Are You Struggling With Adjustment Disorder During COVID-19?

Evaldas Kazlauskas, used with permission

Source: Evaldas Kazlauskas, used with permission

The extended global experience of COVID-19 has exacerbated numerous psychological issues from daily stress to trauma and adjustment disorder. The upheaval of a perceived normal prolongs and worsens the expected stress response, leading to issues adjusting and weathering the storm.

Evaldas Kazlauskas, PhD is a Professor of Clinical Psychology and Head of the Center for Psychotraumatology at Vilnius University in Vilnius, Lithuania. For the last two decades Dr. Kazlauskas has been working in the field of psychotraumatology aiming to provide effective treatments for trauma survivors in Europe.

Jamie Aten: How would you personally define adjustment disorder?

Evaldas Kazlauskas: Stress is inevitable in our life. Fortunately, people are resilient and can overcome challenges. People have learned various ways of coping from previous struggles in their life, and with support from family and friends can usually cope with life stressors well enough. However, facing novel life stressors or multiple stressors, especially after traumatic experiences, can become too much and too big of a burden to deal with. A person can become extremely preoccupied with bad things in life and constantly worry about stressors, making it very difficult to keep on going with professional or routine daily life activities and potentially lead to the development of sleep difficulties. These psychological difficulties associated with life stressors can be labeled adjustment problems. Adjustment disorder is a more severe and prolonged stress response to an identifiable stressor or multiple stressors in comparison to normal adjustment difficulties which impairs psychosocial functioning.

JA: What are some ways understanding adjustment disorder can help us live more resiliently during COVID-19?

EK: Our studies in the general population showed that adjustment disorder most often is a reaction to health problems or illness of a close one, job-related difficulties, unemployment, or interpersonal problems. The COVID-19 pandemic triggers a set of multiple stressors, including health and job-related problems which for many people could lead to adjustment difficulties. Moreover, the pandemic is affecting social life globally. Psychological stress reaction to COVID-19 is normal, as it is associated with a lot of stress to the majority of the population, and it can reduce the ability to cope with daily life and might affect professional activities for many individuals. Adjustment disorders can be viewed as a very intense stress response that impairs daily functioning that many can be at risk of if the stressors persist. However, people can deal with stress and adjustment issues efficiently using well known psychological methods. Various methods range from relaxation or breathing techniques to mindfulness and talking with a close one to help reduce stress and improve adjustment. Resilience is not about ignoring human emotions to stressors. Resilience is about active coping—often with support from others—and being able to bounce back and  overcome difficulties in life.

JA: What are some ways people can cultivate resilience amidst this pandemic?

EK: Self-care is important. Our research showed that a brief, one-month self-help program that included body relaxation and breathing, mindfulness, daily activity planning, and addressing relationship problems can help. Surprisingly, we also found that self-care was similarly effective in comparison to the therapist-assisted program. This indicates that people can successfully overcome life stressors. Anything that works for a person—whether it be mindful breathing, working out, or yoga—can help reduce stress. There are quite a few mobile apps available, most of which are free, which are worth using to try to use to calm down and reduce stress. Furthermore, a lot of life stressors can be overwhelming, so it is important to actively try to identify stressors that are bothering you. As most of the pandemic-related stressors cannot be controlled, I would highly recommend focusing on daily routine and coping with smaller challenges in order to maintain a sense of control over your life. Slicing stressors into small peaches and setting up little but realistic tasks is helpful. Write down a list of several very specific and easily doable tasks, such as calling a friend, cleaning the table, setting up the washing machine, or other simple things. Don’t forget to check off the task on the list after you are done with each of these. Some people like to write on paper, but there are really good apps available to make such lists. Mental health professionals also recommended limiting daily exposure to the COVID-19 related news as it is contributing to chronic stress.

JA: Any advice for how we might use what you have learned to support a friend or loved one struggling with a difficult life situation?

EK: Adjustment disorders are associated with real life stressors. If a close one is having difficulties adjusting to challenges in life, it is very important to actively reach out and communicate. The pandemic can limit our possibilities to meet in person, but human touch and real-life meetings are important and can be very comforting. Luckily, internet technologies can keep us well connected, even in these difficult times. Texting or videoconferencing can help demonstrate that we care for each other and provide emotional support. As adjustment disorders are associated with difficulties in handling daily life activities, it is particularly important to provide practical help to our close ones. Just ask, maybe your friend or loved one needs specific help and advice with difficulties at home. Interestingly, altruistic behaviors can help not only your friend or loved one, but helping others also contributes to the resilience and well-being of the helper.

JA:  What are you currently working on that you might like to share about?

EK: My current work is mostly focused on the development and evaluation of psychological treatment delivered via the internet. The pandemic showed that we urgently need novel digital ways of delivering psychological therapies. There is a lot of evidence that internet-delivered interventions could be very effective for various mental health issues. However, there is still a lot of research needed to identify the best ways to help survivors cope with complex trauma. Furthermore, our team at the Center for Psychotraumatology at Vilnius University, in collaboration with researchers across the globe, is actively involved in research on the psychological impact of the COVID-19 pandemic, and these studies will help mitigate negative effects of the pandemic on mental health.

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