Adjustment disorder

    

Adjustment disorder is a group of symptoms, such as stress, feeling sad or hopeless, and physical symptoms that can occur after you go through a stressful life event.

The symptoms occur because you are having a hard time coping. Your reaction is stronger than expected for the type of event that occurred.

Causes

Many different events may trigger symptoms of an adjustment disorder. Whatever the trigger is, the event may become too much for you.

Stressors for people of any age include:

• Death of a loved one
• Divorce or problems with a relationship
• General life changes
• Illness or other health issues in yourself or a loved one
• Moving to a different home or a different city
• Unexpected catastrophes
• Worries about money

Triggers of stress in teenagers and young adults may include:

• Family problems or conflict
• School problems
• Sexuality issues

There is no way to predict which people who are affected by the same stress are likely to develop adjustment disorder. Your social skills before the event, and how you have learned to deal with stress in the past may play roles.

Symptoms

Symptoms of adjustment disorder are often severe enough to affect work or social life. Symptoms include:

• Acting defiant or showing impulsive behavior
• Acting nervous or tense
• Crying, feeling sad or hopeless, and possibly withdrawing from other people
• Skipped heartbeats and other physical complaints
• Trembling or twitching

To have adjustment disorder, you must have the following:

• The symptoms clearly come after a stressor, most often within 3 months
• The symptoms are more severe than would be expected
• There do not appear to be other disorders involved
• The symptoms are not part of normal grieving for the death of a loved one

Sometimes, symptoms can be severe and the person may have thoughts of suicide or make a suicide attempt.

Exams and Tests

Your health care provider will do a mental health assessment to find out about your behavior and symptoms. You may be referred to a psychiatrist to confirm the diagnosis.

Treatment

The main goal of treatment is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred.

Most mental health professionals recommend some type of talk therapy. This type of therapy can help you identify or change your responses to the stressors in your life.

Cognitive behavioral therapy (CBT) is a type of talk therapy. It can help you deal with your feelings:

• First the therapist helps you recognize the negative feelings and thoughts that occur.
• Then the therapist teaches you how to change these into helpful thoughts and healthy actions.

Other types of therapy may include:

• Long-term therapy, where you will explore your thoughts and feelings over many months or more
• Family therapy, where you will meet with a therapist along with your family
• Self-help groups, where the support of others may help you get better

Medicines may be used, but only along with talk therapy. These medicines may help if you are:

• Nervous or anxious most of the time
• Not sleeping very well
• Very sad or depressed

Outlook (Prognosis)

With the right help and support, you should get better quickly. The problem usually does not last longer than 6 months, unless the stressor continues to be present.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you develop symptoms of adjustment disorder.

Adopted from U.S. national library of Medicine

Document 12

I’m calling this Document 12.

Document 12 is being written in a Word document, because my Internet connection is poor and creaky. It’s the 12^th document I appear to have opened within a certain period of time. It named itself, kind of like it has its own soul. I merely accepted. I said: “Yes, you may take the name of Document 12.”

Can a document have a soul? And what happens when I copy paste it into the InterWebs? Does a little of its soul leach away? Is it a clone, an ember, a scrap of white glare that says writeonmewriteonme you poor wretched wannabe something or other that you are not…yet.

See, the winter isn’t doing me so well. I think I’m going mad. I really do. I try to be funny because it’s the only way I can keep going, I think. It’s February 1, 2011. I will make it to March. I always have.

I haven’t been using my new SAD lightbox properly, even though bug-eyed bunnies with garlands of daisies fairly leapt out of it the first time I tried it. I don’t have time to sit in front of it. I’m supposed to sit there for half an hour, with a book or whatever, while it glares its shiny happy light of wonder at my stricken face, and heals me.

Could it heal me?

What about a vitamin, or a special pill that rattles in my purse like manna, knowing it will pull myself in tight, like a cloak? My legs and arms will be safe by my sides. The world will not devour me, at least not whole.

I sometimes walk along the street and think: I am going to fall, and no one will catch me. I don’t mean a clumsy-footed fall on the ice, while pedestrians laugh and throw eggs and offal at me. I mean, perhaps, that I will stay below, and the world will rise above like a balloon growing distant, with all its warm laughter and colors. So my falling will be more like being left behind.

Or maybe I will forget how to find myself, and where I am, and when I take my glasses off I will not see. Nothing belongs to me; my rings and necklaces are borrowed from the living. Someone might decide to turn off the lights. Someone else might simply close Document 12, and be done with it. Document 12 wants to live, though. It has a beating heart around its edges. Its borders are like the lake I once swam, where I thought I might drown when I had eaten too light a lunch and exercised too fiercely. Keep to the edges, and you will be safe.

I said to myself that day: “You must not panic here. You must put your head down into the water, and make it to the other side.” I put my head down, and I did. I was alone. I kept going.

I feel the flickerings of this sort of fear in the winter. The walls seem too far away, or too close. The ceiling seems lower than it usually does. Did it always meet the edge of the wall, just like that? One misstep and I could knock into a wall, or miss the doorframe. I never do. I never do, and I am strong. But I am also dizzy and weary and confused. I want to know what is wrong with me. Maybe what is wrong with me is also what is right with me. I have been dizzy since the age of three. I can no longer drive on the highway. I will win over this; I will not die.

Everything recedes away. I was talking to a friend the other day at the gym and the world lurched away from me until the edge of the weight machine seemed leagues distant and I felt faint, and I looked at his kind face, and I said: “I think I don’t feel so well.” So he walked me carefully over to the machine that dispenses the Powerade and other drinks, and I bought a Powerade with quarters and drank it.

“How will I get home?” I thought, sitting in a chair with my soft mittens pressed on my forehead. “I might as well be on the Moon.” I couldn’t see how my legs would move to get me there. I couldn’t see it at all. I could place a call, and ask for a ride. How weak would that seem!

But finally I got up, and walked, roughly, over the slurred ice and past the hulking snowdrifts and I don’t how I got there. I don’t know how, but I got home. Keep going.

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My Big Fatass BEA Bookbags

Visited BEA 2011 yesterday for work purposes and found the place was lousy with literary agents. I passed one who has my full manuscript, another who holds a partial, another with a query. But could I speak to them? Nay! I did not want to be the wanna-be author going stalky-stalky in the fluorescence of the (horrible) Javits Center, leaping like a sweaty wildcat upon the unwary agent, two huge bags of ARCS and schwag swinging like fatass saddlebags from my shoulders:

"Um, um, um you read my BOOK yet? You got my book! You read it? HAVE YOU READ IT FOR HEAVEN'S SAKE? D'ya like it?! Can I use that table, over there, for my author signing?"

No, that would not be me, but the whole thing was tough. Everyone has nametags! And the agents' tags have a RED strip at the bottom of their badge, so you can spot them and get that little salivary stalking instinct. Also, the place is even lousier with authors than it is with agents, and they are published. People wait in line to get their signatures. This breeds jealousy, and jealousy hurts.

However, I am gulping down my jealousy to link to some new titles I received ARCs for and of which I heard much buzz/praise. I didn't get copies of everything I saw, because I couldn't carry any more with me. I found myself longing for an eReader, because the fatass bookbags I have mentioned knocked over some old and infirm people as I trudged to the subway after the event.

When She Woke, By Hillary Jordan (Algonquin Books)

(Note: This is the only book I have actually started reading of my new batch, and therefore it's at the top of my list.) I read Mudbound and loved it. So when I heard this new book was out, I darted right over to the Algonquin booth and pleaded for a copy. From page one, this book is intense and terrifying. A cross between The Hunger Games, The Handmaid's Tale, and The Scarlet Letter, When She Woke opens with protagonist Hannah Payne awakening to find her skin, from head to toe, dyed a vivid red through a process called "chroming." She is a felon, convicted of murdering her unborn child, in a futuristic world where church and state are dangerously blurred. For thirty days, her imprisonment will be televised. Then she'll be released into the world, where an even more painful imprisonment will begin. I'll probably be up all night tonight reading this.

Bedbugs, By Ben H. Winters (Quirk Books 9/6/11)
From the author of Sense and Sensibility and Sea Monsters. Everyone is terrified of bedbugs, so writing an "understated horror" novel about this topic is a stroke of brilliance. When I brought out the book and showed it to a few friends, they shuddered. One almost screamed, and said she stays up at night searching for bedbugs. In the book, a "perfect couple" in search of a dream brownstone in Brooklyn Heights find something more sinister: The bedbug problem from hell! My skin crawls at the prospect, although bedbugs are not one of my major phobias. They soon will be.

Why We Broke Up, By Daniel Handler (Little, Brown 1/12)

Follows the story of how Min and Ed "met at a party, saw a movie, followed an old woman, shared a hotel room, and broke each other's hearts." The book came with a postcard on which readers can write in "We broke up because..." and mail it in to the publisher. At the show, there were many such postcards tacked on a board with amusing and heartbreaking reasons for the end of romance. My favorite: "Because he was an ass."

And here are several more than sounded incredibly good but I don't have time to write about in detail. Someone has written about them on Amazon already. You can read it all there. And even order the books should you so desire. Enjoy!

The Language of Flowers, By Vanessa Diffenbaugh (8/23/11)

Victoria has spent her childhood in the foster care system; her only connection to the world is through the world of flowers and their meanings.

Wildwood, by Colin Meloy (8/30/11)

Someone called this "The American Chronicles of Narnia." An adventure into the Impassable Wilderness, a tangled and magical forest in the middle of Portland.

Daughter of Smoke and Bone, by Laini Taylor (9/27/11)
A YA "Girl With the Dragon Tattoo" with a mysterious and unique blue-haired MC.

Carrier of the Mark, by Leigh Fallon (10/11)
Megan moves to Ireland, meets hot boy, discovers she has power over one of the four elements.

Au Revoir, Crazy European Chick, by Joe Schreiber (10/11)
Average high school guy spends a wild prom night with geeky Lithuanian exchange student—who is really an international assassin!


The Unbecoming of Mara Dyer, by Michelle Hodkin (9/11)
Mara wakes up in a hospital with no memory of how she got there. Then she starts to see things, and people start dying. Editor cites an incredible "big surprise twist" ending.

Down the Mysterly River, by Bill Willingham (9/13/11)
A boy and three animals in a very bad forest.

Demystification Opposites Attract

Oh, it's been a long time since I've done one of these demystification posts! So ... the other day, I watched this movie. It's a few years old, but perhaps you've seen it: Knocked Up?