Remember those? Well, you would if you were around in the 1950s and 1960s. I had a rather sheltered upbringing as a child, and just before high school my family moved from a large city to a small town, a hamlet, actually, so the pool of possible people I might personally know who could suffer nervous breakdowns, suddenly became shrunken. People who live in hamlets aren’t supposed to be nervous types. That’s for city folk. However, I do remember that the sister of a friend of mine from the hamlet went off to study music at a prestigious music school and she promptly came home mid-way through the first term suffering what everybody whispered was a “nervous breakdown.” Her parents put her in a convent for a year where she played music to her heart’s content before re-enrolling at another university. I had no idea what a nervous breakdown looked like to the naked eye, and I still don’t. Nervous breakdown people holed up for a while in their homes (or a convent like my friend’s sister) and emerged later to get on with their lives. The family was embarrassed that their relative should be so delicate of mind and spirit, but in truth, a nervous breakdown was not that uncommon. The Rolling Stones sang about their 19th Nervous Breakdown in the late sixties, and then what? Then a mysterious phenomenon swept the land, and suddenly, nobody seemed to have nervous breakdowns anymore.
There was a young man in my graduate program in the early eighties who started acting funny. One day he arrived in the classroom, grabbed the nearest piece of chalk and started scribbling all kinds of mysterious mathematical equations on the board that made infinite sense to him and the Universe. He dropped out but returned to the university a couple of years later and completed the program. I just assumed he had a nervous breakdown. Had he been told he had schizophrenia, well, university might have ended right there for him.
When Chris landed in the hospital in 2003 with his diagnosis of schizophrenia, my father-in-law, a university professor, was hoping that Chris was only suffering from a “garden variety” nervous breakdown, as he put it, the type of mental condition that seems to go hand in hand with academic pressure and your first year away from home. I hadn’t heard that description of a mental health condition for years.
So, since we almost never hear of someone suffering a nervous breakdown these days, I got curious and did the usual quick Internet search, starting with Wikipedia.
“The terms “nervous breakdown” and “mental breakdown” have not been formally defined through a diagnostic system such as the DSM-IV or ICD-10, and are nearly absent from current scientific literature regarding mental illness.[1][2] Although “nervous breakdown” does not necessarily have a rigorous or static definition, surveys of laypersons suggest that the term refers to a specific acute time-limited reactive disorder, involving symptoms such as anxiety or depression, usually precipitated by external stressors.[1] Specific cases are sometimes described as a “breakdown” only after a person becomes unable to function in day-to-day life due to difficulties adapting.[3]“
If Wikipedia is correct, it sounds to me like the term nervous breakdown doesn’t convey the gravitas needed for long term use of antipsychotics, and therefore it has disappeared from the prescribing Bible.
I was a bit suspicious that there seemed to be no link to psychosis in the Wiki definition, so I checked another website associated with natural remedies, and found much more encompassing symptoms, ranging from Irritable Bowel Syndrome, to seeing people who are not there, to depression and mania, inter alia. “In more extreme cases, psychosis can occur where the person will experience complete loss of contact with reality. The symptoms may include hallucinations or visions, feelings of victimization or persecution, strange speech patterns and behaviors as well as extreme guilt or grandiosity.” The Wiki definition sees a nervous breakdown as something discrete (time limited), mainly to do with depression and anxiety, while the natural health website, perhaps to peddle a variety of natural cures, has made a nervous breakdown something universal.
People who suffered from nervous breakdowns in the past, got over them, whether they were suffering from grandiosity, constipation, or fleeting psychosis. Now that the term is no longer in vogue, and the more ominous labels of schizophrenia and bipolar are, we have seen a shift from a garden variety condition to something chronic.