Dr Jozelle Miller
November 8, 2016

How do I move on? Understanding Adjustment Disorder – Part 2

Adjustment disorder is a group of symptoms, such as stress, feeling sad or hopeless, and physical symptoms that can occur after you go through a stressful life event. The symptoms occur because you are having a hard time coping. Your reaction is stronger than expected for the type of event that occurred. An adjustment disorder is a temporary condition caused by stress. It’s linked with psychological and sometimes physical symptoms that can interfere with your everyday life.{{more}}

Causes

Many different events may trigger symptoms of an adjustment disorder. Whatever the trigger is, the event may become too much for you.

Stressors for people of any age include:

o Death of a loved one

o Divorce or problems with a relationship

o General life changes

o Illness or other health issues in yourself or a loved one

o Moving to a different home or a different city

o Unexpected catastrophes

o Worries about money

Triggers of stress in teenagers and young adults may include:

o Family problems or conflict

o School problems

o Sexuality issues

There is no way to predict which people who are affected by the same stress are likely to develop adjustment disorder. Your social skills before the event and how you have learned to deal with stress in the past may play roles.

Types of Adjustment Disorders

There are six different types of adjustment disorders. Each type is associated with different symptoms:

1. Adjustment disorder with depressed mood

People diagnosed with this type of adjustment disorder tend to experience feelings of sadness and hopelessness. It’s also associated with crying. You may also find that you no longer enjoy activities that you formerly enjoyed.

2. Adjustment disorder with anxiety

Symptoms associated with adjustment disorder with anxiety include feeling overwhelmed, anxious, and worried. People with this disorder may also have problems with concentration and memory. For children, this diagnosis is usually associated with separation anxiety, from parents and loved ones.

3. Adjustment disorder with mixed anxiety and depressed mood

People with this kind of adjustment disorder experience both depression and anxiety.

4. Adjustment disorder with disturbance of conduct

Symptoms of this type of adjustment disorder mainly involve behavioural issues, like driving recklessly or starting fights. Teens with this disorder may steal or vandalize property. They might also start missing school.

5. Adjustment disorder with mixed disturbance of emotions and conduct

Symptoms linked to this type of adjustment disorder include depression, anxiety, and behavioural problems.

6. Adjustment disorder unspecified

Those diagnosed with adjustment disorder unspecified have symptoms that aren’t associated with the other types of adjustment disorder. These often include physical symptoms or problems with friends, family, work, or school.

Who Is at Risk of Developing Adjustment Disorder?

Anyone can develop an adjustment disorder. There isn’t any way to tell who out of a group of people experiencing the same stressor will develop an adjustment disorder. Your social skills and methods for coping with other stressors may determine whether or not you develop an adjustment disorder.

How Is Adjustment Disorder Treated?

If you are diagnosed with an adjustment disorder, you would probably benefit from treatment. You may require only short-term treatment or may need to be treated over an extended period of time. Adjustment disorder is typically treated with therapy, medications, or a combination of both.

Therapy

Therapy is the primary treatment for an adjustment disorder. Your doctor or health care provider may recommend you see a mental health professional. You may be referred to a psychologist. However, if your doctor thinks that your condition requires medication, they may refer you to a psychiatrist.

Going to therapy can help you return to a regular level of functioning. Therapists offer you their emotional support and can help you understand the cause of your adjustment disorder. This together can help you develop skills to cope with future stressful situations.

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

o psychotherapy (also called counselling or talk therapy)

o crisis intervention (emergency psychological care)

o family and group therapies

o support groups specific to the cause of the adjustment disorder

o cognitive behavioral therapy, or CBT (focuses on solving problems by changing unproductive thinking and behaviours)

o interpersonal psychotherapy, or IPT (short-term psychotherapy treatment)

How to Prevent Adjustment Disorders?

There’s no guaranteed way to prevent an adjustment disorder. However, learning to cope and be resilient can help you deal with stressors. Being resilient means being able to overcome stressors, on your own; you can increase your resilience by:

o developing a strong network of people to support you

o looking for the positive or humour in hard situations

o living healthfully

o establishing good self-esteem

It can be helpful to prepare for a stressful situation if you know you will need to confront it in advance. Thinking positively can help. You can also call your doctor or therapist to discuss how you can best manage especially stressful situations.

Dr Miller is Health Psychologist at the Milton Cato Memorial Hospital.