I think I am having a “Nervous Breakdown!”

A lot of people have requested that I provide them with a layman’s definition of a “nervous breakdown.” A nervous breakdown can be defined as a “Psychotic Break.” A psychotic break occurs when a person has impaired and or distorted reality testing. This is usually the case when a person is severely depressed or has experienced a stressor that is so overwhelming that the ego becomes vulnerable.  (recent divorce, death of a child, or death of a spouse)  The EGO is responsible for reality testing. This part of the mind (the ego) sits in both the conscious and unconscious  of man.

Another  key point is that when an individual has significant relationship problems, this can lead them to depression, anxiety and lastly a psychotic break. This is why marital therapy and counseling becomes important when there is discord in your primary relationships.  I always see each party, in a relationship, individually to be sure that neither party is psychotic before starting marital therapy.


  1. How would I know if I am having a “nervous breakdown? ” You may began experiencing auditory and or visual hallucinations. Your thoughts can also be disorganized and you may began acting paranoid and or strange.  Occasionally your behaviors can become  disorganized.  This is a medical emergency.
  2. What should I do if I am experiencing any of the above symptoms? You should go immediately to the nearest Emergency Room. Do not attempt to wait for the next outpatient primary care appointment. You can become very paranoid and attempt to hurt yourself or others. The above symptoms should be taken very seriously.
  3. How long should an average nervous breakdown last? A psychotic break should last less than 30 days. If the episode lasts more than thirty days,  your mental health provider should consider other diagnosis. (i.e. Schizophrenia and or Bipolar Disorder with Psyshosis)
  4. Are there any diagnositic tests  to confirm this diagnosis?  At this time, the clinical interview is used to rule in or rule out this particular diagnosis.  Please be sure that you have  a competent mental health provider.  There are a couple of quick in office test, i.e. SCL-90, HAM-D, and or PHQ-9, that may be used to clarify certain mental ilnesses but psychological testing is not usually required to make a  firm mental health diagnosis.
  5. Are the any current treatments that are effective? Yes, there are a number of novel antipsychotic, antidepressant and anxiolytic medications that are effective to treat the patient who is having a “nervous breakdown.”  However, it is important to see a Psychiatrist (preferable board-certified) to develop a prudent treatment plan. Oftentimes,  non-specialist can not handle the psychotic patient.

The bottom line is that a “nervous breakdown” is a very serious medical emergency and should be treated as such. If you notice strange behaviors in family members or friends, go immediately to the nearest emergency room. There may be a little or a lot of  resistance. If the resistance is significant, you should call the police. The police has what is called “parens patriae.” This simply means that “the nation has the power.”  In essence, the government has the right to intervene or take care of persons who can not take care of themselves.

Discussion Point: Do you feel that you have a family member, supervisor or friend that is currently psychotic or experiencing a nervous breakdown? I want to hear from you and I need you to share some of your observations.

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