What's a nervous breakdown?
By Molly Tiffin
Lately, we've seen celebs seemingly lose it. We dissect troubling ways people react to extreme duress.
After a string of bizarre behaviour — including shaving her head and attacking a paparazzo's car — there was wide speculation that Britney Spears was having a nervous breakdown. It's a phrase that's tossed around so casually, it begs the question: what does it really mean?
"Nervous breakdown is a broad term used since the early 20th century to describe a wide range of syndromes that have since been identified as diagnosable illnesses, like depression, anxiety disorders, and bipolar disorder," says Dr Holly Swartz, assistant professor of psychiatry at the University of Pittsburgh School of Medicine. However, doctors have never used the term clinically.
Still, the phrase circulates colloquially. Here's the gist: when you're emotionally overwhelmed, you mentally breakdown. "You lose control and act strangely, sending yourself on a downward trajectory that can lead to total unravelling," says Dr Susan Nolen-Hoeksema, director of the Depression and Cognition Program at Yale University.
While it's unclear if breakdowns are increasing, "depression and anxiety are rising among young women," notes Dr Peter Whybrow, author of American Mania, and these disorders can contribute to breakdowns. But not everyone who's distressed snaps.
"It's based on genetics and environmental factors," says Dr Swartz. "If you're biologically predisposed, then work or family stress or difficult events can tip you over the edge."
So how does a meltdown start?
You act impulsively
"When your problems seem insurmountable, you reach a point where you are unable to cope," says Dr Nolen-Hoeksema. "To distract yourself from your anguish, you may engage in risky behaviours, such as binge eating, substance abuse, or promiscuity. Soon you need bigger hits to smother your emotions."
Just look at how Britney's chain of actions escalated over time.
You self-destruct
During a meltdown, you may "try to release emotional pain by self-mutilation," says Dr Nolen-Hoeksema. You could cut yourself like Angelina Jolie has admitted to doing in the past; develop an eating disorder — Princess Di's bulimia appeared to be tied to depression; abuse drugs or alcohol like Whitney Houston did; or attempt suicide.
You get delusional
Brief reactive psychosis may also set in, where you lose touch with reality. In 2000, Anne Heche she said was God and would take everybody to heaven in a spaceship. "Your brain dissociates with the present to provide temporary relief," explains Dr Nolen-Hoeksema.