Mental breakdown

Mental breakdown (also known as a nervous breakdown) is a non-medical term used to describe an acute, time-limited phase of a specific disorder that presents primarily with features of depression or anxiety.

Definition
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. 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. The referenced condition may or may not involve psychotic symptoms such as those associated with schizophrenia.

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.

Causes
Causes of such breakdowns are varied. A 1996 study found that problems with intimate relationships, such as divorce or marital separation, contributed to 24% of nervous breakdowns. Problems at work and school accounted for 17% of cases, and financial problems for 11%. Surveys suggest that in the United States, health problems have decreased in importance as a contributor to nervous breakdowns, as these accounted for 28% of nervous breakdowns in 1957, 12% in 1976, and only 5.6% in 1996.

Similar disorders
Rapport, Todd, Lumley, and Fisicaro suggest that the closest DSM-IV diagnostic category to nervous breakdown is Adjustment Disorder with Mixed Anxiety and Depressed Mood (Acute). Adjustment disorders and nervous breakdowns are both acute reactions to stress that resolve after removal of the stressor. However, DSM-IV excludes from adjustment disorders cases secondary to bereavement, which contributes to approximately 6-8% of nervous breakdowns.

Nervous breakdown may share some features of acute stress disorder and posttraumatic stress disorder, in that these each occur in response to an external stressor, and may be marked with sleep disturbance, diminished concentration, and mood lability. However, the symptoms of nervous breakdown do not include the constellation of re-experienced trauma, dissociation, avoidance, and numbing of general responsiveness that are associated with the other two disorders, and the types of stressors linked to a nervous breakdown are generally less extreme.

Nervous breakdown may share many features of mixed anxiety-depressive disorder (MADD). However, the definition of MADD suggests a chronic condition, in contrast to the acute, short-term nature of a nervous breakdown.