Mental breakdown is a colloquial term for an acute, time-limited psychiatric 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 mental breakdown is defined by its temporary nature,
and often closely tied to psychological burnout, severe overwork, sleep deprivation and similar
stressors, which combine to temporarily overwhelm an individual with otherwise sound mental
faculties. A mental breakdown also shares many symptoms with the acute phase of post-traumatic
stress disorder.
Definition The terms "nervous breakdown" and "mental
breakdown" have not been formally defined through a medical diagnostic system such as
the DSM-IV or ICD-10, and are nearly absent from current scientific literature regarding
mental illness. Although "nervous breakdown" does not necessarily have a rigorous or static
definition, surveys of laypersons suggest that the term refers to a specific acute time-limited
reactive disorder, involving symptoms such as anxiety or depression, usually precipitated
by external stressors. Many health experts today refer to a nervous breakdown as a “modern
mental health crisis.” Specific cases are sometimes described as
a "breakdown" only after a person becomes unable to function in day-to-day life.
Controversy In How Everyone Became Depressed: The Rise
and Fall of the Nervous Breakdown, Edward Shorter, a professor of psychiatry and the
history of medicine, argues for a return to the old fashioned concept of nervous illness:
Take the women that you know. 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 five symptoms–mild 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
off depression and onto this deeper disorder in the brain and body. That is the point.
"In eliminating the nervous breakdown, psychiatry has come close to having its own nervous breakdown."
"Nerves stand at the core of common mental illness, no matter how much we try to forget
them."
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. Problems at
work and school accounted for 17% of cases, and financial 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. 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. 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 6–8% of nervous breakdowns.
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. Nervous breakdowns may share many features
of mixed anxiety-depressive disorder. However, the definition of MADD suggests a chronic
condition, in contrast to the acute, short-term nature of a nervous breakdown.
See also Adjustment disorder
Causes of mental disorders Grieving
Mental health Metanoia
Neurasthenia Panic attack
Psychosis Psychotic break
Self-medication References
^ a b c d e f Rapport, L. J.; Todd, R. M.; Lumley, M. A.; Fisicaro, S. A.. "The diagnostic
meaning of 'nervous breakdown' among lay populations". J Pers Assess 71: 242–252. doi:10.1207/s15327752jpa7102_11.
^ Mayo Clinic Mental Breakdown ^ SymptomFind Signs and Symptoms of Nervous
Breakdown ^ Hallowell, Edward M & John Ratey. 2005.
Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder.
Ballantine Books. ISBN 0-345-44231-8 ^ Edward Shorter How Everyone Became Depressed:
The Rise and Fall of the Nervous Breakdown, Oxford University Press ISBN 978-0-19-994808-6
^ David Healy Pharmageddon, University of California Press ISBN 978-0520275768
^ Peter Tyrer Models for Mental Disorder, Wiley-Blackwell ISBN 978-1118540527
^ a b Swindle, R., Jr.; Heller, K.; Pescosolido, B.; Kikuzawa, S.. "Responses to nervous breakdowns
in America over a 40-year period. Mental health policy implications". Am Psychol. 55: 740–749.
doi:10.1037/0003-066X.55.7.740. PMID 10916863.