“Adjustment disorder” is defined by psychiatrists as a reaction that causes emotional or behavioral symptoms in response to a change in someone’s environment. The causes are multiple — a relocation, divorce, or job change — and universally result in feelings of anxiety, panic, a sense of being overwhelmed, and/or depression. Travelers, particularly those who have experienced severe emotional stress in the past (history of abuse, military conflict, loss of a loved one, etc.) are at increased risk of suffering from adjustment disorder. Unfortunately for business travelers and students, the symptoms may impede work or academic performance, providing additional stress. One of the more widely used treatments for adjustment disorder is cognitive behavioral therapy: the practice of training one’s mind to redirect negative thoughts. A normal treatment course with a professional therapist varies from 6 to 12 sessions, during which time patients are given exercises to restructure negative thinking patterns in order to interpret their environment in a less biased way. For example, patients who experience persistent panic attacks are encouraged to test out beliefs they have related to such attacks, such as specific fears tied to bodily sensations, and to develop realistic responses to such beliefs. It may not be practical for a traveler who is attempting to deal with the symptoms of adjustment disorder to seek help from a trained cognitive behavioral therapist. They simply do not exist in many parts of the world, or may be prohibitively expensive. One interesting alternative has been developed by the Australian government, which has created an “e-hub” suite of online self-help services on Facebook

Those looking for help can use a free service called Beacon to get in-depth assessment of many online self-help web sites (free and fee-based). Using Beacon, I found a site called Stress and Mood Management that is based in part on cognitive behavioral therapy. Reviewers gave this fee-based service a positive rating. Unfortunately, it is currently undergoing an update and is unavailable. But there are plenty more web sites to be explored. We will continue searching for self help resources — both in the management of medical conditions and mental illness — for all of our nomadic readers. Photo by Eddi van W.


About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .


  1. Very informative information. I moved around a lot while I was younger maybe that was the root of some of my mental hurdles. I found my own method of CBT seemed to help a lot to cure what ailed me.

    In fact i just moved half way across the country and I know no one. This has been fairly stressful.

  2. Thanks , I’ve just been searching for info approximately this subject for a long time and yours is the best I’ve came upon till now. But, what concerning the conclusion? Are you sure in regards to the supply?

  3. This is very helpful and reassuring. Thank you for this! I’m currently about a month into a job that I haven’t worked in a year (that is already considered fairly high stress) on top of a complex living situation has me in over my head. I’ll definitely look into this!

  4. Thanks for this info — I was not aware there was online help for this! Especially good for people who travel.

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