How do you know whether you're having a nervous breakdown?
August 9, 2019 4:58 AM   Subscribe

There have been a lot of stressors in my life for years now, but I have been Handling Them. Last week I hit some kind of wall and I feel like I can't do the things I have to do anymore. Is this what people mean by a nervous breakdown? What do I do about it? More inside.

Not only have my psychosomatic symptoms ramped up (nausea and other digestive upset, insomnia, chronic pain and inflammation), but my brain feels like it's entered some kind of fugue state. I feel like I can't process information - I think about a thing I have to do, and I just... I don't know. Can't figure out how to do it. I'm cycling between rage, fear, and despair.

Here are some of the things contributing to this state of mind:

-My whole immediate family (mom, dad, 32-year-old sister) died, suddenly and traumatically in each case, between 2012 and 2016.
-I have a chronic health/pain issue.
-I have been working as a prison librarian for almost a year now. Stress-wise, it started out bad and has only gotten worse as I have realized that none of the upsetting things about the environment are ever going to let up.
-I feel like I can't quit the job because I'm the primary breadwinner in my household and we live in a rural area with few job opportunities. I have student loans and a 13 year old daughter to take care of.
-I'm on the board of a local nonprofit and I hate it (yes, I am planning to resign from this, but I have a lot of anxiety about how my resignation will be received).
-I'm a member of a chorus and I love doing it but it takes a lot of time and work.
-I don't have a great local support network.
-Politics, climate change, and everything else that's scaring the crap out of all of us right now.
posted by missrachael to Health & Fitness (17 answers total) 12 users marked this as a favorite
I feel like I can't process information - ugh, this. Yes, this is exactly what a breakdown feels like. The staring at walls thing.

I live in a country with an actual safety net, so I dealt with the worst of it by getting signed off work for two weeks to start with, together with a healthy dose of anxiety medication and leaning on my support network for talking purposes. Short-term stressor reduction is key. Depending on your benefits, can you take time off work? If you have access to affordable medical care, get pills (short-term) and investigate therapy or other venues of just plain talking about your problems like chronic pain support groups, because it's amazing how much it helps. Resign from the nonprofit by email for health reasons (mental health IS health).

And honestly, check out of news consumption or limit it to a set slot per day. You need your own oxygen mask first. Spend that time doing whatever's best to reduce your stress levels - for me that was long hot baths, nature contact and silly phone games, which gradually got my brain unwound enough I could read escapist fiction. In two to four weeks of all that, you should be able to at least think about a long-term plan.
posted by I claim sanctuary at 5:31 AM on August 9, 2019 [8 favorites]

I'm so sorry you're dealing with this.


The term "nervous breakdown" is sometimes used by people to describe a stressful situation in which they're temporarily unable to function normally in day-to-day life. It's commonly understood to occur when life's demands become physically and emotionally overwhelming. The term was frequently used in the past to cover a variety of mental disorders, but it's no longer used by mental health professionals today.

....What some people call a nervous breakdown may indicate an underlying mental health problem that needs attention, such as depression or anxiety.

So yeah, that sounds like what you're describing - intense stress and emotional overwhelm that impacts your ability to function. The next steps are probably to talk to your primary care provider and see a therapist if you haven't already.

I hope you get some helpful answers here.
posted by bunderful at 5:34 AM on August 9, 2019 [4 favorites]

I think the term “nervous breakdown” has been deprecated in recent times, but if you’re at a point where you’re feeling overwhelmed and paralyzed by all the shit going on in your life, that’s certainly a crisis point. Whether it technically qualifies as a nervous breakdown is sort of beside the point.

The immediate thing is to reduce your load ASAP. Quit the non-profit and tell them that you’re suffering from health issues and have to reduce your commitments, which is a perfectly valid and true reason. If they’re a jerk about that, then that’s on them, not you.

Ditch the news cycle. A glance at the headlines every couple days will keep you informed, but stop reading the news. If your social media has lots of current events in it, unplug. Not delete your account, necessarily, just stop looking at it. For me, I’ve been reading and listening to audiobooks a LOT more, taking walks, listening to calming music, playing iPad games, etc. Just spending more time in Slow Time instead of online makes a big difference.

Make sure you do the usual stuff like getting enough sleep, eating your vegetables and all that. (One benefit of being online less is that you’re bored enough to just go to bed early. *heh*) If it’s not contraindicated, a magnesium supplement will help counter the physical effects of stress on the body.

After you’ve made those changes, take some time and then re-assess.
posted by Autumnheart at 5:37 AM on August 9, 2019 [11 favorites]

I agree with AutumnHeart, you should reduce your stress load ASAP:

- quit the nonprofit today and take that worry off your plate.
- two week break from cable news or other coverage except for anything that affects you immediately and directly (so, if you’re in hurricane country then keep following climate coverage but take a break from worrying about global climate change)
- use the time that frees up to hang out and do something low key, even if that’s reading a book with your kid
- keep the chorus and try reaching out to the other members as a way of building a local support network. Maybe one of them would want to come over for coffee on the weekend or something like that?

I am so sorry for your losses. We are living in a surreal time already, and I would imagine losing your parents and sister like that gives everything a tinge of “I can’t believe life is like this.” Be gentle to yourself; even with a job and kid it will be normal that some days a loss like this just hits you and you can barely get up. That’s ok.
posted by sallybrown at 6:27 AM on August 9, 2019 [4 favorites]

I'm so very sorry for everything you're dealing with.

Adding to the "reduce your load" chorus. The nonprofit resignation is something you can do today. If you cite health reasons, absolutely no one will push back on that (and if they do, they are a Bad Person).

Stop the news cycle. For mental health reasons of my own, I basically haven't looked at the news or social media since early 2017 and believe me when I say that anything you truly need to know (plus a lot more...) WILL still make its way into your consciousness no matter what even if you are not actively seeking it out.

Are you able to take some time off work or ask your doctor to request a short-term medical leave? In spite of the financial implication, I've noticed that a HUGE, massive weight is lifted when my work hours are temporarily reduced and I immediately feel like I've been given back the headspace and energy to deal with some of my issues.

Does the chorus participation fill up your bucket more than it depletes it? If not, could you think about maybe "pausing" your involvement for a season?

Emily Nagoski just released a new book called Burnout that looks really wonderful; I've only read the first couple chapters but it's already been helpful. I wonder if it might help address some of your workplace stress specifically. Get the audiobook so you don't have to find the time to read a physical book.

Do you have access to a therapist? Just yesterday a friend was telling me about the great experience he's been having with Talkspace. He's able to write and email the therapist whenever it's convenient for him and the therapist checks back in with him anywhere from 1-3x/day with her thoughts and feedback. It looks like they offer financial aid as well.
posted by anderjen at 7:11 AM on August 9, 2019

Response by poster: Thank you for the answers and support so far.

A couple of details to add: I am seeing a therapist (a good one too, thankfully), and I am on Pristiq and as-needed Xanax.
posted by missrachael at 7:30 AM on August 9, 2019

yes, this is what it feels like - it sounds very similar to a period I had in my life last year that I labelled as anxiety & depression, but which was pretty much just life bearing down on me way too hard after some family stuff incl. bereavement

just like I claim sanctuary says: I took time off work, got some short-term medication, and saw a therapist

I'm way better now, and aside from those short-term measures a huge part of recovery for me was to take more agency in the way that I allocated my time between work, non-work, family, fun stuff, etc - I managed to shift my focus at work (helped by an understanding employer), and spent more time on stuff that I find rewarding & fulfilling - & was able to re-distribute the balance between stuff that I was doing out of a sense of obligation, and stuff that I find enriching in my life

for me, just recognising & naming the feeling that I wasn't dealing well with my life, and that I was a person for whom better things were possible and that I deserve those better things - that was enough to start to kindle that sense of agency

so yes, like others have said - dump your non-profit without a backward glance, keep up with chorus, stop reading the news, share what you're going through with your employer & see what support/flexibility they are able to offer

good luck
posted by rd45 at 7:55 AM on August 9, 2019 [3 favorites]

I know when I'm feeling overwhelmed, it can be hard to do something like write the email resigning from the nonprofit board. If it would help you, I would be delighted to compose that email for you. Please feel free to DM me if you would like that.
posted by mcduff at 7:55 AM on August 9, 2019 [18 favorites]

Adding to what the others said: if you have federal, as opposed to private, student loans, make sure you are on an income-driven repayment plan (I'm sure prison librarian doesn't pay the big $$$). I know this is an Extra Thing, but it also might free up some cash for you, which can only help. It obviously involves sensitive personal financial information but I can at least point you to where you can get started, if that would help.

(BTW, if you're an employee of a government, you are probably also eligible to begin running the clock on public service loan forgiveness (again, only for your federal loans).)
posted by praemunire at 8:34 AM on August 9, 2019 [1 favorite]

My therapist called what I was experiencing adjustment disorder when I asked this same question. I've been in therapy for half a year since then, and it's helping me make the changes I need to weather this.

Be well, friend. We're all here for you.
posted by late afternoon dreaming hotel at 8:36 AM on August 9, 2019 [1 favorite]

Mental health issues are genuine health issues, and deserve equal recovery time.

Agree with the good advice above, resign from the nonprofit. Cite health issues without going into detail, it's no one's business. Your statement/answer to any questions is along the lines of "that will not be possible".

Get your therapist or GP (whoever is authorized to do so) to sign you out on a medical leave for six weeks.

Plan to do "nothing" during those six weeks - no projects around the house, no going to help a sick friend, whatever. This is your sleep in and putter around the house time. It is - literally - your mental downtime.

My opinion is that you should stick with your chorus, as it sounds like an important creative and social outlet for you, but you could tell them that you are taking a 2-4-6 week break. Similar to the nonprofit, answer any questions with some version of "that will not be possible".

I checked out of news and most social media a few years ago. I don't participate in the political threads here. For the little social media that I consume, I block or mute those who choose to spread political talk. It's not an indictment of them, it's a mental health protection move for myself. You might consider avoiding current events and news as well.

I am sorry for the losses of your family. That sounds overwhelming without the other stressors in your life. I'm wishing you peace.
posted by vignettist at 9:14 AM on August 9, 2019 [5 favorites]

When I was having a lot of physical symptoms from my stress, I found anti-anxiety meds did a lot to get me functional again. If you haven't told your prescribing doctor how much worse things have gotten, you need to do that. It is a band-aid but band-aids have value too.
posted by metahawk at 9:47 AM on August 9, 2019 [2 favorites]

Yeah my nervous breakdown after a series of traumatic experiences involved nonstop panic, insomnia, starvation, and paranoid delusions that eventually caused me to have to take FML for a month. It was like my brain and body literally shut down and I could barely read or function in any aspect of life. It seems to look different for everyone but that's what I experienced.
posted by Young Kullervo at 10:19 AM on August 9, 2019 [1 favorite]

Oh dear. This is a lot. In some other Metafilter question, someone linked to the Holmes-Rahe Stress Inventory, and it was incredibly helpful for me to add up my stress score (so to speak). Even though it was high, it was helpful for me to realize that yes, I had, in quantitative ways, been dealing with major extra stresses in my life, well beyond the ordinary (and even though the assessment asks about things in the past year, it's still a useful gauge). It was also helpful to see that even good things can add stress. The death of any one immediate family member is a big deal, even without any of this other stuff.

Several years ago I had what I later learned was a series of panic attacks. I went to the ER (which is pretty common, I think; I truly thought I was dying). The resulting doctor visits helped me start taking better care of myself. For example, my doctor told me to exercise everyday. I took this as a prescription, of sorts, and made sure to at least take a good walk every day. That was a good start. Can you do that? I know it feels like one more thing, but perhaps you could combine it with listening to a mindfulness app?

I'd like to suggest, as others have above, quitting the non-profit right away. I know it's stressful, but I suspect the weight off your shoulders will be huge -- and offset the anticipatory stress you are feeling now.

Also, is it possible to take a hiatus from the chorus rather than resigning? It sounds like you like it and find it to be a big commitment. Maybe taking a break would be a good way to re-calibrate.

And, yes, take any vacation leave you have and chill out at home or go visit family, but don't take any trips or make plans that add stress. Good luck to you. This is a lot.
posted by bluedaisy at 12:48 PM on August 9, 2019 [2 favorites]

Any chance your meds have stopped working? Inability to handle stress you'd previously been getting through can be your meds not working anymore. I would recommend talking to your doctor, or your psychiatrist if you have one.
posted by bile and syntax at 12:49 PM on August 9, 2019 [1 favorite]

It has been my experience that your mind and your body tell you when you have reached a limited or gone beyond sustainable levels of stress. For me it becomes clear that normal periods of rest are no longer enough to recover - a weekend doesn’t nothing. I also find that my body finds ways to tell me enough. That used to be an irritating stress cough, possibly caused by otherwise asymptomatic acid reflux. A few years ago I stopped coughing and my back started to play up instead. If I reach unsustainable levels I can go from feeling fine to being barely able to stand up in a day, without any unusual physical exertion. But it always gets better with regular massages and appropriate self care. I have been known to skip out of my massage therapist’s office.

So absolutely ditch the nonprofit role, if at all possible take some time of work and do whatever self care practices make you feel good - a walk in nature, stretching or a bath, curl up with a book or listen to your favourite music. Don’t feel guilty about taking time for yourself. Encourage your daughter to find things she finds relaxing as well and to do them at the same time. These are good habits to learn as you grow up.
posted by koahiatamadl at 1:49 PM on August 9, 2019 [1 favorite]

Agreeing with everyone who recommends resigning from the nonprofit today, in writing. But do not cite health concerns or anything beyond changes to your schedule making your continued participation unfeasible, on the off chance a contact at that organization winds up providing a paying job lead or reference somewhere down the line.
posted by Iris Gambol at 3:32 PM on August 9, 2019 [2 favorites]

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