What Is a Nervous Breakdown?

The meaning of the term and its clinical significance today

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Many misconceptions surround the term “nervous breakdown.” While a nervous breakdown is often used to describe periods when normal functioning is disrupted by extreme stress, the term is not considered an actual psychiatric condition or medical diagnosis.

Instead, a nervous breakdown is a catchall, colloquial phrase that describes symptoms that may represent a number of different psychiatric conditions. The critical characteristic is that these symptoms are intense and make it very difficult for the individual to function normally.

What Is a Nervous Breakdown?

Psychiatrist and author Dr. Gail Saltz gives a brief description of the term "nervous breakdown."

"Nervous breakdown was a term used decades ago to describe any number of feelings of being extremely overwhelmed with symptoms ranging from depression to anxiety to psychosis such that behaviorally your functioning was seriously impaired."

Some descriptors of the term found in the medical literature, primarily prior to the 1960's, include:

  • A point of acute distress that affects our ability to function or meet daily responsibilities
  • A mix of anxiety and depression brought on by stress, time-limited, usually as a response to external circumstances
  • Can be referring to a range of conditions from depression to complete psychosis, or break with reality, including hallucinations and delusions
  • Can develop over time, as an accumulation of stressors, or as a result of an acute crisis
  • A standard part of American vocabulary sometimes in the testimony of great psychological pain, of an impending clash between external forces and internal capacities.

Today the term has no clinical meaning or value. It is often used as a layman's term to describe periods when people experience symptoms of severe distress. Unfortunately, this usage often dismisses people's emotional turmoil in a way that is pejorative or even stigmatizing.

"Typically it’s used in the lay press to denote some acute episode of psychiatric symptoms," says Dr. Sean Luo, Assistant Professor of Clinical Psychiatry, Columbia University Medical Center. "However, this is not a medical term and...it’s certainly not clinically precise."

Origins of the Term

According to Dr. Nwayieze Chisara Ndukwe, Psychiatry Fellow at Mount Sinai Beth Israel, the term "nervous breakdown" gained popularity in the early 20th century. "Colloquially, it was usually used to describe a major personal crisis of almost any kind."

She goes on to explain that "following the First and Second World Wars, when physicians had to treat the enormous psychological toll endured by combatants, focus shifted from mental institutions to a more clinical perspective. Further, a disease model was developed that proposed to explain 'nervous breakdowns' which would later be called the 'psychological distresses', encountered by soldiers." 

She says that this would later give rise to the Diagnostic Statistical Manual of Mental Disorders (the manual psychiatrists use to assist in diagnosis). "The DSM then gave specific names to specific disorders that in the past would have all been lumped into 'nervous breakdown'.  As mental health became better understood and less stigmatized, the general population’s exposure and adoption of these more specific terms (depression, anxiety, panic attack, etc.) became more commonplace." 

Lastly, she notes "we now know there are several situations, genetic factors, and experiences that are more commonly associated with a decline in functioning, and result in a 'nervous breakdown', but there are also several factors that are unknown."

The use of the term declined after the 1960's. Although it is outdated, Ndukwe says, it is still used often as a catchphrase to refer to emotional or psychological distress—usually by those not familiar with mental health. 

Symptoms

While the term nervous breakdown lacks clinical significance, there are a number of symptoms that are often associated with such periods of intense distress. These include:

  • Depression
  • Lack of interest in activities
  • Low motivation
  • Mood swings
  • Feelings of physical illness
  • Emotional numbness
  • Stomach ache
  • Difficulty sleeping
  • Anxiety or panic attacks
  • Trouble concentrating
  • Social withdrawal

Because a nervous breakdown is such a nebulous term, it may indicate anything from depression to anxiety to schizophrenia. It often suggests that a person is having a great deal of trouble coping and has "checked out" from their normal routine. They may have stopped socializing or might be unable to manage daily self-care routines including eating, getting out of bed, or showering.

The symptoms people experience during this time may range from mild to much more severe. Some people may experience thoughts of suicide or self-harm.

Causes

There are a number of factors that can contribute to what is referred to as a nervous breakdown. Underlying mental health conditions are often a contributing factor, but life stresses often also play a role. Sometimes this stress is chronic and seems to build up over time until a person simply cannot cope anymore. In other cases, crisis situations can trigger an acute period of intense distress that leads to symptoms of a breakdown.

Some factors that might contribute to a breakdown include:

  • Job loss
  • Divorce
  • Death of a loved one
  • Financial problems
  • Academic problems or pressures
  • Work-related stress
  • Moving 
  • Abuse
  • Trauma

While some people are able to cope with such struggles, others may be less resilient when faced with extreme stress. Poor coping skills, lack of self-care, low social support, poor interpersonal relationships, unhealthy coping mechanisms, and untreated mental illness may all contribute to the onset of what people refer to as a nervous breakdown.

Treatment

When people seek treatment for a nervous breakdown, it is often because they are experiencing severe symptoms that require immediate intervention. Hospitalization may be necessary for short-term stabilization and then longer-term therapy and medications may be utilized.

The exact type of treatment that is used depends on the patient's diagnosis, which may vary. Some individuals may be diagnosed with depression, others might be diagnosed with an anxiety condition, while others might be diagnosed with another psychiatric condition.

Depending upon the diagnosis, treatment might involve individual counseling, group therapy, family therapy, cognitive-behavioral therapy, or some other form of psychotherapy. Medications including antidepressants may also be prescribed alone or in conjunction with therapy.

Related Words and Meanings

There are some other terms and phrases related to the term nervous breakdown that are often used synonymously. These include:

Nervous diseases: Russian physiologist, Ivan Pavlov, is credited with being one of the first scientists to demonstrate the measurability of mental phenomena. According to the New York Academy of Sciences, “he gave a tremendous impetus to the study of  phenomena that previously had been designated psychical and unsuitable for exploration by scientific methodology.”

In the late 19th century, through his famous experiments involving salivation in dogs as a response to the ringing of a bell—an external stimulus— he was able to link the physiological, environmental and intrapsychic effects on our nervous system (for example, rapid heartbeat as a symptom in anxiety disorders or specific phobias).  Around this same time, terms such as nervous disease, nervous exhaustion, and finally, as described below, “nervous breakdown”, would eventually work their way into our everyday vernacular.

Break-down: The term “breakdown” was first recorded in 1825 as a noun form of the verb phrase break down. Today, it is often used to describe a mental break-down in which a person's normal functioning is severely impaired.

The Importance of Proper Terminology

Essentially stamped out by modern medicine and replaced with the DSM and psychopharmacology, the use of the term “nervous breakdown” is a colloquial remnant of a time when little was understood about mental illness and an unfortunate reminder of the ignorance that continues to pervade society.

“As the mental health fields have advanced, we have come up with scientific, valid, and meaningful descriptors for mental health problems and disorders,” says Dr. Katie Davis. “Now, when we talk about depression, we can label the disorder itself, and we can describe the specific symptoms, like insomnia, suicidal thoughts, loss of energy, and sleep problems.”

Davis stresses the importance of using proper and specific terminology so that we reduce the stigma of mental health issues and get into the habit of talking about these disorders openly, honestly, and objectively. “The language we use to describe mental health disorders can either maintain or reduce the stigma attached to mental health disorders,” says Davis. ”We need to choose our words precisely.”

A Word From Verywell

If you or someone you love is experiencing symptoms of what is sometimes referred to as a nervous breakdown, don't be afraid to talk to your doctor. Reaching out to a physician or mental health professional can lead to appropriate diagnosis, support, and treatment.

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Article Sources

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