In a real dark night of the soul it is always three o’clock in the morning, day after day.
Scott Fitzgerald had one. Since then, we’ve been required to call “nervous breakdowns” by more (perhaps misleadingly, I suspect) precise terms. But in these parlous times, some of us cling for reassurance to the old ways, the WSJ reports (“Time for a Good Old-Fashioned Nervous Breakdown?“):
Fifty years ago, Ms. Shapiro’s experience would have been called a “nervous breakdown”—an unscientific term for personal crises ranging from serious mental illness and alcoholism to marital problems and stress.
Today, psychiatry is more precise. A sudden inability to cope with life’s demands could be classified as one of dozens of specific mental disorders, including post-traumatic stress disorder, generalized anxiety disorder or major depression. There’s no official term for milder forms of “nervous breakdown,” though some patients and clinicians wish there was still a name for a temporary state of being overwhelmed by outside forces without an underlying mental illness.
“I hear the term ‘nervous breakdown’ from a patient at least once a week,” says Katherine Muller, a clinical psychologist at the Center for Integrative Psychotherapy in Allentown, Pa. “The term lives on in our culture, maybe because it seems to capture so well what people feel when they are distressed.”
“Given the economic mess we’re in, a lot of people are coming in saying they think they’re on the verge of a nervous breakdown,” says David Hellerstein, research psychiatrist at the New York State Psychiatric Institute. He says it can be challenging to tell immediately if a patient is having an acute episode of mental illness, or a predictable reaction to extreme stress. Symptoms may be similar—including heart palpitations, chest pains, shortness of breath, uncontrollable crying, dizziness, disorientation, exhaustion and a feeling of “going crazy.”…
I like the return of the folksier, archaic term. More “scientific” terms suggest a precision, a specificity that seems to me impossible in dealing with anything so complex, so messy, so organic, so spiritual as the human mind.
In any case, when mine comes (perhaps I should say, when my NEXT one comes), I hope everyone calls it a “nervous breakdown.” That sounds so much more human — friendlier, somehow — than the more clinical terms.
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The technical term is “totally bummed.”
Why do you cling to this notion of “impossible” in regards to scientific and medical exploration. It comes across at best clinging to the outdated because its ‘familiar’, and possibly just a tad irrational?
Tim, this isn’t about scientific or medical exploration. It’s about presuming to be precise in saying a person suffering from a mental/emotional/spiritual malady is experiencing Disease A and not Disease B.
Science is a fine thing in explaining how my iPhone works (wait, bad example — my iPhone works by magic; let’s say the Space Shuttle instead), but not complex, holistic processes of the mind.
You can document that a certain drug has a certain effect on the brain, under certain conditions. But even then, drugs designed to have Effect A often have Effect B or C on human behavior or on the emotional state of the subject.
There are undoubtedly specific physical diseases of the brain that have verifiable causes you can put your finger on. But even then, we are wise to consider other factors. For instance, Charles Whitman, the Texas Tower sniper, had a highly aggressive brain tumor when he killed 16 people and wounded 32 others.
But he also had been court-martialed as a U.S. Marine, was failing as a student and had other problems. You could even perhaps assume, as the instructor in “Full Metal Jacket” did, that his Marine training played a role in his actions (it certainly gave him the requisite skills).
I just worry about putting a precise, scientific-sounding label on human behavior when it’s so very difficult to have a full understanding of it. It seems to falsely advertise that we know completely what we’re dealing with, when it’s likely that we don’t.
So it is that I prefer Burl’s “totally bummed” or Fitzgerald’s “real dark night of the soul” to official diagnoses from the DSM. Such characterizations are more humble, and more fitting, for everyday usage by most people.
“Given the economic mess we’re in, a lot of people are using it as an excuse for bad behavior and saying they want some attention,” says David Hellerstein, research psychiatrist at the New York State Psychiatric Institute. He says it can be challenging to tell immediately if a patient is having an acute episode of mental illness, or is just a whiny attention whore. – Fixed that for him.
@ Brad, do you mean “Full Metal Jacket” the 1987 Kubrick film? I don’t recall a scene with a “rifle instructor”, just the one with Vincent d’Onofrio and GySgt R. Lee Ermey as the crazed recruit “Pyle” and Gunny Hartman.
I am flummoxed into a case of meloncholic vapors. No one expects anyone to give up nice, poetic terms (I much like Lincoln’s “black dog”), but you again are saying that since something is complicated, you should give up trying to figure it out, to label it accurately, to make things nicer and simpler. I don’t know when you last watched the Today Show, but they go into the this stuff all the time, and I don’t think the audience is left behind in a fugue of despairing nostalgic confusion. We all now have a pretty good idea that the term manic depression is inaccurate and is now considered bi-polar; what schizophrenia is vs simple clinical depression, or ADHD, and that a big part of Fitzgerald’s issues may have been addiction to alcohol.
But the line between having a moment and freaking insane is very clear – especially by the third behavioral example.
Never thought about the terminology before. I lean toward Brad’s expressed viewpoint. Totally bummed and nervous breakdown seem to leave room for hope for a better tomorrow. More clinical terms can be used, sometimes rather snidely, to imply a person will never REALLY be alright.
The performance of many phones doesn’t speak very highly for hard science.
Yes, absolutely, that’s so embarrassing! I never make mistakes like that on movies. About all I can say is that I only saw it once and was underwhelmed, and never saw it again. I just remember the speech about Marine marksmanship regarding Oswald, etc. Of course, of them all, I suppose Oswald was the most impressive example of Marine training. Assuming he acted alone.
[like] what Tim said.
@ Kathleen– As neuroscientists like to say, “What fires together, wires together.” Having one episode greatly increases chances of having another, both because of the experiential neural links, and because of the underlying biology of the person. This doesn’t mean one is forever doomed to the dark night of the soul 24/7, but that one’s vigilance to the possibility of relapse must be maintained. This may mean lifelong medication regimens, or simply maintaining good behaviors, depending on the case.
Life is managed, not cured.