Understanding Adjustment Disorders
Adjustment disorders cause patients to experience ongoing, intense reactions to a triggering event. Oftentimes, it can be hard to diagnose an adjustment disorder. On one side, the patient herself might not recognize that there is even a problem. On the other side, many of the symptoms associated with adjustment disorders are also present in other disorders.
The DSM-V defines six different types of adjustment disorder:
- Adjustment disorder with depressed mood. Symptoms include: chronic sadness, hopeless feelings, an inability to enjoy favorite things.
- Adjustment disorder with anxiety. Symptoms include: worrying constantly, forgetfulness, an inability to concentrate. Children with this type may fear separation from a parent.
- Adjustment disorder with mixed anxiety and depressed mood. Symptoms include: a combination of symptoms described in those two subtypes.
- Adjustment disorder with conduct disturbance. Symptoms include: violent acting out. In teenagers, symptoms may include skipping school and vandalizing property.
- Adjustment disorder with mixed conduct and emotional disturbance. Symptoms include: a combination of depressed, anxiety, and conduct disturbance symptoms.
- Adjustment disorder, unspecified. Symptoms do not fit into other categories. May manifest as physical symptoms.
Diagnosing an adjustment disorder can only be done by a professional. If you suspect you may have an adjustment disorder, contact our offices to explore your therapeutic options.
Adjustment Disorder – When Grief is Not Healthy
Grief is a normal and healthy part of healing after a trauma. Those with an adjustment disorder, however, have an extreme and ongoing response to a trauma that can last long after the inciting incident.
The DSM-V defines criteria for distinguishing between normal, healthy grief and an adjustment disorder. If a patient has some but not all of the diagnostic criteria for the disorder, they may have a related disorder, such as PTSD. A trained mental health professional can help a patient figure this out through conscientious and compassionate work in session.
The most common sign of an adjustment disorder is an outsized reaction to a trauma that continues to interfere with regular life. Additional signs of this disorder include:
- Suicidal ideation
- Feeling hopeless
- Detaching from favorite pastimes
- High anxiety or stress
- Emotional apathy
- Faulty concentration
- Crying jags
- Unhealthy sleep patterns
Given that symptoms overlap with those in other mental health disorders, it is important that a trained professional diagnoses an adjustment disorder. Diagnosis requires:
- Symptoms appearing fewer than 3 months after the trauma
- Outsized reactions to triggers
- Negative ideation that reduces one’s quality of life
- No pre-existing condition that may have similar symptoms
What Causes an Adjustment Disorder?
The trauma that causes an adjustment disorder can take one of many forms. It can even be something many consider positive, such as leaving for college for the first time. Some triggers are chronic and ongoing, as in an abusive relationship, while in other scenarios a combination of events can cause the disorder.
Chronic vs. Acute Adjustment Disorder
Many disorders come in acute and chronic versions. With adjustment disorders, an acute case will last fewer than six months, while a chronic case lasts longer than six months. Additionally, once a trigger goes away in an acute case, the patient’s symptoms disappear. As a contract, chronic sufferers will still have symptoms after the triggers go away.
Treating Adjustment Disorder
Interventions that work effectively with adjustment disorders include therapy, medication, and lifestyle changes. Patients may also need some combination of those. Therapy sessions for adjustment disorder can be individual, group, or family sessions and can include:
- Talk therapy
- Building coping mechanisms
- Identifying negative patterns
- Identifying triggers
Sometimes, medication is the answer for a patient with Adjustment Disorder. Medications that are effective include antidepressants and anti-anxiety medications.
Lifestyle changes that patients can develop to help with this disorder include:
- Fomenting bonds with friends and loved ones
- Focusing on the positive
- Avoiding sublimation and addressing problems
- Documenting successes
- Living a healthy life