What Exactly Is An Adjustment Disorder? Why it Can Be Difficult to Recover?
When people start feeling anxious or sad more frequently than they should, we often assume they are suffering from anxiety or depression. However, there is another mental health disorder that manifests as anxiety, depression, or both.
Adjustment disorders can resemble these other common mental health conditions, but with one important distinction: they are triggered by a stressful life event.
Though most commonly diagnosed in children, adjustment disorders are becoming more common in adults, according to the Johns Hopkins Psychiatry Guide, as we all struggle to adjust to the circumstances COVID-19 has thrown at us.
Here's what you need to know about adjustment disorders, including how to recognize them in yourself and others, as well as how to treat them.
What exactly are adjustment disorders?
High-stress events are strongly linked to adjustment disorders. When something extremely stressful occurs, such as a divorce, job loss, the death of a loved one, an accident that causes you to lose your home or be seriously injured, or any number of other things, people sometimes find it difficult to recover.
They may experience depression, anxiety, or both. They may begin to act out behaviorally, or they may become unable to eat or concentrate on work or life.
"It's a reaction to a stressful life event that is causing significant disruption in your life," says Lindsay Henderson, PsyD, an Amwell therapist. While it's normal to feel sad, restless, or overwhelmed after a major stressor, Dr. Henderson says that when you have an adjustment disorder, those feelings become disproportionate to the stressor and last longer than they should.
What symptoms indicate an adjustment disorder?
Adjustment disorders frequently resemble depression or anxiety. "When we look at diagnosing adjustment disorders, we can categorize and say, 'This is an adjustment disorder with depressed mood,' or 'This is an adjustment disorder with anxiety," Dr. Henderson says. "Or it can be a mix of both depression and anxiety."
However, "adjustment disorder" is not a term that most patients use when seeking help for the first time. People who come into Dr. Henderson's office most of the time will say, "I just can't seem to get over losing my job," or "I can't seem to manage everything in my life the way I used to."
Symptoms of adjustment disorders include difficulty concentrating and memory problems. Gina Shuster, LMSW, a therapist at Oakland Psychological Clinic, sees patients who say things like, "I'm so forgetful now and I never used to be this way", "I'm always flustered;" or "I can't find the right words."
Shuster claims that when anxiety disorders manifest as anxiety or depression, your body expends so much energy just trying to maintain this heightened emotional state that small things like memory and concentration begin to slip. "It's like juggling a slew of balls in the air. Some things will have to be let go at some point "she claims.
What impact has COVID-19 had on adjustment disorders?
COVID-19 has been a major source of stress for those of us who have lived through the last several months. According to the Johns Hopkins Psychiatry Guide, stressors that affect entire communities can be triggers for adjustment disorders.
In addition to worrying about the virus, many people have lost jobs, lost loved ones, and been forced to miss out on milestones such as high school or college graduation, starting kindergarten, and planning weddings.
All of these stressors add up to an increase in people seeking therapy to cope, as well as more reports of mental health issues than ever before.
According to a CDC report released on August 14 and examining mental health in the United States during one week in June 2020, 40% of adults reported struggling with mental health or substance abuse. More than 25% of the 5,412 people polled reported anxiety symptoms, up from 8% before the pandemic, and the prevalence of depression was four times higher (24.3%, up from 6.5%).
Many of those who are now anxious or depressed are most likely suffering from a coronavirus-induced adjustment disorder. "More people are coming in complaining that their usual coping strategies are no longer working.
They are feeling overwhelmed and are having difficulty managing their lives "According to Dr. Henderson.
Shuster has also seen a significant increase in new patients. "We're seeing a lot more adjustment disorders right now because everything is uncertain," she says.
"And people are experiencing major losses, having to cancel things they've been looking forward to for a year, or being unable to celebrate accomplishments that they were so excited and proud of."
Dr. Henderson's first step when speaking with these patients is to try to put their struggles into context with the immense stress we've all been under as individuals and as a society. "When you're living in it, it can be difficult to recognize, appreciate, or truly comprehend how depleting a global pandemic can be on your internal resources," she says.
What is the treatment for adjustment disorders?
Treatment for adjustment disorders that manifest as depression, anxiety, or both of these disorders is similar to that for those disorders; however, therapy is frequently centered on the stressor that initiated the adjustment disorder.
"We want to be able to identify triggers as well as ways to calm down," Shuster says. In order to help people who might be on the verge of a panic attack or who are mired in depressive thoughts to concentrate on where they are in the moment, she teaches her patients grounding techniques, which are comparable to mindfulness exercises.
Shuster favors a grounding technique known as "5-4-3-2-1." It employs all five senses and works as follows: Stop wherever you are and take a look around if you are feeling overwhelmed.
Describe five things you can see. Then there are four things you can touch, three things you can hear, two things you can smell, and one thing you can taste, if possible.
Coping skills such as this exercise assist in bringing people who are feeling overwhelmed back to the present moment. The cognitive behavioral therapy that Dr. Henderson offers patients aims to alter the way we think and provide coping mechanisms for when our thoughts begin to spiral.
She frequently observes patients who engage in catastrophizing and black-and-white thinking, the two main types of negative thinking.
"Catastrophizing is assuming the worst will happen. 'We're in an economic downturn, and I'm sure I'll lose my job,' he says. I won't be able to recover, and we'll be forced to sell our home "she claims. "Black-and-white thinking sees things as all good or all bad, with no room for a middle ground."
When working with patients who have adjustment disorders, Dr. Henderson helps them examine their thoughts and behaviors and make minor changes to their thought patterns, which can improve their mood in general.
Of course, rather than simply reacting to triggers or already heightened emotions, it's also important to be proactive. "The first step in investigating mental health and emotional well-being is ensuring that a person is doing the bare minimum to care for their body and mind.
Eating and sleeping well are essential. I'm talking about everything we hear over and over again. However, people must be reminded of the significance of these issues "According to Dr. Henderson.
Schuster suggests keeping a feelings journal to track your mental health right now, when everyone is struggling emotionally. Then you can look back and see that you're coping much better now than you were a few months ago, and things are truly improving.
Doing something nice for others is another simple way to increase your own happiness. "I'm working on gratitude," Shuster says. And studies show that people are happier when they help others.
So bake a pie for your neighbors, go grocery shopping for your grandparents, or donate to an organization that keeps people safe. A little charitable work can go a long way toward improving your mood.