There’s no such thing as a nervous breakdown
I wrote a book about having a nervous breakdown… but the truth is that there’s no such thing.
I know what you’re thinking. The idea of a nervous breakdown has been a part of the conversation around mental health for so long, how can it not be an actual thing? Well, it’s not.
When I had a breakdown/lost my mind/went mad the official diagnosis on my sick note was “depression and anxiety.” I referred to this as a nervous breakdown because saying I’m off work with depression and anxiety didn’t seem to cover the level of disruption (not to mention pain and anguish) I was experiencing in my life.
What is a nervous breakdown?
The term “nervous breakdown” is actually a somewhat dated expression that was once used as a sort of catch-all for a wide range of mental illnesses – back in the days when all mental health concerns were considered to be more or less the same (he’s gone mad), and nobody cared or knew enough to distinguish between them.
The term doesn’t refer to a specific condition but rather to the build-up of emotional stress in various different forms that can cause a person to become unable to deal with day to day life. You are not likely to find a doctor who will diagnose a nervous breakdown these days, because the diagnosis does not formally exist.
What happens when you have a nervous breakdown?
The problem with the term “nervous breakdown” is that it has become common parlance; people use it to describe any number of different situations on a sliding scale of severity.
As with any mental health concern, it’s very subjective. If you have an infection, markers in your blood will definitively show its presence. With a mental illness of any kind, diagnosis is often achieved by answering a series of questions about how you feel right now, or how you have felt over the last couple of weeks. Your answers can depend on any number of factors.
Of course, for someone deep in the depths of a depressive episode, it doesn’t matter how their day/week/month has gone so far; they are depressed, and they cannot see beyond that. This is how I felt.
When it comes to a “nervous breakdown” this is often a self-diagnosis, or something suggested by a third party. Where a GP will diagnose depression, anxiety or perhaps even sign you off with stress you may feel that you are having a breakdown and choose to call it this. My GP once signed me off with synaptic dysfunction, reasoning that if he said I didn’t have to work then I didn’t have to work and it was nobody’s business why!
The problem with self-diagnosis is that there are no lines in the sand. Where there is a helpful questionnaire and scoring system for depression, and even that is subjective, a nervous breakdown is beyond even this.
This means that one person may have a couple of bad weeks where they feel awful and struggle to perform basic tasks – but ultimately are able to come out the other side relatively unscathed – and they may call this a nervous breakdown. To them, this was a breakdown; they are not being disingenuous or overly dramatic when they refer to having had a “nervous breakdown.”
On the other hand you may find someone in a situation similar to that I experienced, where things fell apart over a period of weeks/months and I found myself unable to function in daily life. By the end of that year, I had lost my job, my home and most of my friends – as well as almost taking my own life more than once. My life broke down. And to be honest, I know mine is by no means the worst story there is about this sort of thing.
Both of these examples could be referred to as a “nervous breakdown” because there is no official diagnosis; nobody can tell you otherwise. But it does also mean that when you say those words, each person interprets them in a different way. No definition is either right or wrong.
Nervous breakdown symptoms
Because it’s not an official diagnosis, and because of what I’ve mentioned above about how we all interpret the term differently, the symptoms of a nervous breakdown can and do vary wildly between individuals.
For me, a nervous breakdown means that a person has broken down in some way and is not able to function normally in their everyday life. Even this will vary from person to person. For example, one person may get up at 5am every day, go to work in a stressful office environment for 9 hours and then come home. If you put another person into that situation they may find they are unable to cope – but that wouldn’t be a nervous breakdown; it would be an inability to deal with someone else’s daily life. They may function perfectly well in their own life.
I think it all depends on what is considered “normal” for any given person. If a person is normally able to do certain things and suddenly finds that they are not, this could be a sign they are experiencing some form of a breakdown.
Symptoms of a nervous breakdown include:
- Feeling anxious, depressed, overly emotional or irritable
- Feeling helpless/hopeless
- Withdrawing from social situations (where one would normally enjoy them)
- A change in normal sleeping patterns – sleeping a lot or hardly at all
- Difficulty focusing or remembering details
- Lacking motivation and interest in life
- Unexplained physical aches and pains
- Moving or speaking more slowly than normal
The key here is that all of these symptoms are in comparison to how a person is normally. Some people always find it hard to focus or remember things; some people always speak slowly. Some have always had problems sleeping. Only when these symptoms are a break from the norm, and a person is probably experiencing more than one, would you consider this to be a nervous breakdown.
The fact there is no official medical diagnosis of “nervous breakdown” does not mean that people do not experience the feeling of “breaking down.” Yes, using this term does make it difficult to know exactly what is going on or how bad things really are. However much like with my GP writing synaptic dysfunction on a sick note, if a person feels they are having a nervous breakdown then that is what’s happening and it’s not for anyone else to question this.
I used to get cross with people saying they were having a nervous breakdown, feeling that they were not having as hard a time as I had experienced. Then I would see people dragging themselves through things that seemed much worse than my experience.
Eventually I realised that everyone in the world deserves our compassion.
For me, the term “nervous breakdown” means Things are as bad as I can imagine them getting inide my head. It’s all relative; what’s unbearable for one may be manageable for another. If someone is going through the worst time they could possibly imagine – even if that seems like nothing in comparison to other people’s suffering – it is the worst thing for them and they deserve support and compassion.