What exactly is a nervous breakdown?

‘Nervous breakdown’ isn’t an official medical term or mental illness, but everyone has some idea of what the phrase means. Although there’s no precise definition, it generally describes the feeling of being under so much prolonged stress that you feel like you’re reaching a breaking point, says neurologist and psychiatrist Dr David A. Merrill.

Feeling you’re having a nervous breakdown can be indicative of an underlying mental illness and you need to talk to your doctor about it right away if it’s impeding your ability to live your normal life, he says. Talk to your doctor about all your symptoms of a nervous breakdown so you can get the right kind of help to tackle your extreme stress and start feeling better. “Nervous breakdowns need to be treated both medically and psychologically,” he explains. “There are lots of new treatments available, so don’t be afraid to ask for help.”

You can’t concentrate

In the short term, stress can boost your brainpower by releasing hormones that enhance memory storage and improve concentration. But in the long term, chronic stress makes it difficult to block out external distractions, which affects your ability to focus on work projects (bad) or your surroundings while driving (really, really bad), Dr Merrill says. In extreme cases, excessive amounts of the stress hormone cortisol can lead to memory loss, according to a study published in the American Journal of Psychiatry. Stress can be a symptom of a nervous breakdown.

You can’t stop eating

Do you reach for a tub of ice cream or packet of biscuits after a long day? There’s a good reason for that. Stress causes the brain to release hormones, including adrenaline, which energises your muscles for a ‘fight or flight’ response. Once the adrenaline wears off, cortisol tells the body to replenish its lost energy stores with food, Dr Merrill says.

The problem is, when you’re stressed for reasons that don’t involve crazy levels of physical activity (say, running from a sabre-toothed tiger), you’re biologically wired to eat when you don’t really need to. High-fat and high-sugar comfort foods increase pleasure chemicals in the brain to trick you into temporarily feeling better, he explains.

Your stomach is upset all the time

Sometimes stress and anxiety can manifest as stomach aches and cramps, Dr Merrill says. But if you notice a cluster of symptoms that includes abdominal pain, constipation, bloating, gas and diarrhoea, you could have irritable bowel syndrome (IBS), which some research suggests is linked with long-term stress.

IBS could be triggered by the immune system’s response to stress, although researchers are still studying this. According to the Anxiety and Depression Association of America, anywhere from 50-90% of people who seek treatment for IBS have a mental health condition, like a general anxiety disorder or depression. If you suspect you have IBS, talk to your doctor about options for physical and emotional relief before it contributes to a nervous breakdown.

You stop caring about how you look

“Neglecting basic self-care is a clear sign of serious mental distress,” Dr Merrill says. Skipping basic hygiene practices, like showering or brushing your teeth, or not caring about things you used to, like your clothing style or make-up, can signal you are having an episode of depression or an emotional breakdown, he says. Stress taxes the mind and body, leading to fatigue and apathy, which can cause a loss of happiness or lack of motivation for activities you used to enjoy.

You have a defensive posture

Have you ever looked at someone and thought: “That person looks depressed?” We communicate a lot through our posture and non-verbal gestures, including our mental state, Dr Merrill says. “When people adopt a ‘protective stance’ – arms crossed, slouching, looking down, or facing away – it shows they are feeling very stressed and defensive,” he explains.

This can become a vicious cycle, with your stress making your feel and look defensive and then your posture keeping people away – which then makes you feel more upset, he says.

You can’t sleep through the night

Chronic insomnia goes hand-in-hand with chronic stress and could be a warning sign of a nervous breakdown. “Stress leads to anxiety, which makes it hard to relax, which then makes it difficult to fall asleep and stay asleep. That means you don’t get the rest and rejuvenation your body needs to recover from stress, which then leads to more fatigue and stress symptoms, causing a vicious cycle of stress and sleep problems,” Dr Merrill explains.

You’re overwhelmed with a feeling of dread

Constantly worried about something, but don’t exactly know what? Overwhelming stress can blow normal worries out of proportion, triggering a nervous breakdown, Dr Merrill says. “People under a lot of stress often interpret benign things as negative, causing them to feel constantly worried even when there is no obvious cause for it,” he explains. “This feeling stems from a loss of control and a sense of hopelessness. People headed for a nervous breakdown have lost the confidence that they’re going to be okay.”