'Adjustment Disorder' Could Explain Why Your Mood Is So Weird Right Now
That lack of patience, irritability, and sudden urge to LASH THE $%@$! OUT at everyone? Yeah, you’re not alone. Here’s why COVID-19 has led to an uptick of cases in my practice of something called adjustment disorder.
I’ve heard it all in the past six months—fury over job loss, dismay at a crumbling social life, discomfort about race, frustration induced by the stir-crazies. As I’ve listened to clients at my psychiatric practice tell me their struggles, I’ve realized that many have something in common despite how different their stories are.
Take Paul—not his real name, of course—an executive in his late 50s whom everyone knew as the boss. He was focused and responsive, the guy who fed off people’s energy and got stuff done. As COVID-19 cases began to rise, though, he noticed that a new irritability and lack of concentration crept in. “My attention is all over the place, sleep has been terrible, and I’m worried about getting sick,” he told me. He started snapping at his wife, and he felt like he was losing his mind.
Paul wasn’t losing it. Technically, what he was going through is called adjustment disorder, which means that you have a bigger reaction than normal to something stressful. You feel worried, jittery, or hopeless—and you don’t have the necessary coping skills to deal with it.
Typically, adjustment disorder is intense and brief, and you can pinpoint where it’s coming from. Other forms of anxiety can make you feel keyed up for months without your even knowing why. Paul and I recognized that his concerns about the virus had hijacked his ability to focus and function.
Recently, I’ve been seeing so many people like Paul that we as a medical community may need to revisit calling adjustment disorder a disorder. Pandemics can cause this, yes, but so can getting divorced, sending your kid to college, or losing a job. So it’s good to know about it now, because at some point, you might have to adjust. And when you do, do this.
Step 1: Seek Real Connection
Online communication (like Zoom, Google Hangouts, Facebook groups, online religious services, and virtual fitness classes) does offer connection, even if it’s not ideal. And it provides something else: a space for enthusiasm. Spending time sharing interests instead of commiserating can lend hope.
Step 2: Plan Stuff, Anyway
Part of the reason adjustment disorder leaves you feeling so off is that you don’t have the skills to adapt to the new reality. Making plans—even if the pandemic spoiled all your previous ones—can help. You just have to get creative. If you’re missing the way conversations unfolded at dinners with friends, host a virtual dinner over FaceTime. Yes, it will feel different, but that’s why it works: New experiences help stimulate a feeling of growth that fights the stagnancy of loneliness.
Step 3: Call Me
Or any qualified counselor, really. Adjustment disorder sometimes goes away on its own, but not always. Make an appointment if you feel totally overwhelmed, you can’t get out of bed, or your personal or work life is compromised.
That last problem is why Paul came to see me. (Okay, his wife nudged him, too.) We worked together to find coping skills, including walks with his wife and online yoga nidra classes, which have great benefits for anxiety and sleep. He also chose to take a low-dose anxiety medication until he felt more comfortable with his new wellness practice.
The truth is that many of us have adjustment disorder, whether we realize it or not, especially given the times. Today, Paul is not completely without anxiety— pretty much nobody is—but he’s able to work, sleep through the night, and enjoy meals with his wife. The irony is that easing adjustment disorder requires making some adjustments. But these steps can make that doable, even if you’re not feeling like yourself right now.
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