The term “nervous breakdown” is often used to describe episodes of overwhelming stress. But mental health professionals abandoned the expression years ago. “If you are hearing the term now, you are hearing it from a layperson who is likely using it to describe a huge number of different psychological difficulties that feel so overwhelming or symptomatic that they greatly affect their ability to function,” says Dr. Gail Saltz, a clinical associate professor of psychiatry at the New York Presbyterian Hospital, Weill-Cornell Medical College. “They feel completely stopped in their tracks and in need of professional help.”
A nervous breakdown can happen to anyone. “Anybody, including people with no history of mental illness, can experience a nervous breakdown,” says Maria Espinola, an assistant professor of psychiatry and a licensed psychologist at the University of Cincinnati. “However, people with histories of mental illness might experience them more often.”
It’s important, then, to understand the common signs and potential treatments for a nervous breakdown, including:
— Intense emotions and mood swings.
— Dramatic lifestyle changes.
— Physical symptoms such as a racing heart rate, trembling and nausea.
— Social withdrawal.
[See: Apps to Mind Your Mental Health.]
Intense Emotions and Mood Swings
What separates a nervous breakdown from an otherwise difficult time in your life is how well you can keep your emotions in check. Feelings that you would normally be able to manage can erupt. “During a nervous breakdown, fear can turn into terror, sadness into despair and hopelessness, and anger into rage and fury,” Espinola says.
Other emotional indicators of a nervous breakdown can include:
— Excessive worry that interferes with your daily responsibilities.
— Increasing irritability, impatience or agitation.
— Thoughts of suicide or self-harm.
Dramatic Lifestyle Changes
A nervous breakdown can interfere with some of the basic functions of daily living, such as eating and sleeping. Some of the most common lifestyle changes that may occur include:
— Fatigue and low energy.
— Lack of appetite.
— Alcohol or drug abuse.
— Reduced exercise and physical activity.
“Because these problems do not typically impact others, they can be missed,” says Nakia Hamlett, a visiting assistant professor of psychology at Connecticut College. “However, by definition, a nervous breakdown will very likely become apparent and, typically, significant others will notice a stark decline in a loved one’s functioning.”
A nervous breakdown may take the form of a panic attack and all the physical changes that accompany it. These include:
— Rapid heart rate.
— Shortness of breath.
— Chest pain.
— Chills or hot flashes.
— Lightheadedness or fainting.
— Sense of impending doom.
“Though panic attacks rarely last more than an hour and often much less, a first one can be devastating until it is clear what it is,” says Dr. David Greenspan, chair of psychiatry at the Philadelphia-based Einstein Healthcare Network.
[SEE: How to Cope With Coronavirus Anxiety.]
“Oftentimes people think someone is avoiding a social engagement because there is disinterest or they don’t like the person, when in actuality what could be happening is they are struggling with life and can’t stand or bear to be around others because of what they are enduring mentally,” says Dr. Delvena Thomas, a Miami psychiatrist. “A common signal of a nervous breakdown is withdrawing from your community and environment. A person is no longer engaging with their family and friends and no longer considered fully functional.”
Examples of social withdrawal include:
— Missing work or school.
— Skipping events and activities they once enjoyed.
— Less communication with friends and family.
— Spending more time in bed or at home alone.
Hallucinations and Intrusive Thoughts
When stress becomes too great, the brain can’t respond in a healthy way, Thomas notes. “The neurons in the brain fire rapidly and work overtime when trying to keep up and manage all of the stress the brain is feeling,” she says. “At some point, the brain will shut down because it doesn’t know what to do or feel next.”
Some examples of the way your brain may respond in extreme circumstances include:
— Auditory hallucinations (hearing voices no one else can).
— Visual hallucinations or flashbacks, often relating to previously experienced trauma.
— Ideas of reference — the sense that external occurrences, such as dialog in a movie, relate to you.
— Intrusive thoughts, often involving harm coming to yourself or others.
Treating a Nervous Breakdown
The right treatment for a nervous breakdown depends on its cause. Anxiety therapy, for example, will be the best remedy for an anxiety-sparked nervous breakdown. “In addition, the best response will also depend upon the person’s individual strengths,” says Forrest Talley, a psychologist in Folsom, California. “In general, the more severe the breakdown, the more likely one is to need and benefit from professional help.”
Professional and home treatments for a nervous breakdown include:
— Psychotherapy, also known as talk therapy. One widely used example is cognitive behavioral therapy, which seeks to help people recognize negative and unrealistic thoughts and change their thinking. This in turn alters their emotions and behaviors related to those thoughts. “Hearing yourself speak about it and be directed by a professional is very effective for a lot of people. Oftentimes by sitting and processing their thoughts, that person will begin to create solutions that actually lift their spirits because they are able to help themselves and don’t feel so helpless,” Thomas explains.
— Medication. Medications including antidepressants, anti-anxiety drugs and sleep aids may be helpful, though a physician should strictly supervise their use. “When someone is overwhelmed and experiences mental decompensation, which includes insomnia, that person will continue to be in the vicious cycle of feeling overwhelmed, anxious, sad and moody because their sleep hasn’t been corrected,” Thomas says. “We can break the cycle by getting them uninterrupted sleep.”
— Rest and de-stressing strategies. “Mental exhaustion is a central feature of a nervous breakdown,” Hamlett says. “Rest is perhaps the most curative ‘home remedy’ for a nervous breakdown.” Hamlett recommends limiting daily obligations and engaging in stress-reducing activities such as watching pleasant television shows, spending time with pets, exercising, spending time in nature, meditating or doing deep-breathing techniques.
[See: 8 Proven Strategies to Stop Overthinking and Ease Anxiety Now.]
A nervous breakdown should not be viewed as a weakness. Anxiety disorders affect nearly 20% of the adult population in the U.S., while about 1 in 12 adults experience depression every year. There are also many legitimate reasons why you might feel overwhelmed and stressed to the point where you’re not sure how you’ll handle it all.
The key is to find ways to manage the stress in your life and get proper treatment for conditions such as depression and anxiety. Taking these steps can reduce both the intensity and frequency of nervous breakdowns in the future.
Heidi Godman reports on health for U.S. News, with a focus on middle and older age. Her work has appeared in dozens of publications, including the Harvard Health Letter (where she serves as executive editor), the Chicago Tribune, Baltimore Sun, Orlando Sentinel and Cleveland Clinic Heart Advisor.
Heidi spent more than 20 years as a TV news anchor and health reporter at ABC affiliate WWSB and more than five years as the host of a daily health talk radio show on WSRQ-FM. Heidi has interviewed surgeons in operating rooms, scientists in laboratories and patients in all phases of treatment. She’s earned numerous awards for outstanding health reporting and was the first TV broadcaster in the nation to be named a journalism fellow of the American Academy of Neurology. Heidi graduated from West Virginia University with a degree in journalism.
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