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.


  1. I consider what I went through to be a nervous breakdown, and it's not all that different from what my grandma went through in her "nervous breakdowns" during which she was hospitalized for weeks but recovered, and was not put on maintenance drugs. Kimbriel

  2. Excellent post, Rossa. I actually like the term 'nervous breakdown' - well, I could have done without having one of course, but it sounds rather respectable. I think the term should defintely be revived - as you say, it's almost genteel, it carries much less stigma and it does not write anybody off. Or, if one has a tendency to them - I have had three - it could be termed a 'nervous debility'. Then the 'patient' or 'sufferer' would be aware that they may need to monitor their stress levels in the future.

  3. Hi Rossa! Nervous Breakthrough is a good term.

  4. Rossa,

    We were all better off, IMO when the term "nervous breakdown" was used.... Long-before we tried to see all of this in 'medical terms,' and preferred to see them in more 'human terms'.

    In other words, I think the common person can get their head around 'nervous break down' pretty easily... and anyone can remember times when they themselves felt as though they were at the peak of having a 'nervous breakdown'.

    So in a sense, I think it can be seen as 'something that could happen to anyone'.... More importantly something that anyone could 'overcome.'

    This is what Robert Whitaker discusses (at least as I read it), about the work of Dorothy Dix, and what Abram Hoffer talked about when he discussed providing 'basic shelter' and human decency to help someone in this type of (temporal) condition.

    My brothers are both mechanics. One of them told me once, "If a metal breaks, and is welded back together... the weld is stronger than the original metal."

    I think if we told people this, they would have hope.... A breakdown could be seen as broken metal... A 'recovery' (thriving) as a weld.

    My 2-cents.

    Be well,


  5. Good comments all around. I agree that we should be told that mended, we can be stronger than what we were originally. Your comments bring to mind R.D. Laing's thought: “Madness need not be all breakdown. It may also be break-through. It is potential liberation and renewal as well as enslavement and existential death.”

  6. "Potential liberation"


    “All the world is full of suffering. It is also full of overcoming.” – Helen Keller

    Be well,


  7. I'm a bit ambivalent when it comes to the stress-thing. I was told, I would have to look out for stress, avoid it by and large, that I probably wouldn't be able to ever do this and that again, as it was far too stressful for someone like me, who had this, allegedly genetic, vulnerability to stress. Among all the thises and thats I was thought not to be able to cope with anymore where quite a lot that I, today, find myself coping with better than ever before in my life -- and actually better than I see so many other, not labelled people cope with similar challenges. It's like Duane says above, quoting his brother: "If a metal breaks, and is welded back together... the weld is stronger than the original metal."

    When I started to view my problems not as an inescapable fate, an illness based on a genetic vulnerability -- and I never really viewed them this way, although having a few doubts in the very beginning, I almost right from the start refused to believe in the stress-vulnerability-model --, but as challenges that I both could and had to deal with and overcome, I immediately started to grow, and to become stronger and stronger. Ironically enough, one of the strengths I developed was that I became a lot more aware of myself in general, and my limitations in particular. That doesn't mean that I just accept these limitations without taking further action. I accept them, then I take a look at why I feel overwhelmed by certain things (in context with my life story), and then I see if and how I might be able to deal with them in a constructive way, anyway, not letting myself be overwhelmed. That may, also ironically enough, include saying "no" to certain expectations and demands. Not because I think of myself as too weak, disabled, or vulnerable to deal with the stress involved, but because I've learned to take responsibility for myself, and that I, no different from everybody else, not am superhuman.

    I've experienced situations, and still sometimes do experience them, where I found/find myself considering going mad again. As a possible escape from having to deal with challenges that immediately seem overwhelming. And that's what madness is, IMO. Not something that just happens, because of a genetic vulnerability, but something I did myself, to escape an overwhelming reality. But I can't make myself do it anymore. It would mean a betrayal against myself, now that I've learned how to deal with things in a responsible way.

  8. I also have never bought into the the idea that people who have had psychotic breaks will always be vulnerable to stress. Certainly there are times when people are recovering that is is best to maintain a serene environment, but I think you are an example of the resiliency factor. People can become more resilient over time and end up very resilient, like welded metal. It annoys me, quite frankly, that there is a misconception out there that once vulnerable, always vulnerable. I agree that madness is an excape from dealing with overwhelming challenges.

  9. thank you for posting this... i was actually searching the internet to help me define what i went through (largely alone) in 2001 (and on)... i like how your article points out that the name might have dropped from the books b/c the pharm companies can't profit from it. sadly, i went about things on my own (meaning stayed out of the western med world) after one doctor told me to drink green tea and another doctor told me to start taking birth control. obviously they didn't get the severity of my situation.

    instead, yoga found me... meditation... i had a great herbalist... and, i changed my diet and habits greatly! this all has helped me on the road to recovery after my nervous breakdown. i feel it's like a snake shedding its skin. if the skin isn't shed (the old, worn-out ways of living) and the old doesn't give way to the new -- then we die and suffocate. and, that's ok too. some people don't want to part with the old ways and they wish to go...

    i have dedicated my life to helping through transitions b/c of what i went through. and, i like the literature around healing the heart...the cultivation of self-love...and the insight brought to us through nutritionists around leaky-gut syndrome to shed more awareness on how folks can heal themselves without needing drugs EVER or at least not for a long period of time!

  10. Thanks for your comment. You were lucky to have found yoga and meditation so soon after. Good luck with your healing work. We are fortunate to be living in a time when more and more people can access these ancient practices.

  11. Indeed, Rossa! Thank you for putting this information out there... Diagnostics can be relieving for people...they can also stigmatize... I feel -- for mental health -- that is more the truth than other forms of health imbalances... I still struggle...but not like I used to... And, I believe in the healing process. I feel the ability to find meaning (personal meaning from the individual) from the imbalance...we can begin to find our way back to some sort of balance. Blessings... May you be nourished. May you be protected. May you be loved.


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