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Adjustment Disorder – Why You Feel irritated and frustrated



That lack of patience, irritability, and sudden urge to LASH the $% @ $! OUT at all? Yes you are not alone Here’s why COVID-19 has resulted in an increase in the number of cases referred to as adjustment disorder in my practice.

I’ve heard it all in the past six months – anger at job loss, dismay at a crumbling social life, discomfort with race, frustration with excitement. As I listened to clients in my psychiatric practice tell me their struggles, I realized that many have something in common, even though their stories are different.

Take Paul ̵

1; not his real name, of course – an executive in his late 50s who everyone knew as a boss. He was focused and responsive, the guy who fed people’s energy and got things done. However, as COVID-19 cases began to rise, he noticed a new irritability and lack of concentration crept in. “My attention is everywhere, the sleep was terrible and I am worried about getting sick,” he told me. He was starting to snap at his wife and he felt like he was going mad.

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Paul didn’t lose it. Technically, what he’s been through is known as an adjustment disorder, which means you react more than normal to something stressful. You feel worried, nervous, or hopeless – and you don’t have the coping skills to deal with it.

Typically, the adjustment disorder is intense and brief, and you can determine exactly where it is coming from. Other forms of anxiety can leave you feeling tied up for months without even knowing why. Paul and I realized that his concern about the virus had abused his ability to focus and function.

Recently, I’ve seen so many people like Paul that we as a medical community may need to reconsider calling adjustment disorder a disorder. Pandemics can cause this, yes, but so can divorce, sending your child to college, or losing a job. So it’s good to know about it now because at some point you may have to adjust. And when you do this, you do this.

Step 1: look for a real connection

Online communications (like Zoom, Google Hangouts, Facebook Groups, online religious services, and virtual fitness classes) provide a connection, even if it’s not ideal. And it also offers something else: a space for enthusiasm. Spending time sharing interests rather than feeling sorry for yourself can give hope.

Step 2: plan things anyway

One reason for adjustment disorder is that you do not have the skills to adapt to the new reality. Making plans – even if the pandemic has tainted all of your previous ones – can help. You just have to get creative. If you don’t know how dinner conversations with friends went, host a virtual dinner through FaceTime. Yes, it will feel different, but this is why it works: New experiences stimulate a sense of growth that combats the stagnation of loneliness.

Step 3: give me a call

Or really a qualified advisor. Adjustment disorder sometimes goes away on its own, but not always. Make an appointment if you feel completely overwhelmed, cannot get up, or your personal or professional life is affected.

The 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 that have great benefits for anxiety and sleep. He also opted for a low-dose anxiety medication until he was more comfortable with his new wellness practice.

The truth is that many of us have adjustment disorders whether we realize it or not, especially given the time. Today Paul is not entirely without fear – almost nobody – but he can work, sleep through the night and eat with his wife. The irony is that some adjustment is needed to alleviate the adjustment disorder. But these steps can make this doable even if you are currently not feeling like you.

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