More Americans say they've been on verge of nervous breakdown

July 2, 2000
Web posted at: 8:15 p.m. EDT (0015 GMT)

In this story: Less serious than mental illness Contributing factors Policy implications RELATED STORIES, SITES

From staff and wire reports

WASHINGTON -- The proportion of Americans who say they've felt the threat of a nervous breakdown provoked by stress, depression and anxiety is on the rise, according to a study released Sunday.

The study, by Indiana University researchers, found that in 1996, more than 26 percent of adults surveyed said they had felt an impending nervous breakdown, up from 19 percent in 1957. In addition, another 7 percent said they had experienced a mental health problem, a question not asked in the 1957 survey.

"Still," the study says, "it is unclear whether the number of nervous breakdowns has increased over the past 40 years, or whether the meaning of the term has changed so that the public's attitude toward psychological problems has become more accepting."

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The increase, most of which occurred in the last 20 years, could be caused by a combination of more people experiencing psychological problems and a lessening of the stigma associated with admitting to a nervous breakdown, said Ralph Swindle Jr., the study's lead author.

"There's been a real change in both Americans' attitudes toward acknowledging mental health problems and in their willingness to talk to people about it," said Swindle.

The survey questioned 1,444 American adults from March to May 1996 and has an error margin of plus or minus 3 percentage points. The findings are reported in the July issue of American Psychologist.

Less serious than mental illness

The study notes that its findings deal with a concept of the nervous breakdown that renders it a less serious condition than mental illness.

"The way the general population uses the term 'nervous breakdown' is a mental collapse," said co-author Bernice Pescosolido. "They were talking about getting to a point in their lives where they couldn't carry on."

Participants in the 1996 study saw a nervous breakdown as related to stress, depression and anxiety, which they considered much less serious than conditions such as schizophrenia.

Those most likely to say they had anticipated a nervous breakdown were young, white single mothers with low incomes and no involvement with organized religion, the researchers said.

As the percentage of Americans reporting a feeling of impending breakdown has increased over the last four decades, the cause of those feelings and the way they're dealt with has also changed.

Contributing factors

In the 1957 survey, most people said health problems had caused them to feel close to a breakdown. But in 1996, the most frequently cited causes were relationship problems, including divorce, separation and other marital strains.

Demographic factors that consistently increased the likelihood of people feeling close to a nervous breakdown over the three study years were: Being white, being a woman, having no religion, having less family income, being younger, having children, and not being married.

While 44 percent of people experiencing these feelings in 1957 sought medical help, only 18 percent did so in 1996. People instead turned to nonmedical health professionals such as psychologists, social workers and counselors. About 18 percent sought help from such sources in 1996 compared to less than 1 percent in 1957.

The proportion of people seeking help from friends and family has also increased, quadrupling to 28 percent in 1996.

Policy implications

The researchers note that for an estimated 162 million Americans covered under some form of managed care plan, primary care physicians often are the initial provider of mental health services for the kinds of problems associated with nervous breakdowns.

"It seems somewhat ironic to us," they write, "that although the public appears more accepting of mental health services from nonmedical providers, they may have to access services through physicians, who they see as less appropriate sources of help for mental health problems."

The authors also write that "a mental health policy emphasis that is prevention centered -- focused on building coping skills, fostering stress resilience, and strengthening ties with family and friends -- is in keeping with the present results."

The Associated Press contributed to this report.

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