Oprah’s Near Nervous Breakdown

Oprah Winfrey been pretty busy the past year: Working to turn around her struggling OWN network, playing a demanding role in Lee Daniels’ The Butler and taping interviews for her own interview show Oprah’s Next Chapter. You might expect that this could have taken a toll on her.

And apparently it did. In an interview with Access Hollywood reporter Shaun Robinson, Oprah revealed that she had nearly had a nervous breakdown.  Apparently Oprah had one of her “Aha! moments” last fall while interviewing KONY 2012 Filmmaker Jason Russell. Russell had recently had a very public breakdown when he was found running naked in the streets of San Diego. Oprah realized “I was sitting and listening to Jason Russell describe his symptoms…. Saying, ‘Um, this sounds pretty familiar to me.’”

Shaun asked Oprah what symptoms did she have:

In the beginning, it was just sort of speeding and a kind of numbness and going from one thing to the next thing to the next thing. I will tell you when I realized that I thought, ‘All right, if I don’t calm down I’m gonna be in serious trouble.’ I was in the middle of doing voiceovers, you know? And I remember closing my eyes in between each page because looking at the page and the words at the same time was too much stimulation for my brain.

Interviewing The Black-Eyed Peas’ Fergie a few weeks later, made Oprah realize she really needed to slow down. “…I had reached a point where I just couldn’t take in anymore stimulation.”

 What is a Nervous Breakdown?

Melancholia by Frederick Sandys

Melancholia by Frederick Sandys

“Nervous breakdowns” don’t really exist — at least not as a formal medical diagnosis. “Nervous breakdown” is a catchall term used to describe an acute situation when a person becomes overwhelmed by stresses in their life.  This situations causes them to temporarily become unable to function normally on a day-to-day basis.

Back in the Middle Ages, this condition was called melancholia. In the early 1900s, it became known as neurasthenia. The term nervous breakdown became popular in the 1930’s through the 1970s. The term is infrequently used today.

The condition is defined by its temporary nature and often closely tied to psychological “burnout,” severe overwork, sleep deprivation and similar stresses that combine to temporarily overwhelm an individual with otherwise sound mental faculties. It also shares many symptoms with the acute phase of post-traumatic stress disorder.

Mayo Clinic psychiatrist, Dr. Daniel K. Hall-Flavin states that although nervous  breakdown isn’t a medical term, and does not indicate a specific mental illness,”that doesn’t mean it’s a normal or a healthy response to stress. A nervous breakdown may indicate an underlying mental health problem that needs attention, such as depression or anxiety.”

The symptoms associated with this condition vary from person to person and may reflect the underlying mental health disorder, which could include:

General Anxiety Disorder

People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work. Sometimes just the thought of getting through the day produces anxiety.

GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months.

GAD affects about 6.8 million adult Americans and about twice as many women as men.

Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.

Bipolar Disease

Bipolar disorder, also known as manic depression, is a psychiatric conditon that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks.

Symptoms of bipolar disorder:

Brief Reactive Psychosis

Brief reactive psychosis is a sudden, short-term display of psychotic behavior, such as hallucinations or delusions, that occurs with a stressful event.

Brief reactive psychosis is triggered by extreme stress (such as a traumatic accident or loss of a loved one), and is followed by a return to the previous level of function. The person may or may not be aware of the strange behavior.

This condition most often affects people in their 20s, 30s, and 40s. People who have personality disorders are at greater risk for having a brief reactive psychosis.

Symptoms of brief reactive psychosis may include the following:

  • Disorganized behavior
  • False ideas about what is taking place (delusions)
  • Hearing or seeing things that aren’t real (hallucinations)
  • Strange speech or language

Post-traumatic Stress Disorder (PTSD)

When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.

PTSD can cause many symptoms. These symptoms can be grouped into three categories:

1. Re-experiencing symptoms

  •     Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  •     Bad dreams
  •     Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms

  •     Staying away from places, events, or objects that are reminders of the experience
  •     Feeling emotionally numb
  •     Feeling strong guilt, depression, or worry
  •     Losing interest in activities that were enjoyable in the past
  •     Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms

  •     Being easily startled
  •     Feeling tense or “on edge”
  •     Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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