What is Adjustment Disorder?
Adjustment disorder is primarily diagnosed in children and adolescents, but not limited to as it can equally affect adults as well. According to the National Institutes of Health (NIH):
“Adjustment Disorder is a condition strongly tied to acute and chronic stress.”
It appears as an emotional and behavioral outcome stemming from life changes or events. At times, there is a need for adjustment when arriving at a life change or event and it becomes a problem when one is unable to meet their own needs to adjust due to the overwhelming feelings they are experiencing. Rather than adjusting in a fluid motion, sufferers of adjustment disorder they hit roadblocks that slow them down from making this adjustment. Their reactions instead are unhealthy, excessive, and begin to hinder their daily functioning in life. In this blog, we will discuss all things adjustment disorder, treatment options, and how you can get help if you need it.
Adjustment Disorder Symptoms
Each individual experiences a different version of their adjustment disorder as symptoms can look very different from another individual’s. Although unique, they are all interrelated. According to the Statistical Manual of Mental Disorders (DSM-5), there are 6 subtypes of adjustment disorders:
With a Depressed Mood.
It is expected to be a learning curve when approaching something new, but an adjustment disorder is identified when symptoms go beyond a normal reaction. An adjustment disorder with a depressed mood is when one becomes more sorrowful and sadder as a direct reaction from the change or event and often leads to feelings of hopelessness. This has a direct reflection on their daily functioning at school, work, or social functioning. Their normal interest is depleted, they struggle with concentration and even have memory loss. Their normal sleep behaviors suffer from it, thus worsening their irritability.
With Anxiety.
Individuals with an anxiety subtype can experience overwhelming feelings that are difficult to sort and understanding themselves. This can appear in excessive worry or anxiousness thus leading to difficulties concentrating and/or memory loss. Some may feel more nervous and jittery than usual and have sudden anxiety when separating from attachments. This is found predominantly associated with separation anxiety in children.
With Mixed Anxiety and Depressed Mood.
Adjustment Disorder with a mix of anxiety and depressed mood encompasses symptoms from both conditions.
With Disturbance of Conduct.
An individual will begin to behave outside the realm of social norms and can turn to violating other’s boundaries, rights, and can become a real issue. For some, this may present as an outburst of mood swings, rage, rebellion, recklessness, revenge, and impulses that are acted upon. Symptoms can feel frightening and disturbing consequently intensifying the misconduct. Some may begin abusing substances such as drugs and alcohol as a result of the adjustment disorder. Symptoms can lead to a bigger problem in relationships and society.
With Mixed Disturbance of Emotions and Conduct.
This is a combination of symptoms from an adjustment disorder with anxiety, depressed mood, and disturbance of conduct.
Unspecified.
An adjustment disorder with unspecified means an individual’s symptoms cannot be categorized in the above subtypes. Behaviors may appear as withdrawal and sudden discomforts in normal activities such as school and work. Bodily symptoms may be apparent such as headaches, body/stomach aches, heart palpitations, sweating hands, being fatigued, and insomnia.
Causes of Adjustment Disorder
Environmental Factors play a huge role in the cause of adjustment disorders. Life changes and events are perceived as stressful and become a hindrance in the daily functioning of an individual causing significant problems. Several examples of stressful changes or events can look like, but not limited to a move, loss or job, divorce, changes in schools, losing a loved one, receiving a diagnosis of a chronic illness, financial difficulties, disaster or tragedy, and much more.
Diagnosing Adjustment Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, a diagnosis of Adjustment Disorder, one must experience symptoms within 3 months of the on setting stressor and lasting up to 6 months or longer. Symptoms cannot be contributed or better explained by an alternative mental health disorder or reasoning such as a medical illness, and drugs and/or alcohol use.
Risk Factors of Adjustment Disorder
Needless to say, it is important to not neglect the chemicals in the brain as root of symptoms. Our emotions, thoughts, and behaviors are affected by the chemicals our brain produces and when these are imbalanced, it can create a problem. Individuals with adjustment disorders either have an excessive amount of these chemicals or not enough to create stability. Genes are another factor to be considered when determining the cause of a disorder. Oftentimes you see familiar symptoms that run in families. This can also be due to learned behaviors as children act from the example shown to them by their parents, thus increasing one’s risk for disorders.
Treatment Options for Adjustment Disorder
Let’s discuss a few treatment options of adjustment disorder:
Therapy
Understanding oneself is a huge advantage when recovery and taking power over your adjustment disorder. This can be done through therapy as it is one of the best things one can do for themselves. Therapy can be done in an individual, family, or group setting offering support for the needs of the individual through empowering the individual with interventions, such as Cognitive Behavioral Therapy (CBT), and developing techniques to manage stress and cope with future stressful events.
Medication
Medication can address the chemical imbalanced aspect of the disorder. When treating adjustment disorder, it is important to treat all sides of the problem to see a real improvement.
Getting Treatment for Adjustment Disorder
Adjustment disorder can affect people of all ages, can become a serious problem, and should never be left unaddressed.
The first step is to check with your health insurance to identify a local provider in-network with your coverage. You can schedule a medication management appointment to be assessed by a medical provider for medications suited for your symptoms and a therapy appointment to receive psychotherapy, better known as talk therapy.
You can also receive a formal diagnosis by going through a doctor or a psychiatrist who conducts comprehensive psychiatric assessment to evaluate your thoughts, feelings, behaviors, and history.
Find mental health professionals that treat adjustment disorder.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710332
- https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
Author: Cecilia Gomez, MSW, LMSW, LCSW-A
Cecilia received her Bachelor’s of Social Work at the University of Mary Hardin Baylor in Belton, TX in May of 2019 and my Master’s of Social Work at Texas Christian University in Fort Worth, Texas in May of 2020. She currently practices Outpatient Therapy.
