The term nervous breakdown is the colloquial term for an acute reaction of the body to extreme mental stress, which is characterized by sudden physical and emotional overreactions on the part of those affected. The causes of a nervous breakdown can be different. If the condition persists, professional help in the form of talk and behavioral therapy, which is often supported by medication, is usually necessary.
What is a nervous breakdown?
A nervous breakdown is triggered by a situation that is extremely psychologically stressful for the person concerned. Such situations can be events such as accidents, experiences of violence, the loss of a loved one or ongoing stress in the private or professional environment. These events, which are also referred to as trauma, represent an acute or latent situation for those affected, in which they are completely overwhelmed and which they cannot cope with. The persistence of the situation leads to overloading of the body and eventual collapse. See phonecations for All You Need to Know About Cross Allergy.
Depending on the occurrence of the nervous breakdown and the persistence of its symptoms, a distinction is made between an acute stress disorder (a brief nervous breakdown lasting several hours to a few weeks immediately after an event) and a post-traumatic stress disorder (mental or social impairment lasting more than four weeks).
The acute nervous breakdown is not considered an illness, but counts as a normal psychological reaction to an extraordinary experience. If there is a post-traumatic nervous breakdown, one speaks of a disease that must be treated. If there is no significant improvement after three months, the disease becomes a chronic post-traumatic stress disorder.
In general, stress can be cited as the cause of all stress disorders. The different types of stress cause enormous mental stress and can be triggered by acute or chronic events. Acute events can be, for example, an accident or a violent crime. Natural disasters and wars also represent an acute stress situation.
The event can become a trauma and thus a source of stress not only for those directly involved, but also for witnesses or helpers. Losing a loved one can also be traumatic. Examples of not acute but constantly occurring stress can be ongoing mental pressure in the private or professional environment or persistent anxiety disorders (phobias). The sustained stress prevents adequate physical and mental recovery of the organism.
Whether someone suffers a nervous breakdown as a result of such events depends to a large extent on what personal coping strategies they have at their disposal. For example, mentally vulnerable people who have little social support tend to develop a stress disorder or are less able to alleviate this disorder again.
Symptoms, Ailments & Signs
The symptoms in the acute phase of a nervous breakdown are different from the symptoms and discomfort during the subsequent processing phase. A nervous breakdown can be announced, for example, by nausea, profuse sweating, tremors or tachycardia, sometimes also by impaired perception.
It is not uncommon for those affected to have the feeling of being beside themselves and no longer in control of their emotional overreactions and irrational actions. Aggressive or listless behavior such as in shock can also be observed. Immediately after the acute phase, many of those affected suffer from an extreme feeling of helplessness and emptiness. For her at this moment there seems to be no way out of the situation. This phase is often characterized by listlessness, desperation and physical and mental exhaustion.
In the processing phase that now follows, more nightmares or flashbacks can occur, depressive moods, sleep disorders, digestive problems, panic attacks or repeated crying fits. The symptoms usually decrease more and more during the processing phase and, in the best case, disappear completely.
If the stress disorder goes into a post-traumatic or chronic phase, it can lead to serious mental disorders if the treatment is missing or wrong. It is not uncommon for those affected to develop a personality disorder with depression, sometimes aggressive behavior, the inability to form personal bonds and an increased susceptibility to suicide.
It is precisely the last-mentioned complaints that also represent the most dangerous complications in the context of nervous breakdowns. In order to treat these concomitant disorders, it is first necessary to carefully and purposefully deal with the triggering trauma as part of professional therapy.
If this therapy is not carried out or is carried out in the wrong way, or if repression and a general defensive attitude on the part of the affected person prevent the sometimes longer necessary treatment, a chronic manifestation and worsening of the symptoms can be expected, which sometimes makes it impossible for the patient to continue to lead a self-determined life.
When should you go to the doctor?
As already described, an acute stress reaction can last from a few hours to a few weeks. If the person concerned has sufficient and suitable strategies to deal with the situation independently with a little calm, a time-out is often sufficient to get over the trauma.
The first point of contact for complaints of all kinds is the family doctor, who will initially issue a sickness certificate based on the complaints. However, if the symptoms persist for a period of more than three to four weeks, a specialist or psychologist should be consulted in consultation with the family doctor. In general and as a preventive measure, this should also be considered without an actual nervous breakdown, in the event of regularly occurring exhaustion and depressive moods.
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Unfortunately, depending on the region, making an appointment with a psychologist or psychotherapist is comparatively difficult. For acute cases, however, there are emergency numbers where trained specialists can listen and at least give initial indications of how to proceed or how to deal with the situation.
In many cases, it will therefore initially be the family doctor who conducts the initial consultation with the person concerned. A detailed anamnesis on the previous history, symptoms and risk factors is an essential part of the examination. If necessary, a referral to a specialist will be arranged. It can often be advisable to also carry out an examination of the physical symptoms.
The diagnosis of an acute stress disorder as a result of trauma is usually made by a medical specialist if the following conditions are met: The person concerned was recently confronted with an event which, due to its severity, represents an extraordinary burden. Such events may include, for example, the direct or indirect (as an eyewitness or helper) experience of death or serious injury, threatened or actual.
Since then, various physical and psychological symptoms and complaints have occurred that can be attributed to the event and that have a massive impact on those affected. If these or other symptoms, which may include, for example, problems falling asleep or staying asleep, difficulty concentrating or increased irritability and aggressiveness, occur within six months of this event, the diagnosis shifts in the direction of a post-traumatic stress disorder.
Diagnosis can be difficult because symptoms can appear immediately after experiencing trauma or with a delay of many years to decades. In extreme cases and a chronic course lasting several years, a permanent personality change after extreme stress must be diagnosed.
Treatment & Therapy
Acute nervous breakdown:
Depending on the person affected and the extent to which they can individually and independently call up or develop strategies to cope with the exceptionally stressful situation, acute stress disorders often do not require any further therapeutic measures. Ideally, the symptoms and complaints should subside on their own after a relatively short period of time.
Post-traumatic stress disorder:
If the symptoms do not subside and there is a risk of serious mental illness, the doctor and patient should agree on further treatment steps together. In extreme cases, the first step is to prevent the patient from committing suicide by admitting him to the hospital as an inpatient. Subsequently, and also during outpatient therapies, different approaches are usually mixed in order to provide the affected person with the best possible support in coping with the traumatic events through comprehensive and complex treatment.
In many cases, cognitive behavioral therapy is used, in which the traumatic experience is confronted in individual or group discussions. A result-oriented realignment and reconsideration of the situation are sought. This approach can be accompanied by drug therapy, which either reduces side effects such as insomnia and headaches or can have a general mood-lifting effect.
Rapid success can also be achieved with herbal preparations such as valerian and hops for calming or homeopathic products. Movement and relaxation techniques often play a not insignificant part in the therapy. Physical activity, meditation or autogenic training help both the body and the psyche to better reduce stress. A regulated and balanced everyday life, a healthy diet and fixed rest periods also help to steer everyday life in a harmonious way.
Outlook & Forecast
The prognosis after the occurrence of an acute stress reaction is very good. The symptoms usually go away on their own within a few days to weeks. However, if the symptoms persist and turn into post-traumatic stress disorder, the chances of a speedy recovery are reduced depending on the length of time untreated.
If there is a threat of a sustained stress reaction, professional help should be sought as soon as possible. Since nervous breakdowns have a very individual course depending on the history, the event and the available coping strategies, consistent self-motivation, a sustainable adjustment to everyday life and a change in behavior are the best prerequisites for a full recovery.
Since traumatic events usually happen unprepared, they cannot be influenced, or only with difficulty, and therefore cannot be prevented. Prevention is only possible to a limited extent by avoiding certain situations from the outset or circumventing them with special caution. The situation is different in the case of prolonged stress or anxiety disorders. If this danger exists, preventive action can be taken through targeted behavioral training or a change in living conditions.
The nervous breakdown requires consistent follow-up care in order to create the optimal conditions to prevent a relapse. This can be done in cooperation with a psychologist, but also with the family doctor. In this context, it is important how intense the nervous breakdown was, whether it can be linked to a specific experience or is an expression of a long-term stress and whether it is occurring for the first time or more frequently.
All of these are factors that are taken into account in an individual aftercare concept. When it comes to a specific triggering event for the nervous breakdown, talking to friends and family often helps in terms of sustainable processing. If the cause is, for example, constant stress at work or in everyday life, it is part of the aftercare to reduce these stress factors as best as possible.
On the one hand, aftercare should also provide the necessary rest for regeneration and, on the other hand, gradually restore resilience. Relaxation exercises and sports are often very helpful. In the sporting field, gentle endurance training is possible without any overload, but games without any competitive character are also ideal.
In the relaxation area, PMR (progressive muscle relaxation) is just as recommended as autogenic training. Problems falling asleep can be reduced with imaginary journeys or soothing music. Yoga also rebalances the mind, soul and body through physical and breathing exercises, relaxation and meditation.
You can do that yourself
Listening to one’s own psyche and paying attention to physical reactions and moods is particularly important when there is an impending overload due to professional or private stress. If it is foreseeable that a stressful situation will last longer, you should try to avoid this situation, create retreats or at least allow yourself enough rest.
Sufficient sleep is of great importance, going to bed early and relaxing by reading offer significant improvement with comparatively little effort. A short break often reduces the stress that occurs significantly and helps to find new ways and new strength. Therefore, planned relaxation breaks through sport or a hobby are very important for a positive general condition.
In the case of acute stress reactions, herbal sedatives from the pharmacy can also be used. Well suited are, among other things, means with valerian or hops. In more severe cases, a prescription sedative with relaxing and calming effects can also help in the short-term. Since the active ingredients create a dependency in the long term, this measure should only be used in individual and absolute emergencies.