Nervous Breakdown

What is a nervous breakdown?

We’ve all heard someone say, “I think I’m having a nervous breakdown.” You may have said this yourself. But exactly what is a “nervous breakdown”? What does this truly mean?

A “nervous breakdown” is a vague term sometimes used by the public or the press. It’s fallen out of favor because it isn’t a medical term and — over time — it’s taken on a negative meaning.

“Nervous breakdown” isn’t a medical diagnosis. It’s not a term your healthcare provider is going to use. It’s not a specific mental condition. Instead, a mental health crisis or a breakdown of your mental health is a situation that happens when you have intense physical and emotional stress, have difficulty coping and aren’t able to function effectively. It’s the feeling of being physically, mentally and emotionally overwhelmed by the stress of life.

With a mental health crisis, your intense reaction to stress shares many features of other medical conditions. Some of the medical conditions you and your healthcare provider will explore as contributing to your mental distress include:

• Depression.
• Anxiety.
• Adjustment disorder. This is defined as psychiatric symptoms associated with a stressful situation. The condition is brought on by a reaction to a stressful or traumatic event.

What happens when you have a mental health crisis (“nervous breakdown”)?

If you're having a mental health crisis, you may feel like you’re losing control. Some event or change in your life is causing you an intense amount of stress, which is causing symptoms such as fear, anxiety, worry, nervousness and depression. You may feel “stuck,” overwhelmed or incapacitated, which makes you unable to cope and function with life.

Are there factors that increase the chance of having a breakdown in mental health?

Factors that may contribute to your intense reaction to stress include:

• Having a personal history or family history of anxiety disorders.
• Having a disease or worsening medical condition that affects your ability to function effectively.
• Having a psychiatric disorder gets worse due to ongoing events.

How serious is a “nervous breakdown”?

A “nervous breakdown” can be a serious health issue if you can’t perform everyday activities because of your stress and struggle to cope.

Everyone handles stress differently. Some people are better able to cope with stress than others. However, when you can no longer do everyday tasks — like getting out of bed, brushing your teeth, or going to work — it’s time to seek professional help.

Some individuals may have thoughts of harming themselves. This is an emergency. Call 911, go to the emergency room or call the National Suicide Prevention Lifeline 1.800.273.8255.

What are the symptoms of a “nervous breakdown” or mental health crisis?

Signs and symptoms of a mental or emotional health crisis vary from person to person, depending on the underlying cause.

Common signs and symptoms include:

Symptoms of withdrawal

• Not showing up for work for one or more days or calling in sick.
• Missing scheduled appointments or social events.
• Slipping into poor lifestyle habits like unhealthy eating, not getting enough sleep or can’t sleep, poor hygiene and not exercising.
• Losing interest in activities or hobbies or things that brought you joy.
• Not wanting to leave your home or be with others.

Symptoms of depression

• Feeling very sad, hopeless, helpless or worried.
• Being irritated, frustrated or having outbursts.
• Having trouble concentrating.
• Having thoughts of self-harm or suicide.

Symptoms of anxiety

• Feeling pain, fear and uneasiness.
• Having nightmares.
• Unable to remain still and calm.
• Nausea.
• Heart palpitations.
• Cold or sweaty hands.
• Dizziness.
• Upset stomach.
• Trembling or shaking.
• Trouble breathing.

Other mental health symptoms

• Panic attack.
• Paranoia.
• Hallucinations.
• Flashbacks of a traumatic event (undiagnosed post-traumatic stress disorder).

What causes the condition?

Some causes of stress that can become too intense and overwhelming to handle include:

• Recent severe personal tragedy, like the death of a loved one, divorce, foreclosure on a home or other severe financial strain.
• Family turmoil or trouble in love relationships.
• Ongoing work stress (burnout) or other work- or school-related problems.
• Chronic medical condition or the worsening of a medical condition.
• Loss of sleep and/or the inability to relax.

Each person is unique, with their own “set point” for a breakdown. There’s no limit to the possible causes or combination of causes that might lead to a “nervous breakdown” or mental health crisis.

How is it diagnosed?

Your healthcare provider will:

• Ask about your medical history and your family medical history.
• Review your current medications.
• Ask if you take any other products, such as herbals, vitamins and supplements.
• Ask about your use of recreational drugs and alcohol.
• Perform a physical exam and order any necessary tests to determine if another health issue is causing or symptoms or making them worse.
• Talk with you about your symptoms and what’s going on in your life.

Your healthcare provider may refer you to a psychologist or psychiatrist who are mental health professionals specifically trained in the areas of emotional, behavioral and mental health issues.

How is a “nervous breakdown” (mental health crisis) treated?

The main treatment of psychological or behavioral stress is psychotherapy (talk therapy). A commonly used form of psychotherapy is cognitive behavior therapy (CBT). The goal of CBT is to manage your intense stress and anxiety by changing the way you think, feel and behave.

During CBT, you’ll:

• Discuss your symptoms and describe how you feel.
• Explore your stress more deeply to gain insight into how to respond.
• Learn how to recognize, reevaluate and change your thoughts and behaviors.
• Use problem-solving skills to learn how to cope.
• Learn how to keep your mind and body calm.

Your healthcare provider may also prescribe medications to manage your anxiety, depression or to help you sleep.

What can I do if I feel I’m on the verge of a “nervous breakdown” or mental health crisis?

Perhaps the best thing you can do if you’re actively engaged in an overwhelmingly stressful situation is to step away from that environment — if you can. Think of this as your personal “time out.” Give yourself some time to calm your mind and body.

Practice deep breathing exercises. Breathe in a full belly of air through your nose (with your mouth closed), hold for three seconds, then breathe out slowly through pursed lips (like your whistling). Repeat a few times.

Call your healthcare provider. If you feel you’re in a crisis, call your healthcare provider right away.

If you have thoughts of harming yourself, call 911 or call the National Suicide Prevention Lifeline: 1.800.273.TALK (1.800.273.8255). You’ll be talking with a skilled, trained counselor. This service is free and confidential and available 24 hours a day, seven days a week.

What can I do to prevent or reduce my risk of having a mental health crisis or breakdown?

Many of the best self-help tips involve lifestyle changes. Although these suggestions may not entirely prevent episodes of uncontrollable stress, anxiety or depression, they may reduce the intensity and frequency of these episodes.

• Learn strategies to relax. Try breathing exercises, mediation, yoga, mindfulness, progressive muscle relaxation (tensing and relaxing muscle groups) and other methods to relax. Visualize and focus your attention on something that makes you calm.
• Take care of yourself. Eat a well-balanced diet, follow good sleep habits and exercise for 30 minutes at least five days a week (walking is a great exercise). Avoid recreational drugs, alcohol and an excessive amount of caffeine (coffee, teas, colas and chocolates). These products can stress your body.
• Get organized and take breaks. Take back some control over your life. Make a to-do list. Set priorities. Take many mini-breaks (such as five minutes every hour). Review achievements at the end of your day. Don’t beat yourself up if you didn’t accomplish everything on your list. Update your to-do list. Know that each day offers a new start and a new opportunity.
• Get counseling. Make an appointment with a mental health professional to learn more ways to manage stress, anxiety and depression. Ask your counselor for information about support groups.

How long might a “nervous breakdown” or mental health crisis last?

It would appear that your reaction to stress, otherwise known in lay terms as a nervous or mental breakdown, is a time-limited condition that is usually brought on by some external event. Features of your reaction to the event are likely some combination of anxiety and depression and lack of an ability to adjust and cope.

No one can say for certain how long it takes to recover from a mental and emotional crisis. Each person is different and has unique stressors and the ability to learn how to cope. However, if you have been accurately diagnosed, your stressor(s) have been identified and you’ve received appropriate treatment, your symptoms are likely to go away within six months. The exception is if your stress is related to the loss of a loved one. In this case, recovery can be much longer.

When should I see a healthcare provider?

When you feel that you can no longer cope with life’s stresses and challenges in healthy ways and you’re significantly struggling to complete ordinary, everyday tasks, it’s time to seek help. You may be at a point where managing your situation on your own isn’t possible. Your primary healthcare provider or a psychologist or psychiatrist can help decipher your symptoms and provide the help you need.

How can I help a friend or loved one who I think is experiencing overwhelming stress?

There are ways to help:

• Listen to your loved one. This is one of the most important things you can do.
• Empathize with what their feeling. “You really have a lot of items on your to-do list.”
• Don’t offer your advice. Instead ask what you can do to help.
• Gently encourage professional help. Perhaps say that you’re worried about them and ask for their thoughts about talking with a doctor. Don’t argue or force the issue.
• Consider contacting professional help if your loved one talks about self-harm. If you think your loved one may harm themselves or has talked about suicide, contact their doctor or call the National Suicide Prevention Lifeline (1-800-273-8255). If you think the danger of self-harm is serious and imminent, call 911.

What’s the difference between a psychotic break and a “nervous breakdown”?

A psychotic break is when someone loses touch with reality and experiences delusions (false beliefs), hallucinations (seeing or hearing something that doesn’t exist) and paranoia. For the most part, a person who is overwhelmed with the stresses and challenges of life (or having a “nervous breakdown”) hasn’t lost touch with reality. They have lost the ability to cope with these stresses, which makes day-to-day functioning difficult.

A note from Cleveland Clinic

People commonly use words like “nervous breakdown” or “mental breakdown” to talk about when a person can’t cope with everyday life. Although the terms aren’t a medical diagnosis, your feelings, reactions and symptoms are very real. Extreme stress that causes intense mental and emotional distress, which keeps you from working, playing and enjoying life is a health condition. These are not signs of personal weakness or failure. If you have these feelings and symptoms, you’re not alone. See your healthcare professional for help.