What Ever Happened to the Good Old-Fashioned Nervous Breakdown?

from wsj.com

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."

"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."

read the rest of the story at wsj.com