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Adjustment Disorders

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 and your reaction to the situation is causing distress for you and/or impairment in your day to day functioning.  

Many different events may trigger symptoms of an adjustment disorder. Whatever the trigger is, the event may become too much for you. Some examples are; loss of a job, death of a loved one, divorce or problems with a relationship, general life changes and illness or other health issues in yourself or a loved one

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. Therapy will entail equipping you with healthier coping mechanisms, reconnecting to a support system and people around you and finding your strengths that can help you not just cope with the present but challenges and changes in the future too.

Behavioural Problems

All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging behaviours that are outside the norm for their age.

The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). These three behavioural disorders share some common symptoms, so diagnosis can be difficult and time consuming. Depression especially in boys can also be mistaken for a behavoiural condition for sometimes anger, defiance and destructive behaviour can be acting out symptoms that are a cry for help.  A child or adolescent may have two disorders at the same time. Other exacerbating factors can include emotional problems, mood disorders, family difficulties and substance abuse.

Correct diagnosis and investigation of the factors causing the behaviour is the first step in dealing with these issues. Psychometric assesments, collateral information  and clinical judegment is then used to find the best way forward to help the family and child to be the best versions of themselves.

Grief and bereavement

The grieving process is very personal. The process will vary from person to person in terms of the order in which one experiences the stages of grief, as well as the time it takes to go through the stages of grief. People who are grieving don't necessarily progress in order. Some people may start with anger. Others may start with denial. The stages of grieving aren't necessarily a one-time experience. Often people who are grieving will cycle through the different stages more than once. However, each step helps with the healing process. Grief is usually divided into 5 stages:

  • Denial. Denial is a stage where one can try to believe that the death hasn't occurred. One may feel numb, or in a state of shock. Denial is a protective emotion when a life event is too overwhelming to deal with all at once.
  • Anger. Anger is a stage in which you're very upset and angry that this tragedy has happened to you.
  • Bargaining. Guilt is a primary emotion during this stage. Searching for something that you personally did, which could have contributed to the death or loss, is all part of bargaining.
  • Depression or sadness. This is a stage in which one may feel a profound sense of sadness. This is normal. It may be accompanied by physical changes, such as trouble sleeping or excessive sleeping, changes in appetite, or difficulty with concentrating on simple daily activities. This is usually the stage in which people reach out for help to the therapist or are brought in by family members.
  • Acceptance. Acceptance is the stage in which you've made an adjustment to the loss. This doesn't mean that you'll never feel other emotions, but usually families find that they're better able to manage their lives overall on reaching this stage. Some resolution has taken place with the death/loss. This may include your religious and cultural beliefs and practices.

CBT

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.It's most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.It is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. Some examples of negative thought patterns or cognitive distortions are: All-or-Nothing Thinking, catastrophizing and over-generalising.

CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You're shown how to change these negative patterns to improve the way you feel. Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

Behavioural Problems

All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging behaviours that are outside the norm for their age.

The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). These three behavioural disorders share some common symptoms, so diagnosis can be difficult and time consuming. Depression especially in boys can also be mistaken for a behavoiural condition for sometimes anger, defiance and destructive behaviour can be acting out symptoms that are a cry for help.  A child or adolescent may have two disorders at the same time. Other exacerbating factors can include emotional problems, mood disorders, family difficulties and substance abuse.

Therapy entails getting a thorough understanding of the issue by using clinical observation, collateral information and psychometric assessments and tailoring the intervention to assist the child to be the best version of themselves.

Trauma

Traumatic stress may arise from a variety of incidents, including artificial or natural disasters such as earthquakes and motor vehicle accidents, rape, school violence and victimisation. Traumatic stress severely impacts personal functioning, interpersonal relationships and employment, and it is associated with a variety of other psychological conditions, including posttraumatic stress disorder (PTSD), anxiety, depression, substance use and somatisation.

In therapy trauma is dealt with by using a five-step model that incorporates the following areas: telling and retelling of the story; normalizing the symptoms; addressing self-blame or survivor guilt to reframe the guilt and restore self-respect; encouraging mastery; and facilitating the creation of meaning. Prognosis is usually good, and change is observed with four to six sessions.

What is Mindfulness

A person’s experience of time tends to be subjective and is heavily influenced by their emotional state. Fears and insecurities about the past and the future can make it difficult to fully enjoy the present. The key is learning how to pay attention and focus on the here and now. Mindfulness is a tool that allows people to be more aware of their physical and emotional conditions without getting bogged down in self-criticism and judgment. In the most basic sense, mindfulness is being consciously aware of your thoughts and emotions.

Mindfulness allows for a diverse set of lenses to be used in viewing situations and processing the meaning attached to it. The way we perceive events and our ability to cope with these events ultimately affects not just the way we respond but the way our body reacts. It works on the premise that if we change the way we see, we subsequently change the way we respond, and this has a profound impact on our stress levels and its consequences on our health and well-being.  Better able to deal with stress. Some of the proven benefits are: enhanced immune functioning, higher pain threshold, age better, enhanced cognition and mental health, happier, energised and less anxious.

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