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CHAPTER 3 What is Nervous Illness?

It will be appreciated that there are different grades of ‘nervous’ suffering. Countless people have ‘bad nerves’ and many of them, although distressed, continue at their work and cannot be said to suffer from nervous breakdown. Indeed, while they readily admit to having ‘bad nerves’, they would indignantly refute any suggestion of breakdown. And yet a nervous breakdown is no more than an intensification of their symptoms. Although this book is concerned mainly with the development and treatment of nervous breakdown, almost every symptom complained of by people with ‘bad nerves’ will be found here, and such people will recognize themselves again and again in the patients with breakdown described in the following chapters. The symptoms are the same, it is but their severity that varies. The person with breakdown feels these symptoms so much more intensely.

Where do ‘bad nerves’ end and where does nervous breakdown begin? By nervous breakdown we mean a state in which a person’s ‘nervous’ symptoms are so intense that he copes inadequately with his daily work or does not cope at all. Doctors are asked if people really ‘break’, and if so, how? We are also asked how a nervous breakdown begins and develops.

The Breaking Point

Many people are tricked into breakdown. A sudden or prolonged state of stress may sensitize adrenalin-releasing nerves to produce the symptoms of stress in an exaggerated, alarming way. This state of sensitization is well known to doctors, but so little known to people generally that, when first experienced, it may bewilder and then dupe its victim into becoming afraid of it. If asked to pinpoint the beginning of nervous breakdown, I would say that it is at the moment when a sensitized person becomes afraid of the sensations produced by severe stress and so places himself in a cycle of fear – adrenalin – fear. In response to his fear, more adrenalin is released and his already sensitized body is thus stimulated to produce even more and more intense sensations, which inspire more fear. This is the fear – adrenalin – fear cycle.

Two Types of Breakdown

Most breakdowns are of two main types. One is relatively straightforward and its victim is mainly concerned with the distressing sensations brought by his sensitized nerves. In such people, nerves may be suddenly sensitized by the stress of some shock, such as an exhausting surgical operation, a severe haemorrhage, an accident, a difficult confinement; or, sensitization may come more gradually following a debilitating illness, anaemia, or too strenuous dieting. This person is often happy in his domestic life and work; indeed, he may have no great problem other than his inability, because of breakdown, to cope with his normal responsibilities.

The second type of breakdown is begun by some overwhelming problem, conflict, sorrow, guilt or disgrace. The stress of prolonged, fearful introspection gradually sensitizes nerves to react more and more intensely to the anxious introspection, until bewilderment and fear of the strange feelings sensitization brings, even of the strange thoughts it may bring, become as much part of the suffering as the original problem, conflict, sorrow, guilt or disgrace. Indeed, it may eventually be the main concern.