Adjustment disoders treatment causes and information

DEFINITION

Work problems, going away to school, an illness — any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you continue to feel down or self-destructive, you may have an adjustment disorder.

An adjustment disorder is a type of stress-related mental illness. You may feel anxious or depressed, or even have thoughts of suicide. Your normal daily routines may feel overwhelming. Or you may make reckless decisions. In essence, you have a hard time adjusting to change in your life, and it has serious consequences.

You don't have to tough it out on your own, though. Adjustment disorder treatment — usually brief — is likely to help you regain your emotional footing.

SYMPTOMS

Adjustment disorders symptoms vary from person to person. The symptoms you have may be different from those of someone else with an adjustment disorder. But for everyone, symptoms of an adjustment disorder begin within three months of a stressful event in your life.

Emotional symptoms of adjustment disorders

Signs and symptoms of adjustment disorder may affect how you feel and think about yourself or life, including:

SadnessHopelessnessLack of enjoymentCrying spellsNervousnessJitterinessAnxiety, which may include separation anxietyWorryDesperationTrouble sleepingDifficulty concentratingFeeling overwhelmedThoughts of suicide

Behavioral symptoms of adjustment disorders

Signs and symptoms of adjustment disorder may affect your actions or behavior, such as:

FightingReckless drivingIgnoring billsAvoiding family or friendsPerforming poorly in school or at workSkipping schoolVandalizing property

Length of symptoms

How long you have symptoms of an adjustment disorder also can vary:

6 months or less (acute). In these cases, symptoms should ease once the stressor is removed. Brief professional treatment may help symptoms disappear.More than 6 months (chronic). In these cases, symptoms continue to bother you and disrupt your life. Professional treatment may help symptoms improve and prevent the condition from continuing to get worse.

Stressful events

One or more stressful life events may put you at risk of developing an adjustment disorder. It may involve almost any type of stressful event in your life. Both positive and negative events can cause extreme stress. Some common examples include:

Being diagnosed with a serious illnessProblems in schoolDivorce or relationship breakupJob lossHaving a babyFinancial problemsPhysical assaultSurviving a disasterRetirementDeath of a loved oneGoing away to school

In some cases, people who face an ongoing stressful situation — such as living in a crime-ridden neighborhood — can reach a breaking point and develop an adjustment disorder.

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TESTS AND DIAGNOSIS

Adjustment disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with adjustment disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

For an adjustment disorder to be diagnosed, several criteria must be met, including:

Having emotional or behavioral symptoms within three months of a specific stressor occurring in your lifeExperiencing more stress than would normally be expected in response to the stressor, or having stress that causes significant problems in your relationships, at work or at school — or having both of these criteriaAn improvement of symptoms within six months after the stressful event endsThe symptoms are not the result of another diagnosis

Types of adjustment disorders

Your doctor may ask detailed questions about how you feel and how you spend your time. This will help pinpoint which type of adjustment disorder you have. There are six main types. Although they're all related, each type has certain signs and symptoms:

Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and experiencing a lack of pleasure in the things you used to enjoy.Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety.Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting or reckless driving. Youths may skip school or vandalize property.Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.Adjustment disorder unspecified. Symptoms don't fit the other types of adjustment disorders, but often include physical problems, problems with family or friends, or work or school problems.

TREATMENTS AND DRUGS

Most people find treatment of adjustment disorder helpful, and they often need only brief treatment. Others may benefit from longer treatment. There are two main types of treatment for adjustment disorder — psychotherapy and medications.

Psychotherapy

The main treatment for adjustment disorders is psychotherapy, also called counseling or talk therapy. You may attend individual therapy, group therapy or family therapy. Therapy can provide emotional support and help you get back to your normal routine. It can also help you learn why the stressful event affected you so much. As you understand more about this connection, you can learn healthy coping skills to help you deal with other stressful events that may arise.

Medications

In some cases, medications may help, too. Medications can help with such symptoms as depression, anxiety and suicidal thoughts. Antidepressants and anti-anxiety medications are the medications most often used to treat adjustment disorders. As with therapy, you may need medications only for a few months, but don't stop taking any medication without talking with your doctor first. If stopped suddenly, some medications, such as certain antidepressants, may cause withdrawal symptoms.