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Loice Vavi

Health Matters

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 is usually brief and  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:

Sadness

Hopelessness

Lack of enjoyment

Crying spells

Nervousness

Jitteriness

Anxiety, which may include separation anxiety

Worry

Desperation

Trouble sleeping

Difficulty concentrating

Feeling overwhelmed

Thoughts of suicide

Behavioural symptoms of adjustment disorders

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

Fighting

Reckless driving

Ignoring bills

Avoiding family or friends

Performing poorly in school or at work

Skipping school

Vandalising 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.

Causes

As researchers are still trying to figure out what causes adjustment disorders. As with other mental disorders, the cause is likely complex and may involve genetics, your life experiences, your temperament and even changes in the natural chemicals in the brain.

Risk Factors

Although the cause of adjustment disorders is unknown, some things make you more likely to have an adjustment disorder. Among children and teenagers, both boys and girls have about the same chance of having adjustment disorders. Among adults, women are twice as likely to be diagnosed with adjustment disorders.

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 illness

Problems in school

Divorce or relationship breakup

Job loss

Having a baby

Financial problems

Physical assault

Surviving a disaster

Retirement

Death of a loved one

Going away to school

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

Your life experiences

If you generally don’t cope well with change or you don’t have a strong support system, you may be more likely to have an extreme reaction to a stressful event. Your risk of an adjustment disorder may be higher if you experienced stress in early childhood. Overprotective or abusive parenting, family disruptions, and frequent moves early in life may make you feel like you’re unable to control events in your life. When difficulties then arise, you may have trouble coping.

Other risk factors may include:

Other mental health problems

Exposure to wars or violence

Difficult life circumstances

Depression

Alcohol and drug addiction

Suicidal thoughts and behaviour

Compared with adults, teenagers with adjustment disorder  especially chronic adjustment disorder marked by behavioural problems are at significantly increased risk of long-term problems. In addition to depression, substance abuse and suicidal behaviour, teenagers with adjustment disorder are at risk of developing psychiatric disorders such as:

Schizophrenia

Bipolar disorder

Antisocial personality disorder

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 Psychiatric Associations, is used by mental health professionals to diagnose mental health conditions. For an adjustment disorder to be diagnosed, several criteria must be met, including: Having emotional or behavioural symptoms within three months of a specific stressor occurring in your life

Experiencing 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 criteria

An improvement of symptoms within six months after the stressful event ends

The symptoms are not the result of another diagnosis

Types of adjustment disorders

 There are six main types. Although they’re all related, each type has certain signs and symptoms:

1. 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.

2. 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.

3. Adjustment disorder with mixed anxiety and depressed mood.

 Symptoms include a mix of depression and anxiety.

4. Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting or reckless driving. Youths may skip school or vandalize property.

5. Adjustment disorder with mixed disturbance of emotions and conduct. 

Symptoms include a mix of depression and anxiety as well as behavioural problems.

6. 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.

Treatment

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.  These are 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.

Lifestyle and home remedies

There are no guaranteed ways to prevent adjustment disorder. But developing healthy coping skills and learning to be resilient may help you during times of high stress. Resilience is the ability to adapt well to stress, adversity, trauma or tragedy.

 Some of the ways you can improve your resilience include :-

Having a good support network

Seeking out humour or laughter

Living a healthy lifestyle

Learning how to think positively about yourself

If you know that a stressful situation is coming up such as a move or retirement  call on your inner strength in advance. 

Remind yourself that you can get through it. In addition, consider checking in with your doctor or mental health provider to review healthy ways to manage your stress. 

For more information contact [email protected] or 0772224231