Adjustment Problems

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, and the reaction is stronger or greater than what would be expected for the type of event that occurred.

Adjustment disorder occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness, and tearfulness, this disorder is also sometimes known as situational depression.

Unlike major depression however, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor.

Its common characteristics include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three. . Adjustment disorder may also be acute or chronic, depending on whether it lasts more or less than six months. If the adjustment disorder lasts less than 6 months, then it may be considered acute. If it lasts more than 6 months, it may be considered chronic. However, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated. Diagnosis of adjustment disorder is quite common; there is an estimated incidence of 5-21% among psychiatric consultation services for adults. Adult women are diagnosed twice as often as are adult men, but among children and adolescents, girls and boys are equally likely to receive this diagnosis. Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, but the concept was recognized for many years before that. When considering biopsychosocial disorders, an athlete’s overtrained state can be due to an Adjustment Disorder.

Types of adjustment disorder are :

1. Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and experiencing a lack of pleasure in the things you used to enjoy.

2. Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.

3. Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety.

4. Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting, reckless driving or ignoring your bills. Youths may skip school or vandalize property.

5. Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.

6. Adjustment disorder unspecified. Symptoms don’t fit the other types of adjustment disorders, but often include physical problems, problems with family or friends, or work or school problems.

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:

Death of a loved one
Divorce or problems with a relationship
General life changes
Illness or other health issues in yourself or a loved one
Moving to a different home or a different city
Unexpected catastrophes
Worries about money

Triggers of stress in teenagers and young adults may include:

Family problems or conflict
School problems
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.

Symptoms of adjustment disorder are often severe enough to affect work or social life. Some of the symptoms include:

Acting defiant or showing impulsive behavior
Acting nervous or tense
Crying, feeling sad or hopeless, and possibly withdrawing from other people
Skipped heartbeats and other physical complaints
Trembling or twitching

To have adjustment disorder, you must meet the following criteria:

The symptoms clearly come after a stressor, most often within 3 months
The symptoms are more severe than would be expected
There do not appear to be other disorders involved
The symptoms are not part of normal grieving for the death of a loved one

On occasion, symptoms can be severe and the person may have thoughts of suicide or make a suicide atte

The basis of the diagnosis is the presence of a precipitating stressor and a clinical evaluation of the possibility of symptom resolution on removal of the stressor due to the limitations in the criteria for diagnosing Adjustment Disorder(AD). In addition, the diagnosis of Adjustment Disorder(AD) is less clear when patients are exposed to stressors long-term, because this type of exposure is not only associated with Adjustment Disorder(AD) but also Major Depressive Disorder(MDD) and Generalised Anxiety Disorders(GAD).

Some signs and criteria used to establish a diagnosis are important, however. First, the symptoms must clearly follow a stressor. The symptoms should be more severe than would be expected. There should not appear to be other underlying disorders. The symptoms that are present are not part of a normal grieving for the death or family member or other loved one

The main goal of treatment is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred.

Most mental health professionals recommend some type of talk therapy. This type of therapy can help you identify or change your responses to the stressors in your life.

Cognitive behavioral therapy (CBT) can help you deal with your feelings.

First your therapist helps you recognize the negative feelings and thoughts that occur.
Then your therapist teaches you how to change these into helpful thoughts and healthy actions.

Other types of therapy may include:

Long-term therapy, where you will explore your thoughts and feelings over many months or more
Family therapy, where you will meet with a therapist along with your family
Self-help groups, where the support of others may help you get better

Medicines may be used, but only along with some type of talk therapy. These medicines may help if you are:

Nervous or anxious most of the time
Not sleeping very well
Very sad or depressed