2013) Models
for Mental Disorder, Wiley-
Blackwell
ISBN 978-1118540527
8. "Signs and Symptoms of a
Nervous Breakdown" .
Symptom Find.
9. Swindle, R., Jr.; Heller, K.;
Pescosolido, B.; Kikuzawa, S.
(2000). "Responses to nervous
breakdowns in America over a
40-year period. Mental health
policy implications". Am
Psychol. 55 (7): 740749.
doi:10.1037/0003-066X.55.7.
740 . PMID 10916863 .
10. "What is a Nervous
Breakdown?" . Health Grades.
Retrieved from
"https://en.wikipedia.org
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n&oldid=806880062"

Last edited 27 days ago

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