The term “nervous breakdown” is a lay term for what happens when a person experiences a severe disruption in normal behavior, thinking and emotions.
Many different conditions can cause a person to have this kind of disruption and to be unable to carry normal functions. Usually, there are external stressors — like work pressures, the breakup of a relationship, or financial troubles — that have been building and building and are having a negative effect on a person who is already internally vulnerable to the effects of stress. Here are some common conditions that can result in a “breakdown” in functioning:
Occasionally, a person will experience a severe external stressor and will have a brief period of needing to adjust to some unforeseen new event or circumstance. The person may feel overwhelmed, unable to cope, and as if he is “falling apart.” In more severe instances, the person might find that his thinking and emotions get “out of control” and his behavior is affected so that the ability to function normally completely breaks down for a few days. This only lasts for a very short while, and the person recovers completely. Most people are familiar with this experience (usually we go through it when losing a job or breaking up with someone), and most people really wouldn’t call this a nervous breakdown in the full sense of the term.
When people are severely depressed, they can become hopeless and extremely fatigued, and lose all motivation. They might start to stay at home, may stop seeing their friends, might lose days at work, and may not be able to keep up with their self-care. Or they might become overwhelmed and agitated, overcome with distress and anxiety, unable to make decisions or to function. They can become suicidal and may need to be hospitalized.
When a person is having an acute manic episode, she can become “high,” overly active, wildly euphoric, impulsive, irritable, paranoid, hypersexual, grandiose, and unable to sleep or eat properly. In its worst states, a manic episode can be characterized by a complete loss of touch with reality that is life-threatening. Almost always, people who are having an episode of mania lose all ability to function normally and need to be hospitalized.
Substance Intoxication And Withdrawal
Many substances and recreational drugs have a negative effect on behavior, thoughts and emotions. In some individuals, these negative effects can be very severe and can last for a few days, resulting in a “breakdown” in functioning. LSD, other hallucinogens, PCP, ketamine, cocaine, amphetamines and MDMA (Ecstasy) are drugs that are known to do this in some people — especially when mixed together or with other substances. I have also known cases where marijuana provoked this kind of a reaction, as well as cases where prescribed medications, such as prednisone (a steroid often used in asthma and autoimmune disorders) and fluoxetine (Prozac) induced acute changes in a person’s mental state.
By definition, a psychotic episode is a severely disruptive brain state in which a person has lost touch with reality and is experiencing disturbing symptoms such as hallucinations, delusions and paranoia. Psychotic episodes happen when someone has a diagnosis of schizophrenia or other psychotic disorders, or when someone has a severe medical or neurologic disorder that is compromising brain functioning.
Post-Traumatic Stress Disorder (PTSD)
The experience of a severe, life-threatening trauma such as a rape or physical abuse can lead someone to have both an acute stress reaction, which happens in the first few months after the trauma, and chronic PTSD, which develops months or years after the trauma. When the symptoms of the stress disorder get very severe and debilitating (intrusive memories of the trauma, nightmares, flashbacks), a person can become paralyzed by the disorder and can become completely unable to function normally.
Rarely, a person can have an acute onset of severe symptoms of an anxiety disorder, such as panic disorder with agoraphobia (fear of crowds or open spaces), to the point that it severely affects behavior and emotions and results in a breakdown in normal functioning. Such a person will stay at home, afraid to venture out in the world, and be overcome with repetitive episodes of panic attacks where they are convinced they are about to die.
In many cases, a person has a “nervous breakdown” because of multiple contributing factors (the loss of a loved one for someone who is already prone to depression, for example). It is important to remember that all of the conditions I have listed can be treated effectively. Learn to recognize early signs of difficulty and changes in normal behavior, emotions and thoughts — in yourself and in those around you — and don’t be afraid to seek professional help and to encourage those around you to seek help.