The term ‘nervous breakdown’ hasn’t been a recognised psychiatric diagnosis since 1970. Today we know that ‘the temporary disintegration of a person’s personality, brought on by extreme stress, can be more accurately explained as a symptom of a larger psychiatric problem, such as depression, generalised anxiety disorder and panic disorder,’ says Winnie de Roover, director of Stellenbosch University’s Mental Health Information Centre. And, according to the classification system (called the DSM-IV) used for diagnosing mental illness, what ordinary people call a ‘nervous breakdown’ doctors call a psychotic break, a schizophrenic episode, a manic break, post-traumatic stress disorder, a severe panic attack, burnout and most commonly, a major depressive episode.
DOWN BUT NOT OUT
Not everyone who is depressed or anxious will have a breakdown. Some people are genetically predisposed that way but what pushes most sufferers over the edge is a moment of extreme stress.
According to Johannesburg psychiatrist Dora Wynchank, most meltdown moments are characterised by ‘a sudden episode of psychological or emotional distress that may have been brought on by a traumatic external event, which lasts for a couple of weeks and affects the person’s ability to function normally from day to day’.
For example, a woman may become depressed after a traumatic break-up, but seeing her ex out with his new girlfriend may be enough of a stressor to overload her coping circuits and cause a mental meltdown. Or, after feeling burnt out at work for a long time, a person can be tipped into breakdown when a big project that she’s spent a lot of time and energy on is suddenly shelved. ‘Both these stressful scenarios force the person out of normal functioning and into intense emotional chaos that is often debilitating,’ says Wynchank.
Experts say the signs of a meltdown episode include: loss of pleasure in all things, uncontrollable crying, dramatic weight loss or gain, sleep disruption or extreme tiredness, feelings of worthlessness and, in extreme cases, a complete inability to function.
In some cases, the person will become delusional, seeing and feeling things that aren’t there. She may become obsessive, prone to self-harm or even suicidal, and her speech patterns may become disjointed. (In 2000, Men In Trees star Anne Heche was found wandering in the desert in the US, claiming to be God and promising to take everyone to heaven in a spaceship.) A person on the verge of ‘cracking up’ can also become manic, evidencing extreme mood highs and odd behaviour, including excessive spending and spur-of-the-moment, socially inappropriate actions – such as Britney Spears’s recent run-in with hair clippers and her assault on a paparazzo.
So how do you prevent yourself from having a nervous breakdown? Says De Roover: ‘Knowing yourself is the best defence: acknowledge that you have a problem, learn what triggers an extra-emotional response from you, seek out ways to protect yourself from those triggers and ask for help. It’s also important that you communicate with the people around you: family, friends and colleagues who know you have a problem can give support when you feel yourself beginning to stress. They need to know what’s going on in order to assist you constructively, whether it’s helping to prioritise work or delegating it to someone else if you’re under too much pressure.’ But, says De Roover, if you still feel you can’t cope, seek professional help.
‘Therapy and counselling can help you identify the root cause of your breakdown and provide you with the tools you need to work through it,’ says Wynchank, adding, ‘Rehab is really only an option if drug or alcohol addiction is involved.’ The most common treatment is a combination of therapy and medication.
Call the Mental Health Information Centre on 021 938 9229 or visit www.mentalhealthsa.co.za for advice on finding a therapist or support group in your area.