"Everything changes and nothing stands still" (Heraclitus of Ephesus, 535–475 BC).

Change can be very positive but it can also bring challenges. We often focus on trying to achieve goals, arrange our lives and hang onto pleasant situations (and avoid unpleasant ones!). Sometimes, experiences that seem ‘good’ last for a long time and experiences that seem ‘bad’ or difficult end quickly. At other times the reverse can be true. One thing that is often true is that change can be stressful and when people experience major changes in their lives (e.g. losing a job or relationship, moving, or entering a new phase of life like retirement or “the empty nest”) some distress is almost inevitable and is quite normal.

However, sometimes the change can be more difficult to manage or accept and people can be left feeling distressed and longing for a time that has passed.

How would I know if I had adjustment difficulties?

Adjustment difficulties often occur when a person has difficulty coping with, or adjusting to, a particular source of stress such as a major life change, loss, or an event.

People with adjustment difficulties often have some of the symptoms of depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities. Other people can be left feeling angry, frustrated, anxious or hopeless. However, adjustment is specific to the person and the situation so no two people will have the same experience.

The type of situation that triggers an adjustment difficulty varies depending on the person, but can include:

  • Ending of a relationship or marriage
  • Losing or changing job
  • Death of a loved one
  • Aging or changes to a person’s ‘role’
  • Retirement
  • Developing a serious illness (yourself or a loved one)
  • Being a victim of a crime
  • Having an accident
  • Undergoing a major life change (such as getting married or having a baby)
  • Living through a disaster

People with adjustment difficulties can develop emotional and/or behavioural symptoms as a reaction to a particularly stressful event. These generally begin within three months of the event and often do not last for longer than six months. Symptoms may cause problems with a person's ability to function; for example, the person may be unable to sleep, work, or study.

When is adjustment a problem?

This can differ between people depending on their personality, their coping skills, the severity of the symptoms, the support they have around them and the demands of life. What is not seen as a problem by one person may cause a number of difficulties for someone else. It is about how it affects you, what it is interfering with and what it is stopping you from doing. Symptom severity in itself does not necessarily indicate how much of a problem adjustment may be in a person’s life. What matters is whether it is a problem for you. Often a little change can be easy to manage but sometimes big changes in life can ‘got on top’ of people. If this happens it can cause or exacerbate physical and mental health problems.

What helps?

Change is a part of life and therefore what is really important is how people manage it. The evidence base suggests that Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Cognitive Analytic Therapy (CAT) and Systemic approaches are effective in helping people manage their experiences of adjustment.

CBT has the strong evidence base for its effectiveness and the long term effects of this treatment often far exceed those of medication. However, everyone is an individual and although the models mentioned above can be extremely effective for managing change, sometimes a different therapeutic approach or a therapy tailored to the individual and their needs is more appropriate. The assessment stage of any therapeutic intervention provides an opportunity to develop an in depth understanding of your difficulties on which a tailored individual therapy can be developed specifically for you.