Adjustment disorder is characterized by a devastating reaction to some stressful event or stressor (s). There is development of behavioural or emotional symptoms that usually occur within three months after the occurrence of the stressor, and does not last longer than six months. A stressor is any identifiable event that causes a lot of stress in a person’s life. Stressful events that can cause stress and tension are new place, marriage, death of a loved one, new job, or fight with peers. It can be both positive as well as negative.
An adjustment disorder can occur at any time during a person's life and there is no difference in the frequency of this disorder between males and females.
Adjustment disorders are less severe than other disorders. Major Depression may develop if help is not obtained.
On the basis of the specific symptoms, Adjustment disorders are classified as:
- Adjustment disorder with depressed mood
- Adjustment disorder with anxiety
- Adjustment disorder with mixed anxiety and depressed mood
- Adjustment disorder with disturbance of conduct
- Adjustment disorder with mixed disturbance of emotions and conduct
- Adjustment disorder, Unspecified
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The main cause of this condition is lack of adjustment to stressful situations. Stressful events can cause a lot of stress and tension. These situations affect a person’s mood and behavior patterns, varying from one individual to the other. Some people may feel sad or depressed, some may start binging on food, some may anger easily – thus, everyone shows a different response to stressful events. Though, these symptoms may reduce after about six months since the onset of the stressful situation.
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The most significant symptom seen is significant level of distress, in its extreme form, higher than what is usually experienced in normal circumstances. Marked impairment is noticed in social, occupational or educational functioning. Once the stressful situation or the stressor ends, the problem does not last for more than six months. If the problem lasts longer than six months, then possibility of some other disorder are considered. It is important to have a differential diagnosis for this disorder to distinguish it from other personality, mood or emotional disorders.
Besides these, other features noticed are depressed mood, somatic or sexual dysfunction and feelings of guilt or obsession.
Since the major cause of adjustment disorder is stress, therefore, stress management programs and other stress intervention techniques can be employed to prevent the occurrence of this condition. An individual can be trained to handle any form of stress before it actually arisesx
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Any kind of psychotherapy should be conducted in a supportive and non-judgmental environment for it to work effectively. It is often solution focused, dealing with a specific life problem. A therapist is a like a guide who helps the individual come out of the problem, by teaching him or her various coping mechanisms. Since adjustment disorder is a short-term condition with stress as the major cause, various forms of relaxation therapies and techniques can be useful. Social support also becomes important for this condition, where the client indulges in alternate activities, which teach him or her to cope better and learn new ways of dealing with stress.
Sometimes, family therapy is also used, mostly for adolescents. Often the family of the individual is either causing or aggravating the problem, so, family systems approach is used. Couples therapy may be used in the cases of marital or romantic relationships.
Usually, medications are not used for such disorders. If used, they are given along with other forms of treatment, this is only when the disorder becomes complicated.
Many times, the individual suffering from adjustment disorder would try to seek help by attending group activities. They participate in group sessions that include persons with similar problems. Often people learn a lot from support groups, including coping skills and managing stress, as they are able to share their feelings with someone suffering from similar problem. Many such support groups have been established recently. It has been seen that recovery is smoother and better with the help of such groups.
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