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Nervous Breakdown

How to know when your stress level is so high that you need to see your doctor.
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Last updated July 9, 2021

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The terms “nervous breakdown” or “mental breakdown” are sometimes used to describe a state of overwhelming emotional stress. Nervous breakdown symptoms can become so intense that you may have difficulty accomplishing everyday tasks.

It’s important to know that the terms “nervous breakdown” or “mental breakdown” haven’t been used by doctors or psychiatrists for years and don’t describe a clinical condition. But many people use it to explain the experience of intense stress that temporarily interferes with normal activities.

A nervous breakdown may be diagnosed as an adjustment disorder, anxiety disorder, mood disorder, acute stress disorder, or other mental health condition.

Signs of a nervous breakdown can vary from person to person. The breakdown may or may not be caused by an underlying mental health condition, such as anxiety, depression, or post-traumatic stress disorder.

Dr. Rx

A nervous breakdown is not a real term used by the medical or psychiatric community. It is frequently used in mass culture to refer to a moment when someone has intense anxiety or emotion, or a mental health crisis. It can be compared to a pot boiling over. The emotion is simmering below and an event triggers it to boil over. Although this can feel overwhelming, confusing, and out of the blue—it is often the moment when a person recognizes that something in their life is not working and that they need to do something differently. —Dr. Bobbi Wegner

Symptoms

The term nervous breakdown can refer to a worsening of a number of different psychological symptoms that make it difficult to continue with daily activities. Some people feel an increase in anxiety, with symptoms of a panic attack such as shortness of breath, shakiness, and upset stomach. Others may feel more depressed, with low mood, low energy, crying, irritability, or suicidal thoughts.

During a nervous breakdown normal routines often become hard to maintain, leading to changes in typical patterns of sleeping, eating, bathing and grooming, and social interactions.

Main symptoms

Physical symptoms

Mood changes

Behavior changes

  • Changes in sleep habits
  • Overeating or undereating
  • Low energy
  • Decline in self-care (such as poor hygiene and a decrease in exercise)
  • Increased use of alcohol, nicotine products, or other substances

Withdrawal from everyday life

Changes in thinking

  • Difficulty thinking clearly
  • Worrying
  • Racing thoughts
  • Hallucinations (hearing, seeing, or smelling things that aren’t there)
  • Having unwanted thoughts that are sometimes scary or anxiety provoking, like images of people you love getting hurt.
  • Nightmares
  • Suicidal thoughts or thoughts of self-harm

Next steps

Most people go through periods of life in which stress becomes hard to manage. If your stress becomes too much to handle or doesn’t get better after a couple weeks, talk to your doctor or a mental health professional.

If you have thoughts of hurting yourself or ending your life or feel too overwhelmed to take care of yourself, call 911 or go to the ER.

Although a nervous breakdown itself is not a medical condition, it may be a sign of an underlying mental health issue. Speaking with a professional is the first step toward getting a specific diagnosis and treatment plan to control your symptoms and learn how to prevent it from happening again.

How to calm someone down

The best approach to anyone in distress is to be a calming presence. First and foremost, let them know you are there to help, and listen to what they need. Never say "calm down." It is invalidating and unhelpful.

When someone is in the middle of an emotional crisis, most often, being by their side, listening more than talking, and being a calming presence is what helps. The goal in the moment is not to solve the bigger problem, it is to help get through the moment so you can help assess what is needed after the moment passes.

The only time this does not apply is if the person is in imminent danger of hurting themselves or someone else. In that case, call 911 immediately.

Causes

Nervous breakdowns occur when life circumstances feel like too much to handle. Examples of triggers of a nervous breakdown include:

  • Major life events, such as childbirth, moving to a new home, or getting divorced
  • Natural disasters
  • Abuse
  • Death of a loved one
  • Persistent difficulties at work or school
  • Health problems, such as being diagnosed with a new medical condition
  • Financial problems
  • Relationship problems, such as a breakup or ongoing disagreement with a friend or family member

Pro Tip

It is not possible to say how long a nervous breakdown lasts since it isn’t an actual medical condition. A “nervous breakdown” can mean different things—from a panic attack to a psychiatric break. The duration is dependent on the symptoms, the intensity, the frequency, and treatment. —Dr. Wegner

Risk factors

Nervous breakdowns may be caused by a combination of genetics and life experience. Factors that increase your risk for a nervous breakdown include:

  • A personal history of anxiety, a mood disorder, or substance use
  • A family history of anxiety or mood disorders
  • Stressful life circumstances
  • Limited social support

Treatment

See your primary care doctor or a mental health professional for help with symptoms of a mental breakdown. Your treatment will vary depending on your symptoms and the underlying causes of your stress. It may include recommendations for lifestyle changes, short-term psychotherapy, or medications.

In cases of severe distress, a brief hospital stay may be recommended. You may be diagnosed with another mental illness such as anxiety disorder, mood disorder, or acute stress disorder.

Pro Tip

To recover from a “nervous breakdown,” taking good self-care is crucial—as it is for all mental health concerns. That means, getting enough sleep, exercise, and healthy food. These three things are the pillars of good mental health. Also, get professional help and stick to the treatment plan. Following these steps will help you recover as fast as possible. —Dr. Wegner

Psychotherapy

Short-term talk therapy can be helpful for many stress-related conditions. Individual therapy may focus on learning relaxation techniques, developing a plan for getting back into healthy daily routines, improving coping skills, and developing plans for addressing problems in your life. Your therapist may also work with you to examine thought patterns to identify and change unhelpful thoughts.

You can also join a support group, which can be helpful for coping with shared experiences, such as medical illness, bereavement, life transitions, and caregiving (for a family with a mental illness or an elderly family member, for example).

Medication

Medications may be useful depending on your symptoms and if you have an underlying mental health condition. Your doctor may recommend medications for a brief period to take as needed for insomnia or anxiety attacks. If anxiety symptoms are longstanding or you are diagnosed with depression, then daily antidepressant medication may be recommended. Common medications for mood and anxiety disorders include escitalopram (Lexapro) and sertraline (Zoloft), but there are many options.

Follow up

You may find that your symptoms go away quickly, particularly if the source of stress cleared up. But you still want to try to adapt some better coping strategies and maintain a healthy lifestyle to prevent it from happening again.

If the nervous breakdown is a result of an underlying mood or anxiety, then it is important to continue medications as agreed upon with your doctor and attend regular follow-up visits to prevent nervous breakdown symptoms from returning.

Prevention

Nervous breakdowns can be prevented by keeping stress under control. Some important ways to improve your ability to handle stressors include:

  • Keep a consistent sleep schedule. Go to sleep and get up at the same time every day. Try not to take long naps during the day because they may interfere with the quality of your sleep at night. Avoid caffeine and alcohol for several hours before bedtime. Try not to use your phone and other electronics before bedtime.
  • Avoid substance use. It is common to turn to nicotine, alcohol, cannabis, or other substances for relief during stressful times. Although substances may briefly relieve distress, they tend to worsen psychological symptoms over time.
  • Exercise regularly. While it’s hard to maintain healthy routines during periods of stress, exercise is an effective way to control mood and anxiety symptoms. Try to do something that gets your heart rate up, such as taking a brisk walk, going for a run, or playing a sport, for 30 minutes at least 3 times per week.
  • Use relaxation techniques. Deep breathing, meditation, guided imagery, progressive muscle relaxation, and yoga can help your mind and body stay relaxed. Short tutorials for these techniques can be found online. Try out different techniques to see which work for you and then include them in your daily routine.
Share your story
Resident Physician, The Mount Sinai Hospital

Dr. Becker is a psychiatry resident at the Mount Sinai Hospital. He received his undergraduate degree in Urban & Regional Studies from Cornell University (2012) and completed his medical degree at the Perelman School of Medicine at the University of Pennsylvania (2018). Prior to medical school, he worked as a pre-medical teaching assistant at Weill Cornell Medicine-Qatar, where he received an Excellence in Teaching Award. His research has focused on global health (including explanatory models of mental illness in Botswana, epidemiology of head trauma, and psychosocial aspects of HIV), adolescent and young adult mental health, and quality improvement. He enjoys communicating health-related science through writing and teaching and joined Buoy Health as a writer in 2018. In his free time he enjoys running, hiking, and exploring new places.

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