What are nervous breakdown symptoms and what helps in the moment? Learn about crying, shouting and shaking episodes, what they resemble and what follows.
It is the morning of Bayram, the religious holiday. The guests will arrive in an hour, there is börek in the oven, the children are fighting in the living room and the phone will not stop ringing. The plate in your hand slips and falls to the floor, and with that small sound of breaking, something inside you snaps. You start crying and cannot stop; your voice rises, your hands shake, you cannot get enough air. The children watch fearfully from the doorway. A few minutes later it all dies down, but what remains is exhaustion, shame and the question, "What happened to me?" In Turkish this is called a sinir krizi, a nervous breakdown or nervous attack. Nervous breakdown symptoms show themselves through intense reactions such as crying, shouting, shaking and a sense of losing control, and they deeply shake both the person going through them and those around them. In this article I explain what this moment is, what it may be a sign of, and what can be done during and after the crisis.
What Is a Nervous Breakdown? Is It a Medical Diagnosis?
A "nervous breakdown" is not a medical diagnosis; no condition by this name appears in the classification systems used in mental health. But what the phrase describes in everyday language is very real: a moment when a person's capacity to cope is exceeded and emotions overflow, uncontrollably, for a short time. Similar expressions are used in different cultures; people describe this experience with words like "I lost it", "I exploded" or "I snapped".
From a clinical point of view, what is called a nervous breakdown can be the outward appearance of several different conditions: an acute reaction to a moment of intense stress, a panic attack, an explosion of anger that has long been suppressed, or a dissociative reaction in which the person feels cut off from what is happening. So saying "I had a nervous breakdown" is a good starting point for understanding what happened, but it is not the final word.
An important point: a nervous breakdown is not a weakness of character or a sign of being "spoilt". Most of the time it is the moment when a burden carried for a long time, lack of sleep and everything left unsaid suddenly become visible in the body and in behaviour.
What Are the Nervous Breakdown Symptoms?
Although a nervous breakdown looks different from person to person, the common symptoms can be grouped under four headings. These symptoms do not amount to a diagnosis on their own.
Emotional symptoms
- Crying or sobbing that cannot be stopped
- Sudden, intense anger, shouting, screaming
- Helplessness, a feeling of "I can't take it any more"
- A sense of fear or terror
Physical symptoms
- Shaking in the hands, legs or the whole body
- Fast, shallow breathing, a feeling of not getting enough air
- Palpitations, tightness in the chest
- Numbness or tingling in the hands and around the mouth
- Weakness in the legs, an urge to collapse to the floor
Behavioural symptoms
- Throwing objects, slamming doors, breaking things
- Running out of the room or the house or, on the contrary, withdrawing into a corner and being unable to move
- Saying hurtful things you did not mean to say
- Self-directed behaviours such as pulling your hair or hitting yourself
Symptoms after the crisis
- Deep tiredness and a need to sleep
- Shame, guilt, regret
- Remembering some moments only hazily
- Headache, muscle pain, a burning feeling in the throat and eyes
A crisis usually peaks within minutes and then slowly fades. However, crises can come one after another in the same day, or, once experienced, can set off the worry, "What if it happens again?"
Nervous Breakdown Symptoms: What Can They Be Confused With?
Some conditions that look similar from the outside need different approaches. Knowing the difference helps you reach the right kind of help and avoid unnecessary fear.
Panic attack
A panic attack can often occur without any obvious trigger, and its main features are intense fear, palpitations, breathlessness and a feeling of "I'm going to die" or "I'm going to lose control". In what people call a nervous breakdown, there is usually a moment of overflow, an argument or a final-straw event; crying and anger are more prominent. The two can also overlap. For more detail, you can read the article on panic attack symptoms.
Outbursts of anger
In people who have long been "the patient one", who never object and who carry everyone else's load, anger builds up and one day may come out with unexpected force. Behind these outbursts there are often words swallowed for years. This topic is covered in more depth in the article on suppressed anger.
Situations that require medical assessment
Some medical conditions can look like a nervous breakdown from the outside. If any of the following signs are present, a doctor must be consulted before treating the situation as psychological:
- Loss of consciousness, not responding to stimuli
- Convulsions, foaming at the mouth, tongue biting or loss of bladder control
- Slurred speech, a drooping face, weakness on one side of the body
- Severe chest pain that does not go away
- Sweating, shaking and confusion in someone with diabetes
In these situations, call 112 (emergency services). Even if a psychological reaction is suspected, medical assessment is important for episodes that happen for the first time and cannot be explained.
What Causes a Nervous Breakdown?
A nervous breakdown is usually the result not of a single event but of a long build-up. The final straw may be as small as a broken plate or a single sentence; but the drops that filled the glass have been gathering for weeks, months and sometimes years.
An endless caring load: Many people, women in particular, who look after an ill mother or father while raising young children and working at the same time, constantly put their own needs off. In an extended family, the person of whom everyone says "She does the most" is often the one who is most exhausted.
Lack of sleep and physical exhaustion: Insufficient sleep markedly lowers the capacity to regulate emotions. For a mother who has just given birth, a factory worker on shifts or a healthcare worker doing night duty, the limit is much closer.
Financial pressure: Rent increases, debts and the worry of not making it to the end of the month leave people living with constant background tension. This tension lowers tolerance for the small mishaps of the day.
Suppressing emotions: Someone who grew up with messages such as "Crying is shameful", "Real men don't cry" or "Don't talk back to your elders" learns to swallow difficult emotions rather than express them. Swallowed emotions do not disappear; when they cannot find a suitable outlet, they can overflow all at once.
Traumatic experiences: After experiences such as an earthquake, an accident, a sudden loss or violence, the nervous system can become more sensitive. A sound, a smell or a piece of news can take the person back to that moment and trigger an intense reaction.
Before blaming the glass for overflowing, we need to look at what has been filling it, drop by drop.
What to Do During a Nervous Breakdown
If it is happening to you
When a crisis begins it is hard to think, so a few simple steps you already know in advance can help:
- Move somewhere safe. If you are in the kitchen, turn off the hob and put down the knife or hot pan in your hand; if you are driving, pull over.
- Lengthen your out-breath. Take a calm breath in through your nose and breathe out slowly and at length through your mouth. Making the out-breath longer than the in-breath slows the body's alarm.
- Plant your feet on the floor. Sit on a chair, feel the soles of your feet touching the floor, put your hand on a cool surface. These simple sensory cues bring the mind back to the present moment.
- Say a short sentence to yourself. A sentence like "This wave will pass" or "I am safe right now" gives you a small foothold against the mind's catastrophic interpretation.
- Postpone the conversation. If the crisis began during an argument, saying to the other person "I can't talk right now, let's talk later" and leaving the room prevents words you would regret.
If it is happening to someone close to you
Seeing a loved one go through a nervous breakdown is frightening. The following can help:
- Ensure safety first: move breakable and sharp objects out of the way.
- Clear the room; if there are curious relatives, neighbours or children, take them to another room.
- Speak calmly, in a low voice and in short sentences: "I'm here", "It will pass", "Let's breathe together."
- Ask before touching; some people calm down when hugged, others feel even more trapped.
- Avoid old-fashioned interventions such as slapping, splashing water in their face, shaking them or shouting "Pull yourself together!" These increase fear and shame.
- Do not give any medication that has not been recommended by a doctor.
- If the person is harming themselves or someone else, or their consciousness is becoming clouded, call 112 (emergency services).
After the crisis has passed
Once the nervous breakdown symptoms are behind you, the body often feels as tired as if it had run a marathon; this is a natural result of the intense alarm it went through and does not mean something has broken. When the storm has died down, the first need is usually rest. A glass of water, a quiet room and a few hours of rest come before talking. The next day, at a calm moment, it is useful to reflect on these questions: What had been building up in the days before the crisis? What were the first signs: a lump in the throat, a clenched jaw, impatience? At what point could I take a break next time?
If the crisis happened in front of the children, it is important to give them a short explanation suited to their age: "Mum was very tired and very upset that day, I shouted and I frightened you. It wasn't your fault." This kind of repair also teaches the child that feelings can be talked about.
When Should You Seek Professional Support?
A single crisis during a clear moment of stress can be a warning sign prompting a person to reorganise their life. However, in the following situations it is important to get support from a mental health professional:
- If the crises are recurring or becoming more frequent
- If you harm yourself or others during a crisis
- If you have begun avoiding certain places or people for fear of the next crisis
- If the crises are accompanied by long-lasting low mood, hopelessness or an inability to enjoy anything
- If the crises began after a traumatic event or appear in situations that remind you of it
- If alcohol or other substances come into play during or after the crises
If you are having thoughts of harming yourself or ending your life, this is an emergency; call 112 (emergency services) without losing time. Whether the symptoms require medication can be assessed by a psychiatrist. Individual therapy allows you to explore, in a safe setting, the burdens that feed the crises and your relationship with your emotions.
How Is a Nervous Breakdown Addressed in Therapy?
The first step in therapy is to see together that the crises are not a moment of "going mad" but reactions that follow a particular pattern. The last few crises are examined in detail: What came before? What were the first bodily signs? Which thoughts went through your mind? How did the crisis end?
Cognitive Behavioural Therapy (CBT) helps in this process with recognising early warning signs, taking a break before reaching the point of overflow and noticing thoughts that fuel anger, such as "I'm always the one doing everything, nobody sees me." Emotion regulation skills such as relaxation, breathing and grounding are practised in sessions and then applied in daily life.
Setting boundaries and expressing needs is often at the centre of the work. If behind the crises lie patterns such as being unable to say "no", being unable to ask for help or always putting one's own needs last, these are addressed step by step.
A schema-focused perspective can help to understand how patterns formed early in life, such as "self-sacrifice" or "emotional deprivation", increase a person's present-day burden. If there is a trauma behind the crisis experience, trauma-focused work may also be part of the process.
Frequently Asked Questions
How long does a nervous breakdown last?
Most of the time it peaks and settles somewhere between a few minutes and half an hour; the tiredness that follows, however, can last for hours. If the crisis continues for a long time, consciousness becomes clouded or the person is not safe, call 112 (emergency services).
Does a person who has a nervous breakdown remember what happened?
Most people remember what happened, but some moments may remain hazy or fragmented. Memory being affected like this under intense stress is common. Not remembering at all or losing consciousness, however, always requires medical assessment.
I had a nervous breakdown in front of my children. What should I do?
Rather than blaming yourself, focus on repair. Once you have calmed down, give your children a short explanation suited to their age, acknowledge that you frightened them and tell them that what happened was not their fault. If the crises keep recurring, getting support for yourself is also a protective step for your children.
Does a nervous breakdown leave lasting damage?
A single crisis on its own usually leaves no lasting damage to the body or mind. What really matters is addressing the burdens that produced the crisis and the likelihood of it happening again. If the crises are becoming more frequent, this is an important signal that something in your life needs to change.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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