Men in particular often struggle to admit that they are having problems coping and may be heading towards some kind of breakdown. The subject is still taboo and carries with it a sense of embarrassment and shame.
But in these tough economic times, men are facing precisely the kind of work and home pressures that can lead to mental implosion.
Here we reveal the facts about nervous breakdowns, spotting the signs and how to respond.
It can happen to anyone
It really can. The recent breakdown of a close male friend of mine, who was going through the process of divorce and losing his family unit, is something that clinical psychologist Dr Funke Baffour has come across all too often in her profession where men are suffering from stress.
"Your friend may have had a breakdown even if he was under stress due to work; it's just that the divorce acted as a trigger," says Dr Funke. "Many people go through horrific things, divorces and bereavement and don't have breakdowns, so it's more to do with our coping mechanisms. Because your friend has had a breakdown and is predisposed, he should always be aware of what causes him stress and look out for the symptoms. It's what I call relax prevention, which is basically you taking control that you don't have a relapse."
What is mental breakdown?
The event can be very different for different people depending on their individual personalities and abilities to cope with stress. Dr Funke explains.
"We're talking about mental breakdown when you're whole body has given up on you. There are two sides to it. The physical side and the mental side. For men it's usually the physical side and some of those early symptoms can be a pounding heart, being unable to sleep, diminished or increased sex drive. What's happening is that the body is preparing itself to deal with stress."
Others may experience strange and uncharacteristic behavioural patterns that feel out of place. These can range from feeling paranoid, that people are out to harm you, to even suicidal feelings. It's also not unusual for some men to have thoughts of grandeur or invincibility.
One common trait is reliving past traumatic events. Sam, 46, who was a fireman, developed post-traumatic stress disorder after a particularly tragic event at work that saw him leave the fire brigade.
"I'd never felt such a sense of powerlessness, not being in control of my thoughts and actions," says Sam. "I became angrier, irritated by the most innocuous of things and realised that what was happening wasn't just a temporary reaction to a disturbing incident. I knew this was quite different."
Dr Funke believes that it is a build up of unreleased, continued stress that gradually contributes to a breakdown. So what are the main scenarios that can trigger a guy to start cracking up?
"In the current climate unemployment has come on top of the ladder," says Dr Funke. "Bereavement and the breakdown of relationships have always rated high but that doesn't always mean that they will cause stress. It depends on the individual. I've had people come into my clinic who are nearing a breakdown and it can be that they just feel everything in their lives is coming down on top of them."
There can be a wide range of causes or 'triggers' behind a mental breakdown, both external (such as work and relationships) to internal in the form of schizophrenia, family mental health histories and clinical depression. The use especially over-use of recreational drugs, including alcohol, can all contribute to a serious mental implosion, which sees an inability to function.
The effects can range from fatigue to confusion, inability to focus and get on with jobs to sporadic crying. The important thing is to take note of the symptoms before the situation gets worse.
Strange symptoms and variable sex drive
There's a standard list of symptoms from insomnia to migraine, low libido, panic attacks and even irritable bowel syndrome. People don't often realise that a physically stressful scenario such as having an operation can also cause physical reactions such as a break out of itching or skin rashes. Interestingly the sex drive can go either way nose-dive or jump into hyper-drive.
"Depending on a guy's psychological make-up some men react differently to deal with the stress," says Dr Funke. "Whereas in some cases people may take drugs to avoid the issue, others may start to have sex more instead of dealing with the problem."
Equally a guy may indulge in more pornography for the same reason. "It's called a sense of avoidance," says Dr Funke. "You're avoiding the issue and engaging in behaviour that isn't adding any value to your life but it's simply avoiding the stress issue."
Sam admitted that his sexual behaviour changed in that he masturbated more and avoided sexual relations due to anxiety and worry that he wouldn't be able to perform successfully. "My self-esteem reached rock bottom, which was scary and totally unlike me as a person. I'd always been confident with women and suddenly I was like this nervy kid who was fearful of rejection."
Self-help and self-realisation
Dr Funke insists that the first thing men need to do is take control. By that she means they have to figure out what is causing them stress. "The key is accepting your stress for what it is. The worst thing to do is deny that it's happening. This is one of the reasons why a breakdown in men can be more pathological and psychotic, because they aren't taking any notice of the signs at an earlier stage."
So look at your work environment or home environment, it might even be both that are causing problems. "Either way, jot it down so it's official," says Dr Funke. "The worst thing to do is brush it aside thinking it will sort itself out. It never sorts itself out because the stress manifests itself in your body, which then starts to break down followed by the mind."
Once you recognise the problem, go to your GP. But before undertaking medication find out if counselling may help you. Cognitive Behavioural Therapy is one method that is popular with men. Dr Funke insists that after 8-12 sessions clients of hers have shown a dramatic change, because the therapy is dealing with the thoughts that are causing the stress.
There is little alternative to escaping an increasing workload, for fear of losing one's job in some cases. But Dr Funke believes that there are still techniques that can be used to avoid extreme stress. "You have to try and implement relaxation. This could be in the form of exercise any kind. So if you're a couch potato, join the gym, start going for walks at lunchtime. Taking up something like yoga can make a big difference and is becoming popular with men these days."
The worst-case scenario is that men can end up in hospital or other institution. So the answer according to Dr Funke is before we get to the worst place, let's deal with the problem.
"Once you've identified what the cause of the stress was then that's your blueprint and you don't go back to that scenario. Obviously you'll continue to experience stress, as we all do, but you would have learnt skills to deal with it. It's important to keep practising at it because once you've suffered a breakdown, you're predisposed to it."
It is important to remember that private therapy can be expensive but in some cases companies will pay for their employees to undertake a course. Alternatively ask your GP about therapists and psychologists who may be provided through the health service.