The designation mental breakdown is the colloquial term for an acute reaction of the body to extreme psychological stress, which is characterized by sudden physical and emotional overreactions of those affected. The causes of a nervous breakdown can be different. If the condition persists, professional help in the form of conversation and behavioral therapy, which is often also medically supported, is necessary.
The hectic everyday life, tension and inner restlessness can lead to a nervous breakdown in the long term.
A nervous breakdown is triggered by an extremely stressful psychological situation for the person concerned. Such situations can be events such as accidents, experiences of violence, the loss of a loved one or constant 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 cannot cope with. If the situation persists, the body becomes overloaded and eventually collapses.
Depending on the occurrence of the nervous breakdown and the persistence of its symptoms, a distinction is made between an acute stress disorder (a short-term nervous breakdown lasting several hours to a few weeks immediately after an event) and a post-traumatic stress disorder (psychological or social impairment lasting longer than four weeks).
The acute nervous breakdown is not considered a disease, 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 needs treatment. If there is no significant improvement even after three months, the disease turns into 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 psychological 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 stress trigger not only for those directly involved, but also for witnesses or helpers. The loss of a loved one can also be traumatic. Examples of stress that is not acute but constantly occurring can be constant psychological pressure in the private or professional environment or persistent anxiety disorders (phobias). The sustained stress prevents the organism from adequate physical and mental recovery.
Whether someone has a nervous breakdown as a result of such events depends to a large extent on the personal coping strategies that they can use. For example, mentally vulnerable people who have little social support tend to develop a stress disorder or to be less able to alleviate this disorder.
The symptoms in the acute phase of the nervous breakdown differ from the symptoms and complaints during the subsequent processing phase. A nervous breakdown can for example be announced by nausea, profuse sweating, tremors or racing heart, sometimes also by perceptual disturbances.
It is not uncommon for those affected to feel as though they are standing next to them and are no longer in control of their emotional overreactions and irrational actions. Aggressive or apathetic behavior, such as in shock, can also be observed. Immediately after the acute phase, many sufferers suffer from an extreme feeling of helplessness and emptiness. For them there seems to be no way out of the situation at this moment. This phase is often characterized by listlessness, despair, and physical and mental exhaustion.
In the processing phase that follows, more nightmares or flashbacks can occur, depressive moods, sleep disorders, digestive problems, panic attacks or even repeated crying fits can occur. The symptoms usually decrease more and more during the processing phase and in the best case they disappear completely.
If the stress disorder moves into a post-traumatic or chronic phase, it can lead to serious psychological disorders if the treatment is missing or incorrect. It is not uncommon for those affected to develop a personality disorder with depression, sometimes aggressive behavior, the inability to enter into personal relationships and even an increased susceptibility to suicide.
The last-mentioned complaints in particular also represent the most dangerous complications in the context of nervous breakdowns. Treating these accompanying disorders requires careful and targeted management of the triggering trauma as part of professional therapy.
If this therapy does not take place or if it is done in the wrong way, or if repression and a general defensive attitude of the person concerned prevent the treatment, which is sometimes necessary for a longer period, chronic manifestations and worsening of the symptoms can be expected, which sometimes makes it impossible for the patient to continue to lead a self-determined life .
As already described, an acute stress reaction can last anywhere from a few hours to a few weeks. If the person concerned has sufficient and suitable strategies himself to cope with the situation independently with a little rest, a break is often enough to get over the trauma.
The first point of contact for complaints of all kinds is the family doctor, who will first issue a health insurance certificate based on the complaints. However, if the symptoms persist over a period of 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 be considered even without an actual nervous breakdown in the case of exhaustion and depressive moods that occur regularly.
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Unfortunately, depending on the region, it is comparatively difficult to make appointments with psychologists or psychotherapists. For acute cases, however, there are emergency numbers that trained specialists can listen to and at least provide initial clues about how to proceed and how to deal with the situation.
In many cases, it will therefore first be the family doctor who conducts the initial consultation with an affected person. A detailed history, symptoms and risk factors is an essential part of the examination. If necessary, a referral to a specialist will be agreed. It can often be advisable to also do an examination of the physical symptoms.
The diagnosis of an acute stress disorder as a result of trauma is usually made by a specialist doctor 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 can be, for example, the direct or indirect (as an eyewitness or helper) experience of death or threatened or actual serious injury.
Since then, various physical and psychological symptoms and complaints have appeared that can be ascribed to the event and that have a massive impact on those affected. If these or other complaints, which may include problems falling or staying asleep, difficulty concentrating or increased irritability and aggressiveness, occur within six months of this event, the diagnosis shifts towards post-traumatic stress disorder.
Diagnosis can be complicated by the fact that symptoms can appear immediately after the trauma is experienced, but also with a delay of many years to decades. In extreme cases and a chronic course over several years, a permanent personality change can be diagnosed after extreme stress.
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 extraordinarily 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 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 further treatment steps together. In extreme cases, the first step is to prevent the patient from suicide by being admitted to hospital. Afterwards and also with outpatient therapies, various approaches are usually mixed in order to provide the person concerned 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 a confrontation with the traumatic experience takes place in individual or group discussions. A result-oriented realignment and re-examination 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-enhancing effect.
Quick successes can also be achieved with herbal preparations such as valerian and hops for calming or homeopathic products. Movement and relaxation techniques also often play a not insignificant role in therapy. Exercise, meditation or autogenic training help both body and mind to better relieve stress. A regulated and balanced everyday life, a healthy diet and fixed rest periods also help to steer everyday life in harmony.
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 a post-traumatic stress disorder, the chances of a quick healing decrease depending on the duration of the non-treatment.
If a persistent stress reaction threatens, professional help should be sought as soon as possible. Since nervous breakdowns have a very individual course depending on the previous history, the present event and available coping strategies, consistent self-motivation, sustainable everyday adaptation and behavioral changes are the best prerequisites for a full recovery.
Since traumatic events usually happen unprepared, they cannot be influenced or can only be influenced with difficulty and thus cannot be prevented. Prevention is only possible to a limited extent by avoiding certain situations from the outset or by taking special care. The situation is different with persistent stress or anxiety disorders. If this is at risk, preventative action can be taken through targeted behavior training or a change in living conditions.
The nervous breakdown requires consistent follow-up care in order to create the optimal conditions so that there is no relapse. This can be done in collaboration with a psychologist, but also with the family doctor. In this context, it is important to know how intense the nervous breakdown was, whether it can be linked to a certain experience or is an expression of long-term stress and whether it occurred for the first time or more often.
All of these are factors that are taken into account in an individual aftercare concept. In the case of a certain triggering event for the nervous breakdown, discussions with friends and family often help with a sustainable processing. If the cause is, for example, constant stress at work or in everyday life, it is part of aftercare to reduce these stress factors as much as possible.
The aftercare should also provide the necessary rest for regeneration on the one hand, and gradually restore resilience on the other. Relaxation exercises and exercise 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 brings mind, soul and body back into balance through physical and breathing exercises, relaxation and meditation.
Listening to your own psyche and paying attention to your physical reactions and moods is particularly important when you are threatened with overwork from professional or private stress. If it is foreseeable that a stressful situation will last longer, you should try to avoid this situation, create points of retreat or at least allow yourself enough rest.
Sufficient sleep is of great importance here; going to bed early and relaxing by reading offer significant improvement with comparatively little effort. A short break often significantly reduces the stress 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 event of acute stress reactions, you can also use herbal sedatives from the pharmacy. Products with valerian or hops, among others, are well suited. In more severe cases, a prescription sedative with a relaxing and calming effect can also help at short notice. Since the active ingredients create a dependency in the long term, this measure should only be used in individual and absolute emergencies.