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Adjustment Disorders

– What is an Adjustment Disorder?

– Symptoms

– Types of Adjustment Disorders

– Causes

– Risk Factors

– Treatment

Adjustment Disorders

What are they?

Adjustment disorders are a group of conditions that can occur when you have difficulty coping with a stressful life event. The distress experienced is out of proportion with expected reactions to the stressor. The symptoms cause marked distress and impairment in functioning; they usually occur during or immediately after experiencing the stressful event.  While the disorder technically lasts no longer than six months, the symptoms may continue longer if the stressor remains. Adjustment disorders can affect both adults and children.

Adjustment Disorder is common and can affect anyone, of any gender, age, race, or lifestyle. Although an adjustment disorder can occur at any age, it is more common at times of major transitions, such as adolescence, midlife, and late life. Adjustment disorder changes the way a person thinks and feels about the world and their place in it.

Symptoms

 
  • Feelings of hopelessness
  • Sadness
  • Frequent crying
  • Nervousness and worry
  • Heart palpitations
  • Avoiding friends/ loved ones
  • Changes in appetite
  • Sleep disturbances
  • Headaches
  • Upset stomach
 
  • Fatigue; feeling lack of energy
  • Increase in use of substances
  • Difficulty functioning in daily activities
  • Ignoring bills and other financial obligations
  • Difficulties making decisions
  • Trouble concentrating
  • rebellious or impulsive actions
  • suicidal thoughts

Types of Adjustment Disorders

There are six types of adjustment disorders, each type with distinct symptoms and signs:

1. Adjustment disorder with depressed mood: this type involves feelings of sadness and hopelessness;  frequent crying; and struggling to enjoy activities.

 

2. Adjustment disorder with anxiety: this type includes feeling overwhelmed, anxious, and worried, as well as problems with concentration and memory. For children, this diagnosis is usually associated with separation anxiety.

3. Adjustment disorder with mixed anxiety and depressed mood: this type involves a combination of experiencing symptoms of depression and anxiety.

4. Adjustment disorder with disturbance of conduct: this type involves mainly behavioural issues such as reckless driving, initiating fights, or other impulsive actions. Teenagers with this disorder may show behaviours including theft or vandalism, as well as skipping school.

5. Adjustment disorder with mixed disturbance of emotions and conduct: this type includes symptoms of depression, anxiety and behavioural issues.

6. Adjustment disorder unspecified: this type has symptoms that are not associated with the other types of adjustment disorder. This is the one type of adjustment disorder that includes the physical symptoms such as: insomnia, muscle twitches or trembling, fatigue, body pain or soreness and indigestion.

Causes

Stressors that often cause adjustment disorder, include:

 

  • Relationship or marriage break up
  • Losing or changing a job
  • Death of a loved one
  • A serious illness – for self or other
  • Being a victim of a crime
  • Having an accident
  • Having a major life change (e.g. getting married, having a baby, or retiring)
  • Natural disasters
  • Ongoing stressors, such as having a medical illness or living near crime

Risk Factors

Certain factors may put people at a higher risk of developing adjustment disorder in response to a significant stressor. These include:

  • Other mental health disorders
  • Lack of support system
  • Difficult life circumstances
  • Chronic stressors
  • Traumatic events during childhood
  • Physical or sexual abuse or assault
  • Overprotective or abusive parenting as a child
  • Family disruptions as a child
  • Frequent moves in early life
  • Having a number of difficult life circumstances happening at the same time
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Treatment

Adjustment Disorder is commonly a short lived disorder and some people get better without treatment. However, when symptoms do not subside on their own, psychological therapy has been show to be beneficial in coping with the stressor. 

Treatment options include Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Solution-Focused Therapy, problem-solving strategies, and stress management techniques. If the stressor involved relationship issues, Interpersonal Psychotherapy (IPT) may also be a good option.