Crew Health Advice: Empowering crew members is key to preventing Adjustment Disorder

The Club reports a case of a crew member recently repatriated following a period of insomnia and heart palpitations.

Upon returning home, the crew member was examined by physicians and diagnosed with Adjustment Disorder. Adjustment Disorder is a very common short-term psychological condition that occurs when a person is unable to cope with a stressor or a recurrent event causing stress to the individual. Adjustment Disorder may manifest with depressed mood, anxiety, maladaptive behaviours causing significant impairment in social, occupational or personal functioning. It is associated with a high risk of suicide (Casey et.al.2014). Therefore, assessment of Adjustment Disorder should include careful monitoring of both symptomatology and suicidal thinking.  

In identifying stressors on board, many seafarers report separation from their families and friends, loneliness, high workloads, shift work, long working hours, limited recreational time, multicultural and multilingual crews as some of the greatest challenges. Stress and anxiety are normal responses to major life changes and stressors. However, when the discomfort, distress, turmoil and anguish to the person are significant, Adjustment Disorder may be the source of the distress.

Signs and symptoms

Symptoms vary and can include the following, usually occurring within three months of the introduction of the stressor, and can cause significant impairment in social, occupational or personal functioning:

• Depressed Mood
• Sadness
• Worry and anxiety  
• Poor concentration
• Anger and disruptive behaviour
• Insomnia
• Physical Complaints (headaches, stomach aches, palpitations, chest pain, etc.)
• Low self-esteem, sense of hopelessness, feeling trapped or lonely, or showing signs of withdrawal

Typical stressors

• Disruptions in close relationships
• Occupational losses or failures
• Major life changes such as leaving home, getting married, being separated from family and friends or loved ones.
• Failure - disappointments or losses
• Changing jobs or adjusting to new jobs
• Being diagnosed with a chronic illness
•  Bullying

Personal management tips for individuals

• Stay positive
• Find a routine
•  Immerse yourself in the culture of the company
• Take notes - observe what is going on around you. Identify problem areas for you, and seek solutions to possible problems
• Set personal goals aligned with the vision of the organisation
• Be open and engage with others onboard by sharing information, ideas and thoughts, and, when appropriate, your emotions and thoughts
• Share and cooperate
• Be trustworthy. When people trust you, do your best to provide positive outcomes
• Be accepting
• Be supportive of others
• Understand both your personal strengths and weaknesses
• Seek assistance when needed
• Be courteous and respectful to your colleagues
•  Increase personal and interpersonal insight
• Apply active listening skills, empathy and validation when communicating with others
• Communicate appropriately and responsibly, resolve conflicts when they arise in socially proactive ways  

Personal Empowerment is the key to personal adjustment and happiness

Organisational management tips for employers

Adjustment Disorder is an excessive reaction to an identifiable life stressor or recurrent stressors. A substantial amount of research suggests that psychosocial risk factors such as high job demands, low job control, high effort - low reward and low social support may contribute to the development of depression and anxiety. Organisations can implement interventions that aim to prevent exposure to psychological and physical risk factors and thus reduce the risk for mental disorders. Adjustment Disorder can be prevented via proactive methods and strategies.

It is important to encourage culture and team cohesiveness onboard to facilitate adjustment, empower employees and promote well-being at sea. Educate employees in acquiring appropriate communication skills, building supportive social networks onboard, and encouraging behavioural well-being can lessen distress arising from stressors.

Empower employees by encouraging active coping skills, communication skills, building supportive social networks onboard and implement resiliency training. Work health can improve employee well-being, performance and safety onboard.

This advice was compiled with the help of our psychological and psychometric screening partners I.M.E.Q.

You can watch their video on Adjustment Disorders at www.youtube.com/watch?v=ZdqYDPqHh64 www.imeq-center.com/