Adjustment Disorder: Definition, Types, Symptoms, Causes, and Treatments

Adjustment Disorder

The adjustment disorder is a short-term condition that occurs when a person has great difficulty coping with a particular source of stress or adapting to it, such as a significant life change, loss, or event. In 2013, the mental health diagnostic system changed the name from “adjustment or adaptive disorder” to “stress response syndrome.”

Because people often have some of the symptoms of clinical depression, such as crying, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes informally referred to as “situational depression.” However, unlike major depression, this disorder does not involve most of the physical and emotional symptoms of depression (such as changes in sleep, appetite, and energy) or high levels of severity (such as suicidal thinking or behavior. ).

Types of adjustment disorder

The following are the six types and their symptoms:

Adjustment disorder with depressed mood

People diagnosed with this type of disorder tend to experience sadness and hopelessness; it is also associated with crying. You may find that you no longer enjoy the activities you did before.

Sometimes, in addition to having difficulty coping with a stressor, as a result of this life problem, people develop depression. If this continues severe enough, they may eventually get a diagnosis of Major Depressive Disorder, but until that happens, the treatment will mainly focus on the stressor.

Adjustment disorder with anxiety

The main symptom that people experience when going through stress is increased anxiety. If this increased anxiety is related to a specific stressor, is more severe than expected, or lasts too long, the likely problem is adjustment disorder with anxiety.

Associated symptoms include feeling overwhelmed, anxious, worried, and having trouble concentrating and memory.

This diagnosis is generally associated with separation anxiety from parents and loved ones’ children.

Adjustment disorder with mixed anxiety and depressed mood

Anxiety and depression often occur in people simultaneously; if this stressor has produced both depression and anxiety, then this specifier should be added.

Adjustment disorder with behavioral disturbance

The primary way we know that stress has affected someone is that they begin to misbehave; this diagnosis with this specifier is seen more often in children who, instead of showing their symptoms such as anxiety or depression, start to Act badly, such as reckless driving or starting fights. Teens can steal or damage property and may start skipping school.

Adjustment disorder with mixed disturbance of emotions and behavior

When stress exceeds a person’s ability to cope, we can see changes in their behavior and feelings; this is often the case in children and adolescents. Still, it can also be seen in adults with poor emotional regulation. Related symptoms include depression, anxiety, and behavior problems.

Adjustment disorder, unspecified

This category can be used when the therapist knows that his reaction to stress causes the client’s problem, but none of the other subtypes seem to fit.

As with the other things we call mental illness, this problem must interfere with your ability to work or go to school, your relationships, fun activities, or cause you personal distress. If not, you may have the issues, but you won’t get the diagnostics if this doesn’t cause a problem for you.

If the only time this happens is when you are under the influence of drugs,  medications, or some other physical or medical problem, this problem must be more than your situation would warrant. This additional problem needs treatment first, and then if you still have symptoms, you can get this diagnosis.

What are the factors and causes?

People exposed to repeated trauma are at higher risk, even if that trauma is in the distant past. Age can be a factor because young children have fewer resources to cope with and are less likely to assess the consequences of a potential stressor.

A stressor is generally an event of a severe and unusual nature experienced by an individual or group of individuals. The stressors that cause adjustment disorders can be highly traumatic or relatively minor, such as losing a girlfriend/boyfriend, a poor report card, or moving to a new neighborhood. It is believed that the more chronic or recurrent the stressor, the more likely it is to cause a disorder.

The objective nature of the stressor is of secondary importance; the most critical link of stressors with their pathogenic potential is their perception by the patient as stressful. The presence of a causal stressor is essential before a diagnosis of adjustment disorder can be made.

There are specific stressors that are more common in different age groups:

Adulthood

  • Marital conflict.
  • Financial conflict.
  • Health problems with oneself / partner or dependent children.
  • Personal Tragedy (Death / Personal Loss).
  • Loss of employment or unstable employment conditions (e.g., corporate acquisition/redundancy).
  • Major changes in life

Adolescence and childhood

  • Family conflict / parental separation.
  • School problems/change of schools.
  • Sexuality problems.
  • Death/illness/trauma in the family.
  • Sudden disasters.

What are the symptoms of adjustment disorder?

A person with a stress response syndrome develops emotional and behavioral symptoms in reaction to a stressful event; these symptoms generally begin within three months and rarely last more than six months after the event or situation.

In an adjustment disorder, the reaction to the stressor is more significant than what is typical or expected for the situation or event. Also, the symptoms can cause problems with a person’s ability to function; for example, the person may have trouble sleeping, working, or studying.

This disorder is not the same as PTSD, as it generally occurs as a reaction to a life-threatening event and tends to last longer. On the other hand, stress response syndrome is short-term, rarely lasting more than six months.

The symptoms are as follows:

  • Depressed mood
  • Impaired labor / social functioning.
  • Agitation.
  • Shaking or spasms
  • Physical ailments (for example, general aches and pains, stomach pain, chest pain, chest pain).
  • Palpitations
  • Disruptive behavior (truancy, vandalism, reckless driving, or fighting).
  • Anxiety, worry, stress and tension.

Note:  Symptoms can vary widely; the person may or may not know the stressor causing the disturbance.

How can adjustment disorder be diagnosed?

If you suspect you may have an adjustment disorder, see your doctor. If there are symptoms, your doctor may perform a physical exam and ask questions about your medical history; However, there are no pictures or laboratory tests to precisely diagnose it, the doctor may sometimes use laboratory tests, such as blood tests or imaging studies such as CT or MRI scans, to rule out physical illness or other medical causes of changes in mood or behavior (such as head trauma) as the cause of your symptoms.

Your doctor will also look for other mental illnesses, such as post-traumatic stress disorder, major depression, or anxiety disorder.

He bases his diagnosis on his report on the intensity and duration of the symptoms, including any problems with daily functioning caused by the symptoms. In general, a stress response syndrome is suspected if the level of distress is more intense than expected, given the stressor, or if the symptoms interfere with normal functioning.

If this disorder is suspected, your doctor will likely refer you to a psychiatrist, psychologist, or other trained mental health professional to help people when they have trouble coping with and managing stressful life events.

How is an adjustment disorder treated?

If you are diagnosed with this type of disorder, you will probably benefit from treatment, it may require only short-term treatment, or you may need treatment for an extended period. Adjustment disorder is usually treated with therapy, medication, or both.

Therapy

Therapy is the primary treatment for an adjustment disorder; your doctor may recommend that you consult a mental health professional and be referred to a psychologist or mental health counselor. However, if your doctor believes that your condition requires medication, you may be referred to a psychiatrist or psychiatric nurse.

Going to therapy can allow you to return to an average level of functioning; therapists offer you their emotional support and help you understand the cause of your disorder; this can help you develop skills to face future stressful situations.

There are several types of therapies used to treat adjustment disorders. These therapies include:

  • Psychotherapy (also called counseling or talk therapy).
  • Crisis intervention (emergency psychological care).
  • Family and group therapies.
  • Support groups specific to the cause of adjustment disorder.
  • Cognitive-behavioral therapy l (which focuses on problem solving by changing unproductive thoughts and behaviors).
  • Interpersonal psychotherapy (short-term psychotherapy treatment).

Medication

Some people with adjustment disorders also benefit from taking medications, as they are used to decrease some of the symptoms, such as insomnia, depression, and anxiety. These medications include:

  • Benzodiazepines, such as lorazepam (Ativan) and alprazolam (Xanax).
  • Anxiolytics in benzodiazepines such as gabapentin (Neurontin).
  • SSRIs or IRSNs, such as sertraline (Zoloft) or venlafaxine (Effexor XR).

Can an adjustment disorder be prevented?

There is no known way to prevent adjustment disorder; however, strong family and social support can help people work through a particularly stressful situation or event. The best prevention is early treatment, reducing the severity and duration of symptoms, and teaching new coping skills.

Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.

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