Can A Nervous Breakdown Cause Psychosis? Why Diagnostic Clarity and Correct Treatment is Key

A nervous breakdown is a deep and sudden descent into psychological turmoil that can have profound repercussions for your emotional well-being and functionality. In some cases, it may also involve disturbing perceptual distorts known as psychosis. But can a nervous breakdown cause psychosis? The answer is complex and elucidates why an accurate diagnosis is essential for effective treatment.

The term “nervous breakdown” is perhaps one of the most common descriptors of psychiatric crisis in our culture. We are all familiar with tabloid headlines describing the breakdowns of celebrities whose sudden transformations play out in front of flashing cameras. The celebrity breakdown has long been a point of public fascination, particularly since the explosion of paparazzi in the early 2000s, providing fodder for gossip magazines and websites and producing now-iconic images that have in some ways come to define what breakdown looks like. For people without a good grasp on psychiatric nomenclature—which is to say, most people—nervous breakdown is Britney Spears with a shaved head and an umbrella clutched tightly in her fists.

But “nervous breakdown” isn’t a discrete diagnosis and most nervous breakdowns aren’t public events. Rather, the phrase acts as a kind of informal descriptor of what are overwhelmingly private experiences of suffering that abruptly damage functionality. “It describes someone who has gone through the tipping point,” explains Phillip Hodson of the British Association for Counselling and Psychotherapy. “They have gone from stress and distress to an over-stressed situation. It’s the difference between, ‘I’m very uncomfortable but I’m managing’ to ‘I’m so unhappy and fraught that I’m not functioning.’”

What “not functioning” looks like, of course, is different for each person. For some, it is an inability to get out of bed, falling into a nearly catatonic state, while for others it is expressed through manic thoughts and frenetic behaviors. Indeed, a nervous breakdown is often imagined to be defined primarily by mood symptoms and anxiety that suddenly become so overwhelming that they cause you to hit a psychological rock bottom. However, mood disruptions and anxiety are not the only indicators of a nervous breakdown and for some, these moments of crisis are marked by perceptual changes that represent a complete breakdown of the psyche. Many people who experience this kind of psychiatric crisis begin to wonder, “Can nervous breakdown cause psychosis?” Exploring the answer to that question can help you gain a better understanding of your own experiences and how to move forward.

What is Psychosis?

Psychosis is, at its core, a break with reality. As explained by the National Alliance on Mential Illness, “Psychosis is characterized as disruptions to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t.” However, while this separation from reality is a common thread throughout psychosis, psychotic experiences are profoundly heterogeneous and may include:

  • Hallucinations: Hallucinations involve sensory experiences of things that are not there, including hearing voices, visual distortions, seeing things, and bodily sensations that are not rooted in reality.
  • Delusions: Delusions are beliefs that are not true or rational. While these beliefs can be virtually anything, they often center around ideas of persecution, that your thoughts are being controlled by external forces, or that you have special powers.

It’s important to note that these symptoms can vary greatly in quality and severity. For example, while many imagine visual hallucinations to involve seeing fully formed images of things that are not there, many people’s visual hallucinations involve transient visual experiences such as seeing peripheral shadows or subtle distortions of actual objects. Recognizing these signs is essential to correctly describing your experiences and identifying the presence of psychosis.

Can a Nervous Breakdown Cause Psychosis?

The answer to whether a nervous breakdown can cause psychosis is not a simple yes or no. For many people, psychosis is clearly a part of the nervous breakdown process. Sarah’s multiple nervous breakdowns, for example, have each been marked by a psychotic experience. “The first episode had to do with romantic, unrequited love. I was delusional and thought I was in love with somebody and that he was in love with me,” she explains. “The outward signs of this were that for a while I became a bit manic—I had a kind of heightened energy. But then, when it seemed obvious that the person I’d fixated on wasn’t in love with me, I thought I was dying.” The delusion of death became a consistent theme in Sarah’s breakdowns, which occurred in what she describes as ‘times of intense stress.” At other times, she believed she was an alien. Former Downing Street Press Secretary, Alistair Campbell, on the other hand, famously believed that he was being “tested on his actions, and saw everything as part of this test” during his nervous breakdown in the mid-1980s.

These experiences can be extraordinarily painful, disorienting, and destructive both during and after the breakdown. One young woman, who experienced her first breakdown in her 20s, says:

It’s terrifying when you lose your mind. You think you know who you are and what you’re doing, and all of a sudden your mind goes into spin drive. I experienced paranoia and psychosis. I didn’t know what was happening to me. I’d feel like I was being sucked down in this vortex, like in Harry Potter where the death-eaters suck out your soul.

Indeed, while nervous breakdowns involving solely mood and anxiety symptoms can be profoundly damaging, those articulated via psychosis can be frightening in a qualitatively different way by untethering you from a reality-based understanding of yourself and the world around you.

However, it’s important to understand that nervous breakdown itself is not a mental health disorder; there is no diagnosis called “nervous breakdown.” Rather, a nervous breakdown describes a particular kind of devolution into psychological distress, one that is sudden and severe, without pointing to a specific type of mental illness. For some, nervous breakdown may be caused by depression or anxiety, for example, and psychosis may be expressions of the severity of those disorders. However, nervous breakdown may also involve mental health disorders such as bipolar disorder or schizophrenia, which are chronic conditions more strongly associated with psychosis. In other cases, psychotic symptoms may point to a short-term psychotic disorder, such as a brief psychotic disorder or schizophreniform disorder, in which you may experience a single psychotic episode that never reoccurs. Psychosis may also be precipitated by traumatic experiences, potentially indicating a trauma-related mental health disorder. As such, it is not that nervous breakdown itself causes psychosis, but that the underlying psychiatric condition—often triggered by overwhelming environmental stressors that bring it to an acute state—elicits psychotic symptoms that are expressed as something like a nervous breakdown.

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The Need for Accurate Diagnosis and Effective Treatment

If you have experienced a nervous breakdown, your psychiatric health has likely deteriorated to the point where you need more intensive treatment than outpatient care can offer. For many, private residential treatment programs offer an ideal setting in which to begin the recovery process in a calm, safe environment removed from the stressors of everyday life. In this milieu, you will have all the resources you need to regain control of your life and restore your emotional and behavioral wellbeing.

The treatment process must begin with an in-depth psychological evaluation in order to gain a full picture of your mental state. This is necessary for obtaining an accurate diagnosis that will steer the course of your treatment; simply having psychotic symptoms does not indicate a particular diagnosis, and there is no one treatment protocol for people who experience psychosis. Describing the exact nature of your psychological distress is therefore not only critical to help you understand the root of these experiences, but to create a personalized treatment plan tailored to your unique needs. While acute symptoms of psychosis are typically treated with antipsychotics, the driving force behind psychosis must be fully addressed in order to produce complete and durable healing. For example, depression with psychotic features requires treatment that is quite different than that for schizophrenia or trauma-triggered psychosis. Due to the difficulties of differential diagnosis in the presence of psychosis, seeking the care of highly experienced clinicians who will be able to correctly classify your psychotic experiences is essential.

Once an accurate diagnosis has been made, you can participate in a curriculum of therapies specifically targeted toward your disorder, symptomatology, and personality. This includes individual psychotherapy, therapy groups, and holistic therapies designed to open up multiple avenues toward healing by giving you the insight and skills necessary to regain psychological wellness. For people who have experienced a nervous breakdown, it can be particularly important to examine the circumstances that precipitated the breakdown in order to identify triggers and create strategies for coping with those triggers in healthy ways in the future.

However, treatment is not solely focused on symptom reduction and prevention; nervous breakdown and psychosis can have a devastating impact on your understanding of yourself, compromise your relationships, and interfere with your professional function, all of which can be emotionally devastating. By exploring these experiences and the responses they elicit, you can resolve painful emotions and remove barriers to healing. Family and couples therapy can also be a critical component of this healing by giving you the personal space and structure necessary to safely discuss your symptoms and their impact on your relationships in order to nurture deeper understanding and stronger bonds with your loved ones.

Nervous breakdowns that involve psychotic symptoms can be deeply troubling and many people feel frightened and profoundly isolated when faced with these phenomena. However, you do not have to go through it alone. Residential mental health treatment programs offer you a serene environment in which to begin your healing journey with the emotional and practical support you need for successful recovery. By connecting with high-quality care, you can engage in a truly transformative treatment experience that will allow you to move forward with newfound purpose, resilience, and joy.

Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring process addictions. Contact us to learn more about our renowned Los Angeles and San Diego-based programs and how we can help you or your loved one start on the path to healing.