On Nervous Breakdowns
My nervous breakdown never happened. The subsequent years were notable, if anything, for their ordinariness. I navigated the transition from childhood to adulthood as gracelessly as everybody else, logging more or less the same defeats and victories. I jettisoned my boyish fears, acquired the mundane preoccupations of a grownup, and went about the business of living. The nervous breakdown never fully left my field of vision, but it became hazy and small, as though viewed from across an expansive veldt. It ceased to be a threat or even, particularly, a source of unease.
And at some point—I can’t say precisely when—I learned the truth, which of course is this: there is no such thing as a nervous breakdown. Medically, it doesn’t exist. The phrase “nervous breakdown” isn’t indexed in the Diagnostic and Statistical Manual of Mental Disorders, and it isn’t used with any seriousness or precision by mental-health professionals. In an article charting the emergence and evolution of the nervous breakdown in American culture, historians Megan Barke, Rebecca Fribush, and Peter N. Stearns refer to it not as a disease, but as a “mildly mysterious disease-like entity”—the artificial foodstuff of the psychiatric world. The nervous breakdown, they tell us, debuted as a concept in 1901, and from its beginnings it was an elusive beast: seen by some as a type of shell shock, by others as a profound fatigue, by still others as a kind of existential paralysis. Its unfixed quality, in fact, seems to have contributed to its popularity, since it could be used to characterize almost any instance of emotional struggle. (Barke and her coauthors note that one “nationally prominent” research psychiatrist of the 1920s identified the symptoms of a nervous breakdown as “almost everything imaginable.”) For a while, particularly during its heyday between the 1920s and the 1960s, the nervous breakdown appeared to be on its way to achieving medical legitimacy. Gradually, though, the model lost support; in a world increasingly concerned with quantifying and documenting its diseases, this newish affliction was just too slippery, too vague, too much a catchall for the myriad anxieties of modern life. Eventually, like an un-oxygenated fire, it sputtered and died, and was never reignited. To be sure, there are things like a nervous breakdown. A person can still, with the blessing of the American Psychiatric Association, suffer from a generalized anxiety disorder, or struggle with depression, or display histrionics, or endure the ruin of a paranoid personality disorder. Each of these conditions undoubtedly visits genuine misery upon its victims. But the nervous breakdown, at least as I once knew it—what I’m tempted to call the classic nervous breakdown, the full system failure, the zombie-rendering event, the threat that hangs like a vengeful spirit above every head—simply isn’t real.