Many misconceptions surround the term “nervous breakdown.” While it 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, the term nervous breakdown is a colloquial catchall intended to describe symptoms that may represent a number of different psychiatric conditions. The key characteristic of a “nervous breakdown” is that the symptoms are intense and make it very difficult for the person to function normally.

Symptoms

While the term nervous breakdown lacks clinical significance, there are a number of physical and mental symptoms that are most often associated with such periods of intense distress. These include, but are not limited to:

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

Because nervous breakdown is such a nebulous term, it may indicate symptoms of anything from depression to anxiety to schizophrenia. Use of the term 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 a “breakdown” may range from mild to much more severe. Some people may experience thoughts of suicide or self-harm during a breakdown period.

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:

AbuseAcademic problems or pressuresDeath of a loved oneDivorceFinancial problemsJob lossMoving TraumaWork-related stress

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.

Origins

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 says. 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 and Statistical Manual of Mental Disorders (DSM), the manual psychiatrists use to assist in diagnosing mental health conditions. “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 that “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.” “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.” The use of the term nervous breakdown declined after the 1960s. Although it is outdated, it is still used often as a catchphrase to refer to emotional or psychological distress—usually by those not familiar with mental health. 

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

‘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, 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 “nervous breakdown” would eventually work their way into our everyday vernacular.

‘Breakdown’

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 breakdown 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 serves as 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.”

Treatment

When people seek treatment for a “nervous breakdown,” it is often because they are experiencing severe symptoms that require immediate intervention. In severe cases, hospitalization may be necessary for immediate, short-term stabilization and then longer-term therapy and medications may be utilized. In other cases, outpatient treatment is enough to help the person manage and cope with their symptoms. The exact type of treatment used depends on the person’s diagnosis. Treatment might involve individual counseling, group therapy, family therapy, cognitive behavioral therapy, or some other form of psychotherapy. Psychotropic medications such as antidepressants, mood stabilizers, and antipsychotics may also be prescribed alone or in conjunction with therapy.

Coping

If you are experiencing psychological or behavioral symptoms of distress, there are some things that you can do.

Talk to your doctor. Your primary care physician can perform a physical exam and conduct lab tests to help rule out any underlying medical conditions that might be causing your symptoms.Try therapy. Your doctor may refer you to a therapist who can help you with your symptoms with psychotherapy.Consider medications. Some symptoms such as anxiety and depression may respond well to antidepressants and anti-anxiety medications.Manage your stress. Try stress management techniques such as deep breathing, progressive muscle relaxation, yoga, meditation, and mindfulness to help you relax and keep your stress levels under control.Get enough rest. It can be hard to cope when you are exhausted. Focus on going to bed at the same time each night and waking up at the same time each day. Avoid electronics or stimulating activities at bedtime.Take care of yourself. Eat healthy, nutritious foods and engage in regular physical activity to maintain your physical and mental health.

It is not uncommon for people to struggle to cope with life’s stresses. When stress starts to interfere with your ability to function it might be a sign of a mental health condition or that you need help finding ways to cope.  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.