• Adjustment Disorder

    Definition

    Adjustment disorder is an excessive, lengthy reaction to a stressful event or situation. It could be one stressor or a combination of stressors affecting one person or a group of people. This reaction seriously damages social and occupational functioning.
    There are several subtypes of the disorder, including adjustment disorder with:
    • Depressed mood
    • Anxiety
    • Mixed anxiety and depressed mood
    • Disturbance of conduct
    • Mixed disturbance of emotions and conduct

    Causes

    Adjustment disorders develop in reaction to stressful life events or major life changes. Some common stressors are:
    • Relationship problems
    • Financial difficulties
    • Family conflict
    • School issues
    • Work changes
    • Major life changes
    • Health problems
    • Divorce
    • Death of loved ones
    • Moving
    • Sexuality issues
    In some cases, ongoing problems (such as living in an unsafe, crime-ridden neighborhood) may cause the development of an adjustment disorder over a longer period of time.

    Risk Factors

    Certain people are more likely than others to have adjustment disorder. Susceptibility can be affected by factors such as:
    • Genetics
    • Flexibility
    • Intelligence
    • Social skills
    • Coping strategies
    • Sex: women are thought to be at higher risk than men (boys and girls are at equal risk)
    People who face certain stressors like medical problems or living in challenging environments may be at greator risk. In these populations, adjustment disorder has been diagnosed in up to 50% of the people.
    The stressor itself may also interfere with an individual’s support network.
    Certain early-childhood family history factors seem to increase the chance that a person may suffer from an adjustment disorder in the future. These include:
    • Frequent moves as a child
    • Abusive family of origin
    • Overprotective family of origin
    • Coming from a disadvantaged background
    • Prior exposure to extreme trauma (such as war) without having previously developed either an adjustment disorder or post-traumatic stress disorder (PTSD)
    Individuals who are at higher risk for adjustment disorders often have other conditions, such as a history of anxiety , depression , bipolar disorder , or eating disorders .

    Symptoms

    Adjustment disorder symptoms are expected to disappear within six months after the causing stressor and/or its results have been removed. In the case of chronic adjustment disorder, the symptoms may last longer than the six-month mark. In general, they are related to ongoing persistent stressors like a chronic medical disability.
    Symptoms may vary, but are similar in that the reaction to the stressor is worse or more excessive than expected. In order for a diagnosis of adjustment disorder to be made, symptoms must interfere with an individual’s social or work functioning.
    Symptoms include:
    • Depressed mood, sadness
    • Difficulty breathing
    • Chest pain
    • Anxiety or worry
    • Feeling of inability to cope
    • Feeling of inability to plan ahead
    • Feeling of inability to continue in present situation
    • Some degree of disability in the performance of daily routine
    • Conduct disorders
    • Disturbance of other emotions and conduct
    Physical Symptoms of Anxiety
    Physical reaction anxiety
    Copyright © Nucleus Medical Media, Inc.

    Diagnosis

    Your doctor will perform an exam. It will be used to assess whether your symptoms follow a recent stressful event, and if the symptoms are more severe than what is normal for you. You will also be evaluated to make sure there is no underlying disorders or disease, such as depression, an anxiety disorder, or post-traumatic stress disorder. Your doctor may refer you to a psychiatrist for diagnosis and treatment.

    Treatment

    The main goal of treatment is to resolve symptoms, and return the person to his or her normal level of functioning. Treatment is important so that the disorder doesn’t become a larger illness, like major depression. Treatment options include:

    Psychotherapy

    Psychotherapy, or counseling, is the primary treatment for adjustment disorders. Therapy is used to help people understand why the stressful event caused the symptoms. It also helps develop coping mechanisms for future stressors. Therapy is generally short-term and can take any of the following forms: individual therapy, family therapy, behavior therapy, or group therapy.

    Medications

    Medications may be used in combination with therapy to ease common symptoms. Antidepressants or anti-anxiety medications may be prescribed on a short-term basis until the symptoms resolve.

    Prevention

    While there is no known way to prevent adjustment disorders, the prognosis is good. Adjustment disorders generally resolve with treatment and time without remaining symptoms.

    RESOURCES

    National Institute of Mental Health http://www.nimh.nih.gov/

    Substance Abuse and Mental Health Services Administration http://store.samhsa.gov

    CANADIAN RESOURCES

    Canadian Psychiatric Association http://www.cpa-apc.org/

    Health Canada http://www.hc-sc.gc.ca

    References

    Adjustment disorder with depressed mood. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 5, 2009. Accessed October 30, 2012.

    Casey P. Adult adjustment disorder: a review of its current diagnostic status. Journal of Psychiatric Practice . 2001;7: 32-40.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.