On the morning of June 12th, the only words that came to mind to describe what I was experiencing were “nervous breakdown.”
I’d heard it many times before and seen it referenced in pop culture, so when it felt like I was losing complete control of my mind, I thought “yes, this must be a nervous breakdown,” and looked up what to do.
But much to my surprise, I discovered nervous breakdowns aren’t actually a real thing.
So what was happening to me?
Acute Mental Distress
A nervous breakdown, in reality, is acute mental distress that renders you unable to function in every day life.
The term “nervous breakdown” comes from the idea of an individual being too nervous to function, or from an over-load of the central nervous system. It’s not a medically recognized term, and does not exist in the DSM 5, but I believe the idea behind a nervous breakdown holds true; it’s just incorrect terminology.
Acute means sharp or severe in effect; extremely great or serious, and distress is defined as great pain, anxiety, or sorrow; acute physical or mental suffering. Combine the two, and you get what I previously thought was called a nervous breakdown.
Acute mental distress happens after prolonged periods where an individual feels physically and emotionally overwhelmed. In these cases, underlying mental health disorders like depression and anxiety can become so severe, the person loses the ability to function in day to day life.
The exact cause and expression of acute mental distress can be different for everyone; however, there are signs, symptoms, and risk factors that are commonly associated with “nervous breakdowns.”
Signs and Symptoms
*A quick note here on signs vs symptoms: a sign is something someone else can observe, while a symptom is felt, but not outwardly observable.
Signs of mental distress include:
- Avoidance of social interactions
- Absence from work
- Changes in appetite
- Decreased personal hygiene
- Isolation within your own home
- Confusion, difficulty concentrating
- Chest pains
- Detachment from self or reality
- Difficulty breathing
- Disrupted sleep patterns
- Excessive fear or paranoia
- Extreme mood swings
- Feeling hopeless
- Feeling overwhelmed
- Lightheaded or dizziness
- Muscle tension
- Thoughts of suicide or self-harm
- Trembling or shaking
Now you may notice that the signs and symptoms of acute mental distress are very similar to those of a panic attack.
To my understanding, acute mental distress is a panic attack, the main difference being a “nervous breakdown” is more about the long term, increased accumulation of symptoms like social avoidance, changes in sleep or appetite, and extreme mood swings, that finally reach a breaking point that results in acute mental distress (which presents as a panic attack.)
On the morning of my breakdown, what I experienced certainly felt like a panic attack, but I didn’t just feel anxious and afraid, I felt like I was literally going crazy.
I had been spiraling mentally for months, and the increasing severity of my mood swings and inability to control my thoughts and emotions indicated something more than a typical panic attack was taking place.
I detailed my thoughts behind my personal breakdown in this post, but through research I’ve found the following to be common contributing factors to “nervous breakdowns” or acute mental distress:
- Family history of depression and/or anxiety disorders
- Injuries or illness that interfere with daily life
- Major life changes such as death or divorce
- Persistent work or school related stress
- Poor sleep patterns and the inability to relax
- Pre-existing anxiety disorders
- Serious financial trouble
If you’ve experienced any of the risk factors on this list, that doesn’t guarantee you will have a nervous breakdown or an episode of acute mental distress. But it does mean you are at a higher risk, and should pay close attention to your mental health moving forward.
What You Can Do During A Breakdown
*Any advice I give will always be based on personal experience and/or skills I’ve learned through therapy or personal research. I’m not a mental health professional, these are just things that have worked for me, or have been shown to help others.
Write Your Thoughts Down
You’re not going to be thinking straight, but communicating your thoughts to others will be even harder. Try to explain what’s happening in your own words: when did you first start noticing a mental change?
Write down any major events that have happened recently that had an emotional impact; establishing a timeline will be important for diagnosis.
Describe any physical symptoms you’re experiencing (are you nauseous, lightheaded, trembling, etc.) Try to put names to the emotions you’re feeling: fear, worry, paranoia, despair, anger…then be specific. If you’re fearful, what are you afraid of? If you’re feeling hopeless, about what?
This should help you to better explain whats happening when you talk with medical professionals in the next step.
Call for Help
After you’ve organized your thoughts, call for help.
If you have health insurance and/or access to mental health professionals, call the mental health department within your insurance plan and explain what you’ve written down. They may be able to help you over the phone, advise you to seek immediate care at a hospital, or schedule an appointment to be seen in person as soon as possible.
If you don’t have health insurance, the National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week: 1-800-273-8255
*If you’re having thoughts of suicide, hurting yourself, or harming others, this is considered an emergency; please call the crisis hotline, 911, or get to the nearest hospital immediately.
Get In-Person Help
The biggest thing that helped me through my breakdown was talking to a mental health professional face to face.
Just talking to someone, for me, was only half the battle. I wanted someone to be able to actually see me physically shake uncontrollably, witness my moods change for seemingly no reason, take my pulse and see how fast my heart was beating…etc.
When you’re in the throws of acute mental distress, it can feel like you’re literally dying. So for me, being physically in front of someone while explaining what was happening, helped me feel less afraid that I was going to die (however unrealistic that fear actually was; and yes, it is possible to both think you would be better off dead, and be afraid of dying.)
How to Avoid A Breakdown in the First Place
So I’m sure you would like to know how to avoid having a breakdown in the first place.
Unfortunately there is no definitive answer, but there are things you can do to take care of your mental health, and therefore limit the likelihood you will experience acute mental distress down the road.
This is nowhere close to a comprehensive list, and I will be writing a lot about coping skills in the future. But here are a few of the most important things that have helped me:
If you already know you have a history of depression, anxiety, or any other mental health disorder, I suggest starting therapy as soon as possible. This doesn’t mean you need to be in therapy forever, but starting consistent therapy sessions can be hugely successful for stress management, which is crucial if you want to avoid a breakdown.
If you don’t know or don’t think you have a mental health disorder, talk about your stresses and worries with a trusted friend or loved one (or you can always send me a private message.)
Talking to others about what you’re going through is a great way to process your thoughts and emotions, and also get a fresh perspective and potential new solutions you may not have thought about before.
Cut Out Caffeine
This one has been huge for me.
In my first session post breakdown, my therapist recommended I cut caffeine out of my diet; there’s plenty of information on why caffeine is bad for you, specifically in relation to anxiety. For me, consuming caffeine on a daily basis was constantly triggering my fight or flight response, and after eliminating it from my diet, I’ve noticed a significant improvement in how I physically react to anxiety.
Everyone knows how important exercise is for your physical health, but it’s also crucial for mental health. There is extensive research on why and how exercise is beneficial for your brain, and it can be as simple as taking a neighborhood walk. But it doesn’t have to be walking…just try to do something that gets you moving for at least 20-30 minutes each day.
For me, I do my best to take my dog for a daily, 30 minute walk around our neighborhood. Some day I hope to step that up to weight lifting, but for now, walking is good enough.
Follow a Regular Sleep Schedule
Practicing good sleep hygiene is crucial. This looks a little different for everyone, but for me that means going to sleep and waking up at the same time every day (weekends included), getting a minimum of seven hours each night, limiting technology use in the hour before bed, and using white noise to help me fall asleep.
(That white noise link is the app I personally use. Specifically, I listen to a combination of rain sounds, as rain is my favorite weather and I find it highly soothing.)
Progressive Muscle Relaxation
Here is an in-depth explanation, but more or less this involves tensing each muscle group, then making a conscious effort to fully relax.
For example, most of us carry tension in our shoulders: to perform progressive relaxation, you would first tense your shoulders (bring them to your ears) then try and fully relax, dropping them as low as they will go, paying attention to the feeling of release as you relax.
Anxiety causes muscle tension, and progressive relaxation has been remarkably helpful for me. I make a mental note to check my shoulders every hour, and almost every time they are already tense and can be “dropped.”
(There is a huge mind-body connection, and I will write more about this in later posts.)
I could also write endlessly about the benefits of mindfulness, and plan to do so in the future. This has been by far the most helpful skill in treating my mental health. But for now we will focus on a very brief overview.
Mindfulness at its core is a Buddhist concept that involves the conscious effort to be in the present moment, while calmly acknowledging and accepting ones thoughts, feelings, and physical sensations.
For me, this can be as simple as noticing when my thoughts slip towards the future or past, and bringing myself fully back to the present moment. Meditation is also an excellent way to practice mindfulness.
Rumination and worry are highly correlated with depression and anxiety, and mindful meditation has shown remarkable success in these areas. After all, if you make a conscious effort to be in the present moment, there is little room left for rumination.
And now I hope you have a better understanding of what a nervous breakdown really is (acute mental distress,) how to recognize the signs, symptoms, and risk factors, what you can do during one, and how to hopefully avoid ever having a breakdown in the first place.