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A Nervous Breakdown - What Is It Really?

Written by: Dr. Martin Winkler, translated to English by Fawn M. Zarkov, M.A.

First version: 22 Jul 2008. Latest revision: 23 Aug 2008.

Question:

 What exactly is a nervous breakdown?
My friend was supposedly admitted to a clinic because of a nervous breakdown. For a few days, she had been feeling nervous, had difficulty sleeping and was constantly anxious and nervous. Should I be seriously worried about her sanity? Is she going through an emotional crisis?

Answer:

Nervous breakdown: a psychological crisis

A "nervous breakdown" is commonly seen as a psychological crisis situation that occurs suddenly (or that even appears over a longer period of time) due to a strain or stress.

This definition is not a clinical diagnosis, but is rather an illustrative description that may convey that the load simply became too heavy for the distressed person to bear. It is, therefore, impossible to provide an official definition for nervous breakdown.

Unlike common perceptions or preconceptions of a nervous breakdown, this stress does not cause the person to become insane, nor does it cause actual damage to the "nerves" = "the central nervous system."

The symptoms of this "mental crisis" are generally short-lived and are quite non-specific, which means that they can also be observed in numerous other psychological and psychiatric conditions. Among these symptoms are, of course, agitation, nervousness, restlessness and the inability to "relax". For this reason, it is also common with sleeping disorders as well as other signs of a tense or stressful situation such as an accelerated pulse, increased respiratory rate, gastrointestinal complaints, dizziness and muscle tension). In these cases, differential diagnostics must be used to preclude such conditions as an anxiety disorder.

However, other common symptoms are dejection and despondency (thoughts such as "I can't do this anymore" or "I don't know what else to do") as if in a state of depression.

It is common among many patients to find one or more social burdens or personal changes that are subjectively difficult (e.g., divorce or relationship conflicts). Once these issues have been mitigated, the symptoms too will subside.

For this reason, psychiatrists most frequently diagnose a nervous breakdown as a so-called "adjustment disorder." This means that burdens as well as personal compensatory possibilities and support are currently not enough to maintain mental stability.

Based on this insufficiency, the following is used as treatment for a nervous breakdown. On the one hand, a short "time out" can be used in an attempt to give clients a certain distance from their problems (e.g., in the home environment) and, for example, to mitigate an acute conflict situation. Sometimes it is enough just to have a night to sleep on it and to talk with a sister, a physician or social services about how to go on from there. Most often it is a matter of finding one's own resources again or building a support network for objectively heavy burdens (e.g., care from family members or children).

In this way, a nervous breakdown can most often be seen as a signal for an already long-existing problem situation, for which the patient himself has not yet been able to find a good solution.

nervous breakdown / psychological crisis

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