What is a Nervous Breakdown, and How Do You Fix It?

The term “nervous breakdown” is one of the most nebulous of mental health descriptors—and yet, perhaps, also one of the most familiar. You hear about celebrities whisked away to rehab after suffering from this vague condition. Your friend, struggling to keep up with the demands of a growing family and a fast-paced career, confides in you that they feel they sometimes feel on the verge of it. And perhaps you fear you are standing at the precipice of the storied nervous breakdown yourself.

But despite our familiarity with the phrase, it often remains a hazy concept. Even if you understand the general gist of it, its exact definition may remain a mystery. This is one of the reasons the prospect of a nervous breakdown can be so frightening—you can recognize its hazy outline but you cannot identify its exact components. Instead, it remains unknown, leaving you feeling powerless over what you are experiencing and scared of what you may experience. So what is a nervous breakdown, and how do you fix it? Learning the answers to these questions can help demystify your condition and create a roadmap for moving forward.

The reason the nervous breakdown may seem like a nebulous concept is in part because it is. The term is not a specific diagnosis with a discrete list of diagnostic criteria. There is no nervous breakdown entry in the Diagnostic and Statistical Manual of Mental Disorders, nor is there a supply of approved nervous breakdown medications to be found at your local pharmacy. “Breakdown is a general term that people use to describe a very, very wide variety of experiences,” says Dr. David Bell, a psychiatrist and psychotherapist at the Tavistock Centre, explains. As Dr. Massimo Riccio, a psychiatrist and medical director of The Priory in Roehampton, explains, “Saying someone has had a breakdown means everything and nothing, and we need a lot more information to fine-tune a diagnosis and make in manageable.”

In other words, a nervous breakdown is a particular manifestation of a diagnosable mental health disorder which can only be identified by looking at the specifics of the nervous breakdown experience. While typically nervous breakdowns are associated with depression or anxiety, these may also be indicative of a range of other disorders, including PTSD, bipolar disorder, or schizophrenia.

But the breadth and lack of specificity of the phrase doesn’t mean that it’s useless. As Dr. Bell put it, “It captures something of the experience.” Indeed, “nervous breakdown” is a kind of shorthand that gives you the ability to communicate what you are experiencing that is simultaneously more and less specific than a discrete diagnosis. In part, this is because the phrase carries with it not only implications about what you are feeling, but also about its impact on your functionality. As opposed to simply “depression” or “anxiety,” categories that can include high-functioning articulations of the illnesses, the nervous breakdown indicates that your ability to function is compromised and that the underlying illness has reached an undeniable level of severity.

Despite the fact that a nervous breakdown is not a diagnosis in and of itself and therefore has no exact diagnostic criteria, there are emotional and physical symptoms that can indicate that you are experiencing a nervous breakdown. These include:

• Depression, hopelessness, uselessness, and emptiness
• Overwhelming anxiety, which may include physical symptoms such as upset stomach, trembling, shaking, and muscle tension
• Extreme mood swings
• Sleep disturbances
• Severe lethargy
• Panic attacks
• Paranoia
• Hallucinations
• Compromised ability to focus or make decisions
• Inability to experience interest or pleasure
• Obsessive thoughts

For some, these symptoms come on suddenly and only immediately prior to the breakdown, while others experience emotional and physical signs of distress for some time. The nervous breakdown itself, however, begins when these symptoms become so overwhelming that everyday function becomes profoundly compromised. As Dean Burnett of The Guardian says, “In the simplest sense it could be that, mentally speaking, a nervous breakdown occurs when an individual finds that the number of things that they are able to cope with is lower than the number of things they have to cope with.” This inability to cope manifests in a variety of ways, including:

• Compromised ability to participate in self-care, including eating and maintaining personal hygiene
• Avoidance of social contact
• Inability to perform professional duties or go to work
• Self-isolation

Often, the breakdown is precipitated by external stressors, such as work stress, financial issues, traumatic events, sleep disruption, illness or injury, and major life events. At other times, however, nervous breakdowns occur when the underlying illness reaches a new level of acuteness for reasons unknown.

Some believe that the popularity of the term “nervous breakdown” comes from the way it allows you to describe psychological distress in a way that avoids the stigma of mental illness. Indeed, researchers have found that people view a nervous breakdown as “being distinct from mental illness” and “as a time-limited rather than chronic condition [and] as a reactive illness, in being caused by external stressors.” In reality, however, nervous breakdown is not distinct from mental illness, but an articulation of a mental illness, which may or may not be influenced by external stressors and may or may not be a time-limited experience. As such, identifying and treating the underlying mental health disorder is the first step toward recovery and finding the right treatment setting is imperative to achieving the best outcomes.

People who are on the cusp of or already experiencing a nervous breakdown are typically at such a severe stage of their illness that outpatient care is no longer an ideal setting for treatment; the overwhelming distress and loss of functionality associated with nervous breakdowns demand a higher level of treatment intensity and oversight than such treatment can provide. In these cases, residential mental health treatment programs are often a more appropriate choice. The residential environment allows you to remove yourself from daily stressors to fully engage in the healing process without everyday obligations interfering with your recovery while being closely monitored by mental health professionals to ensure you are safe. It also gives you the opportunity to receive more treatment in 6 weeks than is possible in a year of outpatient care.

In residential mental health treatment programs, expert clinicians will conduct an in-depth psychological assessment to determine the nature of you condition and provide you with a clear diagnosis. A personalized treatment plan will then be created to target your specific needs to ensure all your symptoms are addressed in a way that is effective and meaningful for you. For many, this is a deeply relieving process; by having a concrete diagnosis, you can begin to understand what is happening to you and how to move forward. By engaging in a comprehensive array of individual, group, and holistic therapies, you can explore your emotional and behavioral struggles while developing the insight and coping skills necessary to restore psychological tranquility and functionality.

A nervous breakdown can be a painful experience and one that profoundly impacts your ability to be in the world the way you want. Dr. Bell, however, believes it can also give you a new beginning:

Obviously, what people want when they’re in that state is immediate relief, which is perfectly understandable. But when a person has spent their whole life functioning in a particular way, what starts off as a breakdown turns into a breakthrough, if they see someone who is psychotherapeutically trained. A well-managed breakdown can give the person an opportunity to understand what went wrong. In fact, for some people, not breaking down is a problem.

Dr. Riccio agrees. “Once you’ve had one and [had treatment], you learn about yourself, about your coping strategies, and this will help you deal with life in a different way.” If you believe that you may be suffering from a nervous breakdown, getting the help you need can be a transformative experience that allows you to create a strong foundation for ongoing wellness and recapture your sense of purpose and joy.

Bridges to Recovery offers comprehensive residential treatment for people struggling with mental health disorders as well as co-occurring substance abuse and eating disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to lasting wellness.