Nervous Breakdown - what is it

[who_knows]

What is a Nervous breakdown exactly.Is it just a non medical term for someone suffering from a combination of psychological problems that build up and come together all at once like depression,stress,anxiety etc and the person loses all control

[Coral Rhedd]

What is a Nervous breakdown exactly.Is it just a non medical term for someone suffering from a combination of psychological problems that build up and come together all at once like depression,stress,anxiety etc and the person loses all control

 

Pretty much. You will know one if you have one. I think another word they may use for it now is decompensation. But I am no psychologist. One will probably come along presently if you wait around.

[reverse]

it is an interesting term.

 

why not think of it like a automotive breakdown.

 

a car can fail to function correctly for a variety of reasons.

 

the point is to know when you car is needing a rest and when it is overheating...that sort of thing.

 

I like to draw the comparison between a pulled muscle and a nervous breakdown.

 

once you have been stupid enough to pull a muscle...nothing but rest will see you right.

[atinymonkey]

why not think of it like a automotive breakdown.

Because the human mind is more complex than a car, that's why.

 

once you have been stupid enough to pull a muscle...nothing but rest will see you right.

You seem to be saying nervous breakdowns are the byproduct of 'stupid' behaviour. Is that actually what you think?

[Peels]

What is a nervous breakdown?

 

In the Middle Ages, it was called melancholia. In the early 1900s, it was known as neurasthenia. From the 1930s to about 1970, it was known as a nervous breakdown. "Nervous breakdown" is a term that the public uses to characterize a range of mental illnesses, but generally it describes the experience of "snapping" under immense pressure, mental collapse or mental and physical exhaustion.

 

Nervous breakdown" is not a clinical term. There is no psychiatric definition of a nervous breakdown, and it has nothing to do with nerves. "Nervous breakdown" is an inexact and unscientific term that is no longer used in psychiatry.

 

The diagnosis that most closely resembles what the public calls a nervous breakdown is major depression. The mental illness known as a "nervous breakdown" may also be something like panic attacks, schizophrenia, post-traumatic stress disorder or acute stress disorder.

 

from http://people.howstuffworks.com/question653.htm

[reverse]

Because the human mind is more complex than a car' date=' that's why.

 

 

You seem to be saying nervous breakdowns are the byproduct of 'stupid' behaviour. Is that actually what you think?[/quote']

 

 

No not really.

 

Unless you know what the potential liabilities of a situation are ...I guess you can't be accused of failing to analyse the down side of the risk.

 

Some people will keep on putting themselves under increasing pressure despite all the warnings from professionals and friends, that is stupid.

[Coral Rhedd]

[quote name=reverse

Some people will keep on putting themselves under increasing pressure despite all the warnings from professionals and friends' date=' that is stupid.[/quote]

 

I think that rather depends upon how much pressure an individual can stand. I remember reading in books (novels ) where doctors recommended a sea cruise. However most people have to make a living and the more strained their circumstances, the more necessary work is.

 

Since I work in rehabilitation, I've known people who've had to choose between lessened mental pressure and paying the rent.

 

Sometimes, for some people, there just aren't any good choices.

 

Also, I have noticed that at the beginning stages of depression, people tend to deny to themselves how depressed they really are, and deeper into depression, feeling snakebit, they tend to underestimate how much they are capable of, as if recovery were a dim light at the end of a very long tunnel.

[reverse]

Can you give an example?

 

I'm not sure what you mean by that choice between paying the rent and reducing pressure.

[Glider]

Can you give an example?

 

I'm not sure what you mean by that choice between paying the rent and reducing pressure.

 

Working harder to increase income in order to pay the rent, or easing off to reduce the pressure and possibly failing to pay the rent.

 

Everybody has demands. The net demand placed on anybody is the sum of the demands placed on each role a person has. Most people have many roles: spouse, parent, employee, earner, carer, friend, colleague, mentor, houskeeper, manager etc..

 

Each of these roles comes with its own demands. When the total demand approaches an individual's capacity to meet it, the individual begins to experience anxiety. At this point, they will begin to reduce their output to some demands (i.e. by reducing their activity in other roles). Unfortunately, this often leads to an unbalance. For example, if work demands increase, then, to maintain a 'steady' load, a person will often reduce their input into other roles such as spouse, friend, parent; those more flexible 'social' roles.

 

This may ease the net demand, but places stress on those relationships. If it goes on too long, those relationships may begin to break down, which places a greater load on the individual.

 

If the net demand exceeds the capacity of an individual, then that individual will fail to cope. This failure to cope is the beginning of a 'nervous breakdown' (which as Peels stated, is not a clinical term).

 

Whatever role begins to fail will present a disproportionate demand, heightened by anxiety and fear of failure. The individual will devote more than necessary resources to keeping that particular ball in the air. At this point, other balls begin to fall leading to more anxiety (greater demand) and increased stress.

 

If nothing changes significantly, this will soon lead to a generalised failure to cope and an almost phobic avoidance of further demand. The individual will shut themselves off, physically and emotionally to avoid further demands, but in the process, also close themselves off from any support that might be available. This is also accompanied by a severe depression, even more anxiety and a severe reduction in self-esteem and self-efficacy. This is what is commonly termed a nervous breakdown.

 

The important thing to remember is that it doesn't really matter where the demands come from. It is the net demand that is critical. As such, when the net demand is exceeded, the failure to cope will be generallised. For example, if the demands of a person's job grow too high, their family/social life will suffer also. If the demands of their social relationships increase too much (e.g. marital/relationship difficulties), then their work will suffer.

 

People only have one focus of attention and that will tend to be directed towards the source of the greatest perceived demand (i.e. the source of greatest anxiety), so by definition, all other demands will recieve less attention. If those demands are 'maxed out' and cannot afford such a reduction, then they will begin to fail and the whole process begins to collapse. It is for this reason that balance is important, as is maintaining a margin of safety. It is dangerous to 'max out' any particular demand (e.g. job), if the demands of other roles (e.g. parent/spouse/friend/carer or whatever) are also close to maximum.

[Coral Rhedd]

Thank you Glider. Your explanation is perfect.

[lepidoptera]

I know what a nervous breakdown is. I have had several. I'm only thirteen, and I'm already screwed up. I am seeing a therapist and a psychiatrist and being diagnosed with several things, none of which I am too pleased with. If you want to know what a nervous breakdown is, send me a private message.

[reverse]

it's ok.

 

I have seen it several times.

 

Thanks, hope you get good help in learning to detect and manage it.

 

so with the caught between a rock and a hard place situation....I mean what’s the point going beyond your present mental strength level?

 

You will only pull a brain muscle and be out of the game for ages...

how is that going to help you?

 

It's not like you can beat it, you have no choice but to ease up on the pressure until you get mentally stronger.

 

I see what you mean…. but can you see my point about the futility of trying to fight it by increasing the effort.

it's like one of those finger pop toys.

[Coral Rhedd]

It's not like you can beat it' date=' you have no choice but to ease up on the pressure until you get mentally stronger.

 

I see what you mean…. but can you see my point about the futility of trying to fight it by increasing the effort.

it's like one of those finger pop toys.[/quote']

 

Actually, I see your point. I just disagree somewhat, but the devil is in the details.

 

One of the first things the theraputic community seems to want to do is convince people they are helpless and must passively surrender to the ministrations of those who know better.

 

I have known people who have beaten it and people who have not. Often the difference has been mere determination. You see, a person who will push himself/herself to the point of a nervous breakdown may also have the wherewithal to push towards recovery.

 

In too many instances, those who have had "breakdowns" are labeled ("This will be with you for the rest of your life!"), medicated ("You will probably always need antidepressants!"), and are not seen as partners in their own recovery. Indeed, many so-called theraputic communities don't even see rehabilitation as an advantage.

 

I hate to be cynical, but who do doctors make more money off of, people who recover or people who become chronic consumers of mental health resources?

 

The people I see who get well are the people who finally say "screw it" to everyone else's evaluation of them and begin to find their own internal balance. Sometimes this means doing less that people expect them to do, sometimes this means doing more, and sometimes this means going in a completely different direction. I have seen supplements and exercise do wonders for people. Finding work where they can pace themselves or that is uniquely suited to their talents and needs also helps people to recover.

 

Most people who initially push themselves past their breaking point seem to simply being doing what society simply expects of them: Parenting, contributing, working. When you opt out of these, you get punished by things like complaining teachers, out of control children, bill collectors, and unhappy family members. This is the rock and the hard place.

[reverse]

yes.

 

thats why I use the pulled muscle analogy.

 

it's preventable

it's repairable,

and its inevitable in certain situations.

[Glider]

One of the first things the theraputic community seems to want to do is convince people they are helpless and must passively surrender to the ministrations of those who know better[/b'].

They must be really bad therapists. What would be the point of trying to convince a person, who, as a function of their condition, already believes themselves to be helpless and dependent, that they are helpless and dependent?

 

In too many instances, those who have had "breakdowns" are labeled ("This will be with you for the rest of your life!"), medicated ("You will probably always need antidepressants!"), and are not seen as partners in their own recovery. Indeed, many so-called theraputic communities don't even see rehabilitation as an advantage.

It's true about labelling, but this is usually by the public, not the clinicians, and is due to the public perception of mental illness (which is also the reason that charities to do with mental illness are significantly under subscribed when compared to those dealing with the more 'popular' physical illnesses). Remember, the term 'breakdown' is a lay term, not a clinical one.

 

Which particular 'theraputic community' would not see recovery/rehabilitation as an advantage? Surely that contradicts the term 'theraputic'?

 

I hate to be cynical, but who do doctors make more money off of, people who recover or people who become chronic consumers of mental health resources?

Here (in the UK), it would be the former. Due to governmental changes in the funding mechanisms of GP practices, a relatively fast patient turnover is rewarded. This is why people with chronic conditions are finding it harder to register. Chronic consumers are a drain on resources that have to come out of the practice budget.

 

As for the actual salary of doctors, that remains unaffected by the recovery or otherwise of individual patients. It would be a clear conflict of interests for doctor's salary to be linked in any way to the state of their patients. It would certainly be unethical to give doctors a financial incentive to prolong the suffering of their patient, wouldn't you agree?

[YT2095]

It's not like you can beat it' date=' you have no choice but to ease up on the pressure until you get mentally stronger.

[/quote']

 

another way, is as Glider mentioned, we all have different roles in our lives. and if you can clearly identify and seperate these roles, and don`t allow for any overlap or encroachment into other parts of your life, very often when you`ve had time in a different role and go back to the one creating the pressure, it`l like you`ve had a mental holliday anyway, and you can view it again with a fresher and more realistic perspective again.

I find that helps me "Cope", I actualy think of them as different lives, and Never allow them to mix in anyway, I don`t even allow talk of the other. so in effect when I come home, the rest stay outside my front door, when I lock the gate at the garden, there`s no talk of home life allowed there etc...

[Coral Rhedd]

They must be really bad therapists. What would be the point of trying to convince a person' date=' who, as a function of their condition, [i']already[/i] believes themselves to be helpless and dependent, that they are helpless and dependent?

 

Actually, most of them at the clinic I have in mind in my post (no name to protect the guilty) are MSWs. There is a part time doctor and the day to day management of the clinic is the responsiblity of an MSW.

 

Patients are either without resources or generally have few resources. People with funds or good insurance go elsewhere.

 

The clinic runs a TLC (Transitional Living Center), a substance abuse program, a PSR (Psycosocial Rehabilitation), a Payee Program and an outpatient program.

 

I have been puzzled myself about why there seems to be so much energy invested in keeping people dependent. Perhaps the answer lies in the service gap between dependency and self-sufficiency. There is so much risk in moving toward rehabilitation because people who become gainfully employed lose all benefits within two months. No doubt they see many people fall through that crack and end up worse off.

 

However, I have visited and taught a seminar at the PSR, and noticed that people get constant "messages" of incapability:

 

"You are not ready for your own bank account Danny."

"Most of our consumers just need to learn to take baths."

"I think our consumers need to take part time jobs that do not pay too much." (This is because an income over a certain amount disqualifies them for disability, but this income is still far below poverty level.)

 

No kidding. I have actually these things said to people. I think these are messages of low expectation and I think they undermine recovery.

 

It's true about labelling, but this is usually by the public, not the clinicians, and is due to the public perception of mental illness (which is also the reason that charities to do with mental illness are significantly under subscribed when compared to those dealing with the more 'popular' physical illnesses). Remember, the term 'breakdown' is a lay term, not a clinical one.

 

Maybe we have a different understanding of labeling. In order to diagnose, the clinician must first apply a label using the DSM. Without the label -- the clinic gets no funds. It is not uncommon to see people's diagnoses change once they stop seeing clinic therapists. Often they go from major depression to schizotypal (with clinic therapists) to bipolar to PTSD. Some of them even get well.

 

A diagnoses of PTSD is never given even when it seems warranted because it on its own (despite its debilitating symptoms) is not a legal disability that would qualify someone for Supplemental Security Income.

 

Once someone qualifies for Supplemental Security Income (SSI) or SSDI, the clinic often suggests that the clinic become that person's Payee. That is to say that the clinic now manages that person's money.

 

Which particular 'theraputic community' would not see recovery/rehabilitation as an advantage? Surely that contradicts the term 'theraputic'?

 

Exactly.

 

Here (in the UK), it would be the former. Due to governmental changes in the funding mechanisms of GP practices, a relatively fast patient turnover is rewarded. This is why people with chronic conditions are finding it harder to register. Chronic consumers are a drain on resources that have to come out of the practice budget.

 

Chronic consumers are meat and potatoes here. If they do not get well, they can remain clinic patients. The documentation process to keep them in this "category" while still showing increments of progress produces an astounding amount of paperwork. "Accountability" kills a lot of trees.

 

As for the actual salary of doctors, that remains unaffected by the recovery or otherwise of individual patients. It would be a clear conflict of interests for doctor's salary to be linked in any way to the state of their patients. It would certainly be unethical to give doctors a financial incentive to prolong the suffering of their patient, wouldn't you agree?

 

MSWs are cheap. Those working at this clinic get huge patient loads. Seventy people usually. They do Crisis Line and Intakes and must accomplish the massive paperwork tasks and still see the "consumers" for therapy. Most paperwork is accomplished outside the hours of 8-5. In addition, there is a rotating on call. The financial incentive is a paycheck. If they do not jump through the proper paperwork hoops, they will not keep their jobs.

 

I am not saying that these are evil people. I am saying the system is the problem.

 

However, please enjoy the follow story:

 

A woman I knew from the PSR told me that her payee had embezzled her money. This was two years ago, and the embezzler had been dismissed but not brought to trial and the consumer still had not gotten her money back.

 

Finally, the woman pressured the clinic to take the former employee to trial. She asked me to attend the trial as she was very nervous about giving a victim statement and wanted someone with her.

 

During the trial, I heard the defendant's attorney claim that the clinic had been reimbursed by insurance. The former payee was found guilty and sent to prison for a term of three years.

 

Last I heard, the woman still had not had her $6,000 dollars returned to her. When I pointed out to the woman that the clinic had been reimbursed for their "loss" by insurance and that she should surely now get her $6,000 dollars back, the woman said: "I cannot afford to make them (the clinic) mad at me because I need therapy and I need to go to PSR (where this very clean and intelligent woman will learn to take baths and do house chores such as sweeping).

 

She still has no had her money returned to her.

 

Dependancy can be a terrible thing.

 

Why do I not report this? Because the laws of confidentiality bind me. Because I work for a different agency. Because this woman is afraid to speak the truth.

 

Six thousand dollars would buy this woman a used car. With a used car, she would be able to get to work in this auto dependent town. This woman is fully capable of working, but her "theraputic community" has convinced her that she should go easy on herself because she "could relapse at anytime."

 

Sorry to be long with this post, but I am not a psych professional. I have no language to describe these things except the language that describes what I have observed.

[Ophiolite]

Coral, to hear of these instances third hand is depressng enough. Someone immersed in the scenarios you describe is 'entitled' to a nervous breakdown. Depressng as they are thank you for sharing them with us.

 

Edited for spelling

[Glider]

Sorry to be long with this post, but I am not a psych professional. I have no language to describe these things except the language that describes what I have observed.

Nonetheless, you have described it very well. It sounds like a very depressing situation and I can see how it could make a person seem cynical. It must be very hard and extremely frustrating to work under those circumstances; watching what goes on and not able to do anything about it. It sounds awful.

[Coral Rhedd]

Thank you Ophiolite and Glider.

 

I have the funds to move to a new location and will be looking for an entirely different type of work. I tried very hard to be supportive of my consumer's needs but I have found the system really squeezes them. Voc Rehab is not very responsive either. I had one consumer spend months putting together a Business Plan for Self-Employment only to be told that the Division of Vocational Rehabilitation would not support his plan because he did not already make $900 a month.

 

They chose to totally ignore that the new business he would be starting was substantially different from his previous business. They ignored the fact that the Small Business Development Center and other organizations felt his projected business would be a success. They ignored their own guidelines and they misled and lied to him, and to me by extension.

 

I just want out of this business. I am ashamed to be a part of the system.

[mike90]

Want to know what what a nervous breakdown is? Simple. Thats what happens when a persons stress factors in there life far outbalnace their support and coping mechanisms. Almost anyone could fall victim to one as they hinge on a persons circumstances more then their personality. So basically all it takes is everything in your life going wrong at once, or enough problems in one area ie finances, work, emotional or physical well being etc. I wouldn't wish the pain of going through one on my worst enemy. Recovery can take a long time with a high chance of relapses if you cant change the root causes or find new ways to cope with them