Sometimes change occurs quickly and without warning. At other times, it is more predictable. Change can sometimes be a good thing, as with a promotion or a retirement. At other times it is not, as with job loss, the death of a loved one, or illness. However it happens, change is a form of stress and can have more of an impact than we might expect. Adjusting can be difficult.
Adjusting to life’s changes, even good changes, can trigger a type of depression. Symptoms can be emotional and physical. People may find it hard to function, and may feel sad, hopeless, or anxious. They may have difficulty sleeping, feel tense or tired, have little appetite and difficulty concentrating, or lose interest in their usual hobbies.
When change triggers depression symptoms that make it hard to cope from day to day, doctors call this condition adjustment disorder. More recently, the name has been changed to stress response syndrome. Informally, it is also known as situational depression. As people adjust to the situation, their symptoms improve. How long this process takes is different for each person.
Now, you may think that not feeling well during tough times is normal, and you are right. Feeling stressed during change is a common human experience. Still, the emotions can be severe. Although change may cause the symptoms, the experience can be as challenging as major depression.
Situational depression symptoms can be similar to those of depression. While with depression, symptoms may appear with or without a trigger, in this case they always start after a specific life event. Symptoms are usually short-term in nature, and generally improve within a few weeks to months after the event. Most commonly, people start to feel better within about six weeks. It is unusual for symptoms to last longer than six months. For adults with this condition, thoughts of suicide are uncommon. Research suggests that 10 per cent of all adults will be affected by adjustment disorder at some time in their lives. However, that number could be higher.
Note that stress response syndrome is different from post-traumatic stress disorder. In post-traumatic stress disorder, people are more likely to experience unpleasant flashbacks of a traumatic or life-threatening event. Post-traumatic stress symptoms tend to last a long time.
In contrast, stress response syndrome symptoms are similar to grief, in which there is an emotional response to a loss. Grief involves feeling deep sorrow, as when a family member or loved one dies.
Stress response syndrome is more common in children and teens, affecting about 30 per cent. In young people, stress response syndrome may look different than it does in adults. Adolescents are more likely to act impulsively as they react to a difficult life event. They may experiment with substances, act out, skip school, fight, or even self-harm. These outbursts are often not in keeping with their usual behaviour. Such actions may show that a young person’s coping skills are less well developed.
As life events unfold, adults may feel that they do not know how to respond to their new emotions. People describe feeling as if the rug has been pulled from under their feet. They feel rudderless and overwhelmed, like they have lost their identity or sense of self. Depending on the type of stress that they have experienced, even core values and beliefs may be questioned. When such feelings come on quickly, it can be frightening.
Although symptoms will resolve with time, certain strategies can help. Going back to basics is a good first step. Work toward getting enough sleep, good nutrition, and moderate exercise like a brisk walk every day. These essentials are especially important for children. Talking to a friend or partner can help you to cope. Support can also come from someone who is not close to the situation, such as a psychologist or counsellor.
People are often reluctant to visit a counsellor, seeing it as a sign of weakness. However, short-term talk therapy has been proven to be helpful for people with stress response syndrome. If you had a badly sprained ankle, you wouldn’t hesitate to see a physiotherapist. Think of talking to a counsellor in the same way. A physiotherapist may prescribe exercises (tools) to help the ankle feel better. In the same way, a counsellor can help you to think about types of tools you have used to cope with stress in the past. Some of those tools may be helpful now, or it may be time to develop new coping tools. A counsellor is like a physiotherapist for the brain. Most people do not feel it makes you weak to visit a physiotherapist to heal a physical injury. In the same way, seeking appropriate treatment for stress is a wise way to care for your health.
If a change in your life is causing you stress, it often helps to talk about what has happened and how you are feeling. Telling your story and feelings to a friend or family member is a good start. And certainly, do not be too shy to talk to a health care provider such as a counsellor, doctor or nurse. They will have ideas to help you. Discuss your experience and get counselling. Know that you do not have to cope alone.
Learning to observe and manage your own natural responses to stress is important. The good news is that we can learn new coping skills at any stage of life. The coping skills people use at 20 years of age are not the same ones used at age 50 or 70. We all carry an imaginary toolbox of coping skills, and use different ones depending on the situation. Sometimes, the most helpful tool might be to remove yourself from a difficult situation, either temporarily or permanently. At other times, it is better to stick with the challenge while using other tools, like relaxation techniques, to get through it. Distraction with exercise, hobbies, or social activities can be helpful.
Sometimes, a tool is used to evaluate the trigger. For instance, if the trigger is a job loss, consider whether the life change could be positive. You might be able to spend more time with family, or try a new career you’ve always wanted. Perhaps the right tool may be to re-evaluate your choices and opinions objectively, without blame or guilt, staying open to making a change if necessary. Any or all of these tools can be used to deal with the same stressful trigger.
Remember, the first coping tool that you try may not help you to feel better. In that case, be willing to try another. Despite your best efforts, you may find you just do not feel better in a reasonable amount of time. In that case, it is worth considering other options, such as an antidepressant. See a doctor to discuss the pros and cons of medication.
Some coping tools almost never help people to get better, and may even cause harm. Substance abuse, such as using alcohol and drugs to cope, is the most common example. Drugs and alcohol may help you to temporarily escape your symptoms. However, it is clear that substance abuse does not result in good outcomes. If you find that you are reaching for substances to help you feel better, re-arm your toolbox with healthier coping options.