After ending an unhappy marriage and getting laid off twice, Hannah Shapiro last year found herself alone with two small children to support in Miami, far from her family in England. “I was so scared, I was paralyzed,” she says. “My heart was racing. I would take the kids to school and get back into bed.”
After a week like that, Ms. Shapiro, age 33, says she had a “light bulb” moment. “I thought, ‘What the heck am I doing in bed? I can turn this around.’ And I did.” She put her writing skills to work and set up a communications consulting business. She still gets anxious at times but no longer feels she’s on the edge of breaking down. “I just made myself snap out of it,” she says.
Fifty years ago, Ms. Shapiro’s experience would have been called a “nervous breakdown“—an unscientific term for personal crises ranging from serious mental illness and alcoholism to marital problems and stress.
Today, psychiatry is more precise. A sudden inability to cope with life’s demands could be classified as one of dozens of specific mental disorders, including post-traumatic stress disorder, generalized anxiety disorder or major depression. There’s no official term for milder forms of “nervous breakdown,” though some patients and clinicians wish there was still a name for a temporary state of being overwhelmed by outside forces without an underlying mental illness.
“I hear the term ‘nervous breakdown’ from a patient at least once a week,” says Katherine Muller, a clinical psychologist at the Center for Integrative Psychotherapy in Allentown, Pa. “The term lives on in our culture, maybe because it seems to capture so well what people feel when they are distressed.”
Sir Isaac Newton was one of the greatest scientists and mathematicians that ever lived. He was born in England on December 25, 1643. He was born the same year that Galileo died. He lived for 85 years. Sir Isaac Newton suffered from nervous disorders (picture below):
“Given the economic mess we’re in, a lot of people are coming in saying they think they’re on the verge of a nervous breakdown,” says David Hellerstein, research psychiatrist at the New York State Psychiatric Institute. He says it can be challenging to tell immediately if a patient is having an acute episode of mental illness, or a predictable reaction to extreme stress. Symptoms may be similar—including heart palpitations, chest pains, shortness of breath, uncontrollable crying, dizziness, disorientation, exhaustion and a feeling of “going crazy.”
In some cases, it could be both. For Debra Stang, the pressure had been building long before she snapped. Her best friend had died in January 2001, and Ms. Stang, then 32, felt surrounded by grief at her job as a social worker at an inner-city trauma center near her home in Merriam, Kan. “I went to work every day and came home and cried every night,” she says.
There were warning signs, including chest pains, but she kept working until the morning of what would have been her friend’s birthday the following April. “I couldn’t get out of bed. It was like my arms and legs simply wouldn’t work,” she recalls. Ms. Stang was diagnosed with bipolar disorder, which she thinks began in her teens. Rest, medication and counseling enabled her to work full-time again, as a writer. “I don’t think I would have had the guts to pursue that dream if I hadn’t realized how fragile life is,” she says.
Pictured below, Abraham Lincoln, suffered from bouts of severe deperssion:
The “nervous breakdown” phenomenon appears to be more common than in years past; although with no official definition there is little firm data. According to a 2000 report published in American Psychologist, 26% of Americans surveyed in 1996 said they felt “an impending nervous breakdown,” compared with 21% in 1976 and 18% in 1957. Respondents cited divorce and marital issues and financial and job stress. Such triggers, though, are often just the final straw for someone already struggling to cope.
“It’s not necessarily the stress, but how one deals with stress,” says T. Byram Karasu, chief psychiatrist at Montefiore Medical Center in Bronx, N.Y. “Not every divorced person has a nervous breakdown—some go to a party.”
A self portrait of Vincent van Gogh (below):
Some of history’s most successful people—Sir Isaac Newton, Abraham Lincoln, Vincent van Gogh—hit a mental wall at a time of discouragement or exhaustion. By the early 1900s, so many actors, artists and authors were said to suffer “nervous breakdowns” that the term acquired cachet. “A nervous breakdown was a respectable career path in some professions,” Dr. Hellerstein says.
Wealthy people with mild symptoms often recuperated in plush retreats. People with severe mental illness, especially with erratic behavior, were sent to asylums. “Rich people had ‘nervous breakdowns’; poor people ‘went insane’—although they were two different things,” Dr. Karasu notes. By the 1960s, the Diagnostic and Statistical Manual (DSM) was codifying patients’ conditions; “nervous breakdown” has never been included.
“It isn’t really a disorder—it’s modern life,” says Prudence Gourguechon, past president of the American Psychoanalytic Association. “We all know what it feels like. Your capacity to act as an adult is exceeded by the demands on you at the moment, for whatever reason.”
Such feelings are typical of anxiety—”one of the most underappreciated states of human misery,” Dr. Gourguechon says. Someone who feels a breakdown coming on should seek help, experts advise. Self-medicating with alcohol or drugs is dangerous. In the short term, the severity of symptoms matters more than the diagnosis.
A person in extreme distress over a job loss or a breakup “could be a risk to themselves even though they’ll get better,” says Dr. Hellerstein. He would probably temporarily prescribe a benzodiazepine like Valium or temporarily admit the patient to a hospital, he says.
Hannah Shapiro says she is proud that she snapped out of her nervous breakdown on her own. “Sometimes we find our greatest strength through challenging times,” she says. (Credit: Pictures – Getty Images, Narrative – Melinda Beck for the Wall Street Journal).
The Master of Disaster