Mark Hillman, Ph.D., (PSY) LMHC My Therapist is Making Me Nuts!Written by Mark Hillman

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From Troubled Times

Adjustment Disorder

Adjustment Disorder covers a wide range of emotional or behavioral symptoms that arise after the onset of certain disruptive life-changes - or "stressors" - in an individual's life. While situations such as moving to a new city, becoming a parent, experiencing financial difficulties, retiring, or feeling worried and anxious over world events can certainly elicit varying degrees of upset, Adjustment Disorder is characterized by distress that is excessive in relation to the stressor and ends up hindering key areas of an individual's life, including social, academic, or occupational functioning.

Adjustment Disorder can affect anyone and is fairly common. The stressor may be a single event or, in many cases, the disorder is a reaction to multiple stressors, for example, marital problems and marked business difficulties. An individual usually experiences the symptoms of the disorder within three months of the stressor(s). Adjustment Disorder is considered acute if it lasts less than six months and chronic when it persists for more than six months.

Although reactions, or symptoms, by and large depend on the individual and on the event(s) or situation(s) that caused the initial distress, Adjustment Disorder usually first presents as a negative change in work or school performance along with significant changes in social relationships. Some people with Adjustment Disorder experience symptoms very similar to depression. High levels of worry and separation anxiety are also possible symptoms. Some people manifest their symptoms through their personal conduct, for example, becoming withdrawn, or engaging in reckless behavior.

Symptoms

There are many different categories of Adjustment Disorder, each with specific symptoms:

Adjustment Disorder With Depressed Mood - Characterized by feelings of hopelessness, sadness, or bouts of crying.

Adjustment Disorder With Anxiety - Characterized by nervousness, worry, or jitteriness.

Adjustment Disorder With Mixed Anxiety/Depressed Mood - A combination of the two subtypes listed above.

Adjustment Disorder With Conduct Disturbance - Characterized by failure to adhere to societal norms and rules. Individuals with this subtype may violate the rights of others or engage in dangerous behavior.

Adjustment Disorder With Mixed Disturbance of Emotions/Conduct - This subtype includes people with anxiety or depression combined with conduct disturbance.

Unspecified - Characterized by other reactions such as social/emotional withdrawal, inhibition, or physical symptoms with no direct medical cause, such as stomachaches or headaches.

Causes

Adjustment Disorder can occur when an individual feels overwhelmed by a specific event or set of circumstances and their ability to cope well in many or all areas of daily life becomes threatened. Examples of common stressors include:

Personal challenges, such as job loss, financial crises, moving, ending a significant relationship.

Developmentally related stressors, such as going away to school, getting married, becoming a parent, retiring.

Continuous stressors, such as caring for an ill loved one, living in a high crime area, or cyclical business downturns.

Seasonal changes and holidays.

A global or nationally significant event, such as war, political unrest, poverty or famine.

Disastrous situations such as fires, floods, tornadoes and earthquakes.

Treatment

Adjustment Disorder is very treatable. If left untreated, the symptoms of the condition can become progressively worse and/or develop into other debilitating disorders, such as depression or Post-traumatic Stress Disorder. Individuals suffering from Adjustment Disorder can even be at greater risk of suicide.

There are therapists who are especially experienced in helping those who suffer with Adjustment Disorder and providing pivotal help in relieving the symptoms, addressing the original stressor(s), developing new coping skills, and responding to the many ways the condition has affected personal and professional aspects of an individual's life.

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