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Monday, February 6, 2012

Mental Health and Adjustment Disorder

Adjustment disorder is a short-term condition that occurs when a person is unable to cope with, or adjust to, a particular source of stress, such as a major life change, loss, or event. Because people with adjustment disorders often have symptoms of depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes called "situational depression." Unlike major depression, however, an adjustment disorder is triggered by an outside stress and generally goes away once the person has adapted to the situation.
The type of stress that can trigger adjustment disorder varies depending on the person, but can include:
  • Ending of a relationship or marriage.
  • Losing or changing job.
  • Death of a loved one
  • Developing a serious illness (yourself or a loved one).
  • Being a victim of a crime.
  • Having an accident.
  • Undergoing a major life change (such as getting married, having a baby, or retiring from a job).
  • Living through a disaster, such as a fire, flood, or hurricane.
A person with adjustment disorder develops emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within three months of the event and rarely last for longer than six months after the event or situation. In an adjustment disorder, the reaction to the stressor is greater than what is typical or expected for the situation or event. In addition, the symptoms may cause problems with a person's ability to function; for example, the person may be unable to sleep, work, or study.
Adjustment disorder is not the same as post-traumatic stress disorder (PTSD). PTSD generally occurs as a reaction to a life-threatening event and tends to last longer. Adjustment disorder, on the other hand, is short-term, rarely lasting longer than six months.

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What Are the Symptoms of Adjustment Disorder?

An adjustment disorder can have a wide variety of symptoms, which may include:
  • Feeling of hopelessness.
  • Sadness.
  • Frequent crying.
  • Anxiety (nervousness).
  • Worry.
  • Headaches or stomachaches.
  • Palpitations (an unpleasant sensation of irregular or forceful beating of the heart).
  • Withdrawal or isolation from people and social activities.
  • Absence from work or school.
  • Dangerous or destructive behavior, such as fighting, reckless driving, and vandalism.
  • Changes in appetite, either loss of appetite, or overeating.
  • Problems sleeping.
  • Feeling tired or without energy.
  • Increase in the use of alcohol or other drugs.
Symptoms in children and teens tend to be more behavioral in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to experience more emotional symptoms, such as sadness and anxiety.

How Common Is Adjustment Disorder?

Adjustment disorder is very common and can affect anyone, regardless of gender, age, race, or lifestyle. Although an adjustment disorder can occur at any age, it is more common at times in life when major transitions occur, such as adolescence, mid-life, and late-life.

How Do I Find Out if I Have Adjustment Disorder?

If you suspect you may have an adjustment disorder, see your doctor. If symptoms are present, your doctor will perform a complete physical exam and ask questions about your medical history. Although there are no imaging or lab tests to specifically diagnose an adjustment disorder, the doctor may use some tests -- such as blood tests or X-rays -- to rule out physical illness as the cause of your symptoms. Your doctor will also look for other mental illnesses, such as post-traumatic stress disorder, major depression, or an anxiety disorder.
Your doctor bases his or her diagnosis of adjustment disorder on your report of the intensity and duration of symptoms -- including any problems with daily functioning caused by the symptoms. In general, an adjustment disorder is suspected if the level of distress is more intense than would normally be expected, given the stressor, or if the symptoms interfere with normal functioning.
If adjustment disorder is suspected, your doctor will likely refer you to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses.

How Is Adjustment Disorder Treated?

Psychotherapy (a type of counseling) is the most common treatment for adjustment disorder. Therapy helps the person understand how the stressor has affected his or her life. It also helps the person develop better coping skills. Support groups can also be helpful by allowing the person to discuss his or her concerns and feelings with people who are coping with the same stress. In some cases, medication may be used to help control anxiety symptoms or sleeping problems.
If you have symptoms of adjustment disorder, it is very important that you seek medical care. Major depression may develop if treatment for adjustment disorder is not sought. Further, a substance abuse problem may result if you turn to alcohol or drugs to help you cope with stress and anxiety.


Dr. Neal Houston
PhD - Sociologist
 Most people with adjustment disorder recover completely. In fact, a person who is treated for adjustment disorder may learn new skills that actually allow him or her to function better than before the symptoms began.

Can Adjustment Disorder Be Prevented?

There is no known way to prevent adjustment disorder. However, strong family and social support can help a person work through a particularly stressful situation or event. The best prevention is early treatment, which can reduce the severity and duration of symptoms, and teach new coping skills.

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