Adjustment disorder is a mental illness in which the affected person reacts with various psychological symptoms after a decisive life change, for example, a job change, move, retirement, etc., or after stressful life events such as a bereavement, accident, divorce or similar.
What is an adjustment disorder?
An adjustment disorder means that the individual is reacting to a stressful life event. This may be expressed in a negative change in his state of mind or in disturbed interpersonal behavior. The disorder occurs when he is unable to adapt to the new difficult situation that has occurred over a long period of time because he is unable to accept it psychologically or physically. Characteristically, he feels subjectively distressed and emotionally impaired. The social relationships as well as the performance are limited in an adjustment disorder. This can lead to a high level of suffering for the affected person.
Causes
People can normally adapt to changing situations or events. This is different with an adjustment disorder, which can affect all age groups, because here the affected person is not able to do so. Psychological symptoms occur, for which there are many reasons as the cause, for example if the changes that have occurred are too stressful or if several changes occur at the same time, leading to psychological overload. Sometimes the affected person also does not have sufficient coping strategies. Triggering stress factors can be, for example, prolonged conflicts in the private or professional environment, illnesses, deaths, financial problems, a move, the birth of a child and much more. It can be about almost every possible stressful event that can occur in life. This includes negative situations, but also positive ones. It does not matter how hard the event that has occurred is, but how the stress is subjectively felt, how many difficult events there may have been beforehand, how resilient the person is and manages to cope with the situation. This determines whether an adjustment disorder will occur and what degree of severity will result. The risk of developing an adjustment disorder may also be higher if the affected person experienced stress in early childhood. Adjustment disorder usually lasts for a maximum of six months.
Symptoms, complaints, and signs
Symptoms can be varied in adjustment disorder and can manifest, for example, in the form of depressed mood. Anxiety, worry, anger, bitterness, a restlessness, sadness, despair, emotional confusion, a mood slump, and sleep problems are also typical complaints. The sufferer often feels that he or she can no longer cope with and continue the realities of everyday life, believing that he or she is no longer able to cope with everyday tasks. Feelings of isolation and distress can also occur with adjustment disorder. A lack of interest, problems with concentration as well as an increasing loss of zest for life can lead to the fact that the social behavior and the performance of the affected person are considerably limited. The consequences are often a social withdrawal up to aggressiveness. In addition to the psychological problems, somatic complaints are also possible with an adjustment disorder, for example disorders in digestion and tension.
Diagnosis and course
If an adjustment disorder is suspected, the psychiatrist and psychotherapist first asks what complaints are present, how often and in what severity they occur. He then determines whether the affected person is able to cope with everyday life or whether the disorder has already assumed such proportions that, for example, he is currently no longer able to pursue his profession or care for the children. The result of the interview serves as a basis for the physician to be able to check whether it is a normal reaction to a stressful event or an adjustment disorder in need of treatment. After that, results are also available as to what resources are available in the affected person to cope with the stress, i.e., the adjustment disorder.
Complications
Adjustment disorder is usually treated by a psychologist or psychiatrist and is not a physical illness.With an adjustment disorder, the affected person often feels alone and insecure, which not infrequently leads to a feeling of distress. The affected person often takes this feeling out on his friends and relatives. This results in altered social behavior and social withdrawal. People with adjustment disorders are often plagued by a feeling of emptiness or increased worry about a particular issue from the past or future. Joylessness, sadness, and also anxiety are also common complications of adjustment disorder. The signs vary greatly and all usually result in depressed mood, anxiety and worry. Treatment is either through talking in therapy or medication. The therapy usually does not hit immediately, it takes time to treat the adjustment disorder. The affected person complains of feelings of anxiety and can no longer cope with everyday life on his own. Especially in adolescents, social behavior is affected. In a few cases, sufferers also lose their jobs, lapse into severe depression and also begin to have suicidal thoughts. Friend and relatives should definitely stand by in case of adjustment disorder and also inform a doctor about it.
When should you go to the doctor?
Many people suffer from adjustment disorder during their lives – triggered by stressful life circumstances and serious life changes. If the symptoms of adjustment disorder are so severe that normal daily living is no longer possible, sufferers should see a doctor immediately. If one can no longer find one’s way in one’s current life and symptoms such as restlessness, nervousness, social withdrawal, dejection and sleep disturbances considerably limit the quality of life, a visit to the family doctor is recommended. The family doctor, as a trusted physician, can get an initial picture of the individual complaints and then write a referral to specialists. The specialist in psychiatry can treat the stressful symptoms by means of medication or also make a recommendation for psychotherapy. In most cases, adjustment disorder can be treated well with psychotherapy. By discussing current problems and thoughts, emotional relief can be achieved. Psychotherapy is designed to help people cope better with their new circumstances and find individual solutions to their problems. The supportive conversations can have a positive effect on the patient’s mind and provide relief. New ways to better deal with stressful life circumstances in the future can also be found and practiced by means of psychotherapy.
Treatment and therapy
The main option for treatment of adjustment disorder is psychotherapy, which also functions as counseling. Therapy can provide emotional support and help guide the sufferer back to a normal routine. In addition, this treatment offers a good chance to identify why the adjustment disorder occurred. Those who understand the causes can learn to develop healthy coping strategies to better deal with other stressful events that may occur later in life. It is always important to identify this in time and manage against it. In some cases, when talking is not enough, medications are also used to help with symptoms such as depression, anxiety, or even suicidal thoughts. Antidepressants as well as anti-anxiety medications have worked well for adjustment disorder.
Outlook and prognosis
Adjustment disorder can last from a few weeks to many years. Some doctors and psychologists tend to consider adjustment disorder “benign” because in many cases it resolves completely or can be treated successfully. Most adjustment disorders improve within six months or disappear completely. However, psychologists and physicians no longer refer to an adjustment disorder if symptoms persist for more than six months. For reactive depression, this time limit is extended to two years. This diagnostic guideline possibly distorts the actual prognosis of adjustment disorders. To date, few studies exist that specifically address adjustment disorder. This is another reason why the prognosis is often unclear. In addition, adjustment disorders are very diverse.Since adjustment disorders cover a wide spectrum and can have many different triggers, the prognosis depends strongly on the individual case with its respective conditions. The more resources an affected person has and uses, the more likely the condition will improve. The psychological complaints that make up adjustment disorder can become chronic and thus persist for several years. An example of such a course is chronic grief. Adjustment disorders caused by migration and the associated “culture shock” often improve once the person has settled into his or her new environment and is well integrated.
Prevention
There is no way to prevent adjustment disorder in any case, but there is a chance to develop healthy coping strategies to deal with it during times of high stress, for example. It is also helpful to lead a healthy lifestyle with enough periods of rest to create a healthy balance. Exercise, yoga and meditation are also very good for being balanced, reacting appropriately in difficult situations and thus preventing an adjustment disorder. Many factors play an important role.
Aftercare
As a rule, no special aftercare options are available to those affected by an adjustment disorder. However, these are also not always necessary, since the adjustment disorder should be treated primarily by a physician. After successful treatment, care should be taken to prevent these disorders from recurring and to avoid them. In most cases, treatment of this disorder is done through therapy with a psychologist. Above all, early treatment should be initiated to prevent further symptoms and complications. Friends and family should point out the symptoms of the adjustment disorder to those affected, while also initiating treatment with a doctor. In some cases, the disorder is also supported with the help of medications, so that regular intake should be ensured. Possible interactions with other medications can also occur. Often, the support of family and friends also has a very positive effect on the further course of the disease and can prevent further complications and complaints. The life expectancy of the affected person is not reduced by the adjustment disorder.
What you can do yourself
More and more people have to deal with serious stresses in everyday life, which can have serious effects on a person’s body and mind. Because adjustment disorder often manifests itself in negative mood states and interpersonal social behavior disorders, it is difficult to hide in social life. Since adjustment disorder is often the result of stressful times, it is best mitigated with sufficient rest for regeneration. In everyday life, those affected should plan enough time for themselves. Since the adjustment disorder is usually temporary, friends and family can be supportive during this difficult time and lend a hand to the sufferer. Another self-help method for adjustment disorders are so-called relaxation exercises and meditations, in which the affected person can feel himself well and let go of the stresses of life. Some people, on the other hand, need intense physical activity to relieve stress and regain a pleasant sense of well-being. Since each person is individual, everyone should explore for themselves what does them good. With sports sessions, relaxation exercises, rest periods, etc., the symptoms of an adjustment disorder can be alleviated so that the affected person can regain his strength and actively participate in life.
