Adjustment Disorder Diagnosis and Treatment Adjustment disorder is a mental disorder that results from unhealthy responses to stressful or psychologically distressing events in life. This failure to adapt then leads to the development of emotional and behavioral symptoms. All age groups are affected by this disorder; and children have the same chance of developing the illness. While difficult to determine the causes of adjustment disorder, researchers suggest that genetics play a large part, as well as chemical changes in the brain, life experiences and mood.
Some common stressor contributing to the disorder ncludes; the ending of a romantic relationship, loss of a Job, career change, an accident, relocating to a new area or loss of a loved one. (Mayo Clinic, 2010) An adjustment disorder causes feelings of depression, anxiousness, crying spells, sadness, desperation, lack of enjoyment, and some have reported experiencing thoughts of suicide. Additionally, the illness causes one to be unable to go about their normal routine or work and visit with friends and family. The lengths of symptoms vary from zero to six months (acute) and longer than six months (chronic).
In the cases of acute adjustment disorder, symptoms can go away eventually; however, in chronic cases, symptoms begin to disrupt your life whereas, professional treatment is necessary to prevent the illness from worsening. Lastly, this disorder carries the possibility for abuse of alcohol and drugs, and eventually could result in violent behavior. According to a report issued by Tami Benton of WebMD, “the development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurs within 3 months of the onset of the stressor(s).
These symptoms or behaviors are linically significant, as evidenced by marked distress in excess of what is expected from exposure to the stressor, or significant impairment in social or occupational (academic) functioning. The stress-related disturbance does not meet criteria for another specific axis I disorder and is not merely an exacerbation of a preexisting axis I or axis II disorder. The symptoms do not represent bereavement. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months”. A determination is made as to whether the illness is acute or chronic.
A differential diagnosis issued by Benton states that, “Adjustment Disorder’s (AD) are located on a continuum between normal stress reactions and specific psychiatric disorders. Symptoms are not likely a normal reaction if the symptoms are moderately severe or if daily social or occupational functioning is impaired. If a specific stressor is involved and/or the symptoms are not specific but are severe, alternate diagnoses (eg, posttraumatic stress disorder, conduct disorder, depressive disorders, anxiety disorders, depression or anxiety due to a general medical condition) are unlikely’.
Benton, 2009) “Clinical treatment modalities are difficult due to lack of clinical trials; as these AD originates from a psychological reaction to a stressor, the stressor must be identified and communicated by the patient. The non-adaptive response to the stressor may be diminished if the stress can be “eliminated, reduced or accommodated. Therefore, treatment of ADS entails psychotherapeutic counseling aimed at reducing the stressor, improving coping ability with stressors that cannot be reduced or removed, and formatting an emotional state and support systems to enhance adaptation and coping.
Further, the goal of psychotherapy should include; an analysis of the stressors that are affecting the patient, and determine whether they can be eliminated or minimized, clarification and interpretation of the meaning of the stressor for the patient, reframe the meaning of the stressor, illuminate the concerns and conflicts the patient experiences, identification of a means to reduce the stressor, maximize the patient’s coping skills, assist patients to gain perspective on the stressor, establish relationships, attend support groups, and manage themselves and the stressor.
Psychotherapy, crisis intervention, family and group herapies, cognitive behavioral therapy, and interpersonal psychotherapy are effective for eliciting the expressions of affects, anxiety, helplessness, and hopelessness in relation to the identified stressor(s)”. (Benton, 2009) For patients with minor or major depressive disorders, who have not responded to psychotherapy and other interventions; trials of antidepressants are recommended.