Causes of Nervous Breakdown

Like many people, I turn to the Internet when wanting to research a topic. As mentioned in earlier posts, I was not satisfied with what I found on the Web concerning a definition of nervous breakdown, personal stories of those undergoing - or attempting to recover from - nervous breakdown, or a real definition of this disabling life event. Nor am I satisfied with what I've found on the Net concerning the causes of nervous breakdown.

Often, what I did find was very short, lacked substance, and did not provide the background that would enable me to understand what pushed me finally over the edge. These explanations also lacked a 'human' element with which I could identify and compare to my own shattering experience. Consequently, they weren't much use to me which is a shame. Because I guess I figure that if I can better understand the causes, I can safeguard myself from any re-occurrence of this horror.

To overcome these shortcomings I'd like to share with readers: first, what I have found on the Internet regarding causes of nervous breakdown, and second, what I believed triggered mine.

What the Internet Says

Not much, is what I've found. I Googled "causes of nervous breakdown" and I came up with little. And what I did come up with were so broadly defined as to be almost useless to me. The Discovery Health website states that nervous breakdown is caused by "immense pressure, mental collapse or mental and physical exhaustion". An entry in Wikipedia suggests that underlying causes include failing relationships (separation and divorce), financial problems, and problems at work and school. Native Remedies provides a more exhaustive list including 

• Stress
• Depression
• Alcohol and drug abuse, particularly cocaine
• Genetics (family history)
• Coexisting medical conditions, such as vitamin deficiencies, thyroid disorders, movement disorders, skin and limb problems, etc.
• Anxiety surrounding major life changes or disorders, such as pregnancy/after birth/labor, menopause, etc.
• Schizophrenia
• Extreme guilt or emotional problems

An entry on Yahoo states "Depending on the severity of stress that a person is experiencing, it can greatly impact whether they have a complete nervous breakdown, or not. A complete nervous breakdown happens when significant negativity occurs in one's life. Many things can trigger that tip over the edge. When someone is experiencing numerous losses and outside negativity, they become vulnerable. Too often other people see this as a weakness, and they do not recognize that the person that they love has become overwhelmed, which can make it very difficult for anyone involved in assisting their loved one."

In short, and like many areas of human psychology and psychiatry, I suspect that the professionals are a) not quite sure what leads to a mental breakdown and b) should  a person be  experiencing a breakdown, and instead of using that definition, are determined to pigeon-hole the sufferer into a diagnosis that meets current, and sometimes inappropriate, practice. In other words, a sufferer that can no longer cope is classified, perhaps, as depressed, anxious, bi-polar, psychotic, or any number of other sub-classification. The problem with such classifications is that these can lead to inappropriate treatment.

In my humble opinion - and once again, I warn that I am not a professional - my nervous breakdown was caused by a wide range of trigger, many building over time but continually added to, which finally overwhelmed me. 

Genetics and Stress

Genetic Predisposition - a wide range of research indicates that there is a statistically relevant correlation regarding mental illness, a predisposition to same, and hereditary factors. In other words, if a member of your family or ancestry has had a mental illness, you are more vulnerable to it. In my case the deck was stacked against me. My paternal grandfather had a breakdown, I'm told. My maternal aunt suffered from severe depression and committed suicide. My mother suffered from a variety of mental illnesses. That said, she managed to cope and eventually recovered.

My genes made me vulnerable to breakdown or other mental illnesses. When I think back, I realize that I was - and am - possibly more susceptible to nervous breakdown than others. I have always been a 'nervous type'. Even as a teenager, I suspect that fear of the unknown controlled me, or influenced me, more than others. Also, I was and still am a rather sensitive type. My feelings are easily hurt. I have never coped well with stress. That is all part and parcel of my genetic makeup - those characteristics with which I have little control. Consequently, and though I didn't know it, I was predisposed to suffer from a nervous breakdown or other mental illness.

Stress - if you look carefully through the information available on the Internet, one of the biggest factors leading to nervous breakdown is stress. Stress, as we all know, is a part of living. Good stress motivates us to do well or to protect ourselves and those that we love, or to take a risk for our own benefit. Bad stress, on the other hand, can undermine our sense of well-being. And if one is hit by too much bad stress it can result in catastrophe.

Which is precisely what happened to me. Thinking back on it, a whole range of stressors were at work that eventually led to my breakdown:

I am an Expatriate - years ago, I moved to Ireland. I have done my best to settle here. But the stress of being an immigrant can be ongoing. In my case, I constantly had to work at fitting in. I constantly had to work at making myself feel at home. Occasionally, I was accosted by bigotry and xenophobia on the part of those that I met here. Being an immigrant is always hard work. The stress can be ongoing.

Business and Work - I owned a couple of businesses. They demanded a great deal of time, and they were continually stressful. Working weeks could often approach 80 hours or more. When the economy hit a downturn, the stress became more acute. Being a 'Type A' I continually pushed myself. I worked more and more hours. I worried more and more about the future. I knew that I had taken on too much but I wasn't sure what to do about it. Often, I felt trapped, alone, and under continual pressure. When I delegated, the work wouldn't be done. When I didn't delegate, the work added more pressure on me. 

Marriage - if I admit it, my marriage wasn't satisfying either to myself or to my now ex-wife. The house was often filled with an underlying tension. We did not communicate well or easily. We might argue but rarely were issues fully resolved. I felt guilty about the situation, believing that I was much to blame. As the years went on, the stress in our relationship grew. Before I finally left the house, only months before the breakdown, I was suffering from so much stress that my hands shook and I couldn't sleep. 

Separation - but leaving the house did little to help my situation. I felt guilty that I had let down and failed my wife and children. I felt ashamed that I had finally left. My family's reaction didn't help. Phone calls were full of bitter, hate-filled, and accusatory language. My sleeping patterns became more disturbed. Living alone, I was filled with loneliness and fear. My stress levels grew greater.

Finances - these also began to suffer. I worried about the future. I was determined to continue to support my wife and children as I had long promised to. Not supporting them was not an option, nor should it have been, nor will it ever be. But this added to my stress levels.

Depression and Anxiety - I became depressed. Coupled with high levels of anxiety, my sleep was further disturbed. Concentrating became difficult. My appetite suffered. I fought this with exercise and anti-depressants, but I know that at that point I was having very real trouble coping with life. My 'pressure cooker' - in other words, my ability to cope with stress - had become full. I didn't know it then, but it would take only a few more stressors, even small ones, to push me over the edge.

A Tsunami of Stress Leads to Nervous Breakdown

Looking back at it, I now realize that my nervous breakdown was not caused by one event but rather a series of ongoing high-stress situations that pushed me first to the edge and then beyond, and off a cliff that was nervous breakdown. Genetically, I was set up for a breakdown, and more vulnerable to one. Add to that a childhood that was filled with stress, then pile on the ongoing stress of living life as an immigrant, the stress of a failed marriage, business and work-related stress, feelings of guilt and  the shame of failure, and you had me: a fellow ready to implode. Which is exactly what happened.

Looking back, I could have taken other actions and made other decisions that may have prevented the breakdown or at least made it less severe. I could and should have taken a long vacation from work. I could and should have sought more appropriate medical and counseling support, and sooner rather than later. I could and should have talked to my family earlier about what I was feeling and what I was fearing (though I don't know that they would have understood or have been able to help). 

But I took none of these actions. Instead, I became vulnerable to the world around me. And as I've described in other posts, the situation soon grew beyond my control.

If you, or a person you know, is experiencing high levels of stress; if those stressors are battering you from different directions, frequently, and without mercy; if you are having trouble sleeping, having trouble eating, and you are suffering from depression and anxiety - my only advice is to urgently care for yourself. See a counselor that deals in these areas. Share with friends or family. Take time for yourself and treat yourself gently.

Allow yourself to decompress and you could avoid the trauma of nervous breakdown. I sure wish I had.

I Will Not Be Afraid Anymore

The more I try to get a handle on my breakdown - of how to fix myself - the more elusive the answers become. There are periods of time - days in fact - when I can only shake my head at the situation I've created for myself, and of the insane behavior that I engaged in to get me here.

A breakdown, as I have said in previous posts and as I'll again reiterate, is a destroyer. It destroys families and relationships, businesses, dreams, wealth, careers, and self-confidence. During my breakdown, I became unrecognizable to myself, my family and my friends. Not only physically but behaviorally. I grew a beard, something I'd never done before. I dressed differently, strangely, in loose-fitting garments. When I think back - and I shudder to do so, such is the shame I still feel - I believe that I saw myself in my mind's eye then as some sort of prophet or guru or healer. I hoped, I think, to help others. To be frank, it is something that I have always wanted to do. Due to my family history, I was raised as a caregiver. I guess, in my insanity, that call to action was made large as if I had become a physical caricature of what I most wanted. Thinking back, however, I only became a crazy fool.

My decision making and judgmental capabilities were similarly impaired. In other words, I made some crazy, crazy decisions during the period of extreme breakdown. Decisions that, with a sounder mind, I would never have remotely considered.

In a two week period immediately following the breakdown I: bought a house; bought a boat; bought a truck; bought thousands and thousands of dollars of new IT equipment that had no real purpose; took a number of international flights that I could not afford. Most of these 'investments' have, now, no value. Instead, the memory of them causes me extreme angst. But in defense of the crazy man that I was then, I think that what I was doing was looking for safety. The house that I bought and that I now live in reminded me of a childhood home in which I had experienced much happiness. The boat and truck were memories of a much younger me and my father and the times we spent together in his boat and a truck so very similar to the ones I bought. The IT equipment had to do with absurd plans that I had to form a business that was to help others. The holidays - well, those were just 'because', I guess. Because I was running from myself and the extreme fear and paranoia that I was experiencing.

For me, the breakdown was all about fear, and fear is what I've been left with - even now, three years later. Scratch the person that is the 'me' in recovery and you'll discover fear. Fear of what I did. Fear of what I became and perhaps, I fear, I could still become. Fear of neighbors and friends and what they might do to me still. Fear of finances and of running out of money because I find working to be almost impossible. Fear of being alone. Fear of being with others.

Fear has enveloped my being. It courses through my blood like a chilling Autumn. It can make me dizzy, causes me nightmares, and often makes me want to isolate myself behind a locked door even though I am also afraid now of being alone. It is the damnedest thing because when I really try to think about it I know that the fear has no basis in reality. I know I'm okay, at least on some levels. I know that monsters don't lurk outside the door. Rather the monster lurks in me.

Fear is just that, I guess. A monster that is the residual of the breakdown I experienced. My fears are irrational. But they are also terrifying.

If you or someone you know has - or is - experiencing a breakdown, they may be similarly afraid even if there is no logic to that fear. Getting over it - or through it - is so very difficult. In my case, professional counseling is helping. Yoga also helps me to relax and take my focus off of my fear. And a simple mantra that I say to myself over and over again, "I will not be afraid anymore" also seems to help. I do know that recovering from mental illness is a long journey. Mine is still continuing, and it will I suspect for some time.

Nervous breakdowns - or any kind of mental illness - is a horrible experience. Surviving mental illness and a breakdown is difficult. Recovering from one is just as difficult. But by taking things one day, one minute, one moment at a time; by getting professional help; by trying to learn to trust myself again and re-gain my confidence; I strive every day to continue my recovery.

All I want is to be able to look at myself in the mirror and realize that the man I used to be has come back and can be trusted. He no longer has to hide because he is no longer controlled by fear.

How to Help Someone Recover from Nervous Breakdown

Having suffered a breakdown, I have been asked how friends and relatives can constructively support those that have gone through a similar event. The answer is, With love and comfort.  But remember that recovery is a long process. Those having suffered from a breakdown can often slip backwards due to a number of factors. To help, you must understand why this occurs, provide constructive support, and practice the patience of many saints.


"Triggers". That's the word that mental health experts (including my therapist) use to describe events that can push a person into nervous breakdown. Triggers can also cause those trying desperately to recover from nervous breakdown to re-experience the emotional tsunami that they incurred during the height of illness.

Triggers can cause a person trying to heal to slip back into the dark cave of fear, loneliness, and trauma. They can also cause a person suffering from mental illness to suffer yet again from breakdown. For that reason alone, I do everything that I can to avoid triggers. Unfortunately, life is full of them.

Take this week. It's not a good week. Every now and then, it seems that I'm confronted by a vortex of stressful, emotionally charged situations. These are not good for my mental health and I know it. But somehow, I have to deal with them.

Over the past week: I learned that my father, whom I love dearly, has pancreatic cancer. A business deal that I stupidly became involved in during the height of my breakdown 3 years ago has gone pear-shaped and is causing a great deal of stress, anger, and fear. My core business as a writer continues to suffer. I begin to worry that in only a few months I won't be able to pay for the basics. For the first time in my life I'm experiencing a nagging physical problem. My GP is so concerned that she has ordered an MRI. I am also confronting other issues - other triggers. Smaller issues that grow larger in my mind. When I can look at these smaller challenges rationally, I realize that they are not worth worrying about. But during high-stress days or weeks, these smaller issues flood my being with additional fear. And the internal critic starts again: "It's been 3 years since the breakdown. For God's sake grow up and get a grip!"

The carefully constructed cocoon of healthy behaviors that I've constructed begins to erode. As the darkness falls, I'll begin to forget what I've learned. Sleep becomes difficult. Nightmares re-occur. Hands begin to shake. I'll stop eating correctly. I'll stop exercising. I'll forget to practice the tools that I've been taught. My world is once again a place of hopelessness. What I really want is for it to all stop. For someone, something, to intervene and to take the nightmare that I've experienced, and re-experienced, away once and for all.

But as I've stated in other Posts, recovering from mental breakdown is my responsibility. No one else, really, is going to help me to recover. Except me.

But, and a big BUT: if you are the friend or relative of someone suffering from breakdown, you can help by encouraging positive action. To understand how to do so, you must realize that if your loved one has gone through a breakdown, they are inclined to engage in some very crazy, very illogical, very scary thinking....

Dealing with the Darkness

Fortunately, I've also learned that during these times of darkness I hit some sort of bottom. I know that things will - must - get better. My training seems to finally kick in. This morning, for instance, I realized that I needed to do some Yoga. I'd promised to work at this at least 5 days a week, but I hadn't bothered in over 4 days. I made myself practice this for 30 minutes. I made myself take a shower, get dressed, start working despite the fact that my brain is so over-loaded that what I might write could very well make little sense. I'll make myself go down and get something to eat. I'll make myself focus on something in my life that is filled with hope and joy - my grandchildren, perhaps. Or the beauty of the far hills that I can see from my windows. 

I'll plan out my day so that I know it will be as full as I can make it. I set myself a simple goal: get through this day in one piece without going crazy. That's all I have to do. Just make it through this one day. Tomorrow, I know, will take care of itself. It sounds so simple. Yet it's a great deal of work.

I could use some help, but my healthy thinking is replaced with fear and self-loathing. In short, my thinking is 'crazy' (see below). If you want to help someone you know recover from breakdown, realize that there will be times of darkness during the recovery process, and that the person suffering is afraid to call out for help.

A Note to Those Who Want to Help

If you are a friend or relative of someone suffering from nervous breakdown or similar mental illness, I plead with you to begin to understand the debilitating nature of this area. By understanding, you will be able to better help.

Mental illness is just like any other illness. It is often curable. But to achieve that, sufferers simply need your loving support. Unfortunately, many of those trying to recover often will not - or are unable to - reach out for help from friends or family. Here is my own example, nutty as it is: Rarely do I share what I'm going through with my friends or family. I don't do that for a number of absolutely silly reasons: I worry that they will judge me. I worry that they will worry excessively about me. I worry that they will run from me because they might be unable to cope with these occasional slips that I am experiencing. I worry that they will become angry at me for taking too long to recover. I also worry that they will come to believe that I might never fully recover: that the Dad, friend, grandpa that they have come to know and love has disappeared forever. 

So if they ask me how I'm feeling, I will lie. I'll tell them that I'm fine. Even if I feel like hell, which is how I feel today. In short, I'm ashamed of how I feel. I don't want to share that.

These are disastrous patterns of thinking that, I know, only stifle my recovery. But that's the lousy thinking that goes on in my head during these periods of darkness.

If you, as a friend or relative, want to help, in my book it's fairly simple: let your loved one know that you are there. Let them know that you are willing to listen. Let them know that they are safe. Encourage healthy thinking and behavior by understanding the tools that they are learning, and remind them to use those tools. Encourage them to share because during dark periods, many are too embarrassed and too ashamed to do just that. 

Recovering from mental breakdown is a lonely, difficult process. By knowing that you love them unconditionally, sufferers of mental illness will be able to hold tightly onto that love and derive the strength and courage from you to carry on. 

Recovering from Nervous Breakdown

It's a New Year. And with it renewed Hope. Hope that I can recover. Hope that I can lead a normal, productive life that allows me to contribute to those that I love and to society at large. Hope that I can finally walk permanently out of the darkness that swallowed me and into a life that is satisfying and contented.

So just for today, let's talk about recovering from nervous breakdown, and the hope that we must grasp tightly onto  in order to accelerate that recovery.

Based on what I have experienced, and what I continue to battle, recovering from nervous breakdown is no easy task. It requires a great deal of work. It is a search for wellness punctuated by slippery periods of darkness, emotional turmoil and hopelessness. But based on my experience, and despite the frequent reappearance of many symptoms, recovery is possible.

I write this because despite discussions with a number of therapists and mental health practitioners, no one has ever handed me a 'list' of do's and don'ts: of what I should do to help my recovery. Instead, I had to collect these steps in bits and pieces. Creating them as I have here helps me to formalize what I have learned to date. Mind you, it's all a work in progress, just as is my recovery. I hope the following is of some help.

Actions to Recover from Nervous Breakdown

1. Regaining Hope: I put this at the top of the list because in my experience it is the most critical part of recovery, and unfortunately - and at least for me - one of the most difficult to achieve. My breakdown left me as a shell of what I had been before. My confidence was replaced by fear, shame, and self-loathing. Trust in myself and others was replaced by uncertainty. My definition of self had been fundamentally altered. Before, I thought myself to be a reasonably good husband and father; a successful writer and business person; a person others could count on in times of trouble. But following the breakdown, I was only filled with feelings of failure. 'Hope' for a future - any future at all - had vanished completely.

Yet hope is what motivates me to get up in the morning. Without hope - for love, for family and friendship, for a modicum of financial security, for contentment with oneself, for a productive future - the world seems a a dark hole within which I have no place or sense of belonging.

When all hope is lost due to mental illness, regaining a sense of purpose seems at times almost impossible. But we can all take actions to nurture hope within us.

Here's what I did to do just that.

2. Therapy: ongoing professional therapy, with a highly qualified specialist in trauma counseling, is at the fulcrum of my recovery. I see this woman every two weeks (I would see her more often if I could afford it) and have done so for almost two years. She creates a safe space for me in which I can share anything that is on my mind. She is not judgmental. She is supportive and caring. She has taught me a variety of simple-to-learn tools to help me cope with periods of anxiety and depression, including breathing and visualization exercises. She offers me ongoing encouragement. She continues to help me to dig down into the causes of my breakdown (which for me are important to understand so that I can avoid another one) and to resolve those issues. She suggests a number of activities (see below) and motives me to action those. She pushes me when I need it, and lets me off the hook if I need a quiet time for reflection. Our sessions are a great deal of work - during and after our hour together - and often unsettling as I confront myself, my past, and my actions and behavior. However, I know that her continued counselling is vital for my very survival, and also know that I'll be relying on her for many months to come.

3. Socializing: during my breakdown and driven by fear, my only real desire was to isolate myself. Yet isolation from others - from the joy of simple companionship - leads to further distress. Loneliness is no cure for breakdown. Rather, it only makes things worse. My counselor encouraged me to take part in a social activity. In my case, she believed it was more important to do so because I live on my own. Following her advice, I joined a local choir. We sing together twice a week. Singing has always made me feel good about myself, and working with the choir members can fill me with joy. Recovery requires socialization. If you're suffering from nervous breakdown, make certain that you do not isolate yourself. Instead, get involved with others even if every fiber of your being tells you not to.

4. Alanon and Sharing: I also joined Alanon (the support organization that works with relatives and friends of alcoholics). I qualify because my mother, now passed on, was an alcoholic. I meet with a handful of other people once a week. During these sessions I can share how I am feeling and any emotional turmoil I am experiencing in complete confidentiality. I am not here to promote Alanon or any other Twelve Step program. All I can tell you is that for me it works, and is having a positive impact on my recovery. I also suspect that the process of 'group therapy through sharing' not only enables me to decompress, but also provides personal fulfillment because by sharing my experiences I am also helping others. While you may not quality for Alanon or a similar program, I do suggest some sort of 'group sharing' process. Google 'Mental Illness 12 Step Programs' for possible options.

If you do not quality - or simply don't want to take part in such a program, I only suggest that you find someone you trust to talk to. A friend or relative can offer you a release valve for your emotions. They might also provide insight into how you really are (and I find that I can be terrible at  really knowing how I'm doing until someone sees me - and tells me) and offer suggestions. But don't be discouraged if you are unable to find the 'right' person. Remember that most non-professionals simply don't understand mental illness and nervous breakdowns. If they are unable to appreciate your situation, or if they 'scoff' at your desire to find help, fire them and locate someone else who is more helpful and sympathetic.

5. Work and Routine: work has defined me for years. Yet I am currently not working a whole lot for two reasons a) I am emotionally unable to work as much as I had before the breakdown and b) there simply isn't a whole lot of work out there in this Recession-plagued economy. Nevertheless, I make sure that I work. I work a minimum of 4 hours a day either at paid-for business writing (when I have some to do), or on new creative projects, or on this blog. When I work I try to be as disciplined as I was in the past. When I finish something, and if I'm proud of what I've written, it makes me feel rather good about my day and myself.

I also try to plan my day. We all need something of a routine to make life work...simple mileage markers that set out our day. But due to the aftermath of the breakdown, some days are still horrible. I'll get depressed. I won't have the energy, the motivation, or the will to complete simple tasks like walking across the street for a quart of milk. Eating becomes difficult because I don't want to prepare anything. Cleaning the house, doing laundry, making the bed...all of it sometimes seems overwhelming. At times all I want to do is smoke a cigarette and stare out the window.

And yet. I know that if I get off my butt and complete a task - any task - I'll feel better for doing so. I've learned to congratulate myself when I do something. Did I make dinner? Good man! Did I take out the garbage or vacuum? Wonderful! Did I drive into town to buy groceries? That's super because I not only made the drive there and back in one piece, but also had to plan, buy, and put away groceries. Good for me!

Routines that I used to take for granted are now unpleasant activities that can sometimes seem well beyond my abilities. And yet I know that if I make myself do them - one thing at a time - I'll get through the day in one piece, and experience just a bit of normalcy. And 'normalcy', that wonderful but often elusive feeling of self-belief and fulfillment when accomplishing even the most simple of tasks - is what I am trying sometimes desperately to capture. 

6. Exercise: I try to get as much as I can because exercise stimulates endorphins and makes me feel better about myself. I try to walk a few miles every week. I practice Yoga every day (most of the time anyway). In good weather, I work in the backyard. Frankly, I hate doing this stuff. But the reward is pretty terrific. I might be having a bad day. I'll exercise and immediately feel better. So what the heck and why not? 

7. Eating / Drinking: the old axiom 'moderation in all things' works very well when I bother to put it into practice. If I eat well, I certainly feel better about myself. If I drink moderately, I also benefit. I never (okay, almost never) drink to excess. The couple of times I did so taught me a lesson: I became anxious and depressed. So while I do enjoy a drink, I've put a stiff limit on the amount I'll imbibe. 

8. Sleep and Naps: I try to get a good 8 hours a night. Some nights are still troubled by nightmares or days-long periods of sleeplessness. I've learned to nap and try to take a siesta most days. I've learned: if I'm having a bad day or feel hopeless or crazy, an hour's sleep lets me wake refreshed and not feeling quite as bad. In other words: if I feel like taking a nap I no longer beat myself up for being lazy.

9. Quieting the Internal Voices: I don't know about you, but I'll often talk silently to myself. And that little voice inside my head will often be full of ill will. It will berate me and what I've gone through. It will beat me up for my past behavior and the consequences that I and my family have suffered due to the breakdown. It will make my life a misery. When that bad tempered voice fills my head as it does so often it can wreck my day and my life. Quieting it is very, very hard to do. I've learned to gently 'blow' those thoughts from my head. That is, I visualize a nasty self-loathing thought as a dark cloud.. I then blow- and keep on blowing until it disappears over the far horizon. As I say, it's hard to do and there are days - nay, weeks! - when I'm not successful. But I also know that if I am to recover fully, and have a renewed sense of hope, I have to rid myself of these internal critics who have nothing good to say about me.  Too, during Yoga I'll try a simple mantra. Rather than hearing that voice shrill "You're a bad man!", I'll instead replace it with "You're a good man."  In short, I do my best to stifle those voices in order to gain some inner peace.

10. Drugs: Yes, I took Lexipro for a few months to help me combat depression and did so on the advice of my therapist and GP. Frankly, I didn't like the drugs at all. They resulted in a number of physical side-effects that I found to be unpleasant, although not debilitating. For this reason, I've decided that I will never again take such drugs. I prefer to conduct the battle without the aid of medication. But that's me and my opinion. As my therapist says, drugs are a short-term bridge that help us to get from one side of the breakdown to the other. If you're asked to take them, consider it. But my only advice is to conduct some research first. Avoid protracted use. If you're concerned, contact another medical practitioner for other opinions.

11. Spirituality: I am NOT here to espouse a particular view on religion or spirituality. I'm no theologian or minister. Frankly, I find such bombast to be unhelpful if not downright damaging. Recently, for instance, I found a website on mental health. It's only suggestion on recovering from nervous breakdown was to find Jesus. The remark left me cold. What if I happen to be Jewish or Muslim or atheist? Then what?

I will say, however, that spirituality and a sense of the religious have formed another - at times wobbly - leg of my recovery. I like to think that someone, somewhere - someone who is much bigger and more powerful and more caring than me - knows what they're doing. I pray. I ask for help. I ask that those I love are also protected and helped. I don't expect a miracle. I don't anticipate my bedroom to be filled with rapturous light. But sharing in this way with a power larger and more loving than me gives me hope.

12. Toward a New Definition of Self and Self-Discipline: Though my breakdown occurred over three years ago, I know that my recovery is only starting, and will be a lifetime journey. I still suffer from nightmares, occasional sleeplessness, an inability to properly focus on tasks at hand at times, and prolonged periods of depression and anxiety that leave me in darkness. During those dark times I want my life to end. I see no hope for a future. I let the voices take over; the ones that tell me that I'm a failure; that I hurt people that I cared for; that I am useless to myself and those that I love. Those times are torture.

But slowly, ever so slowly, things are getting better. The nightmares and periods of sleeplessness don't occur as often. The tools that I've learned, when I remember to use them, can silence those voices. I am learning to be patient with myself, knowing that recovery takes its time and that I will slip now and again. And probably most importantly, I know that I have much more work to do.

I know that I must redefine who I am. What is important to me. What my future holds and what I want and need. I know that I must be honest with myself to do this, which is difficult for me to do. I know that during dark times or times when I can't work, I must avoid beating myself up but instead let my body - and mind - rest. I know that I must remember to put into action what I've written above - a sort of Program of Self-Help. I need to do that because recovery is also about self-responsibility. No one is going to make me recover. Instead, I must choose to recover. If I don't, I have a good chance of either re-experiencing another breakdown which could possibly be far worse than the first one, or be institutionalized. I'll pass on those two options, thank you very much.

It comes down, I think, to self-discipline. Of learning to control my mind and heart to some extent, in hopes of protecting and nurturing myself. But self-discipline is also about freedom: of letting myself recognize that I am free again to be what I want to be and that despite what I (and countless others) have endured, my life will be what I make of it. I may have experienced a profound illness, but now I am learning the tools that give me renewed hope for a fulfilling future.

At the end of the day it's a simple choice for me. I can either recover or I can die. I choose to recover. I hope you do too.

Consequences

I ended up staying in the psychiatric unit for six days, most of that time against my will. Even thinking about it sends a rush of anger and fear through me like a deadly firestorm.

Though I had been traumatized by a fire, not one professional in the unit ever troubled to treat me for the physical or emotional consequences. Instead, they viewed me as a patient needing help for mania, depression, psychoses and alcoholism. I was put in lock-down, unable to venture out of the facility without permission. I found myself to be living with twenty other patients, many of whom were also there involuntarily, who were suffering from anything from schizophrenia to attempted suicide. Living with them made me feel even more depressed, filling me with worry that perhaps I was without any hope at all.

Having stripped me of my Lexipro anti-depressants, they had substituted these with a medication that the doctors refused to name, though I told them that I would refuse to take the pills without a thorough knowledge of what was going into my body. A nurse, perhaps believing that I was within my rights to know, finally gave me some information: the drug turned out to be an anti-psychotic. One of the possible side affects was suicide. I point-blank refused to take the new drug. But the duty nurses decided not to re-issue me with the Lexipro. Consequently, I began to suffer from withdrawal symptoms. I should explain that when ending treatment for anti-depressants, users should gradually step-down the intake over a period of a month or more. In my case, and as stated, I was not given the opportunity such an opportunity. And due to the quick withdrawal, I began to experience standard side-effects: depression, shaking hands, and a general feeling of unwellness and instability.

At this time I was also seen by the house Psychiatrist. The young man, we'll call him Dr Joe, looked to be no more than 25 years old and probably fresh out of med school. With little real experience, I suspect that he had some sort of rule book that he followed; a question and answer sheet of some kind. He treated me like a child and idiot savant. Our 'sessions' lasted only minutes. He never questioned me about the after affects of the fire. He never asked how I really felt, or what I wanted. Instead, he plowed along his own path, confident, it seems, that our conversations would eventually lead to my 'cure'.

During this stay, I felt increasingly frightened, increasingly angry, increasingly filled with hopelessness and insecurity. At all times I protested my 'innocence' to staff, and demanded firmly to be released. I made certain that I acted with compelling normalcy: I dressed as well as I could, considering that I had few clothes with me; I always presented myself well; I did my best to keep to myself, but made certain that I did not isolate myself from the other patients. I worked hard to keep to the rules of the unit. However, within that tense and confusing environment I found that I could sleep and eat little. I felt constant anxiousness, and a shaking of my hands - and heart - that was even more frightening than the Unit that I had been forced into.

I was finally able to get through to a lawyer. He met and convinced the house Psych that I was being held against my will. He discovered that they could find no real proof of alcoholism, depression, mania, psychoses, or any other psychological problem (which in some ways astounds me, considering that I knew that I had suffered through a breakdown and fire). Finally, and realizing that I was not going to harm myself or others, they agreed to release me. But the damage had already been done.

Over a two week period I had experienced: the initial breakdown at my daughter's wedding; the fire in which I had almost died of smoke inhalation and for which I was not given any treatment; days of sleeplessness and lack of food; the high-end stress of family separation and isolation; and now the humiliation and confusion of being detained in a Psychiatric Unit without my consent.

I was released at 11:30 PM a few days following my lawyer's intervention. I was released without proper medication (that is, renewal of my anti-depressants). I was released still suffering from the trauma of the fire simply because no one had ever bothered to ask me about it.

I went out into the world a half-man. On the outside I was confident and smiling. On the inside, I was terrified. The pressure cooker of my emotional being had suffered complete and absolute breakdown. It would get worse over the coming months and even now I continue to suffer from symptoms due to the lack of treatment during those early, important, days.

I look back at this entire period of my life with horror. I am convinced that following the wedding or following the fire, if I had been given a little Tender Loving Care; if someone, anyone, had offered real help and hope; if I had been given an opportunity to rest and recover in a place of safety, my life today would be very different from what it is today. I suspect that the nightmare that I had faced then would have ended. Instead, the nightmare continues, even to this day.

Involuntary Incarceration

No one enjoys having their personal freedoms removed. Guilty or not guilty, and without benefit of trial, a prison sentence - no matter how short - can be terrifying. In countries around the world, however, mental health legislation has been written to remove personal freedoms in situations deemed threatening either to the sufferer or the general public.

Unfortunately, these laws that are meant to protect are also open to abuse.

In Ireland, the process of requesting an involuntary mental health assessment, part of this country's 2001 Mental Health Act, is straight-forward: a relative, friend, police officer, doctor, member of the public - apparently almost anyone - can request that a person be subjected to an involuntary mental health assessment. Moreover, the assessment can lead to an involuntary admission into a psychiatric hospital if the assessment indicates that a) "You have a mental illness, severe dementia or significant intellectual disability and there is a serious risk that you may cause immediate and serious harm to yourself or others" or b) "You have a mental illness, severe dementia or significant intellectual disability and your judgement is so impaired that your condition could get worse if you were not admitted to hospital for treatment that could only be given to you in hospital and going into hospital would be likely to improve your mental health significantly."

The above conditions are even contained in a free online booklet, "Your Guide to the Mental Health Act 2001", which we can all access with a simple click of a button! Have a read. You'll be shocked to find that almost anyone can be involuntarily incarcerated.

Which is exactly what happened to me.

Reading the above 'rules' for involuntary mental assessment and admission, I quickly realized (and hope you do too) that these rules make a number of assumptions. First, they assume that those requesting the involuntary assessment are telling the truth and/or have a damned good reason for bringing this action: in other words,  they are certain that you are a serious threat to yourself or others. Second, it assumes that the person who is the subject of the assessment really will become worse without intervention, and will actually improve if admitted to hospital even against their will (and possibly better judgement).

Based on what happened to me, the 'rules' need to be changed.

Lose Hope All Ye Who Enter Here

In my room at the hotel, a room that had become my sanctuary, I rose early. Though I had gone to bed past midnight, though I was exhausted, I found sleep impossible to obtain. Only 30 hours had passed since the fire. Since that time I had managed less than 5 hours of sleep and a single sandwich to keep me going. Sitting on the bed, I knew that I was tired, hungry, scared, confused, and overwhelmed. I also knew that despite my mental and emotional state I was going to have to quickly find a new place to live. I could not afford to stay in a hotel forever.

The previous day's encounter with my ex-wife, my ex-GP, my daughter, and the health practitioners who had insisted on a mental health assessment haunted me and filled me with anxiety. I knew that I needed time: time to get my bearings; time to take a breath; time to sleep and eat; time to figure out how to get help and from whom. I decided to phone a good friend.

I chatted with him at length about what had happened. This person, a fellow I had long trusted, seemed genuinely concerned and helpful. Still dressed in my pyjamas, I began to talk with him about what to do next. He seemed intent on confirming which hotel I was at and in which room number. I told him.

As we continued to talk I heard a knock on the door. Opening it, I found my daughter and ex-wife standing there. They moved aside. A group of people marched into my room: two men and a women both from the Irish Health Services department. A cop - or were there two? - followed them. Within my hotel room, a private space that I had already paid for, a place that I deemed a momentary sanctuary from the nightmare that I had, and was again, experiencing, they surrounded me.

They asked me to come with them. I refused. They told me I had no choice. I was to be committed to the local hospital's psychiatric unit for evaluation. My friend was still on the phone. I pleaded with him to help me. Little did I know that he had been contacted by my wife who had convinced him that I urgently needed psychiatric intervention. He agreed, and unknowingly became an accomplice in my incarceration.

Fear and anger rose within me. Knowing that I had no other option, I agreed to come with them. I asked them to let me go into the bathroom to change into street clothes. Afraid that I would harm myself - a fear that was unjustified - they refused. If I wanted to change I would have to do that in front of my daughter.

The hotel manager appeared at the door, a manager that I knew. He couldn't look me in the eye. With the Health Services goons closely guarding me, the cop following, my ex-wife and daughter following them, and all of us following the hotel manager, I was frog-marched out of the hotel and to a waiting hospital van. I was forced inside and sat between two of the goons.

I was being treated like a common criminal. The only embarrassment that I did not experience was the click of restraints snapped about my wrists and legs. As you can imagine, I was swept up in an emotional whirlwind: fear, anger, humiliation, shame, guilt...all of these were added to the pressure cooker of emotions that were the result of the breakdown and fire. I was now teetering on an edge of insanity.

I was taken to the hospital. There I was grilled by a psychiatrist that I never met again. Not once did he ask about the fire. Instead, he asked questions that I now don't remember, so upset was I. I was introduced to a nurse. She asked me about my current use of medication. I was taking Lexipro at the time for depression, a course that had been prescribed by a doctor. They had somehow survived the fire. She stripped me of them. I was then led into the main psychiatric unit. There I met other nurses and introduced myself. Somehow, I managed to keep a grip. Rather than showing the heated anger that I felt, I told them simply: "I'm being held here against my will. I ask you all to remember that."

I turned as the main door was closed and locked behind me. For the first time in my life I was imprisoned. I had no way out. I was at the mercy of the staff that surrounded me. I had been incarcerated without benefit of any 'trial' and fully against my will.

Disoriented, hungry, and filled with a sense of injustice, I allowed myself to be led to the room that I would share with three others for the next six days.

Falling onto the bed, the only emotion that I can remember is one of absolute hopelessness. But finally I slept.

Symptoms of Nervous Breakdown

Following my breakdown I scoured websites and books for symptoms, hoping to identify what had happened to me, why it had happened, and when these various maladies might disappear. Too, I was desperate to identify with others, hoping that by acknowledging my symptoms I could somehow, and in some way, get a handle on myself which would enable me to heal.

I should explain that I've always been the stubborn type. Tell me I have a health problem and yes, I'll do what the doctor tells me but, not quite trusting the doctor's advice, I'll also do what I think my body and mind need for recovery. My search for, and understanding, of my personal symptoms hoped to do just that - to increase my chances of, and accelerate, healing. 

But when researching on the Internet, I discovered so many, many symptoms. I had experienced some of these. But many I had not. As with my search for a definition of nervous breakdown, I found the list of symptoms to be dizzying in their length and complexity. 

Somewhere out there, a person suffering from what they think might be a nervous breakdown could very well read this. Therefore, I am now sharing my own symptoms, including certain behaviors, hoping you can identify with them. By doing so, I also hope you realize that a) you are not alone, that many others have - or are currently - experiencing the living nightmare you are going through and b) based on my experience, you have every reason to expect a recovery from all, or most, of these symptoms in the shorter-term.

Shorter-Termed Symptoms of Nervous Breakdown

I experienced the following symptoms during the first days and weeks of my breakdown:

Spiritual / Emotional Symptoms

Fear - profound fear dominated my life. I was afraid, so very afraid, of almost anything and everybody. I was afraid to be alone. I was afraid to be with people. I was afraid that I would die. I was afraid to live. I was afraid of myself and what I would do. I was afraid of others and what they would do. I suspect now that my fear was driven by one primary cause: I had lost control of my life and the world that I understood. Loss of control yields a loss of belief in self, and consequently a complete loss of direction. Rules, benchmarks, and the road maps we have created to survive life disappear. I was lost in a world that was no longer familiar and which had no sense of purpose. My fear - yes! - terrified me. It caused me to lose sleep. I ate little. It flooded my being so much so that it pushed out rational thinking and behavior. Fear controlled me.

I am, of course, still afraid on occasions. We all are. But fear no longer controls my life. 

Paranoia - hand in hand with fear were feelings of paranoia. I no longer trusted anyone. I was convinced that people were attempting to kill me; to destroy me; to take from me my very definition of self in addition to my physical property. Due to paranoia, I had great trouble building trust with anyone. That feeling was compounded by the behaviors of others which proved my distrust to be accurate.

My feelings of paranoia have completely disappeared.

Psychotic episodes - yes, I had a number of them and I'm still ashamed to admit it. I experienced visions. I 'felt' that people were talking to me. This one is difficult to explain... I never heard voices (and in fact, when asked by professionals if I heard voices, I rightly denied it because they had not asked the right question. Too, I knew that what I was experiencing was nuts), but I 'felt' their presence and within that, felt their silent commands or approval. For instance, if I was in a shop looking to buy a present for someone, I would know that I would be guided to the right place to find it. And voila, that's exactly what would happen. Or if I was taking a walk and was confused how to get to a certain place, I knew that I would be guided in the right direction. And most of the time, I was. Of course, there are perfectly logical reasons why I did what I did: why I got to my final destination; why I found what I did to purchase. But these episodes were persistent for about a year. Oddly, I found great comfort in them, coming to believe that I was being protected by a power much greater than myself. While these were certainly psychotic episodes, I'm glad that I had these types rather than those of the destructive variety. And as I grow healthier and stronger, I take solace in the hope that perhaps someone or something really was protecting me. God knows, I needed the help.

Feelings of Grandeur - yep, I'm sorry to say I had those too. For a while - perhaps a month following the breakdown - I felt that I could do no wrong nor be hurt (which is odd: my delusions of grandeur contrasted spectacularly with the fear that I consistently felt. But breakdowns are illogical and unpredictable. So these contrasting symptoms are perfectly reasonable within the context of breaking down). My most memorable moment of grandeur: I became convinced that I could help everyone to achieve their personal dreams. I vividly remember one poor woman who happened to sit by me in a restaurant. As I remember, we discussed the business that she hoped to soon start. All that she required was funding. I told her - and I believed it - that I was a venture capitalist; that her idea had sound merit; that I was perfectly willing to help. In fact, I had established a large financial trust to help people of similar merit. I gave her my card as we parted. Luckily, she must have sensed the ludicrous nature of our conversation because she never contacted me. 

Everything was a Metaphor - for a few weeks, everything that I looked at or heard or touched or experienced represented something else. A deeper symbolism, perhaps. A meaning that few others could see but which I could understand. I would see incredible love in a small flower. I would see peace in the vibrant contrasting colors of nature. I would hear tranquility in a dove's coo-ing. Yes, of course this makes perfect sense on some levels. But during this period, these metaphors possessed a magic and a super-reality that I also took comfort in, and that I still have trouble explaining today. 

Depression - I could become severely depressed for days at a time. The depression fed into my feelings of fear, which reinforced the depression. It became a vicious cycle. In time I was able to break that cycle.

Anxiety - similarly, and for a wide range of reasons discussed in earlier Posts, I suffered high levels of anxiety (see Fear, above).

Mania - motivated and coerced by fear, I experienced two or three episodes of mania. That is: I was emotionally 'higher than a kite'. During these periods I had incredible energy. I could work for hours at a time. Once, and despite having less than an hour's sleep the night before, I drove 7 hours straight without stopping and with no apparent ill effects. These manic episodes occurred, as I say, only 2 or 3 times (which was more than enough, let me tell you) but quickly disappeared and have not reappeared since those early days of the breakdown.

Isolation - during the early days especially, I desired to isolate myself from everyone I knew. I suspect that this was due to a few reasons. First, I was extremely ashamed of what was happening to me, and also fearful of those around me. Second, I suspect that my body and mind searched for rest, much as most animals do when they are injured. This symptom also quickly left me. 

Physical Symptoms

I also experience the following physical symptoms during, and directly following, my breakdown:

Dizziness - and this one too I have trouble explaining. Though my balance might be perfect, I perceived the world around me as being out of kilter by a good 45 degrees. These periods are made worse whenever stress levels or anxiety increased. I suspect that this feeling of dizziness is a reaction to adrenalin as it pumps through my body.

Sweating - during the first few days of breakdown I sweated profusely. I'm sure this was due to a number of factors: increased blood pressure and metabolism, extreme anxiety / fear; increased adrenalin output. This symptom disappeared quickly.

Trembling - particularly of the hands, which has also completely disappeared.

Exhaustion - and who wouldn't be? All I wanted to do was sleep which was my body's reaction to the situation, and a good one it was, too. Sleeping helped me to heal. I welcomed it. However, many times and despite being exhausted I could not sleep simply because I was too frightened or anxious to do so. 

Panic Attacks - I experienced only one of these. One was enough. I never want to go there again.

Inability to Cope - and while this is not physical, it was all-encompassing. I could no longer cope with any additional stress. I could not deal with people. I made very, very poor decisions due to many of the symptoms outlined above. For instance, I resigned a highly profitable client in the belief that I wasn't doing a good job for that company. That's just one of them. Many others were to follow.

Complications Due to PTSD

On top of all this, and as the result of the fire, I suffered symptoms of PTSD (Post Traumatic Stress Disorder). Mind you, the marital separation and wedding were also traumatic events and I suspect that some of these symptoms were already present, though I chose to ignore them.

My PTSD symptoms included:

Fight or flight - when confronted by a traumatic event, human beings - and many other living creatures - take action to defend themselves. Fight or flight behavior is part of our natural defense mechanism. We either fight, and confront our adversary, or we fly, escaping from that which terrifies us. In my case I did both: I 'fought' back, occasionally exhibiting eruptions of anger toward real or imagined adversaries, or I took flight, usually climbing in my car to escape, or locking the door to keep danger out.

Both behaviors disappeared within a few months of the fire.

Nightmares and flashbacks - of the traumatic event occurred sporadically. The nightmares were powerfully terrifying in which I, or my loved ones, died. Flashbacks could occur at anytime. Usually, those flashbacks incorporated traumatic memories of the fire. Triggers included sights and sounds (such as ambulances, police cars, and fire trucks, as well as sirens and alarms), and smells especially the smell of smoke. Nightmares have almost completely disappeared. Flashbacks continue to occur. These little beasts incite illogical feelings of fear within me which can linger all day long.

Hyper-vigilance - exactly as the name implies. I was 'hyper-watching' all the time. I suspect that this is a natural reaction to trauma: we all become more aware of our surroundings in order to protect ourselves. Physically, I became jumpy, restless, and continually irritable. I had trouble concentrating. This symptom has completely eased since the fire.

Three Years Later: Longer-Termed Symptoms

The symptoms of the breakdown worked to wreck much of my life. During the past three years, I have - and continue to - work hard to re-build what I have lost. But it's working. Slowly, slowly, things are coming right. To be frank, I'm not certain that I will ever fully recover. I know that my work life has been severely affected. Today, I only work half time as opposed to the many, many hours I used to be capable of working. But it's coming back, and all by keeping focused and through a hell of a lot of discipline.

Some symptoms continue to affect me, but to a much lesser degree than before, no matter what I've done to eliminate them. These include:

Dizziness as above - especially during times of high stress leading to anxiety

Inability to Focus - occasionally I will be unable to focus on a task at hand. This drives me nuts as I've always been highly motivated and highly focused.
Flashbacks - of the fire

Periods of sleeplessness - lasting approximately 3 nights when they occur.

Periods of depression - lasting for up to 4 days, and usually brought on by something that's gone wrong in my life, or triggered by a memory that saddens me or makes me anxious. I work hard to not to sink into these, and must work even harder to get out of them when I'm in them.

Critical Psychological Effects

But even more importantly, and since all of these events, some of the very fabric of my being has changed. The nervous breakdown, together with those other events that compounded this, have changed how I look at myself and my future.  Four years ago I like to think I was confident and hope-filled. Today I lack self-esteem, am often not confident in my capabilities, and can easily lose hope. Even little things - an unthinking comment or slight from a friend or acquaintance - can send me into a tailspin.

I used to think I was fairly 'attractive'. That I had much to give people. Now I'm not sure. I have to argue with myself to stay positive. Often a little voice in the corner of my mind will say, "You're worthless. You have nothing to offer. You're a bad man." At those times it takes all of my energy to fight this whispering devil. And I can only do so with exercise and sleep.

Nervous breakdowns are destroyers. We end up fighting not only ourselves but those external people who are supposed to help because they either do not know how to help or use methods that are ineffective. We fight in order to survive and we often have to fight alone.

Symptoms of nervous breakdown are complex in their display and presentation, often misunderstood, and can - as we have all read - result in death if improperly treated. Symptoms can also last for the longer-term, affecting a person's self-image, their ability to earn a living, relationships, futures...their entire lives.

Only self-awareness, a great deal of humility, and a whole lot of self-help (coupled with professional and family support) can allow a nervous breakdown sufferer like me to arise Phoenix-like from his or her ashes. To do so requires a re-building of personal resilience, and an understanding that life - as I knew it pre-breakdown - has changed forever.