The term “nervous breakdown” is often overused and ambiguous. It could mean anything from a bad day and being overwhelmed to a having a psychotic episode.
We often hear of celebrities “going through a nervous breakdown” when there are reports of erratic behavior or a significant change in the way they present themselves, but we may also hear a coworker proclaim “I’m on the verge of a nervous breakdown” when circumstances are particularly chaotic at the workplace.
But what does the phrase “nervous breakdown” actually mean? It is first important to note that it is not a clinical term. A trained clinician will assess for symptoms that may lead to a diagnosis, and there is no “nervous breakdown” diagnosis.
Despite this, “nervous breakdown” is used as a blanket term, often in a context where the details of mental distress are not openly discussed. There is some shared sense of what the term means. If I were to conduct a small survey, it is likely that people generally would agree that a nervous breakdown indicates a point of abnormal psychological distress.
In order to label the change in behavior as abnormal, we must first have a sense of what is the standard behavior. From that point, what we see or experience as the norm is jilted by a “breakdown.”
What Does a Nervous Breakdown Look Like?
So what does a breakdown actually look like? And how can we prevent it? This article will discuss the perception of a “nervous breakdown,” what may be occurring from a mental health care perspective, and a guided series of evaluative questions to highlight the key elements of a “nervous breakdown.”
First, let us begin by diving into the components of a “catch all” nervous breakdown. Just as understanding the standard behavior is significant in the approach of this topic, there are also a few other elements that I will highlight.
Take a moment to consider this illustration:
Imagine you are riding a bicycle down the road. Moving at a steady pace on flat, even ground, your thoughts are light. There is not much happening around you and the sun is shining.
After turning the corner onto a busier street, you see a friend. You briefly stop and say hello. They are thrilled to see you. They comment on your nice bicycle and praise your recent career success. You take a picture together to share the coincidental encounter with your mutual friends, and continue biking.
Now the street is fairly congested and you notice that there are many more people out on their bicycles. A few bikers zoom past you. You decide to pedal a bit faster. As you are picking up the pace, the sky darkens and rain begins to fall from the sky. You are surprised by the change in weather but are grateful that you at least have a light jacket for your ride — a slight cover of protection against the storm.
Continuing on your route, you are approaching a large hill. Still, many bikers seem to be passing by. This is odd. You usually feel like you are leading the pack, or that you are at least maintaining the average pace. You pedal harder. Left, right, left, right. Beads of sweat collect on your forehead and your hands are cold and wet from the rain.
You reach for your water bottle only to realize that you do not have it with you. The muscles in your legs begin to hurt as they strain against the incline. It is now raining hard and visibility is low. The wind is strong. Somehow now there is no one around you. The only person you see is a distant biker that passed several minutes ago.
Your jacket is soaked through and sticking to your skin. The wind has increased. You look down to shield your face. You have forgotten your destination. You are only concerned about staying on the bike. Suddenly, pain surges through your right calf. Your breath shortens and your heart is racing. You grimace in pain then look up, sweat and rain stinging in your eyes.
In an instant you hit a large hole, the change in terrain twists the front tire and launches you through sticks and rocks until you collapse into muddy gravel. In extreme pain lying on the ground, you hear the familiar hiss of your bike tire losing air. Your eyes close. You do not remember what happens next.
A few weeks later, you see a picture that was taken of you on the side of the road, injured from the crash, covered in dirt, rain, and blood. Your bike is mangled next to you. Your mind reels. How did that happen?
In this simple story, things go from good to painful quite quickly. It may be a bit dramatic, and you may be left with several questions about the plot structure and development, but the story parallels a few key elements of what come to mind with a nervous breakdown.
Elements of a Nervous Breakdown
Imagine the two photographs from the story side by side; one where you are smiling with a friend and the sun is shining, and the one where you are injured and battered on the side of the road.
Often, from the outside, this is how we imagine a nervous breakdown. Things were good, and then they were not. The commentary around this rapid shift in a person’s life might go something like this: “One minute they were on top of the world, then they had a nervous breakdown … and well, just look at them.”
There is a stark contrast between the life that was presented to world and the disarray exposed a short time later. Timing is significant.
After seeing someone in one state and then unpredictably “broken down,” the outcome often becomes the focal point. In the story of the biker, we can point to a variety of elements that impact the outcome: difficult weather conditions, challenging terrain, lack of hydration, hitting the hole, losing site of the destination, damaging the bicycle, and the looming sense of inadequacy as bikers pass by.
Yet again, with just a snapshot of the scene, others often place their own meaning on the situation. A passerby may say, “That person was foolish for biking today,” or, “They obviously weren’t prepared for these conditions.” The second picture is labeled as “breakdown.”
From the perspective of the biker, we know that it wasn’t that simple. Putting yourself back into the role of the biker, you might have said something like this after the crash:
“I usually have no problem with a hill that size.”
“If it wasn’t for the wind and rain, I would’ve seen the hole.”
“I thought about going a different route … I wish I would’ve that day.”
“I had a long ride the day before and my body was exhausted.”
“I should have stopped when the rain got bad.”
Although these statements may be valid, the outcome is the same. The journey started smooth and positive and ended with pain and confusion. Beyond the tangible components of the story, the biker’s lack of awareness, comparison to others, and thinking that they alone were fully equipped to handle the circumstances, ultimately led to the crash.
These factors are certainly at work when people are experiencing or about to experience extreme mental distress labeled as a “nervous breakdown.” First, the lack of awareness: to one’s body, to the environmental systems, to mental wellness, and the direction they are headed all lead to the outcome.
If the biker had a sense of the forecasted weather, was fully prepared for the ride, acknowledged their own energy level, explored what was causing the pain in their calf, considered whether it was wise to continue biking when they could not see, adjusted their thoughts, and evaluated the risks, alternative routes, and priority to their destination, the outcome would have been much different.
However, what actually happens, is a complete shutdown of awareness and in a desperate effort to continue, all energy is dedicated to the basic task of “staying on the bike.” This is similar to what a nervous breakdown might look like; a person is often not aware of what they are fully experiencing in the moment.
Throughout the story, the biker assesses their own performance based on the bikers around them. Imagine the effect this has on the biker’s overall journey, continually noting where they are and how fast they are going. Social comparison plays a large role in the way that we navigate many things in life and the same is true in this case.
If all of the other bicyclists were behind, how would that have changed the biker’s thinking? What if they had all pulled off on the side of the road? The progression of a nervous breakdown as well as the response to whatever behavior is being presented is very much impacted by social context.
Need for Support
“I do not need anyone. I can do this alone.” We have all thought this at some point. Perhaps that is true in limited contexts, but the majority of life requires other people. Most things we own are the products of someone else, we have developed our values from our experiences with people, and we certainly have expectations for the people in our own life.
Yet, asking for help in times of mental, emotional, and spiritual struggle continues to be very difficult for some of us. How might have the biker’s story been different if they had reached out for support?
Am I Having a Nervous Breakdown?
Just as we have assessed the story of the bicyclist, you have the ability to assess your own story at this point in time. Perhaps you feel as though you are under a lot of pressure and stress. Maybe feeling out of control.
Or maybe you just feel detached from life right now and are not sure why. Walk through these ten steps to know what you are experiencing and what you can do about it.
1. Take a deep breath
In … and out. Repeat slowly five times. Deep breathing has a number of health benefits but it is particularly helpful in slowing your mind and body down to have clarity while moving through the next eight steps.
2. Scan body
Take note of where you are experiencing tension. Is this normal? Where are you experiencing pain? What is the source of the discomfort?
Have you been eating more than usual? Have you been eating less than usual? How nutritious is your current diet?
When was the last time you moved your body? Do exercise regularly? Have you exercised regularly in the past? What do you notice about your overall health when you exercise?
How are your relationships? Are you feeling distant from the significant people in your life? What are the current dynamics with your partner/children/parents/close friends?
6. Check in with the people around you
What have they noticed in your life and in your behavior? Warning: Do not ask these questions if you are not prepared to receive the answer.
7. Spiritual health
How are you experiencing God? What comes up for you when you reflect on that question?
If you were to map out your thoughts, what would it look like? Try journaling to clarify what thoughts you are having.
9. Make a plan
What has this evaluation revealed? Does this feel like a bigger issue than you realized? If you felt “stuck” in any area or were concerned about what you realized, it may be a good time to consider therapy. You are not alone and there is support available to help you approach this.
10. Execute plan
Recognizing an obstacle is not enough. You must change direction or acquire tools to overcome. Follow through with your plan for positive change. If that means asking questions to see what therapy is like, please feel free to contact me or one of the other counselors listed in the counselor directory.
We all can relate to that crashed bike on the side of the road feeling. The most useful tool you have right now is self-awareness. You have walked through these ten steps and likely have a better understanding of how you are handling life right now.
If you are “on the edge of a nervous breakdown,” or feeling stuck or overwhelmed, counseling can be a useful tool to help you better understand your experience and how to move forward. Take a step toward strengthening your mental health and schedule an appointment today.
“Pane”, Courtesy of Staboslaw, Pixabay.com, CC0 License; “Bicycle:, Courtesy of Free-Photos, Pixabay.com, CC0 License; “Weeds”, Courtesy of Eli-DeFaria, Unsplash.com, CC0 License; “Green Trees”, Courtesy of Kazuend, Unsplash.com, CC0 License