What is an Adjustment Disorder?
In an adjustment disorder, a patient experiences a chronic and intense reaction to a triggering event. Diagnosis is difficult, oftentimes, with adjustment disorders because the patient may not notice or acknowledge symptoms. Symptoms, too, can look like some of those associated with other mental health disorders.
Adjustment disorders come in six different types, according to the DSM-V:
- Adjustment disorder with depressed mood. Symptoms include: feelings of sadness or hopelessness, loss of pleasure in previously enjoyable activities.
- Adjustment disorder with anxiety. Symptoms include: perseverating, lack of concentration, memory issues. In children, this type of adjustment disorder can present with fear of separation from a parent.
- Adjustment disorder with mixed anxiety and depressed mood. Symptoms include: some combination of the symptoms above.
- Adjustment disorder with conduct disturbance. Symptoms include: acting out in violent or reckless ways. In adolescents, this can take the form of truancy or vandalism.
- Adjustment disorder with mixed conduct and emotional disturbance. Symptoms include: some combination of symptoms from the depressed, anxiety, and conduct disturbance types.
- Adjustment disorder, unspecified. Symptoms can be physical or manifest at home or work. Do not fit into other types.
If you suspect that you or a loved one may have an adjustment disorder, reach out to a mental health professional. Diagnosing this condition requires professional intervention and support.
Adjustment Disorder – When Grief is Not Healthy
When we experience triggering events, the result often takes the form of grief. As such, grief can be a healthy part of the healing process. In an adjustment disorder, however, the response to trauma is extreme. Mental health professionals use diagnostic criteria defined within the DSM-5 to distinguish between healthy grief and the presence of an adjustment disorder.
Patients may sometimes exhibit some but not all of the diagnostic criteria for an adjustment disorder, even when grief is intense and outsized. In these cases, the patient may have something more along the lines of PTSD or a panic disorder. Only a mental health professional can make the distinction.
Recognizing the Symptoms
Commonly, a patient with an adjustment disorder experiences a reaction to a triggering event that is extreme; as a result, the patient is unable to engage in their normal, day-to-day activities. Symptoms can also include:
- Thoughts of suicide
- Feelings of hopelessness
- Lack of interest in favorite pastimes
- Feelings of stress and anxiety
- Emotional withdrawal
- An inability to concentrate or get daily tasks done
- Episodes of intense crying
- Insomnia or faulty sleep hygiene
Since adjustment disorders share symptoms with other mental health disorders, it is important to receive a diagnosis from a professional. According to the DSM-5, an adjustment disorder should also include:
- Symptoms appearing less than 3 months after the triggering event
- The patient presenting with reactions that are outsized in comparison to the triggering event
- Negative thinking that compromises day-to-day life
- No other pre-existing conditions that might come with obsessive or negative thinking
Adjustment Disorders – The Causes
Traumatic events such as job loss or experiencing an accident or crime can cause an adjustment disorder. In some cases, the triggering event might be something that many consider positive, such as moving to a new city. Additionally, adjustment disorders sometimes stem from a combination of events. In yet other cases, triggers can be chronic, as with domestic abuse.
Chronic and Acute Adjustment Disorder
As with many other mental health disorders, an adjustment disorder can come in an acute and a chronic form. Acute versions last less than six months; chronic adjustment disorder lasts for more than half a year. When triggers are eliminated or disappear in acute adjustment disorder, the symptoms can cease. In chronic adjustment disorder, symptoms may still present after a triggers have disappeared. Either acute or chronic adjustment disorder requires the treatment of a mental health professional. Chronic patients may need treatment over a longer period of time.
The Treatments for Adjustment Disorder
Common interventions such as therapy, medications, and lifestyle changes (or a combination of those) are effective treatments for adjustment disorders. In therapy, which can be individual, family, or group therapy, patients typically work on:
- Talk therapy
- Acquiring management skills
- Spotting negative behaviors or patterns and eliminating them
- Understanding they can and should ask for help
- Identifying triggers
- Building and leveraging coping mechanisms
Sometimes, medication is part of effective intervention for Adjustment Disorder. Medications for this disorder can include antidepressants or anti-anxiety medications. Recommendations depend on the symptoms exhibited and their intensity.
Lifestyle changes that patients can work on in the treatment of Adjustment Disorder include:
- Learning how to bond or reconnect with a network of friends and loved ones
- Centering thinking on the positive aspects of life
- Coping with problems and not shoving them aside
- Tracking one’s successes
- Maintaining a healthy lifestyle