As a psychologist, I typically ask patients to describe the emotional state or social situation that brings them to my office. In 34 years of clinical experience, I’ve heard a variety of descriptions. Some individuals have researched their symptoms and may describe themselves as depressed, anxious, phobic, obsessive-compulsive, or anorexic. Others use common words or descriptions such as “I’m sad”, “I worry too much”, or “I’m paranoid!” Some are quite articulate and offer symbolic interpretations such as “My heart’s been eclipsed” or “I’ve lost the wind in my sails”.
Some patients describe family, social, or cultural circumstances as part of their emotional status and condition. I’ve heard “My family put the ‘D’ in dysfunctional” or “We have to use rent-a-cop at the Christmas Dinner”. Some focus on a specific event or situation of concern such as “I’m going through a divorce” or “I’m worried about a surgery”.
It’s also common to encounter a description of their difficulties from a social or competency standpoint. Common interpretations of their condition might be “I’m not running on all cylinders” or “My light’s gone out”.
One label is often used to describe all the above – the presence of years of stress, a mental health condition, social problems, and an impairment in their ability to function effectively in the home or community. The description for this condition is often “Bad Nerves”. “Bad Nerves” is patient’s diagnosis – a description of several impairments and/or problems that are generally more complicated than any single clinical issue such as a phobia or depression. The term “Bad Nerves” doesn’t suggest that the physical nerves, neurons, or nervous-system structure of the body is impaired. Shaking and tremors in the hands may be the most visual and observable symptom of “Bad Nerves” but the self-diagnosis suggests more than anxiety or tremors.
The term “Bad Nerves” is almost never used to describe situational depression, grief, or an emotional reaction to a specific stressor. Instead, the term “Bad Nerves” often suggests several different emotional, personal and social problems that have been active for many years. In some cases, it’s difficult to identify when “Bad Nerves” started or what stressful events are involved. In other cases, an incident in the past may be identified as the starting point, suggesting the Bad Nerves began after a divorce, work injury, death of a loved one, or other significant trauma.