What is a “Nervous Breakdown”?

Medically speaking, there is no such thing as a nervous breakdown. Which is very annoying to discover when you’re right in the middle of one. — Marian Keyes

The term “nervous breakdown” is a colloquial expression that is widely used in everyday conversations to describe a situation in which an individual experiences intense emotional or psychological distress, often to the point where they are unable to function normally in their daily life. It’s important to note that “nervous breakdown” is not a clinical term recognized within the framework of psychiatric diagnoses (Mayo Clinic, 2023). Rather, it serves as an umbrella term that people use to characterize an acute episode characterized by symptoms like overwhelming anxiety, depressive episodes, severe stress, or emotional turmoil, often precipitated by a specific life event or a combination of stressors.

Clinical Underpinnings

While the term “nervous breakdown” lacks formal medical standing, the symptoms it seeks to describe often align with recognized mental health conditions such as Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), or Adjustment Disorders. For instance, individuals experiencing what may be colloquially termed a “nervous breakdown” could display a range of symptoms like extreme restlessness, fatigue, insomnia, profound sadness, and even suicidal ideation (American Psychiatric Association, 2022). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), published by the American Psychiatric Association, serves as the standard authority for the diagnosis of mental health conditions and offers criteria that clinicians use to identify these disorders. Thus, in a clinical setting, it’s crucial to go beyond the vernacular of a “nervous breakdown” to arrive at a formal diagnosis that can guide treatment strategies effectively.

Psychological and Social Factors

Psychosocial stressors frequently serve as catalysts for what people commonly refer to as a nervous breakdown. Events like a divorce, loss of a job, or death of a loved one often create an environment of acute stress that overwhelms the individual’s ability to cope (Monroe & Harkness, 2011). Chronic stressors such as ongoing relationship problems or continual work pressures can also lead to a breaking point, culminating in acute symptoms. Additionally, societal norms and expectations can contribute to the perceived severity of these episodes. Our fast-paced, achievement-oriented society often stigmatizes mental health issues, exacerbating the stress individuals feel when they cannot maintain their daily functions (Twenge & Campbell, 2009).

Treatment and Recovery

Management of the symptoms associated with a so-called nervous breakdown largely depends on the underlying psychiatric diagnosis. Treatments often involve a multi-faceted approach that could include psychotherapy, pharmacotherapy, and lifestyle modifications. Cognitive Behavioral Therapy (CBT) has been found to be particularly effective in treating disorders related to anxiety and depression (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). Antidepressants or antianxiety medications can also help manage symptoms, but these are often most effective when combined with other forms of treatment. In severe cases where there is an immediate risk to the individual or others, hospitalization may be necessary.

While the term “nervous breakdown” may be embedded in cultural vernacular, it is important for both healthcare providers and patients to recognize that the symptoms warrant thorough clinical evaluation and treatment. Understanding the complexities underlying this non-clinical term can facilitate a more compassionate and effective approach to managing the severe emotional and psychological distress that it seeks to describe.

If you feel that you’re having a nervous breakdown, seek help.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline. It’s available 24 hours a day, every day. Or use the Lifeline Chat. Services are free and private.

U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish-language phone line at 1–888–628–9454 (toll-free).

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.

Mayo Clinic. (2023). Nervous breakdown: What does it mean? https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/nervous-breakdown/faq-20057830

Monroe, S. M., & Harkness, K. L. (2011). Recurrence in major depression: a conceptual analysis. Psychological Review, 118(4), 655.

Twenge, J. M., & Campbell, W. K. (2009). The narcissism epidemic: Living in the age of entitlement. Atria Books.