Sunday, July 31, 2011

Won't be blogging for a while

I'm off on vacation with Ian and Chris and will be back later in August. There is the usual amount of last minute rushing around and I am exhausted!

 I doubt I'll be posting anything during the vacation, but will be always on the lookout for good material for this blog.

I hope all of you are enjoying your summer. Stay healthy and well.

...Rossa

Wednesday, July 27, 2011

Handbook of Complementary and Alternative Therapies in Mental Health

I've been so busy preparing my book proposal that I haven't had any time to write this blog. While researching the market for my book I came across the following text book that I think readers ought to know about. I checked the Index rather quickly and I notice that even F.M. Alexander, originator of The Alexander Technique, is listed.

Handbook of Complementary and Alternative Therapies in Mental Health, edited by Scott Shannon, MD. Dr. Shannon is a former head of the American Holistic Medical Association, another excellent resource to keep in mind.

Editorial Reviews

"Handbook of Complementary and Alternative Therapies in Mental Health represents a comprehensive overview of reapidly expanding field that includes chapters by 24 leading psychiatric/psychological experts in these fields... There are few previous books of this nature or scope for professional audience... This is an excellent compendium of integrative and holistic therapies, not just for mental health... This groundbreaking text should become a standard reference for any mental health care professional. It is well written, and a pleasurable read."

-WORDTRADE

"Shannon imposes a detailed format that includes an in-depth overview of the field, safety considerations, extent of published research on each approach, and validation of effects... Shannon makes a persuasive argument that Eastern and Western medicine can easily complement one another and reinforce each other's strengths in healing many forms of mental illnesses. Highly recommended for graduate students, researchers and clinicians in both mental health and medicine."

-CHOICE

"Mental health professionals would be well advised to look into the topics covered in this book, both to broadentheir professional horizons, and, to get some idea of what their clients are likely to be up to."

-INTERNATIONAL REVIEW OF PSYCHIATRY

"This is a very useful book, organizing a large amount of information in a relevant, easy-to-use format. It provides a clear, up-to-date description of the interface between current medical practice and the therapies it covers, particularly contraindications and potential interactions. It is an important beginning of the dissemination to mental health professionals of information about alternative therapies many clients are already using."

-divine, inc.

"This volume is a significant contribution to the emerging field of complementary and alternative medicine. Dr. Shannon's survey of the scientific evidence underlying complementary and alternative approaches to mental healthcare is dazzling, and will add to the growing respectability and acceptance of these approaches. Shannon shows compellingly that pharmacological treatments for mental disorders, which currently dominate psychotherapy, are but one possible approach. This book will become a classic in its field."

-Larry Dossey, MD

Author: Reinventing Medicine and Healing Words

"Dr. Scott Shannon has compiled a thorough guide to alternative therapies in the mental health field; one that will be most useful for both patients and health professionals. There is so much more out there than conventional approaches. This book tells you what is available and how to make use of it."

-Andrew Weil, M.D., Author of 8 Weeks to Optimum Health and Director of the Program in Integrative Medicine at the University of Arizona in Tucson

"Self-care is the the foundation of 21st century medicine, and with this book Scott Shannon has powerfully provided the reader with access to a multitude of options for improving their mental health. While filling a critical void in medical reference texts, this book also allows the public a comprehensive and in-depth look at the mental health therapies of holistic medicine -- America's newest specialty."

-ROBERT S. IVKER, D.O., President-elect of the American Board of Holistic Medicine and author of the bestselling SINUS SURVIVAL

"Well researched and well written, this compilation enhances our understanding of CAM approaches and enlarges our perspective as mental health professionals."

-JAMES S. GORDON, M.D.

Author, Manifesto for a New Medicine: Your Guide to Healing Partnerships and the Wise Use of Alternative Medicine; Founder and Director, Center for Mind-Body Washington, DC

Tuesday, July 19, 2011

Continuing on the path

Last week I had a phone appointment with Sue Frederick, a career intuitive/numerologist. Numerologically, I am in my second Saturn return. Though I missed a career path in line with my "non-awakened" self on my first Saturn return  (aged twenty-eight), I have a second chance around the age of fifty-eight. Since I had already read Sue's book, and know my number (22/4) I was mainly using this conversation as a chance to see if she could add anything that would help me with my future plans, which include retiring in two years.  What I was hoping, was that Sue might suggest something different than the path I have been on for nine years.

What I have been doing the past nine years is my path, according to Sue. She must have noticed the enthusiasm I displayed when I talked about schizophrenia. No doubt I was born to have a son develop "schizophrenia," and then for me to find it the most interesting thing that ever happened to ME! But how can you think it's all about you, some may ask, when clearly your son has suffered this terrible tragedy?  Well, as you know, I don't see schizophrenia as a tragedy, I see it as an opportunity for growth, especially for the so-called afflicted, but also for anyone around him or her who cares to listen and learn.

I did get some immediate ideas from Sue about taking advantage of my second Saturn return. One is to do a proper book proposal, including a market analysis, chapter summaries, etc. I have been concentrating on finishing the manuscript edits, but Sue convinced me just to get the proposal sent out to agents before August. The book doesn't have to be finished. I knew that, but an agent had asked me to send him the finished book, so I was putting all my effort into finishing it. Sue says September will be a numerologically  important month, and the proposal should be in as many hands as possible by then. The stars will do the rest. Oh, yes, a laptop is essential for what I want to do, she added.

Since my work is cut out for me before I leave on vacation in August, I am encouraging Chris to write a blog post on the topic "what worked for you and what didn't work for you in your recovery?" He is free to trash  his parents' misguided efforts to help. It may be a question of getting him to stop writing.

Sunday, July 17, 2011

For the memoirists out there

Nice little piece from the New York Times about a mother who wrote her scorching memoir before she had children.

Every memoirist makes her own set of rules to write and to live by, and in these 12 years, the strictest rule to which I have adhered has been this: Before I have written anything about my son, I have asked myself whether I could imagine him turning to me some day, and saying, I wish you hadn’t told that story about me.

Read more

Tuesday, July 12, 2011

E. Fuller Torrey a texbook case

I haven't been posting for a while, and thought I should stir the pot a little lest this blog be forgotten. Trolling the Internet today for ideas I came across this article in Salon on Jared Loughner, the Arizona gunman, that dates back to January this year.

I have never liked Dr. E. Fuller Torrey because I think he lacks empathy. He compartmentalizes people at best and wants to institutionalize and drug them at worst. He's determined to force medicate people, which I know has it's appeal for many, but not for me. However, I came across this quote from an article in Salon, and it's so weird that Torrey thinks lucid dreaming is for sickos. It's not just E. Fuller Torrey. Most psychiatrists think lucid dreaming is a dangerous sign of psychosis. (I'm trying to teach myself how to do it.) What planet do they live on?

Salon: I was struck by his obsession with "lucid dreaming."

Torrey: When someone comes in and talks about lucid dreaming, drugs are the first thing I wonder about. But with schizophrenia, you can get almost anything that's weird like that. In itself, it didn't stand out to me.

Comments to this article

Hepola said that stood out to her, and Torrey seems to see it as a sign of mental disturbance or drug use. Anyone know why? I though lucid dreaming was just an interest of some people. I remember Omni publishing an article, back in the 80's, on learning to lucid dream. How is it, or an interest in it, connected to mental disorders?

—Christopher1988

This is the first I read about Loughner's interest in lucid dreaming. My first thought was: There's nothing insane about it, and in his case, perhaps he was desperate to try to control nightmares. It's possible that a normal person's worst occasional nightmare is the stuff of a schizophrenic's nightly experience.

—Quiet Type

I object to the characterization that lucid dreaming is the result of a drug addled brain, or something that signals mental illness.

I've been lucid dreaming for most of my adult life but didn't know it had a title until a dozen or so years ago---and I'm a senior citizen.

Lucid dreaming means that I can not only remember dreams and recount them in detail, but I can wake up briefly (for instance, to go to the bathroom or reclaim the covers from under my husband) and return to the dream when I fall back asleep. And sometimes I can change things in the dream when it continues.

It's a pleasurable experience in general. In fact, I also used to be able to fly in my dreams but that "ability" seems to have left me as the years passed. I miss the feeling of taking off and soaring just as if it were happening in the waking world. In fact, I've actually said to people how much I miss flying in my dreams---and I'm far from crazy. Also, when I have the rare nightmare, I actually have to get out of bed, walk around, and do something to wake myself fully before attempting to sleep again because those kinds of dreams can -- and have -- also continued, and can be a horrible experience.

When I discovered information on the internet about studies done on lucid dreaming, I also read about keeping a dream journal. But that seemed stupid to me because I didn't feel the dreams were sending me messages (although they are often based on memories of people and places--oftentimes out of their normal context) and I figured they were meant for me to enjoy and not analyze.

Having explained all of that, I need to say that I've only been "under the influence" of drugs twice in my life when the doctor gave me something to ease migraines. That was a long time ago and the second time (when I took it before bed) I clearly was able to "talk" myself through the dream it produced. (This is the result of the pill. It will wear off and you'll be OK...) That drug was eventually removed from the market but not before I flushed my bottle full down the toilet.

The only "mental illness" I've experienced is SADD (seasonal affected disorder--a form of depression resulting from lack of sunshine in winter months).

Moreover, there are probably millions of us lucid dreamers in the world. We are of danger to no one. I think it's unfortunate that the "respected psychiatrist" didn't challenge the questioner. Lucid dreaming (I believe Loughner called it by another name in his YouTube ramblings) is not responsible for the actions of that young on Saturday.

—greenholdt

Friday, July 8, 2011

People on psych drugs are "consumer leaders"

The NAMI Convention  is now well underway in Chicago. Holistic types seem thin on the ground. While a convention always has an impressive list of speakers and corporate goodwill, are people missing a very fundamental point here, that all the meds and all the institutional "help" can get in the way of cure. Most people I have corresponded with over the years about their mental health have told me that recovery happens off the drugs, and is a very personal story of coming to grips with yourself. My feeling is that a lot of people get lost in the bureaucracy of health care and that becomes the on-going story. Never enough money, the wrong medications, the side effects from the medications, trouble with the insurance company, problems with social housing. The professionals are in charge of the game and making a living from it. I might feel reassured by all the convention hoopla if statistics bore out that vast numbers of people are getting better using all those new drugs and hospital and recovery programs.  Success favors the individual who makes it his or her business to recover.

From the NAMI Convention agenda

1:30pm-5:00pm    Ask the Doctor Sessions and “ASK US”

(A chance to ask questions of top researchers and clinicians sharing work underway to treat and defeat mental illness. You’ll also have the chance to hear important perspectives from our consumer leaders.)

For the record, here is a PARTIAL LIST OF PAST EXHIBITORS AT NAMI NATIONAL CONVENTION (A - M only). The full list is found here.

3dASAP Promotional Solutions
Abbott
Abraham Low Self-help Systems
Allsup
American Psychiatric Nurses Association
American Psychiatric Association
American Psychological Association
Anne Sippi Clinic Adult Community Services
Astrazeneca Pharmaceuticals
Behavioral Tech, LLC
Borderline Personality Disorder Resource Center
bp Magazine and Esperanza
Bristol-Myers Squibb
California Association of Marriage & Family Therapists
Cenpatico
Centers for Medicare and Medicaid Services
Changing Options, Inc.
College of Psychiatric and Neurologic Pharmacists
Consortium on the Genetics of Schizophrenia (COGS)
CooperRiis: A Healing Community
Cyberonics, Inc.
Defense Centers of Excellence
Disability Rights Section, U.S. Department of Justice
Dominion Hospital
EmFinders
FDA Office of Women’s Health
Fred Friendly Seminars, Inc.
GlaxoSmithKline
Gould Farm
Hanbleceya Treatment Center
Harmony Behavioral Health
Harvard Brain Tissue Resource Center
Hazelden Publishing & Education Services
Hopewell
Institute of Living/Hartford Hospital
International Center for Clubhouse Development
Irwin Foundation
Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Johns Hopkins University
Keffer Software Products, Inc.
Lakewood Center
Lilly
Magellan Health Services
Maguire Publications
Maryland Psychiatric Research Center
McGraw Systems
McLean Hospital
McNeil Pediatrics
MedicAlert Foundation
Meehl Foundation
Menninger Clinic
Mennonite Media Productions
Mental Health Co-op
Merry Meadow Farm
Mytherapysession.com

and

Here is a list of NAMI donors and amounts for 1st Quarter 2011

Bristol-Myers Squibb Campaign for a Better Tomorrow $100,000

Bristol-Myers Squibb NAMI Family to Family Education Program $62,500

Bristol-Myers Squibb NAMI Corporate Supporter Membership $25,000

The George Cohee Foundation General Donation $6,034.00

The Susan Stein Shiva Foundation General Donation $5,000.00

Anonymous General Donation $200,000.00

Anonymous General Donation $200,000.00

Allsup, Inc. HelpLine $25,000.00

Pfizer Multicultural Action Center $10,000.00

Bristol-Myers Squibb Campaign for a Better Tomorrow $100,000

Bristol-Myers Squibb NAMI Family to Family Education Program $62,500

Pfizer Treatment Access Education and Outreach Project $25,000.00

Pamlab Corporate Supporter Membership $35,000.00

Ortho-McNeil-Janssen Pharmaceutica NAMI Beginnings $60,000.00

Shire Child & Adolescent Action Center $150,000.00

Pfizer Campaign for a Better Tomorrow $25,000.00

The Van Ameringen Foundation Parents & Teacher as Allies $45,000.00

$1,136,034

Major Foundation and Corporate Contributions Registry

TOTAL: $2,084,568

Thursday, July 7, 2011

Valet service

Chris is doing everything for us except donning the uniform and flicking lint off our shoulders with a brush. His agenda is blank now that the summer is here and his voice teacher is on vacation, choir and amateur opera rehearsals are in hiatus, and his part time employer is also away. Oh, yes, Dr. Stern is away for most of the summer, too.

So, here's what he's doing. Menu planning, grocery shopping, cooking, laundry, pick-up and delivery of Ian's shirts, cleaning the apartment once a week, sorting the mail and accepting the delivery of packages. In his spare time (there's still a lot of it), he has initiated the process for becoming a citizen in this fair country and is dealing with the bureaucracy involved.

Though he says he's feeling overwhelmed (he's a young man, after all, housework is stressful), he does this all so enthusiastically and well that it raises the question, why isn't he in full time work or back at university or in vocational training? It's been seven years now since his first hospitalization, and ten years since we began to suspect something was not right. His intellect is not impaired, he's much better than he's ever been, but he's still hanging around the apartment with Ian and me, his parental units.

I do believe that people who have experienced what Chris has gone through tend to be too self-sacrificing for their parents and others, no thought for themselves. This is something to be worked through, but how? Being a valet to his parents surely isn't helping, unless this is just something he has to do as part of the working it out process. Our situation is a bit complex in that we are not citizens of the country we are living in, and Ian and I do not intend to stay here after we retire. This means that if Chris wants to remain here with his brother Alex after we leave, he'll need citizenship. What he would do here without a skill is beyond me, but that's a long way off, in any case, and maybe by then he'll have one.

I know Chris is thinking about possible directions, but this is still in the thinking stage. I will be overjoyed when he exercises more structure to his day in a field of his choosing.

Tuesday, July 5, 2011

The diagnosis changes everything

Schizophrenia at the Schoolgate is a blog written by a married mother of four about her recent "coming out."  Her Kindle eBook book, Surviving Schizophrenia: A Tale of Sound and Fury is available at the following location. It's also available at amazon.co.uk and amazon europe. She's got a great cover, a pastel portrait-like photograph of mother and child. Shades of my own deconstructed Paul Klee image, but pinker and prettier.

Here she writes about her second hospitalization, six years after her first, her entry into a day program, which is when, for the first time, she is told she has "schizophrenia."

I, on the other hand, have nothing to do. Nothing. I am not smoking now, I have stopped in the hospital again. So I can't even do that. After a couple of weeks of almost total inactivity I am visited by a community psychiatric nurse. She asks me what I want out of life now that I am out of hospital. I reply that I want something to do, and friends to spend time with. And so she refers me to a day hospital, Hanhemann House in Bournemouth town centre. Here I am to learn to build up my confidence and become a worthwhile member of society again.

At least the immediate worries of how to survive have receded. I am on Social Security benefits, and my rent is paid by the council. I am not smoking and can't drink with the medication I am taking, and anyway, I am too embarrassed to meet up with my old friends. So I live cleanly, and cheaply. At the day hospital, I am given a hot meal each day.

I have been attending Hanhemann House for almost a month and I have hopes that things may improve. There is no pressure here. We patients are given a little education by the nursing staff on the nature of mental illness, and some half hearted attempts are made to motivate us into activity, but most of the time we are left alone. I feel safe, and relaxed.

But then, in one day, my life changes. The doctors call me in for a meeting. There are at least six people in the room – nurses and doctors of various descriptions. And they break the bombshell to me. I am suffering from schizophrenia. I am schizophrenic. This has been on my records, apparently, for six years already – I was diagnosed when I was just nineteen, at the time of my first breakdown, but at the time it had not been thought appropriate to inform me.  It is a lot to take on board. For the last six years, since my first breakdown, I have thought myself to be normal – nervous, OK very nervous, but essentially normal. During this time I have completed my degree, held down jobs, functioned in society. It has been a struggle, but by and large my life so far has been a success. Yet now I learn that all this time I have apparently had a disabling illness. These people knew about it all along. I have confirmed it by breaking down again.

I am very scared. I am a freak, a social outcast. I am an unknown quantity. A maniac. A schizophrenic. The 'Team' then tell me that the prognosis is bad. I ask what is a prognosis. They say I basically have no future. I will get worse as I grow older. I can never expect to be normal. I must accept this, I am told. I must face the fact that I have no future.

I lose all hope at that point. My only comfort is in the medication they prescribe, that induces in me a sort of stupor. The drugs affect my state of mind to such a degree that every action becomes an effort. I decide that it is just not worth making that effort. I switch off now, recede into an almost trance-like state and refuse to take any real part in life. And at Hanhemann House nobody seems to expect anything of me anyway. I can drift along, lounge half asleep on the various saggy and stained sofas provided for the purpose. Occasionally I attend one of the rehabilitative talks that are supposed to be my primary reason for being there, but even here nothing much is expected and I sit in my chair, eyes half open, closing, closing... I start smoking again, because everyone else at the hospital does so and it seems a not unreasonable sort of way to pass the time.

The nurses do try to educate us about mental illness. I learn that schizophrenia affects one per cent of the population. That schizophrenics are not aggressive, and that they are in fact far more likely to hurt themselves than other people. I am told these things, but nothing distracts from the fear that is contained within the word Schizophrenia, and the prognosis that I have been given. My life is effectively over.

Monday, July 4, 2011

Not sorry enough

Dr. Joseph Biederman, the popularizer of the bipolar child phenomenon, and two colleagues, have been called into the principal's office by the Harvard Medical School and the Massachussetts General Hospital, and, gosh, they are very sorry. Instead of being publically drawn and quartered for accepting pharmaceutical money for promoting dubious research and misleading the public, they have been given the adult equivalent of writing on the blackboard 50 times (okay, once) that they are very sorry that they have brought Harvard and MGH into disrepute, and they will never do it again, or, at least, they will check with their employer first before they accept any more money from industry...  for a year. So, it's Harvard and MGH that are "upset" about being in the spotlight, and we the public will have to continue to cyberstalk Dr. Biederman et al, until, what? But they are not apologizing for the hell they have wreaked on the public, to which this "apology" letter attests. (Thanks to One Boring Old Man via Stephany and for bringing this wrap-up to my attention.)

One Boring Old Man says that the evidence for the bipolar child is thin on the ground, and he demonstrates in his post how paltry the evidence is that the bipolar child hinges upon. "Over the course of the years between 2000 and 2008, Biederman’s group reported 9 clinical trials [among their 78 articles]. I included this table because I was surprised at how thin it was – seven small open label trials, one retrospective analysis [of someone else's Janssen financed double blind study], and only one double blind trial of their own. With all the noise they were making, I would’ve expected more:"

We can fight back by continuing to agree from here on in that there is no such thing as childhood bipolar disorder, there never was, there probably never will be. Bipolar is a rare occurence, and was diagnosed only in adults until Dr. Biederman got going. What we have are children acting out. We also have children who act out in a myriad of ways as a result of being given a cocktail of pharmaceuticals that go along with this diagnosis or cause this diagnosis to happen in the first place. I said "acting out." Head banging rage and talk of suicide is acting out, but try telling that to parents who feel that nobody understands their particular situation. This is not a discipline problem, they insist, my child is really ill. He has (Biederman inspired) bipolar. To which I would say, a problem is still a problem in need of a solution, but it isn't bipolar.

Anger and irritability can take people's breath away when a rare child gets going. (I was an extremely angry, irritable child who, if this happened today, might have been placed on an antipyschotic.*) It seems like a mental illness, it walks and talks like a mental illness, but is it a mental illness or is it a failure to understand how to help? Families aren't getting the kind of help they need because Dr. Biederman and colleagues have sidelined psychological and nutritional support in favor of pharmacogical treatment. For years we have heard that talk therapy doesn't work but really what was going on was that pharmacology paid more to the doctor, who had no incentive to speak well of the competition. So a real avenue of help has been trashed and it will take quite a while to right that wrong.

____________________
*Holistic thought: I used to vent my spleen a lot, regularly, several times a day in fact. Anybody and anything set me off. For those not familiar with this expression, a spleen is an organ near the stomach that produces and cleanses the body's blood.** To vent one's spleen means Fig. to get rid of one's feelings of anger caused by someone or something by attacking someone or something else. Jack vented his spleen at his wife whenever things went badly at work. Peter vented his spleen on his car by kicking it when it broke down.  There were two events that happened round about the same time that may have turned me into the sweet, good-natured person I am today (irony). When I was eleven years old my spleen was surgically removed. I also remember that just before Christmas, my mother grabbed me by the shoulders and said, in a very menacing tone of voice, that if I ruined one more Christmas for the family she was going to knock my teeth down the back of my throat! Two possibly unrelated events. Same outcome. I changed.

**Cambridge On-Line Dictionary

Sunday, July 3, 2011

What ever became of the nervous breakdown?

Remember those? Well, you would if you were around in the 1950s and 1960s. I had a rather sheltered upbringing as a child, and just before high school my family moved from a large city to a small town, a hamlet, actually, so the pool of possible people I might personally know who could suffer nervous breakdowns, suddenly became shrunken.  People who live in hamlets aren't supposed to be nervous types. That's for city folk. However, I do remember that the sister of a friend of mine from the hamlet went off to study music at a prestigious music school and she promptly came home mid-way through the first term suffering what everybody whispered was a "nervous breakdown." Her parents put her in a convent for a year where she played music to her heart's content before re-enrolling at another university. I had no idea what a nervous breakdown looked like to the naked eye, and I still don't.  Nervous breakdown people holed up for a while in their homes (or a convent like my friend's sister) and emerged later to get on with their lives. The family was embarrassed that their relative should be so delicate of mind and spirit, but in truth, a nervous breakdown was not that uncommon. The Rolling Stones sang about their 19th Nervous Breakdown in the late sixties, and then what? Then a mysterious phenomenon swept the land, and suddenly, nobody seemed to have nervous breakdowns anymore.

There was a young man in my graduate program in the early eighties who started acting funny. One day he arrived in the classroom, grabbed the nearest piece of chalk and started scribbling all kinds of mysterious mathematical equations on the board that made infinite sense to him and the Universe. He dropped out but returned to the university a couple of years later and completed the program. I just assumed he had a nervous breakdown. Had he been told he had schizophrenia, well, university might have ended right there for him.

When Chris landed in the hospital in 2003 with his diagnosis of schizophrenia, my father-in-law,  a university professor, was hoping that Chris was only suffering from a "garden variety" nervous breakdown, as he put it, the type of mental condition that seems to go hand in hand with academic pressure and your first year away from home. I hadn't heard that description of a mental health condition for years.

So, since we almost never hear of someone suffering a nervous breakdown these days, I got curious and did the usual quick Internet search, starting with Wikipedia.

"The terms "nervous breakdown" and "mental breakdown" have not been formally defined through a diagnostic system such as the DSM-IV or ICD-10, and are nearly absent from current scientific literature regarding mental illness.[1][2] 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.[1] Specific cases are sometimes described as a "breakdown" only after a person becomes unable to function in day-to-day life due to difficulties adapting.[3]"

If Wikipedia is correct, it sounds to me like the term nervous breakdown doesn't convey the gravitas needed for long term use of antipsychotics, and therefore it has disappeared from the prescribing Bible.

I was a bit suspicious that there seemed to be no link to psychosis in the Wiki definition, so I checked another website associated with natural remedies, and found much more encompassing symptoms, ranging from Irritable Bowel Syndrome, to seeing people who are not there, to depression and mania, inter alia. "In more extreme cases, psychosis can occur where the person will experience complete loss of contact with reality. The symptoms may include hallucinations or visions, feelings of victimization or persecution, strange speech patterns and behaviors as well as extreme guilt or grandiosity." The Wiki definition sees a nervous breakdown as something discrete (time limited), mainly to do with depression and anxiety, while the natural health website, perhaps to peddle a variety of natural cures, has made a nervous breakdown something universal.

People who suffered from nervous breakdowns in the past, got over them, whether they were suffering from grandiosity, constipation, or fleeting psychosis. Now that the term is no longer in vogue, and the more ominous labels of schizophrenia and bipolar are, we have seen a shift from a garden variety condition to something chronic.