ADJUSTMENT DISORDER

Loss of any kind; be it a loss of a job, death, good health, material possession or a valued relationship brings an expected temporary loss.  Grief is necessary to free us from the loss.  Most of us recover progressively in a matter of months to years.  Loss is more painful when it comes unexpectedly.

Anniversary reaction occurs with sadness on the anniversary of the event or seasonally such as remembering the loss of loved ones on Christmas. Success surprisingly causes a paradoxical reaction with the loss the responsibilities of the less responsible position.  Normal reactions include fluctuations in mood and behavior.  With death or other significant loss, first there is disbelief that lasts days to months. The purpose of funerals and viewing of the body is to help us accept the death.  One then goes through a period of disorganization - unable to complete tasks on time, difficulty concentrating, thinking that you must be losing your mind even visual hallucinations of the person, redoing the event over and over in your mind with different endings is normal during this period of mourning.  You may feel guilty for living, good health or even imagine yourself with the same symptoms or illness as the lost one. Reorganization eventually occurs when you are able to remember the person lovingly without the burden of the sadness or the event objectively- maybe you did contribute to the loss of the job or relationship, own your part in the situation. Coping skills kick in and you no longer feel handicapped.  Recovery may take years. There is no time frame as long as you are progressively improving.

My purpose is for you to distinguish normal from abnormal reactions to loss.  It is not normal to become progressively socially isolated, paranoid, develop actual medical illness, deny the loss, develop low self-esteem or suicidal/homicidal behavior.  Sadness is normal.  Depression (loss of pleasure of life, melancholy, decreased appetite/weight loss or gain, crying spells, destructive behavior) is not normal.  Depression with or without anxiety in response to a stressor is called an adjustment disorder.  Prayer always works, but faith requires action, and medical treatment is needed.  Just as in major depression, an adjustment disorders responds well to counseling and medication to increase certain chemicals in the brain. Depression is a medical problem like hypertension.  You cannot reason your way out. It requires more than just an attitude adjustment and untreated it remains stealing your joy, stealing you from your life and your loved ones. The longer you linger there brain cells actually slow/down regulate and cause a mental slowing, but you can recover with treatment.  

As the holiday season approaches, Pastor Buie has already mentioned how some feel saddened at this normally joyous time of year.  This is likely a normal reaction to loss of some kind in the past; we naturally miss those who have moved on or feel the loss of income greater during this season. You are not alone. If it overwhelms you, it will overwhelm you.  Your primary care provider should be able to assist you directly or find you the necessary assistance confidentially.  If you have thoughts of suicide, walk into the nearest emergency room - insured or uninsured. Know you are loved and needed. Cry about it.  Pray about it and leave it alone. If you can’t, please seek help immediately.
Lynne M. Greene, MD