Managing Difficult Life Transitions

Life is a process of beginnings and endings. In both life and nature, there are times when things move slowly and don’t seem to change very much. Then, suddenly, changes may be thrust upon us dramatically and unexpectedly. The ebb and flow of transitions are as natural as day and night.

A life transition can be positive or negative, planned or unexpected. Some transitions happen without warning, and they may be quite dramatic, as in cases of accidents, death, divorce, job loss, or serious illness. Other life transitions come from positive experiences such as getting married, going away to college, starting a new job, moving to a new city, or giving birth to a child. Change, by nature, is stressful.

Examples of Life Transitions

Life transitions can include any of the following:
• Accidents
• Serious illness
• Leaving for college
• Buying a house
• Getting married
• Having a baby
• Changing jobs
• Divorce
• Selling a house
• Relocation
• Retirement
• Significant loss (of a person, job, pet, or anything important)

Life transitions can also occur because we feel in a rut. We may have the nagging feeling that something is wrong, although we can’t quite put our finger on the reason. Our lives may seem like they’re not going the way we thought they would and that time is passing us by. This often leads to the feeling that it’s time for a change.

Life transitions are challenging because they force us to let go of the familiar and face the future with a feeling of vulnerability. Any significant loss makes most people feel fearful and anxious. Since the future may now be filled with questions, it is normal to feel afraid. We live in a culture that has taught us to be very uncomfortable with uncertainty, so we are anxious when our lives are disrupted. On the positive side, these transitions give us a chance to learn about our strengths and to explore what we really want out of life. This time of reflection can result in a sense of renewal, stability, and a new equilibrium.

Stages of Life Transitions

Successfully moving through a life transition usually means experiencing the following stages:

1. Shock.
2. Negative feelings (anger, anxiety, confusion, numbness, self-doubt, etc).
3. Loss of self-esteem.
4. Beginning to accept the change.
5. Letting go of the past.
6. Beginning to feel more hopeful about the future.
7. Feeling increased self-esteem.
8. Feeling optimistic view about the future.

The process of moving through a transition does not always proceed in these nice, predictable stages. People typically move through the stages in different ways, often cycling back and forth several times, but with a decreasing amount of time spent in the more negative stages.

Coping Skills

Life transitions are often difficult, but they have a positive side, too. They provide us with an opportunity to assess the direction our lives are taking. They are a chance to grow and learn. Here are some ideas that may help make the process rewarding.

Accept that change is a normal part of life. People who have this attitude seem to have the easiest time getting through life transitions. Seeing changes as negative or as experiences that must be avoided makes them more difficult to navigate and less personally productive.

Expect to feel uncomfortable. A time of transition is confusing and disorienting. It is normal to feel insecure and anxious. These feelings are part of the process, and they will pass.

Don’t be in a rush. When your life is disrupted, it takes time to adjust to the new reality. Expect to feel uncomfortable during a transition as you let go of old ways of doing things. Try to avoid starting new activities too soon, before you have had a chance to reflect and think about what is really best for you.

Take good care of yourself. Transitions are very stressful, even if they are supposed to be happy times. You may not feel up to participating in your normal activities, but you should find something fun to do for yourself each day. Get plenty of rest, exercise, and eat well.

Learn to identify and express your feelings. While it’s normal to try to push away feelings of fear and anxiety, you will move through them more quickly if you acknowledge them. Make them real by writing them down and talking about them with trusted friends and family members. These feelings will have less power over you if you face them and express them.

Focus on the payoffs. Think about what you have learned from other life transitions. Recall the stages you went through, and identify what you gained and learned from each experience. Such transitions can provide a productive time to do some important self-exploration. They can be a chance to overcome fears and to learn to deal with uncertainty. These can be the gifts of the transition process: to learn more about yourself and what makes you happy and fulfilled.

Stay sober. Using alcohol or drugs during this confusing time is not a good idea. It can make the process more difficult.

Build your support system. Seek the support of friends, family members, and/or, if necessary, a mental health professional. These individuals can help you voice your concerns, while lending support through difficult times.

Acknowledge what you are leaving behind. This is the first step to accepting the new. Think about how you respond to endings in your life: Do you generally avoid them, like the person who ducks out early on her last day on the job because she can’t bear to say good-bye? Or do you drag them out because you have such a hard time letting go? Perhaps you make light of endings, refusing to let yourself feel sad. Before you can welcome the new, you must acknowledge and let go of the old.

Keep some things consistent. When you are experiencing a significant life change, it helps to keep as much of your daily routine as consistent as you can. This is not the time to make big decisions in others areas of your life.

Accept that you may never completely understand what has happened to you. You are likely to spend a lot of time feeling confused and afraid. This makes most of us very uncomfortable. The discomfort and confusion will pass, and clarity will return.

Take one step at a time. It’s understandable to feel like your life has become unmanageable. To regain a sense of power, find one small thing you can control right now. Then break it down into small, specific, concrete steps. Write them down and post them on your computer monitor or mirror. Cross off each step as you accomplish it.

In the same manner that a caterpillar transitions into becoming a butterfly, changes occurring in our lives are natural and unavoidable. Accepting the inevitability of change, and learning to better cope with the process, can result in a stronger, more capable self. Be patient.

Obsessive-Compulsive Disorder

Can’t get that thought out of your head? Losing sleep over a comment you made to a person at work? Feel like you just have to get the house clean so you can feel better? Gotta mix those eggs and grits together? Are these normal concerns and habits? Or are they over the top…a sign of a mental disorder?

Obsessive-Compulsive Disorder (OCD) is a neurobiological disorder that affects approximately 2.5 percent of the population, or one out of every 40 people. People with OCD often say that they feel as though their brain is stuck on a certain thought and they are unable to let go of it. They are bombarded by unwanted thoughts over which they have little control…except by engaging in repetitive, and oftentimes nonsensical, behaviors.

If we were to break down the term “Obsessive-Compulsive”, we would find a good definition of the disorder; an “obsession” is a worry, thought, or mental image that persistently intrudes into an individual’s thinking. The individual may then utilize a “compulsion” (i.e., repetitive behaviors or mental exercises), to relieve the discomforting thoughts and images created by the obsession.

An example of this might be as follows: Upon going to bed at night, a person begins to think about someone breaking into the house. This thought becomes persistent, and may also be accompanied by other, perhaps more disturbing, thoughts. This, of course, is the “obsession.” As the psychological and physical discomfort increases for the person, he/she may get out of bed, turn all the lights on, and go around to all the doors, making sure they are locked. This is the “compulsive” act. If performing this action doesn’t relieve the fear and discomfort, the person may perform the compulsion numerous times.

Common obsessions include:

- Thinking about germs and contamination

- Thinking that one has done harm to another

- Fearing that one will be harmed

- Having a need for neatness and order

- Needing things to be a certain way

- Fearing that one will make a mistake

- Fearing one will lose control of oneself

Common compulsions include:

- Excessive handwashing

- Checking and rechecking locks (or the stove & oven)

- Repeated arranging of objects

- Repeated counting of objects

- Silently repeating words

- Saving or hoarding things

While most of us include pleasant rituals in our lives, such as lighting candles for religious events and celebrations, or reading prior to retiring for bed, the rituals that are a part of OCD are anything but pleasant. The worries of leaving the house unlocked, or of becoming contaminated by germs, can become extremely stressful and interfere with normal functioning.

Most people with OCD first show symptoms before the age of 40, with as many as half first experiencing symptoms during childhood. The symptoms may fluctuate over time, ranging from mild to extremely severe. Men and women appear to be equally affected by the disorder.

Most people with OCD realize that their obsessions and compulsions are excessive and irrational, but feel unable to control them. Because they are aware of them AND they feel embarrassed by them, people also tend to be secretive about their symptoms.

In many cases, individuals suffering from OCD are able to keep their rituals a secret from everyone, including family members. Sure, family members may have some idea that the OCD sufferer is a little strange in some ways (i.e., takes too long in the shower, washes hands frequently, vacuums the house every day, won’t throw anything away, etc.), but they wouldn’t say the loved one has a “problem”.

During the course of a normal visit to ones physician, it would take a very astute doctor to pick up on OCD. The secrecy with which the OCD individual guards his/her problem poses yet another obstacle to diagnoses and treatment.

The most effective treatment for OCD is a combination of medication and cognitive-behavioral therapy. Selective serotonin reuptake inhibitors (SSRIs) are frequently used by physicians to treat OCD. Examples of SSRIs include Prozac, Luvox, Zoloft, and Lexapro.

Cognitive-behavioral therapy involves teaching patients how to change their behavior so that they can change their thoughts and feelings. The cognitive aspect of the therapy helps the patient change thought patterns and reduces the catastrophic thinking and exaggerations typical of people with OCD. Completing as many as 20 sessions of cognitive-behavioral therapy has been reported to reduce OCD symptoms by up to 80 percent.

Treatment with medication alone is helpful, but not as effective as combining it with cognitive-behavioral therapy. Medication can help to reduce the number and duration of intrusive thoughts, but it doesn’t teach an individual the tools for coping with the thoughts when they occur. Thus, relying on medication alone results in a higher relapse rate; the intrusive thoughts return when the medication is discontinued.

So, in answer to the original questions posed at the beginning of this article, most of these thoughts and habits are pretty normal, meaning that most of us indulge in those, or others that are similar. If, however, these types of thoughts and behaviors interfere with your everyday living—taking up more than an hour each day and interfering with work and relationships—it is important to talk with your doctor about it. Don’t make the mistake of keeping it a secret, especially when effective treatments are available.