Technology Bay

Lindsay Lohan drinks too much, Michael Jackson was allegedly addicted to painkillers, and Keira Knightley and Jennifer Aniston smoke—in real life and in movies. Sure, we’re used to celebrities exhibiting self-destructive behaviors, and most of us are too wise to light up or down a bottle of tequila because our favorite stars do. But all too often, famous folks engage in “healthful” or seemingly benign practices that could actually jeopardize the health of those who do follow their lead. Examples:

1. Lady Gaga and “circle” contact lenses. The use of cosmetic contact lenses that extend beyond the iris giving the appearance of larger eyes has come into fashion, thanks to Lady Gaga, who displayed the look in her “Bad Romance” music video. But these drugstore circle lenses—which come in various colors like violet and teal—can cause a host of eye problems. The American Academy of Opthamalogy issued a warning on Wednesday against the lenses stating that “inflammation and pain can occur from improperly fitted, over-the-counter lenses and lead to more serious problems, including corneal abrasions and blinding infections.” Though illegal in the U.S., they’re still widely available for purchase over the internet, if you don’t mind putting your vision at risk.

2. Suzanne Somers and bioidentical hormones. After being diagnosed with breast cancer, Somers declined conventional treatments like chemotherapy and tamoxifen. And she continued to take “bioidentical” hormones (identical in structure to what’s naturally made by the body) like estrogen despite the fact that oncologists routinely tell breast cancer patients to stay away from estrogen, since it can fuel the growth of the most common kind of tumor. Somers extolled the health benefits of bioidentical hormones for lifelong disease prevention on Oprah, much to the chagrin of many medical professionals. For example, Susan Love, a breast cancer surgeon and author of Dr. Susan Love’s Breast Book, said Somers is taking a “crazy” approach to breast cancer prevention. Somers herself admitted her practices were controversial. “[My doctor] told me I could die, but here I am eight years later doing just fine,” Somers told U.S. News in an interview last year to promote her book on the subject.

3. Baseball players and “performance enhancing” drugs. Baseball fans were devastated to learn that many of their favorite players, including Cy Young, award-winning pitcher Roger Clemens, and home run slugger Barry Bonds, were named as steroid users in the Mitchell Commission report issued in 2007. Perhaps most upset were the parents of teen athletes who had to then figure out how to keep their own kids off steroids after witnessing their role models breaking records on them.

4. Kardashian sisters and QuickTrim. The reality show stars, Kim and Khloe Kardashian, are paid to endorse QuickTrim diet products, which contain potentially harmful herbal diuretics and laxatives, according to Adriane Fugh-Berman, a physician and associate professor of complementary and alternative medicine at Georgetown University Medical Center. After analyzing the products’ content for U.S. News, she concluded, “I don’t think anyone should take these products.”

5. Heidi Montag and plastic surgery. The star of the reality show, The Hills, increased her fame quotient by undergoing 10 cosmetic procedures in one day including a nose job, mini browlift, Botox, liposuction, and buttocks and breast augmentation. Richard Chafoo, chief of plastic surgery at Scripps Memorial Hospital in Encinitas, Calif., criticized the multiple surgeries, which took 10 hours to perform, as excessive and risky. There’s no reason, he added, that a 23-year-old like Montag, untouched by the ravages of aging, would need so many procedures.

Grade schoolers and young adults who play lots of video games are more likely to have ADHD or other attention problems, according to new research in Pediatrics. Does that mean it’s time to yank the game controller? Maybe, maybe not. Here’s why.
 
There’s plenty of data showing that TV time doesn’t help young children, and may be distracting them from what they really should be doing–which is playing and interacting with people. A few studies show that preschoolers who watch lots of TV are more likely to have ADHD, but cause and effect hasn’t been proven. (It could be, for example, that kids who have short attention spans are more drawn to TV than others.) Although some studies have explored the link between violent TV shows and aggressive behavior, there’s been very little research on video games and ADHD, surprising because every teenage boy I know seems to be glued to games like “Grand Theft Auto” and “Halo.”

So a team led by researchers at Iowa State University looked at how video games affect attention and ADHD. They found that both children (most of the 1,323 kids surveyed were ages 8 to 11) and young adults (most of the 210 polled were between 18 and 24) had more attention problems if they played more video games. The same was true if they watched more TV. The children who exceeded the two hours of daily screen time recommended by the American Academy of Pediatrics were more likely to have attention problems. 
 
Again, this study doesn’t prove that TV and video games cause ADHD. The researchers did try to tease that out by checking on the school-aged children’s attention problems 13 months later. Children who had clocked the most screen time during the previous year were most likely to have attention problems, they found. But enough studies have found this correlation that parents of kids with heavy TV and video-game habits might want to think twice.
 
So what’s a parent to do? Here are three simple steps to help reduce the negative exposure of TV and video games on children, based on interviews with researchers:

• Adopt the two-hour-a-day limit on screen time from the American Academy of Pediatrics as the daily maximum dose, not the baseline. Many parents make weekdays TV-free; others reward good behavior with a small dose of video games. Treat screen time as a privilege, not a right.
• Consider the content of what your kids are watching. Many video games and TV shows are violent and sexually explicit, even shows on broadcast TV. There is plenty of evidence that these shows have a bad influence on children’s behavior and self image.
• Play the games your children play, and watch their shows. Not only will you then be well-equipped to make decisions on whether the content is appropriate, you can discuss it with them. Diane Levin, coauthor of So Sexy So Soon, told me that explaining to your children why you are bothered by sex and violence on TV not only helps them understand why you’re imposing rules, it helps them learn how to set limits of their own, and explain such limits to their friends.

Marijuana as medicine is nothing new, despite the current groundswell of laws making pot legal for medical uses. Here’s a quick fact file on cannabis and its medical history, makeup, and legality.

1. “Marijuana” is a Mexican term that originally was applied to low-quality tobacco.
2. The plant was cultivated in China for therapy (and recreation) over 4,700 years ago.
3. More than 20 prescription medicines containing marijuana were sold in U.S. pharmacies at the turn of the 20th century. Pot-based medications were commonly available until 1942, when cannabis was stricken from the U.S. Pharmacopeia, the official compendium of drugs considered effective. From 1937 to 1942 the federal government collected a tax of $1 per ounce for such drugs.
4. About 17,000 studies on marijuana and its components have been published, according to the National Organization for the Reform of Marijuana Laws, an advocacy group, but fewer than 20, all of them small, have included human subjects.
5. The federal government is in the pot-growing business. Under a federal contract, the University of Mississippi in Oxford cultivates marijuana for use by researchers, who have to be cleared by the National Institute on Drug Abuse.
6. The plant has nearly 500 chemical compounds, called cannabinoids.
7. Fourteen states and the District of Columbia have legalized medical marijuana: Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington. But patients in these states face federal prosecution for using it—or for growing or possessing pot for medical purposes.
8. Federal law prohibits physicians from prescribing or otherwise actively supplying patients with the drug. But in 2002 the U.S. Supreme Court backed an appellate court ruling that physicians who discuss it with patients, or provide oral or written recommendations, are protected.

We all know that exercise is good for our health. However, have you imagined that exercise could improve your mind? “Exercise is the single best thing you can do for your brain in terms of mood, memory, and learning,” says Harvard Medical School psychiatrist John Ratey, author of the book, Spark: The Revolutionary New Science of Exercise and the Brain. “Even 10 minutes of activity changes your brain.” If you need a little extra incentive to lace up those sneakers, here are five ways that exercise can enhance your brainpower:

1. It reverses the detrimental effects of stress. Jumping on the treadmill or cross trainer for 30 minutes can be an instant way to blow off tension by boosting levels of “soothing” brain chemicals like serotonin, dopamine, and norepinephrine. What’s fascinating, though, is that exercise may actually work on a cellular level to reverse stress’s toll on our aging process, according to a June study from the University of California at San Francisco. The researchers found that stressed-out women who exercised vigorously for an average of 45 minutes over a three-day period had cells that showed fewer signs of aging compared to women who were stressed and not active. Working out also helps keep us from ruminating “by altering blood flow to those areas in the brain involved in triggering us to relive these stressful thoughts again and again,” says study coauthor Elissa Epel, an associate professor of psychiatry at UCSF.

2. It lifts depression. Research suggests that burning off 350 calories three times a week through sustained, sweat-inducing activity can reduce symptoms of depression about as effectively as antidepressants. That may be because exercise has been found to stimulate the growth of neurons in certain brain regions damaged during depression. What’s more, animal studies have found that getting active boosts the production of brain molecules that improve connections between nerve cells, thereby acting as a natural antidepressant.

3. It improves learning. Exercise increases the level of brain chemicals called growth factors that help make new brain cells and establish new connections between brain cells to help us learn. Interestingly, complicated activities, like playing tennis or taking a dance class, provide the biggest brain boost. “You’re challenging your brain even more when you have to think about coordination,” explains Ratey. “Like muscles, you have to stress your brain cells to get them to grow.” Complicated activities also improve our capacity to learn by enhancing our attention and concentration skills, according to German researchers who found that high school students scored better on high-attention tasks after doing 10 minutes of a complicated fitness routine compared to 10 minutes of regular activity. (Those who hadn’t exercised at all scored the worst.)

4. It builds self-esteem and improves body image. You don’t need to radically change your body shape to get a confidence surge from exercise. Studies suggest that simply seeing fitness improvements, like running a faster mile or lifting more weight than before, can improve your self-esteem and body image.

5. It leaves you feeling euphoric. Yes, that “runner’s high” really does exist if you’re willing to shift into high-intensity mode. Ratey recommends sprint bursts through interval training. Run, bike, or swim as fast as you can for 30 to 40 seconds and then reduce your speed to a gentle pace for five minutes before sprinting again. Repeat four times for a total of five sprints. “You’ll feel really sparkly for the rest of the day.”

Parents are really worried about childhood vaccine safety, but the public-health community doesn’t seem to get it. A new survey reveals that 54 percent of parents are concerned about the adverse effects of vaccines, and 25 percent think some vaccines cause autism in healthy children. Yet just last week, the federal government vaccine advisory board called for all Americans 6 months and older to get flu shots next fall, including the vaccine against the H1N1 flu strain. If the goal is to protect the public’s health, you’d think the feds would first want to address the fact that a big chunk of parents think vaccines aren’t safe.

The vast majority of parents do have their children vaccinated against childhood diseases; 88 percent of the 1,552 parents polled in the January 2009 survey just published in Pediatrics said they follow their doctor’s recommendation for childhood vaccines. But 11.5 percent said they’d refused at least one vaccine for their children. Here are some more numbers:

*90 percent of parents said that getting vaccines is a good way to protect their children from disease.

*88 percent of parents said they generally follow doctors’ recommendations on childhood vaccines.

*54 percent of parents said they are concerned about serious adverse effects of vaccines.

*31 percent said parents should have the right to refuse required childhood vaccines for any reason.

*25 percent said some vaccines cause autism in healthy children.

*11 percent think their children do not need vaccines for diseases that are not common anymore. 

The vaccine most often refused is the new HPV vaccine against a virus that causes cervical cancer. Fifty-six percent of the parents said they had refused that shot for a child. When asked why, parents said it was because there has not been enough research on this vaccine (78 percent); that the vaccine has not been on the market long enough (75 percent); that “my children are at low risk for this disease” (59 percent); and that “the risk for adverse effects from this vaccine is too great” (59 percent). The HPV vaccine was approved in 2006, and it protects against a sexually transmitted virus, so it makes sense that parents of young girls are willing to wait a few years for more information. Contrast that with the reasons parents gave for refusing the MMR (measles, mumps, and rubella) vaccine. Parents’ concerns were not with how long the MMR has been used (the three vaccines were approved in the 1960s) but rather, “I have read or heard about problems with this vaccine”. 

Actually, there aren’t many problems with the MMR vaccine. Before it was introduced, about 450 children a year died from measles, and 20,000 were born blind, deaf, or retarded from rubella infections. The vaccine all but eliminated these diseases as childhood health risks, and serious side effects are very rare. What those parents have been hearing, of course, is the widespread coverage of the controversy surrounding a 1998 paper by British scientist Andrew Wakefield correlating MMR vaccines with autism. The paper, which surveyed 12 children, was retracted last month by the journal the Lancet for falsified data and unscientific methods. With the Wakefield study discredited, there is no evidence that vaccines cause autism. In the past decade, large, well-conducted studies have found no link between autism and the MMR or other vaccines. Still, as this new survey shows, many parents think that vaccines aren’t safe. Increasingly, that means they also aren’t getting their children vaccinated against diseases like measles, mumps, and rubella that can kill or maim their children. 

The pediatricians and public-health officials aren’t clueless; as the authors of the Pediatrics study note, “Officials must attempt to develop more effective and targeted education campaigns that focus directly on this issue if their goal is to match parents’ level of concern with the available scientific evidence.” But so far, those efforts don’t seem to have gone much beyond one message: “Science says vaccines are safe.” 

That science-says message is clearly no longer working for many parents. If doctors and public-health officials want to use the power of vaccines to protect children’s health, they’re going to have to first figure out how to effectively respond to parents’ fears.

All kinds of pain such as back pain, headache and knee pain, to jaw and neck pain, chronic pain disrupts people’s lives, resulting in doctor’s visits and missed work or school days. One common cause of chronic pain is fibromyalgia, a condition that affects an estimated 5 million Americans.

It causes widespread pain and fatigue and is often tied to other health problems, such as irritable bowel syndrome and depression. But the condition is controversial, partly because of the way it’s been diagnosed until now—using a tender point exam, in which a doctor applies pressure to 18 points on the body and diagnoses fibromyalgia if the patient reports pain in at least 11 of those points.

A new method offers an easier way to diagnose fibromyalgia, using questions that put more emphasis on cognitive problems and other symptoms common in those with the condition. It doesn’t require doctors to perform a physical or administer a tender point exam. The new set of questions is expected to result in more fibromyalgia diagnoses because the tender point exam, used for the last 20 years, may have missed many men with fibromyalgia, since they tend to be less sensitive to the pain than women. The American College of Rheumatology, which had previously endorsed the tender point exam, has preliminarily accepted the new method as a diagnostic tool for fibromyalgia pending further research.

Do you think you may have fibromyalgia? These questions can help you find out. Keep in mind that fibromyalgia must be diagnosed by a doctor, so even if you think you have symptoms, see a medical professional to be sure, says Robert Katz, coauthor of a study describing the new method, published in May’s Arthritis Care & Research.

• Do you have widespread pain? Specifically, determine if the pain is located in seven or more of the following areas: shoulders, upper arms, lower arms, hips, upper legs, lower legs, jaw, chest, neck, or abdomen. (Please note that if you have pain on both sides of the body—say, in both your left and right upper arms—each arm would count separately.)
• Do you experience any other fibromyalgia symptoms, such as irritable bowel syndrome, fatigue, problems thinking or remembering, muscle weakness, abdominal pain or cramping, numbness or tingling, dizziness, insomnia, depression, constipation, nausea, nervousness, chest pain, fever, dry mouth, itching, frequent or painful urination, or wheezing?
• Have your symptoms been present for at least three months?
• Do you have another medical disorder that may otherwise explain the pain?

If you answer yes to the first three questions and no to the last one, you may have fibromyalgia. Follow-up with your doctor for a full assessment.

There are almost 2.5 million infants are admitted to the hospital each year due to infections, and if children up to age 5 are included, the number of infection-caused hospitalizations soars to 4.5 million annually, according to a recent report. Luckily, most serious infections are preventable, experts say.

Vaccines have helped to dramatically reduce the numbers. Simpler measures, such as soap and water, are also tremendously effective at removing even scary bugs like methicillin-resistant Staphylococcus aureus, or MRSA. To protect your child from a surprise hospital stay, watch out for the pathogens most often responsible for pediatric admissions:

Rotavirus
Just a few years ago this severe diarrhea and dehydration-causing virus was a real menace, landing more than 50,000 infants and young children in U.S. hospitals annually, according to the Centers for Disease Control and Prevention. Since 2006, however, hospitalizations have dropped by 45 percent, thanks largely to the arrival of two vaccines—RotaTeq and Rotarix—and the agency’s Advisory Committee on Immunization Practices’ recommendation that children be immunized. After helping cripple the virus’s threat, Rotarix hit its own snag in March when bits of pig virus unexpectedly showed up in the vaccine, prompting the Food and Drug Administration to advise suspending its use. In May, however, the agency deemed the vaccine safe and gave doctors the go-ahead to again administer Rotarix, which is given orally in two doses versus RotaTeq’s three. Alas, vaccinated kids can still catch the virus. But those who do usually have a much milder infection than unvaccinated children, says Robert Baltimore, a professor of infectious and bacterial diseases at Yale University School of Medicine. The vaccines are recommended for babies between 2 and 6 months old.

Streptococcus pneumoniae
This bug, which can lead to life-threatening meningitis and deafness, is the most common bacterial cause of pneumonia. But pneumococcal infections have become a lesser danger among children in the U.S. since 2000, when vaccination with the Prevnar or PCV7 vaccine became routine. After its introduction, severe pneumococcal diseases in children younger than 5 fell by 80 percent, according to the CDC. The vaccine protects against seven types of S. pneumoniae, while more than 90 so-called serotypes exist. In Feburary, the ACIP recommended the use of a new vaccine instead, named Prevnar 13, that children under age 2 should receive in four doses. PCV13 protects against an antibiotic-resistant form of the bacteria as well as 12 other serotypes. If a child has a fever, cough, and noisy, labored, or rapid breathing, pneumonia—an infection of the lung—may be the culprit.

H1N1 “Swine Flu”
Since April 2009 when experts first identified an H1N1 outbreak, the virus has killed an estimated 1,300 children and adolescents. Young kids are particularly vulnerable, with the highest rates of U.S. hospitalizations for H1N1 being reported in children under age 4. As with regular flu, symptoms include fever, cough, and runny nose. But infants may have no respiratory signs of the virus, according to the federal government’s flu.gov website. Although swine flu had a milder impact than expected last year, experts have recommended that everyone older than 6 months get vaccinated ahead of the upcoming flu season. The 2010-11 seasonal flu vaccine is expected to cover both seasonal flu and H1N1, while last year’s came in two separate vaccines. Count on H1N1 to continue making headlines in months ahead, says Baltimore.

RSV
Nearly all infants and toddlers will be exposed to respiratory syncytial virus, or RSV, and can even catch the bug from a parent, who may mistake their own RSV infection for a common cold. The risk of RSV infection is smaller in young healthy children, but in infants and premature newborns, RSV can be serious and may lead to pneumonia. The virus is responsible for killing as many as 200,000 children worldwide, and hospitalizing anywhere between 75,000 and 125,000 infants in the U.S. annually, according to the CDC. No RSV vaccine exists. As a preventive measure, high-risk infants are typically given an antibody shot against it.

MRSA
Methicillin-resistant Staphylococcus aureus infection has led to nearly 30,000 child hospitalizations in the last decade, according to data from just over two dozen children’s hospitals newly published in the journal Pediatrics. MRSA cases in kids leapt from 2 in every 1,000 hospital admissions in 1999 to 21 in 2008, researchers reported. What has experts especially concerned is that the so-called superbug, which causes pneumonia and bone and joint infections, is being acquired in the community, not in the hospital as it has in years past. What’s more, this breed of MRSA, which survives on surfaces as well as on hands, is genetically different than hospital-acquired MRSA and can cause severe, even lethal infections in otherwise healthy children. The majority of MRSA skin infections—unsightly red bumps or boils—can be treated, however, without hospitalization, says Baltimore. The bacteria often spread among children playing contact sports, as they lurk on their sweaty gym socks, jerseys, and other workout gear that may be shared.

Neisseria meningitidis
While Neisseria meningitidis infection is more rare than others on this list, it is extremely harmful, leading kids quickly downhill before doctors have time to administer antibiotics. The bacteria, which can cause meningitis, bloodstream infections, or death, can live in the nose and mouth and spread among people living in close quarters. A vaccine that protects against four types of N. meningitidis is recommended for children ages 11 and older before they go off to college. A type not protected by the vaccine is dangerous in kids younger than 2. Beware of the telltale splotchy purple rash, especially if it darkens or spreads rapidly, a signal to see a pediatrician right away.

Pertussis
Whooping cough, or pertussis, is a bacterial infection that causes a very distinctive cough and cold-like symptoms. A vaccine for pertussis has long held it in check. Within the last 30 years, however, U.S. pertussis cases have been increasing. The infection is usually mild in adults and children, but in infants, pertussis may be life-threatening. Pneumonia, seizures, and brain damage are additional dangers. DTaP, a combination vaccine that also shields against tetanus and diphtheria, is given to children in five doses: once at ages 2, 4, and 6 months, once between 12 and 18 months, and once between 4 and 6 years old. Because the vaccine’s benefits wane over time—and because infants under 2 months are not protected—adults and healthcare workers who are in regular contact with infants are advised to get a whooping cough booster, the Tdap, to avoid spreading the infection.

Decades ago modern medicine all but stamped out the nervous breakdown, hitting it with a combination of new diagnoses, new psychiatric drugs and a strong dose of professional scorn. The phrase was overused and near meaningless, a self-serving term from an era unwilling to talk about mental distress openly.

But like a stubborn virus, the phrase has mutated.

In recent years, psychiatrists in Europe have been diagnosing what they call “burnout syndrome,” the signs of which include “vital exhaustion.” A paper published last year defined three types: “frenetic,” “underchallenged,” and “worn out” (“exasperated” and “bitter” did not make the cut).

This is the latest umbrella term for the kind of emotional collapses that have plagued humanity for ages, stemming at times from severe mental difficulties and more often from mild ones. There have been plenty of others. In the early decades of the 20th century, many people simply referred to a crackup, including “The Crack-Up,” F. Scott Fitzgerald’s 1936 collection of essays describing his own. And before that there was neurasthenia, a widely diagnosed and undefined nerve affliction causing just about any symptom people cared to add.

Yet medical historians say that, for versatility and descriptive power, it may be hard to improve upon the “nervous breakdown.” Coined around 1900, the phrase peaked in usage during the middle of the 20th century and echoes still. One recent study found that 26 percent of respondents to a national survey in 1996 reported that they had experienced an “impending nervous breakdown,” compared with 19 percent from the same survey in 1957.

“ ‘Nervous breakdown’ is one of those sturdy old terms, like ‘melancholia’ and ‘nervous illness,’ that haven’t really been surpassed, although they sound antiquated,” the historian Edward Shorter, co-author with Max Fink of the book “Endocrine Psychiatry: Solving the Riddle of Melancholia,” said in an e-mail message.

Never a proper psychiatric diagnosis, the phrase always struck most doctors as inexact, pseudoscientific and often misleading. But those were precisely the qualities that gave it such a lasting place in the popular culture, some scholars say. “It had just enough medical sanction to be useful, but did not depend on medical sanction to be used,” said Peter N. Stearns, a historian at George Mason University near Washington, D.C.

A nervous breakdown was no small thing in the 1950s or ’60s, at least by the time a person arrived at a doctor’s office. Psychiatrists today say that, most often, it was code for an episode of severe depression — or psychosis, the delusions that often signal schizophrenia.

“I don’t remember people who got that label ever using it as their own complaint — it was very much stigmatized,” said Dr. Nada L. Stotland, a former president of the American Psychiatric Association and a professor at Rush Medical College in Chicago, who began practicing in the 1960s. “Whether it was ‘nervous exhaustion’ or ‘nervous breakdown,’ anything that sounded psychiatric was stigmatized at that time. It was shameful, humiliating.”

The vagueness of the phrase made it impossible to survey the prevalence of any specific mental problem: It could mean anything from depression to mania or drunkenness; it might be the cause of a bitter divorce or the result of a split. And glossing over those details left people who suffered from what are now well-known afflictions, like postpartum depression, entirely in the dark, wondering if they were alone in their misery.

But that same imprecision allowed the speaker, not medical professionals, to control its meaning. People might be on the verge of, or close to, a nervous breakdown; and it was common enough to have had “something like” a nervous breakdown, or a mild one. The phrase allowed a person to disclose as much, or as little, detail about a “crackup” as he or she saw fit. Vagueness preserves privacy.

Dr. Shorter said that the term “nervous” has traditionally been a “weasel word” for mental troubles, implying that the cause was something physical beyond the person’s control — their damaged nerves, not their mind. And a breakdown, after all, is something that happens to cars. It’s a temporary problem; or at least, not necessarily chronic.

Through the ages, every generation has attributed its own catchall diagnosis to larger cultural changes. Industrialization. Modernization. The digital age. The 19th-century philosopher William James reportedly called neurasthenia, from which he claimed to suffer himself, “Americanitis,” in part the result of the accelerating pace of American life. So it was with breakdowns. The causes were largely external — and recovery a matter of better managing life’s demands.

“People accepted the notion of nervous breakdown often because it was construed as a category that could handled without professional help,” concluded a 2000 analysis by Dr. Stearns, Megan Barke and Rebecca Fribush. The popularity of the phrase, they wrote, revealed “a longstanding need to keep some distance from purely professional diagnoses and treatments.”

Many did just that, and returned to work and family. Others did not. They needed a more specific diagnosis, and targeted treatment. By the 1970s, more psychiatric drugs were available, and doctors directly attacked the idea that people could effectively manage breakdowns on their own.

Psychiatrists proceeded to slice problems like depression and anxiety into dozens of categories, and public perceptions shifted, too. In 1976, 26 percent of people admitted seeking professional help, up from 14 percent in 1947, according to Dr. Stearns’s analysis. And “nervous breakdown” began to fade from use.

The same fate may or may not await “burnout syndrome,” which for now has backing from some doctors and medical researchers. But it has another 30 years to outlast the classic “breakdown.”