Life Transitions

A life transition is a major change from one stage of life to the next. It might be a new job, a move, a divorce, a diagnosis, or a loss. Some you choose. Others you do not.

Many people feel unsteady during a transition, even when the change is one they wanted. There are good reasons for that, and they are well understood. This page sets them out, and points to support when you need it.

By Team TherapyRoute

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Transitions as stressors

Stress names two things at once. There is the event, and there is what the event does to you. A stressor is the event or the demand itself, the thing that requires an adjustment. When distress follows an identifiable change, that change is the stressor.³ Distress also arrives without one, which is a different matter and not what this page is about.

Identifying the stressor, describing it, and working out whether it can be reduced or accommodated is where clinical work on this begins.³ All of us share a vulnerability to life's difficulties,¹ and that vulnerability is human, not a weakness.

Why the same change lands differently

The same event can barely register with one person and feel catastrophic to another. How difficult a change becomes depends on a few personal factors. These include your capacity to cope, the support around you, and how you have managed hard times before.³

Losing a job can feel like a relief to one person and a catastrophe to another.³ The timing matters too. A small new stress can be hard to bear when an older one has not settled, because the two demands add up.

A change can have an obvious meaning and a private one as well.³ The private meaning is usually the one that matters. It is rarely obvious.

Grief belongs in transition

Even a welcome change can involve real loss. Grief is the process of facing a loss and then revising what you had assumed about the world.⁴

Even when a loss is expected, part of you goes on feeling that it has not happened. The first task of grieving is to accept that the loss is real.⁴ Acceptance is gradual.

Denial is a state of not fully taking in what has happened. It can apply to the facts of a loss, to what the loss means, or to the fact that it is permanent.⁴ Naming what has ended can make the change easier to bear.

When change meets illness or loss

Some transitions are among the hardest anyone faces. Grief and fear are common when a person is facing serious illness or the end of life.² In people who are terminally ill, anxiety and low mood most often appear intertwined rather than separately.²

One thing is worth knowing early. Palliative care is often heard as a signal that treatment has stopped, and it is not. It is care aimed at quality of life, for patients of any age and any diagnosis, and it runs alongside treatment intended to cure as readily as it does at the end of life.²

The family is part of this, not an audience to it. Hospice services routinely provide bereavement counselling to the family, and some hospitals run bereavement programmes of their own.² What is available differs from place to place, so it is a fair question to put to the treating team.

What helps during a transition

There is no single right way through a change, and time on its own does less than it is credited with. What matters is what a person does with the time.⁴ A first move is to name the specific loss inside the change, including a change you chose. A new job can cost you colleagues you liked. A move ends a daily routine you had stopped noticing.

Keep part of the week fixed while the rest of it moves. Stress-management work often starts by having a person record where their time actually goes, across work, family, rest and the things they do for their own sake, and then protect what is important but never urgent: rest, exercise, and time with people.¹ Deliberate relaxation belongs in that category. It lowers muscle tension and general arousal, and people who can do it tend to rest and sleep better.¹

Keep the people. Stress happens in a social context, so involving those closest to you in what is going on is sensible rather than indulgent.¹ Social isolation is repeatedly observed as a risk for poorer outcomes after exposure to a major stressor.¹ Putting feelings into words, rather than into action, is part of how they become manageable,³ so the conversation worth having is the one about what the change means to you, not only what happened.

Expect the first stretch to be the worst of it. Anything unfamiliar is hard at first, and settling into something new takes time. Finding the early weeks difficult says nothing about how the change will turn out.

When to reach out for help

Some transitions ask for more support than friends and family can give. Reactions to a stressor are transitory for most people. They can also settle only partly, or carry on while the stressor itself carries on.³ Two things are worth watching. One is distress that is still heavy after the change itself has settled. The other is distress that has begun to show in your work or study, or in your closest relationships.³

After a serious loss it is easy to arrive at the conclusion that everything is gone. Part of the work is holding that conclusion up against what is in fact still there: work that still means something, relationships that have not ended, capacities that remain.³ Therapy gives you a setting in which to make sense of the change, and time to steady yourself before deciding what comes next.

When you are ready, our guide can help you find the right therapist.

Related terms

You may also find these related pages useful.

• Change Management - Skills and strategies for handling change effectively
• Resilience - Personal quality that supports steadier transitions
• Personal Growth - Development that often grows out of change

References

1. [1] Kaplan & Sadock's Comprehensive Textbook of Psychiatry (10th ed., 2017). Section 27.10, Stress and Psychiatry.
2. [2] Kaplan & Sadock's Comprehensive Textbook of Psychiatry (10th ed., 2017). Section 27.9, End-of-Life and Palliative Care.
3. [3] Gabbard's Treatments of Psychiatric Disorders (2007). Chapter 35, Adjustment Disorder.
4. [4] Worden. Grief Counseling and Grief Therapy (5th ed., 2018). Tasks of Mourning.

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This page is for general information and learning. It is not a substitute for professional assessment or care. If a change feels overwhelming, please reach out to a qualified professional.