The medical world doesn’t use the term nervous breakdown, but what does it mean?

nervous breakdownCC: Yuris Alhumaydy at Unsplash

Most adults will know the term nervous breakdown. Either we know someone who’s reached the mental equivalent of rock bottom, or we’ve been there ourselves. Although nervous breakdown is a commonly used word, you won’t find it in the DSM-IV. In fact, the closest you can get in terms of a psychiatric classification is ‘Adjustment Disorder with Mixed Anxiety and Depressed Mood.’

So what is a nervous breakdown then?

The term nervous breakdown is fairly antique. Around the 1920s when people first began associating nerves with depression, it was assumed that a breakdown in the nervous system leads to their poor mental state. It was recognized that this all formed a part of depression. However, the patient in question wasn’t melancholic, they were depressed with a heavy dose of anxiety.

As there is no DSM-IV classification for a nervous breakdown, it’s better to demystify what it is by picking the symptoms apart:

  • The person is experiencing severe mental distress, to the extent that they cannot function in their daily lives
  • Extreme mood swings and outbursts
  • Insomnia, hallucinations, and flashbacks due to PTSD
  • Paranoia
  • Symptoms of anxiety: including cramps, palpitations, and high blood pressure

Overall, the person experiencing a nervous breakdown may have functioned well prior to the event. Slowly, however, the signs of a nervous breakdown can start to become obvious.

What are the signs that a nervous breakdown is about to happen?

At first, it may seem as though the patient is dysfunctional. They could stop taking care of themselves in the ways that they usually would. For example, those who take great pride in their appearance may suddenly become unkempt. Or, the colleague who usually has excellent work attendance might suddenly start calling in sick. Other signs that a friend or family member is on the brink of a nervous breakdown include:

  • They develop poor eating and sleeping patterns
  • They’ll stop showering as much as usual
  • They begin isolating themselves at home
  • Career development is no longer a priority
  • They may not take an interest in their hobbies anymore

Another way to think of this condition is that someone has finally experienced burnout. They have may been pushing themselves too far for too long. Or, they could be trying to hold it all together following a horrific life event, but they have reached their maximum capacity to do so. However, it’s not always the case that the breakdown will rise immediately after the lifeevent. For example, Prince Harry once told The Telegraph that he came close to a breakdown 20 years after his mother’s death.

Another more famous example of a nervous breakdown? Britney Spears in 2007. Or, more recently, Demi Lovato in 2018.

Is this condition isn’t classified, how is it treated?

And herein lies the problem with ditching the antiquated title nervous breakdown; we don’t know how to treat one. Simply tackling it as though it is a depressive disorder may have minimal effect. For example, if the patient receives an SSRI, but anxiety is the primary component, they may only help in 53% of cases.

A smarter approach would be to tackle the problem as though it is an adjustment disorder. As you can see from the Mayo Clinic’s description, many of the symptoms come incredibly close to that of a nervous breakdown.

Overall, a blend of psychotherapy, supportive medications, and an attempt to tackle the root of the problem would prove effective. However, until the medical community develops a stronger agreement as to what a nervous breakdown is, patients may suffer from inadequate treatment.

About the Author

Laura McKeever
Laura has been a freelance medical writer for eight years. With a BSc in Medical Sciences and an MSc in Physician Assistant Studies, she complements her passion for medical news with real-life experiences. Laura’s most significant experience included writing for international pharmaceutical brands, including GSK.