Adjustment Disorders: Causes, types & Treatment
An adjustment disorder is a type of stress-related mental illness where a person cannot adjust with his parents, siblings, friends, colleagues, spouse or with those with whom he/she has a relationship. The person may feel anxious or depressed or even have suicidal thoughts. Their normal daily schedule or routine may feel distressing or stressful. They can make reckless decisions. In essence, these types of people have a hard time adjusting to change in their lives, and it has serious consequences in their personal and family & social life. Most of the time, people adjust to such changes within a few months. But if someone continues to feel miserable & self-destructive, the person has an adjustment disorder.
Adjustment disorder treatment usually is likely to help people to regain their emotional footing.
Symptoms: Symptoms vary from person to person. But for everyone with adjustment disorder symptoms begin within three months of a stressful event in their life.
1. Sadness and depression
3. Lack of enjoyment
5. Crying/ weeping spells
7. Anxiety which may include separation anxiety
11. Trouble in sleeping
12. Difficulty concentrating
13. Feeling overwhelmed
14. Thought of suicide
1. Fighting, quarrelling
2. Reckless driving/ movement
3. Ignoring bills/spending without thought
4. Avoiding family/ friends/ colleagues
5. Performing poorly in school or at work/business.
6. Skipping school/ absent from work
7. Destroying property
The adjustment disorder can be acute (less than 6 months) and chronic (more than 6 months). Types of adjustment disorder can be the following:
1. Adjustment disorder with depressed mood
2. Adjustment disorder with anxiety
3. Adjustment disorder with mixed anxiety and depressed mood
4. Adjustment disorder with disturbance of conduct
5. Adjustment disorder with mixed disturbance of emotions and conduct
Causes: Researchers have found diverse causes. It can be seen with other mental disorders, the cause is likely complex and may involve genetics, life experiences, disappointed love, separation or divorce, break-up, temperament and even changes in the natural chemicals in the brain.
Risk factors: 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 disorder. Both positive and negative events can cause extreme stress.
Some stressful situation includes:
1. Being diagnosed with a serious illness
2. Problem in school/workplace/business
3. Divorce, separation or relationship breakup
4. Job loss/ loss in business/failure to obtain an expected result in the exam
5. Having a baby especially newborn
6. Financial problems
7. Physical assault
8. Emotional trauma
9. Surviving a disaster
11. Death of a loved one
12. Going away from 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.
If a person generally does not cope well with change or does not have a strong support system within his family or intimate relationship, then he/she may be more likely to have an extreme reaction to a stressful event.
The risk of an adjustment disorder may be higher if a person experiences stress in early childhood. Overprotective or abusive parenting, family disruptions and frequent moves early in life may make a person unable to control events in life. When difficulties arise, they have trouble coping.
Other risk factors may be – other mental health problems, exposure to wars or violence, and difficult life circumstances.
Complications: People who have another mental health disorder, a substance abuse problem or a chronic adjustment disorder are more likely to have long-term mental health problems, which may include: depression, drug addiction, suicidal thoughts, and abnormal behaviour. Psychiatric disorders such as – schizophrenia, bipolar disorder, and antisocial personality disorder can also develop.
Treatment: There are mainly two types of treatment for adjustment disorder – psychotherapy and medication.
Psychotherapy: This is also called counselling or talk therapy. Therapy can be attended individually, in groups, some time with family members. Counselling can provide emotional support and help the patient get back to normal routine life. It can also help learn why the stressful event affected the patient so much. As the patient understands more about this connection, he can learn healthy coping skills to help them deal with other stressful events that may arise in future.
Medication (Allopathic): Antidepressants and anti-anxiety medications are the medications most often used to treat adjustment disorders. It can work better with therapy. The patient may need medications for a few months to even years. If stopped suddenly, some medications especially certain antidepressants may cause withdrawal symptoms. These have also other severe side effects.
Homeopathic Treatment: Homeopaths talk to the patients, family members and even friends or colleagues to collect the overall symptoms. It is important to know when did the symptom first noticed. Major life events, especially recently, both positive and negative are also needed by the homeopath.
Other symptoms can be derived from asking the following questions:
1. Has the patient shared the issue with family and friends?
2. How often do they feel sad or depressed?
3. Do they have suicidal thoughts and if yes, how they are planning?
4. How often do they feel anxious or worried?
5. Is there any trouble with sleeping?
6. Do they have difficulty finishing tasks that were previously manageable?
7. Are they avoiding social or family events or relationships?
8. Are they facing specific problems in school or work or business?
9. Have they made any impulsive decisions or engaged in reckless behaviour that doesn’t seem like them?
10. What other symptoms or behaviours are causing them or their loved ones distressed?
11. Do they drink alcohol or any other illegal drugs? If yes, how often?
12. Have they taken treatment for other psychiatric or mental disorders in the past? What type of treatment? What was the result?
13. Are there any genetic problems?
14. What is the overall lifestyle?
Based on the collected symptoms, any medicine can be selected and successfully cure the patients.
With medication some other things can be of great benefit:
1. Establishing a good support network with family, colleagues and friends
2. Being spiritual, practising religious rituals, knowing the almighty creator and trying to make a close connection with Him
3. Seeking out appropriate humour or laughter
4. Living a healthy lifestyle
5. Learning how to think positively about self
Dr-Benojir Homeopath, Director@BPATC