What we really talk about when we talk about nervous breakdowns
By: Sarah Mcmanus
Tags: Self Harm, Hope, Mental Illness, Anxiety, Depression

What we really talk about when we talk about nervous breakdowns

Just because it isn’t a medical term, doesn’t mean it isn’t a useful one.

It’s a term you’ve probably heard thrown around often — a nervous breakdown. Yet oddly, it isn’t a term used in the world of mental health. It was used more in the past, but even then it wasn’t a medical term as such. To figure it out, let’s first look at the ‘nervous’ part of it.

The idea of it being a nervous breakdown stems from the time when the words neurotic and psychotic were used more broadly and were considered polar opposites. A person who is experiencing high levels of paranoia and delusions, amongst other symptoms, would be considered psychotic. You might have heard the term ‘psychotic break’, which is characterized by a person losing touch with reality and possibly being out of control, in a severe way.

At the other end of the spectrum, someone with anxiety, obsessive-compulsive behaviour or depression is neurotic. Rather than a psychotic break, when neurotic issues become out of control, that’s where ‘nervous breakdown’ comes in.

When we talk about a nervous breakdown, what we’re really saying is that illnesses or disorders of the anxiety and depression kind have gotten out of control to the point where it significantly interferes with daily life. That’s what happened to me.

When I refer to having had a nervous breakdown a couple of years ago, people don’t often take me seriously.

The word breakdown is thrown around the same way people refer to themselves as ‘a bit OCD’ and stuff like that, and often it is used in place of better-suited words such as ‘meltdown’ and ‘overwhelmed’.

Credit to Eric Ward via Unsplash

What I mean when I say I experienced a nervous breakdown, is that my depression and anxiety got so out of hand that I couldn’t function properly anymore. It wouldn’t have taken a genius to see it coming had anyone taken the time to really listen when I asked for help, which I’d been doing since I was a young teen, to no avail. Looking back now I can see I was hanging on by a thread for a while, only getting by because of my self-harm habit and pretending to myself that crying daily was normal behavior somehow.

The cracks only grew with some changes at work. I was working full-time in a job with a long commute, alone 90% of the time in an office, with a high level of responsibility. I kept my head above water, in spite of a years-long depressive episode and heart-palpitation-causing anxiety, until I couldn’t anymore. All it took was one change to push me over the edge.

The last week that I worked in that job, I would start to cry almost as soon as I awoke each morning, and then in the shower, all through the commute, on and off throughout the day at work, and then all the way home. The only short periods in which I wasn’t crying were only after I cut myself, which I did often because it was the only way to make the anxiety stop. Half-way through that week, I began to seriously plan my suicide. It had been an abstract concept for a long time, and more serious on and off for many years, but the plan began to crystalize then.

By some miracle, which I will be eternally grateful for, I had a moment of clarity. Although I’d given up on the idea of getting help quite some time before, I decided to give it one last try.

As tempting as it was in some moments, I knew that what I really wanted was a break, not a permanent end to my life.

I made a doctor's appointment, and after a very long of crying and cutting myself at work, I opened up to someone new. And thank God I did. She is still the best doctor that I’ve seen; she listened patiently, responded with kindness, and most importantly, she took me seriously. She agreed that I really wasn’t getting any kind of quality of life. We discussed options and I left with a prescription for anti-depressants, and a sick note for two weeks off from work.

I think I slept better that night than I had in years. It didn’t cure everything, nothing could do so that quickly, but I had a little bit of hope again. In the end, that two weeks off became six months, and then when I felt more ready to return to work, it wasn't the same job. Going through that journey from total despondency to a relatively healthy person changed me in more ways than I would have expected.

Don’t get me wrong, this isn’t a ‘what kills you makes you stronger’ kind of a deal. I really didn’t feel like I’d gained any strength through all that, but what I did gain was even better — self-respect, an understanding of my limitations and abilities, the confidence to set boundaries, and a whole lot of empathy. I hadn’t exactly been short on empathy before, but something about being broken down to nothing and working hard to get back up does give you the ability to relate to others more.

Three years ago, I thought it was acceptable to simply survive, and to do so because of (very unhealthy) coping mechanisms. Now I know that surviving isn’t all there is to life, and that living is not easy, it takes hard work, and courage, but it’s worth it.

Next time you hear someone say that they had a breakdown, ask them what it means for them. For some, it will mean a short period of feeling overwhelmed, but for some it means being completely decimated by anxiety and depression, and living to tell the tale.