Nervous Breakdown or Mental Breakdown vs Stress Breakdown

The word "breakdown" is often used to describe the mental collapse of someone who has been under intolerable strain. There is usually an (inappropriate) inference of "mental illness". All these are lay terms and mean different things to different people. I define two types of breakdown:

Nervous breakdown or mental breakdown is a consequence of mental illness

Stress breakdown is a psychiatric injury, which is a normal reaction to an abnormal situation such as combat.

The two types of breakdown are distinct and should not be confused. A stress breakdown is a natural and normal conclusion to a period of prolonged negative stress; the body is saying "I'm not designed to operate under these conditions of prolonged negative stress so I am going to do something dramatic to ensure that you reduce or eliminate the stress otherwise your body may suffer irreparable damage; you must take action now". A stress breakdown is often predictable days - sometimes weeks - in advance as the person's fear, fragility, obsessiveness, hypervigilance and hypersensitivity combine to evolve into paranoia (as evidenced by increasingly bizarre talk of conspiracy or MI6). If this happens, a stress breakdown is only days or even hours away and the person needs urgent medical help. The risk of suicide at this point is heightened.

Often the cause of negative stress in an organization can be traced to the behavior of one individual. The profile of this individual is on the serial bully page. I believe bullying is the main - but least recognized - cause of negative stress in the workplace today. To see the effects of prolonged negative stress on the body click here.

The person who suffers a stress breakdown is often treated as if they have had a mental breakdown; they are sent to a psychiatrist, prescribed drugs used to treat mental illness, and may be encouraged - sometimes coerced or sectioned - into becoming a patient in a psychiatric hospital. The sudden transition from professional working environment to a ward containing schizophrenics, drug addicts and other people with genuine long-term mental health problems adds to rather than alleviates the trauma. Words like "psychiatrist", "psychiatric unit" etc are often translated by work colleagues, friends, and sometimes family into "nutcase", "shrink", "funny farm", "loony" and other inappropriate epithets. The bully encourages this, often ensuring that the employee's personnel record contains a reference to the person's "mental health problems". Sometimes, the bully produces their own amateur diagnosis of mental illness - but this is more likely to be a projection of the bully's own state of mind and should be regarded as such.

During the First World War, British soldiers suffering PTSD and stress breakdown were labeled as "cowards" and "deserters". During the Second World War, soldiers suffering PTSD and stress breakdowns were again vilified with these labels; Royal Air Force personnel were labeled as "lacking moral fibre" and their papers stamped "LMF". For further commentary on this issue, click here. It's noticeable that those administrators and top brass enforcing this labeling were themselves always situated a safe distance from the fighting; see the section on projection.

The person who is being bullied often thinks they are going mad, and may be encouraged in this belief by those who do not have that person's best interests at heart. They are not going mad; PTSD is an injury, not an illness.

Sometimes, the term "psychosis" is applied to mental illness, and the term "neurosis" to psychiatric injury. The main difference is that a psychotic person is unaware they have a mental problem, whereas the neurotic person is aware - often acutely. The serial bully's lack of insight into their behavior and its effect on others has the hallmarks of a psychosis, although this obliviousness would appear to be a choice rather than a condition. With targets of bullying, I prefer to avoid the words "neurosis" and "neurotic", which for non-medical people have derogatory connotations. Hypersensitivity and hypervigilance are likely to cause the person suffering PTSD to react unfavorably to the use of these words, possibly perceiving that they, the target, are being blamed for their circumstances.

A frequent diagnosis of stress breakdown is "brief reactive psychosis", especially if paranoia and suicidal thoughts predominate. However, a key difference between mental breakdown and stress breakdown is that a person undergoing a stress breakdown will be intermittently lucid, often alternating seamlessly between paranoia and seeking information about their paranoia and other symptoms. The person is also likely to be talking about resolving their work situation (which is the cause of their problems), planning legal action against the bully and the employer, wanting to talk to their union rep and solicitor, etc.

Transformation

A stress breakdown is a transformational experience which, with the right support, can ultimately enrich the experiencer's life. However, completing the transformation can be a long and sometimes painful process. The Western response - to hospitalize and medicalize the experience, thus hindering the process - may be well-intentioned, but may lessen the value and effectiveness of the transformation. How would you feel if, rather than a breakdown, you viewed it as a breakthrough? How would you feel if it was suggested to you that the reason for a stress breakdown is to awaken you to your mission in life and to enable you to discover the reason why you have incarnated on this planet? How would it change your view of things if it was also suggested to you that a stress breakdown reconfigures your brain to enable you to embark on the path that will culminate in the achievement of your mission? [More | More]

Differences between mental illness and psychiatric injury

The person who is being bullied will eventually say something like "I think I'm being paranoid..."; however they are correctly identifying hypervigilance, a symptom of PTSD, but using the popular but misunderstood word paranoia. The differences between hypervigilance and paranoia make a good starting point for identifying the differences between mental illness and psychiatric injury.

Paranoia

Hypervigilance

paranoia is a form of mental illness; the cause is thought to be internal, eg a minor variation in the balance of brain chemistry

is a response to an external event (violence, accident, disaster, violation, intrusion, bullying, etc) and therefore an injury

paranoia tends to endure and to not get better of its own accord

wears off (gets better), albeit slowly, when the person is out of and away from the situation which was the cause

the paranoiac will not admit to feeling paranoid, as they cannot see their paranoia

the hypervigilant person is acutely aware of their hypervigilance, and will easily articulate their fear, albeit using the incorrect but popularized word "paranoia"

sometimes responds to drug treatment

drugs are not viewed favorably by hypervigilant people, except in extreme circumstances, and then only briefly; often drugs have no effect, or can make things worse, sometimes interfering with the body's own healing process

the paranoiac often has delusions of grandeur; the delusional aspects of paranoia feature in other forms of mental illness, such as schizophrenia

the hypervigilant person often has a diminished sense of self-worth, sometimes dramatically so

the paranoiac is convinced of their self-importance

the hypervigilant person is often convinced of their worthlessness and will often deny their value to others

paranoia is often seen in conjunction with other symptoms of mental illness, but not in conjunction with symptoms of PTSD

hypervigilance is seen in conjunction with other symptoms of PTSD, but not in conjunction with symptoms of mental illness

the paranoiac is convinced of their plausibility

the hypervigilant person is aware of how implausible their experience sounds and often doesn't want to believe it themselves (disbelief and denial)

the paranoiac feels persecuted by a person or persons unknown (eg "they're out to get me")

the hypervigilant person is hypersensitive but is often aware of the inappropriateness of their heightened sensitivity, and can identify the person responsible for their psychiatric injury

sense of persecution

heightened sense of vulnerability to victimization

the sense of persecution felt by the paranoiac is a delusion, for usually no-one is out to get them

the hypervigilant person's sense of threat is well-founded, for the serial bully is out to get rid of them and has often coerced others into assisting, eg through mobbing; the hypervigilant person often cannot (and refuses to) see that the serial bully is doing everything possible to get rid of them

the paranoiac is on constant alert because they know someone is out to get them

the hypervigilant person is on alert in case there is danger

the paranoiac is certain of their belief and their behavior and expects others to share that certainty

the hypervigilant person cannot bring themselves to believe that the bully cannot and will not see the effect their behavior is having; they cling naively to the mistaken belief that the bully will recognize their wrongdoing and apologize

Other differences between mental illness and psychiatric injury include:

Mental illness

Psychiatric injury

the cause often cannot be identified

the cause is easily identifiable and verifiable, but denied by those who are accountable

the person may be incoherent or what they say doesn't make sense

the person is often articulate but prevented from articulation by being traumatized

the person may appear to be obsessed

the person is obsessive, especially in relation to identifying the cause of their injury and both dealing with the cause and effecting their recovery

the person is oblivious to their behavior and the effect it has on others

the person is in a state of acute self-awareness and aware of their state, but often unable to explain it

the depression is a clinical or endogenous depression

the depression is reactive; the chemistry is different to endogenous depression

there may be a history of depression in the family

there is very often no history of depression in the individual or their family

the person has usually exhibited mental health problems before

often there is no history of mental health problems

may respond inappropriately to the needs and concerns of others

responds empathically to the needs and concerns of others, despite their own injury

displays a certitude about themselves, their circumstances and their actions

is often highly skeptical about their condition and circumstances and is in a state of disbelief and bewilderment which they will easily and often articulate ("I can't believe this is happening to me" and "Why me?" - click here for the answer)

may suffer a persecution complex

may experience an unusually heightened sense of vulnerability to possible victimization (ie hypervigilance)

suicidal thoughts are the result of despair, dejection and hopelessness

suicidal thoughts are often a logical and carefully thought-out solution or conclusion

exhibits despair

is driven by the anger of injustice

often doesn't look forward to each new day

looks forward to each new day as an opportunity to fight for justice

is often ready to give in or admit defeat

refuses to be beaten, refuses to give up