Schools Division Office

LAGRO HIGH SCHOOL

MANIFESTATION OF NERVOUS BREAKDOWN

In partial fulfillment of the requirements for the subject

Presented by:

Alejandro, Erika O.

Barcelon, Angel Jhunicha H.

Donsol, Audrey B.

Perez, Shara Rayne S.

Siagan, Karl Gerard M.

Templonuevo, Regina Angelou R.

March 2020
 Chapter I

INTRODUCTION AND ITS BACKGROUND

This chapter encompasses the introduction and background of the Study as it

presents the researcher's purpose in conducting the study. It describes the statement of the

problem, its significance and contributions to the community. The definition of the terms

used will also be in this chapter. The researchers aim to give nothing but an information

regarding with the study.

Introduction

“You can do anything, but not everything,” as quoted by David Allen. The K-12

program began its implementation to equal the curriculum standard of foreign countries.

This is an added two year-curriculum that provides mastery of concept and skills, develop

lifelong learners, and preparation for entering tertiary level. This program offers a

different specializations that is divided onto three: Academic, Technical-Vocational

Livelihood, and Sports and Art. Academic Track includes three stands: Accountancy,

Business, and Management (ABM); Humanities and Social Sciences (HUMMS); and

Science, Technology, Engineering, Mathematics (STEM).

STEM students are focused on learning the subjects Mathematics and Science,

mainly. The STEM 11 students that will be a part of the study are the fourth (4th) batch of

Senior High School to graduate. According to National Alliance on Mental Illness

(NAMI), being a student is stressful, but trying to juggle school works and other

responsibilities while not having mental stability can make it even harder.
 Nowadays, students are faced with numerous responsibilities in various areas of

their lives. It is evident that they frequently suffer from symptoms of a nervous

breakdown. First of all, nervous breakdown is considered to be a mental health crisis

triggered by excessive stress and a poor or limited ability to cope with stress in healthy

ways. The primary signs of this mental health crisis among students are depression,

anxiety, mood swings, and declining performance at the educational facility. 

In addition, when students struggle from a nervous breakdown, they are more

likely to become addicted to alcohol and drugs. In order to prevent the development of a

nervous breakdown, it is vital to take appropriate measures from different sides, including

students themselves, their parents, teachers,

Based on Jennifer Huizen's article, nervous breakdown or commonly dated as

mental breakdown are terms used to describe the emotional or physical stress that makes

someone unable to function properly in a day-to-day life. Though before it was widely

known to be a part of mental illnesses but now medical community does not use the term

nervous breakdown as to describe specific medical condition anymore. Though it is not

anymore used to describe specific medical condition, nervous breakdown still remains as

a sign of underlying mental health condition, such as depression, anxiety, or post-

traumatic stress disorder or PTSD.

According to John M. Grohol, Psy.D., “nervous breakdown is not a condition to

be afraid of, as it is simply an indication of overwhelming stress and mental illness in a

persons' life.”
Background of the Study

Nervous breakdown not an illness, but a mental crisis and was also known as

nervous exhaustion, nervous collapse or neurasthenia. In the 1880s, the term was referred

to a specific medical disorder which was clearly a nervous illness and not a mental

illness. It was distinguished by pain weakness, migraine headaches and fatigue. This

condition was incorporated with the symptoms of depression. Including these symptoms:

despair, hopelessness, a sense of uselessness and the inability to take pleasure in every

aspect in their lives. Nervous breakdown closed the doors for men and women from their

prevailing lifestyle. During the period of having an intense mental distress people was

unable to function for their everyday life. It sometimes made people weak to get out of

bed for months at a time.

In the 1900s, it became part of the broader diagnostic category of neurosis, and

removed from medical usage. But the term ‘nervous breakdown’ is said to be popular as a

less stigmatized way to define a reducing temporary episode of mental illness. Nervous

breakdown is a combination of physical and emotional stress that was intolerable. It is

caused when stress is too much for the people to bear it. It made the people to work

ineffectively, this mental crisis is a risk for people who experienced it.

However, nervous breakdown is often being used to describe other mental crisis

like stress, pressure and other mental illness but it is different from those. Stress is a

physical, mental or emotional factor that causes bodily or mental tension, pressure is the

feeling of stressful urgency caused by the necessity of doing or achieving something,

especially with limited time. While other mental illness refers to a wide range of mental
health conditions- disorders that affect your mood, thinking and behavior. On the other

hand, nervous breakdown is caused by different types and amounts of stress that affects

people differently.

Statement of the Problem

This current study explores different factors that affects student's nervous

breakdown.

In general, the researchers aims to answer the following questions:

1. What is the demographic profile of the respondents in terms of:

1.1 Name: (Optional)

1.2 Sex

1.3 Age

2. What causes the nervous breakdown among the students?

3. What are the different ways of coping up of students with a nervous breakdown?

4. What could be the possible effects of nervous breakdown on them?

Scope and Delimitation

This study focuses on the nervous breakdown that the grade 11 STEM

students are experiencing. The aspects looked into were the academic factors that causes

mental breakdown, symptoms, student's ways of coping up and the possible effects of

suffering from nervous breakdown.

The main purpose of this research is to identify the common problems that the

students encounter and how this affects their behavior in their classes. This study will not
include the other aspects that are not related to nervous breakdown among students.

The data collection will be conducted to the total population of grade 11 STEM

students of Lagro High School who will represent the population. The study would be

done through the utilization of questionnaire to the students as a survey and reference.

This study focuses only to the five (5) students that the researchers have as respondents.

The data gathered are from the interview that the researchers conducted.

The researchers believe that the topic is appropriate, relevant and timely. This

kind of study gives answers to questions about the certain problems experienced by the

students. The interview will be done by the first week of March 2020.

Significance of the Study

The findings of this study will redound to the benefit of society considering that

students are suffering from mental breakdown. This will also broaden the knowledge and

understanding of the readers to this specific mental crisis. Benefitting the study are the

various sectors as follows:

Students. This research will give the students more insight on the causes, effects

and coping mechanisms if and when experiencing nervous breakdown.

Parents. This research will enlighten the parents on how their children are

feeling, the pressure they are in and will help them understand and help their children for

things to get better for the students and have someone they can count on during a nervous

breakdown.

Teachers. This refers to the teachers who took years of studying to be able to

teach students everything they need to know moving forward to higher level of education.
This research aims to inform them on the real situations of students and how they can

help them.

Institution. The study will inform the institutions about the mental instability of

students and the academic factors that causes it for the institution to help the students

lessen the factors affecting their mental crisis.

Future Researchers. This will inspire future researchers to delve deeper into the

topic that will aim to help more students be aware of what they are going through for

them to be better at handling nervous breakdowns.

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter of the research presents the literature and studies related to the

current research being conducted. The chapter presents the synthesis of found related

studies, articles, journals, and many more that will help to fully understand the topic. This

also gives comprehensible information that aims to broaden the knowledge of the said

study.

Local Literature

Tomacruz (2018) stated that Commentaries from various journalistic publications

in the Philippines argue that destructive exhibitions of social and mental problems among

the youth can be accredited to both social and academic factors, and that addressing these

problems requires a holistic approach coming from various social institutions such as the

family, the school and policy-making bodies.

Pachucki, Ozer, Barrat, and Cattuto (2015) suggest that the structure

interaction networks of adolescents influence the robustness of depressive symptoms.

Moreover, students who have low perceived quality of support were more likely to

experience mental health difficulties to which students are involved with both curricular

and extra-curricular activities is also indicative of their psychological well-being and

distress as seen in qualitative (Buckley & Lee, 2018) and quantitative studies (Billingsley
& Hurd, 2019; Lushington et al., 2015). Various social, developmental and academic

challenges offered by the school shape the minds of these late adolescents as they strive

towards the attainment of their respective degrees and better life conditions during early

adulthood.

Based on the study of Mazo (2015) entitled, “Causes, Effects of Stress, and the

Coping Mechanism of the Bachelor of Science in Information Technology Students in A

Philippine University” this study sought to determine the causes of stress, the effects of

stress, and the stress coping mechanisms of Bachelor of Science in Information.

Technology students in the Leyte Normal University, Tacloban City. It tested some

assumptions using the descriptive survey method with 51 respondents. Thesis

writing/research and school requirements/projects were the most common causes of

stress. Sleepless nights and irritable/moody feeling were the common effects of stress.

There was disparity on the causes and effects of stress between the male and female

respondents. There was an observed disparity between the male and female responses.

Local Study

Based on the study of Maria Teresa Tuliao R. (2015) : A qualitative study on the

stigma experienced by people with mental health problems and epilepsy in the

Philippines "Nervous Breakdown nowadays is very rampant, suicide cases rising among

youths" (2015)

Manifestation that triggers Mental Breakdown of Students in Ilo-Ilo National High

School Findings suggest that students suffer from more health-related complaints than
their non-studying peers (Iraga et al., 2014). According to research on health problems

among Filipino students, a significant amount of students does not seek professional help

for their health-related problems. These results are in conflict with the common

knowledge that young and educated people would benefit from a significantly better

health status compared to non-studying peers (Bunag et al., 2016).

Based on the study of Marjorie Quiballan (2015) : The Relationship between Mental

Health and Academic Achievement among Senior High Students The reason why senior

students experienced higher level of depression was due to increased workload or

assignments during final year of studies. Similarly, a study conducted by Bucsit et al,

(2014) also found out that 41.9 % of students in a public institution in Philippines were

faced with depression problem. Depression among adolescents should not be

underestimated.

According to Advincula (2014), stress is physics word which refers to the amount of force used

on an object and it relates in real life as to how certain issues that carry force applied to human

life. Examples financial difficulties, health challenge issues, conflicts with friends, all carry force

or pressure on person's body -mind and spirit. Some of the pressure or force originate from the

environment but most often comes from within a person's head in the form of worry, anxiousness,

regret, discouragement and low confidence.

Foreign Literature

According to John Smurch (2016) .In the past decades, the relationship between

work and mental health has changed enormously. There is a worldwide increase in the

experience of stress in the workplace for a range of reasons, including structural changes,

changing work contexts, the shift to more knowledge-based work and the continuous
introduction of new technology (van der Klink,2015). Western societies have changed

from industrial to service economies, which implies that the work of most of the working

population is no longer physical but mental. Meanwhile, workers started to perceive work

as an important contributor to quality of life, in which ambitions can be fulfilled.

Worldwide, common mental health problems in workers, such as adjustment disorders,

depression and anxiety, may affect functioning and often lead to reduced productivity at

work and sick leave (Wang et al., 20016; Lerner & Henke, 2018). As the work content

and the perception of work have changed, a new type of support was sought by students

from professionals in occupational health care. Nowadays, workers need tools to cope

with mental aspects of and in work, besides protection from riskful physical work

demands. Therefore, specific interventions need to be initiated in occupational health care

of workers on sick leave due to common mental health problems. Primary and secondary

care usually focused on recovery of symptoms instead of return to work (RTW). The

general practitioner (GP) and the occupational physician (OP) often lack time and skills

to optimally deal with these workers, resulting in a minimal approach (Anema et al.,

2016; Nieuwenhuijsen, 2014). As an alternative, ways have been sought to encourage

OPs to play a more active role. In 2000, the Dutch Society of Occupational Medicine

(NVAB) published a new practice guideline, which promotes a more active role of the OP

facilitating RTW of the worker, instead of a minimal role. The focus of this thesis will be

the evaluation of this practice guideline entitled ‘The management by OPs of workers

with common mental health problems’. Aim of this thesis is to contribute to quality

improvement of occupational health care for these workers. This chapter started with a

case description of a worker with mental health problems. From here, the introduction
continues with an explanation of the main concepts used in this thesis, followed by a

description of recent developments in (Dutch) occupational health care. Specifically, the

role of the OP is explained in the context of the guideline on the management of workers

with mental health problems. The elements of the guideline for the OP can be placed in a

widely accepted conceptual model that serves as theoretical framework for this thesis.

According to this framework, the objectives and outline of this thesis are

described.Common mental health problems, or common mental disorders, reflect a broad

term that applies to conditions ranging from experiencing stress symptoms to severe

psychiatric disorders, such as psychosis. In working populations, the following common

mental disorders constitute the majority of mental health problems: adjustment disorder

(stress-related disorder), depression, and anxiety disorder. Adjustment disorder is an

accepted diagnosis in DSM-IV and ICD-10, and refers to a maladaptive reaction to an

identifiable stressor, occurring within a short time after onset of the stressor (APA, 1994;

WHO, 1992; van der Klink & van Dijk, 2017). Such a reaction is characterized by

depressive symptoms, anxiety, and/or inappropriate behaviour. Stressors may be related

to work or family life. Although generally considered as minor psychiatry, adjustment

disorders may have extensive disabling consequences. Most patients with an adjustment

disorder recover within two to six months, even when no specific guidance or therapy is

given, but there is a considerable risk of prolonged disability. In occupational settings,

this diagnosis can be applied to many overlapping stress-related concepts and diagnoses,

such as neurasthenia, nervous breakdown, burnout, and surenage. These concepts and

diagnoses have distress symptoms and malfunctioning in one or more social roles in

common (van der Klink, 2015).Depressive and anxiety symptoms are terms to describe
minor, and usually mixed, syndromes often seen in primary care, as well as major

conditions classified by the DSM-IV (APA, 2015). Common mental disorders do not only

share a high incidence, they also show communality of symptoms. While adjustment

disorders are often accompanied by depressive and anxiety symptoms, anxiety and

depressive disorders in terms of the DSM-IV classification are considered more severe.

This notion is reflected by the DSM-IV criteria, which state that an adjustment disorder

diagnosis is not allowed if the severity and duration threshold for anxiety or depressive

disorder are reached (APA,). In these more severe mental disorders, an individual's

vulnerability plays a dominant role, which is relatively independent of the interaction

with the environment. There is a gradual transition from adjustment or stress-related

disorders that are fully determined by the interaction between individual and a demanding

environment up to more severe mental disorders, such as depression and anxiety disorder,

which are determined by other factors as well. Factors that constitute a risk for more

severe disorders are a hereditary vulnerability, a developmental vulnerability, less

adequate coping styles, stressors on several domains of life, a quantitative or qualitative

lack of social support, and physical co- morbidity (van der Klink, 2017). This thesis

concerns all common mental disorders mentioned above, as they prevail in the

occupational health care setting. In 2016, a study by Schröer clarified that the existing

style of guidance by OPs on common mental health problems was ineffective. In 2014,

Terluin published a study on 'surménage', which is French for mental overload or

nervous breakdown. Surmenage is a diagnosis commonly used by GPs and OPs to denote

a maladaptive response to psychological stress in everyday life. This diagnostic concept,

closely related to the DSM diagnosis Adjustment Disorder, reflected problems that could
be handled in primary care (Terluin, 1994). At the same time, van der Klink et al. (2016)

published a handbook for Ops on guidance for mental disorders related to work. An

activating policy was recommended, aimed at both the individual worker and the work

environment. These studies represent a change in attitude from a passive, reactive, non-

directive style of guidance to a more activating, proactive, therapeutic style. In the early

1990s, the role of OPs regarding sick leave and work disability was seen as

predominantly supporting the RTW of the patient from the moment that a more or less

stable state of recovery was established. In the years thereafter, the profession aimed to

change the recovery process itself in cases of stagnation, prompted by the high risk of

disability. Inspired by the Individual Placement and Support model in the vocational

rehabilitation for people with severe mental illnesses (Bond et al., 2018; Michon, 20`6),

activation became the key concept, based on cognitive behavioral principles and graded

activity (van der Klink, 2015).

According to Van der Klink (2016), an individual experiences a lack of control in

his or her direct interaction with actual features of the environment. An adjustment

disorder may result in depression or anxiety disorders, if the instigating crisis remains

unsolved. Therefore, he argued that minimal interventions should focus on the stress-

related component, and enhance problem-solving capacities for workers to cope with

regular problems in work. In this manner, adequate and early guidance of individuals

with adjustment disorders could prevent the development of more serious

psychopathology. In addition, enduring sick leave in itself has secondary consequences

that are potentially harmful: loss of daily structure, diminished social contacts, and

deterioration of self-esteem. Graded activity may be an important element that can help
individuals RTW, as it signifies that individuals resume work partially, in order to enable

full RTW (Blonk et al., 2016). Partial RTW can be viewed as a type of gradual exposure

to the work situation. This type of exposure may promote full RTW through various

mechanisms. By gradual work resumption, experiences of success may be fostered. That

is, by performing the tasks that one is able to, individuals may acquire a sense of self-

efficacy and control (Bandura & Adams, 2017). Exposure to work may also provide

experiences that challenge dysfunctional beliefs (Tryon, 2015). Partial RTW might also

help to establish a daily working rhythm, it may offer distraction, and it may promote

commitment towards one’s work and colleagues. The importance of gradual work

resumption is also advocated in the literature with respect to physical injury (Briand et

al., 2017; Durand & Loisel, 2014).

Gradual work resumption can be established by steps such as the implementation of

worksite accommodations, temporarily assignment to alternative job tasks, and gradual

increase of the worker’s hours or involvement in performance Gradual work resumption

can be established by steps such as the implementation of worksite accommodations,

temporarily assignment to alternative job tasks, and gradual increase of the worker’s

hours or involvement in performing increasingly demanding job

tasks (Franche et al., 2016, Shrey, 2015). Until recently, OPs did not have the tools for

such specific interventions. In the past it was not even considered a legitimate role for

OPs to initiate therapeutic interventions, even though they were in a favorable position to

do so. GPs were expected to initiate therapy, but were in a less advantageous position

with regard to knowledge of the patient's work and work situation. The last decade,

mental ill workers have been referred frequently to specialized psychological care. As the
focus of mental health specialists has been mostly symptom-based, instead of work-

based, workers may not get the optimal care they need and productivity loss may be

higher than necessary. As an alternative, ways have been sought to encourage OPs to play

a more active intervening role

According to Poh Keong,Pua, Chee Sern,Lai,Ming Foong and Che Ibrahim in

their literature review, The Relationship between Mental Health and Academic

Achievement among Students is that mental health issues often occur among students and

create a negative impact on students.

According to Sidi and Shaharom (2002), stress is a part of human life since time

without realizing it,therefore, the phenomenon is something unavoidable and it depends

on the person to manage or handle stress well. Mental health is defined by World Health

Organization(WHO) (2004,10) as: …a state of well-being in which the individual realizes

his or her own abilities, can cope with the normal stresses of life, can work productively

and fruitfully, and is able to make a contribution to his or her community. Understanding

mental health in the research environment A Rapid Evidence Assessment Susan Guthrie,

Catherine Lichten, Janna van Belle, Sarah Ball, Anna Knack, Joanna Hofman There is no

textbook experience, as Dr David Bell, consultant psychiatrist and psychotherapist at the

Tavistock Centre, confirms. 'Breakdown is a general term that people use to describe a

very, very wide variety of experiences.' Still, he feels it is an 'appropriate' word. 'It

captures something of the experience,' he says. Despite the fact that, as Dr Massimo

Riccio, consultant psychiatrist and medical director of The Priory in Roehampton, points

out: 'There isn't really any such thing in medical terms - saying someone has had a

breakdown means everything and nothing, and we need a lot more information to fine-
tune a diagnosis and make it manageable.'

According to Gordon Parker in the American Journal of Psychiatry called "The

Mechanics of a 'Breakdown'." , He traces the origin of the phrase to the late 19th century,

then delves into the (surprising substantial) literature examining what people seem to

mean when they refer to a "nervous breakdown." Parker finds that the phrase broadly

correlates to what clinicians would call "adjustment disorder," a broad diagnosis applied

to patients who suffer emotional or behavioral symptoms in the wake of identifiable

stress. What's consistent in the use of the word "breakdown" is that it refers to an acute

condition -- something that comes upon a person at an identifiable moment, and does not

persist indefinitely. Parker himself suggests that the idea of a "breakdown" is similar to

the effects of melancholia, a severe form of depression often characterized by anergia, or

overwhelming listlessness: I continue to be struck by how often those with melancholia

describe a physical state of "mechanical failure." Their descriptors include "an inability to

get out of bed to wash" and feeling as if "walking through thick sand weighed down by a

dozen wet blankets."

Foreign Study

A study conducted by Nasab, Azami Rezaee & Bostani, Mehdi (2014) : A Study

of the Relation between Mental health and Academic Performance of Students of the

Islamic Azad University Ahvaz Branch stated that “the findings of this research, it can be

concluded that the higher the mental health of the students, the better their educational

performance, although it seems that the students’ educational performance is also affected

by other factors and their interactional effects as well.” The results from this research
study showed that general health and some of its components, such as depression and

anxiety, had a significant relation with educational performance, while no significant

relation was observed between Academic performance and other components such as

physical symptoms and social performance disorders.

Based on the study of Thalappilillil Matthew Celine and Jimmy Anthony

(2014) : A Study on Mental Disorders: 5 years Retrospective Study stated that “Most

cases were occurred in the age group of 30-40 years. Mental disorder was more among

Females than Males in 0-29 years and less than equal 60 years, but in 30-59 years males

were more.”

Paola Pedrelli, et. al. (2014) suggests “mental health problems are outlined, such

as the importance of including parents in the treatment, communicating with other

providers, and employing of technology to increase adherence. It is concluded that, by

becoming familiar with the unique problems characteristic of the developmental stage

and environment college students are in, practitioners will be able to better serve them. “

Shantini Thuraiselvam (2015) stated that “mental health problem has become

the most common and significant problem among the student population compared with

general population. Bowyer (2012) suggests that study work-load consists of the time

needed for contact and independent study.” in her research entitled Factors That Affect

Student's Mental Health: A Study at Taylor's University School of Hospitality, Tourism

and Culinary Arts Final Year Student.

RESEARCH DESIGN AND METHOD

This chapter presents the methods to be used in the study. The outline of this

chapter as is: research design, the instruments used, sampling technique, research locale

and the procedure of data gathering to be utilized in the study. As the researchers have

chosen a qualitative, case study approach for this study, these concepts are described in

detail.

RESEARCH DESIGN

The study is a qualitative research wherein the method ployed is case study. Case

study according to Yin (1994) it is “an empirical inquiry that investigates a contemporary

phenomenon within its real-life context, especially when the boundaries between the

phenomenon and context are not clearly evidential and relies on multiple sources of

evidence. The researchers used case study to gather information or background data about

the respondents’ experiences or life.

The researchers used case study for it is a process or record of research in which

detailed consideration is given to the development of a particular person, group or

breakdown is a situation that can be further studied through this research design.

RESEARCH INSTRUMENTATION

A semi-formal interview was the main tool in gathering the needed data. The

chosen instrument will be used in the collection of data to test the validity and reliability

of the research study being conducted. Interviews will be used to meet face-to-face

individuals to interact and generate ideas coming from the students having the said

mental crisis. It is an interaction in which oral questions are posed by the interviewer to

get and produce oral response form the interviewee.

The researchers have to identify a potential source of information, and structure

the interaction in a manner that will bring out relevant information from the respondents.

The questions that will be given are medically-reviewed by experts and will help satisfy

the statement of the problem and will help reach a certain conclusion regarding the study.

SAMPLING TECHNIQUE

The researchers used purposive sampling technique, a form of non-probability

sampling where respondents are chosen by the researchers based on their correlation with

the study. The main goal of purposive sampling is to focus on particular characteristics of

a population that are of interest, which will best enable the researchers to gather the

needed data for the study.

It is easy for the researchers to gather data and will be able to come up with

conclusions easily using purposive sampling technique because the respondents have
experienced the focus of the study.

RESEARCH LOCALE

The study was conducted at Lagro Senior High School Library located at

Ascencion Ave. cor, Misa De Gallo St. Lagro Subdivision wherein it is close to both the

respondents and researchers. Thus, time will not be a hinder on conducting the said

interview with the chosen respondents.

DATA GATHERING

The researchers will have to issue a permit or a letter of consent for

Respondents cooperation in conducting the study. Then, a schedule will be set depending

on the availability of both the researchers and respondents. And will have to administer

an interview in a private venue wherein the respondents' profile are to be kept

confidential.