Adjustment Disorder
What is an Adjustment Disorder?
Patients with adjustment disorder experience outsized and long-lasting reactions to adverse events. Some people call it “situational depression” because the symptoms come after an identifiable trigger and the symptoms are similar to chronic depression.
Adjustment disorder can be difficult to diagnose because patients often see their reactions as typical of anyone in the same situation. Furthermore, the symptoms can mimic other mental disorders.
There are six types of adjustment disorder that each present their own challenges and symptoms:
- With anxiety
- With depression
- With the disturbance of conduct
- With mixed anxiety and depressed mood
- With mixed disturbance of conduct and emotions
- Unspecified
Only a trained professional can diagnose a patient with any of these types of adjustment disorder.
Adjustment Disorder vs. Healthy Grief
Each of these triggers can cause negative emotions in people without any mental health disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) helps professionals determine if a patient reacts to the identified problem healthily or develops adjustment disorder.
The DSM-5 is the authority on mental health diagnoses, and it is in its fifth version. Leading mental health researchers and practitioners worked together for many years to develop the DSM-5. It includes diagnostic criteria, definitions, and symptoms of every single recognized mental disorder in the world.
When someone experiences negative emotions in the wake of a traumatic event, it’s not necessarily a sign of adjustment disorder. Grief and fear in some measure can be healthy as well. If patients do not meet all of the criteria in the DSM-5, it’s possible that their experiences are perfectly healthy.
Some patients may experience severe mental distress following an adverse event but not qualify for an adjustment disorder diagnosis. Instead, these people might suffer from other disorders, such as PTSD or panic attacks. Only a trained mental health professional can make that determination.
Adjustment Disorder Criteria & Symptoms
Although mental health disorders often overlap with their symptoms, each one has unique characteristics that set it apart. The hallmark characteristics of adjustment disorder are:
- The patient’s distress outweighs the original event
- The person experiences problems in their relationships, work, or other vital parts of their lives
These issues can manifest in several specific ways. Patients all experience adjustment disorder in unique ways. However, some common symptoms include:
- Suicidal thoughts or attempts
- Feelings of hopelessness
- Loss of interest in favorite activities
- Anxious thoughts and worries
- Withdrawal from the support system
- Trouble concentrating
- Avoidance of life’s “necessary evils” such as paying bills or attending work
- Crying spells
- Difficulty falling or staying asleep
- Sleeping too much
These symptoms can indicate several other mental health disorders as well. That’s why it’s essential to refer to the DSM-5 for diagnostic criteria. Mental health professionals use this guide to make diagnoses so that patients get the help they need. According to the DSM-5, patients with adjustment disorder:
- Begin experiencing their symptoms within three months after an identifiable trigger
- Have more negative emotions than one would expect following the event
- Experience such negative feelings that it interrupts their daily lives
- Cannot pin their symptoms on other mental disorders, such as pre-existing depression or anxiety
What Causes an Adjustment Disorder
Some patients can link their troubles to one traumatic event. Getting fired, being the victim of a crime, divorce, death of a loved one, and natural disasters can all kick off a person’s adjustment disorder.
Sometimes, the trigger may seem like a positive change at first glance. Patients who begin new jobs or attend college for the first time can have difficulty with the sudden change, leading to adjustment disorder.
Several problems can pile up on a patient and cause adjustment disorder. For example, a patient could get physically ill and have difficulties at work all at once, leading to adjustment disorder.
Finally, triggers can recur frequently or present a constant threat. For example, a child who witnesses domestic abuse at home or a person who lives in a dangerous neighborhood can develop adjustment disorder as a reaction.
Can Someone Have Chronic Adjustment Disorder?
Patients with these symptoms may experience acute or chronic adjustment disorder. With the acute version, patients experience the symptoms for six months or fewer. Typically, the symptoms go away when the person removes the stressor or learns to use healthy coping mechanisms.
With chronic adjustment disorder, patients continue to struggle with their symptoms for longer than six months. Even when the trigger resolves as much as possible, the person continues to experience symptoms.
While the treatments for both acute and chronic versions of adjustment disorder are similar, patients with persistent problems may need help for longer than their counterparts with acute adjustment disorder.
Adjustment Disorder Treatment
The treatment options for adjustment disorder include psychotherapy, medications, and lifestyle changes. Psychotherapy can include individual appointments, group sessions, or family counseling, depending on the needs of the patient. In each of these therapies, patients learn to:
- Manage their symptoms
- Ask for support
- Identify and turn-around negative thoughts
- Understand why the trigger affected them this way
- Talk through their feelings
- Modify their destructive behaviors
Medications may also play a role in recovery, depending on the type and severity of the symptoms. For example, patients with frequent panic attacks may need anti-anxiety medication while those with depressive symptoms use antidepressants.
Certain lifestyle changes can help make professional treatments more effective. Patients can try these treatments at home:
- Reconnect to a healthy support system
- Search for purpose and happiness in each day
- Address problems head-on instead of avoiding them
- Write down a list of personal achievements and good qualities
- Make healthy choices, such as eating healthily and getting enough exercise