How does adjustment disorder differ from normal reaction?
It's normal to worry after losing a job or getting divorced. A disorder is spoken of when the reaction is clearly stronger than expected or lasts longer, and most importantly, it disrupts functioning: a person cannot cope with work, stops communicating, cannot take care of children and himself. Another difference is the clear association with the event: symptoms appear soon after the event, usually within a month, and subside as circumstances change. At the same time, criticism of the state is preserved, and the person himself notices what is happening to him.
- Symptoms appear within a month after the event
- Severity greater than expected for this situation
- Work, study, relationships, life suffer
- There is a clear and understandable reason
- The condition is usually reversible
- Different from normal grieving after loss
What are the manifestations
The picture depends on which experiences come to the fore. For some, anxiety predominates: constant tension, expectation of bad things, inability to relax, palpitations. Others experience depression: loss of interest, tearfulness, a feeling of hopelessness, but without the depth of a major depressive episode. In adolescents, the disorder often manifests itself as behavioral disturbances: absenteeism, conflicts, and risky behavior. Often there are physical complaints for which no organic reason can be found.
- Anxiety, tension, anticipation of trouble
- Depression, tearfulness, loss of interest
- Irritability and angry outbursts
- Sleep and appetite disorders
- Difficulty with concentration and memory
- Headaches, palpitations, stomach pains
- Withdrawal from communication and previous activities
What increases the risk
People experience the same event differently, and it’s not a matter of willpower. What matters is the strength and suddenness of the stress factor, the accumulation of several difficulties at once, the lack of loved ones to turn to, and past experience of difficult experiences. Chronic illnesses, pain, financial instability and forced migration significantly increase the risk. Children and adolescents are especially vulnerable when their parents divorce, change schools, or move because their ability to influence the situation is limited.
- Several difficult events in a row
- Lack of support from loved ones
- Past episodes of anxiety and depression
- Chronic illness or pain
- Loneliness, moving, loss of familiar circle
- High responsibility and inability to influence the situation
How to make a diagnosis
There are no special tests. A doctor or psychologist finds out what event preceded the condition when the symptoms appeared, how much they interfere with life, and whether there are signs of other disorders - a depressive episode, anxiety disorder, post-traumatic stress disorder. Standard questionnaires that assess the level of anxiety and depression over time help. Sometimes basic tests are prescribed to rule out physical causes of similar complaints: thyroid disease, anemia, vitamin deficiency.
- Detailed conversation about the event and symptoms
- Assessing the impact on work, school and relationships
- Anxiety and Depression Scales
- Rule out depressive episode and PTSD
- Basic tests for physical complaints
- Mandatory self-harm risk assessment
Help and self-help
The main method is psychotherapy: it helps to express experiences, see the situation differently and find working ways to cope. The cognitive-behavioral approach, problem-oriented and short-term formats are effective, and in case of family difficulties, family counseling. Medicines are not the mainstay, but the doctor may prescribe them for a short course for severe anxiety or insomnia. Alcohol and self-prescribed sedatives worsen the course. Sleep patterns, movement, and reconnecting with people are important.
- Psychotherapy as the main method
- Restoring sleep and nutrition patterns
- Regular physical activity
- Conversation with loved ones, avoiding isolation
- Dividing a problem into manageable steps
- Avoiding alcohol and self-medication
- Short course medications only as prescribed by a doctor