- Hey everybody, today we're going to talk about
adjustment disorders, what are they,
what symptoms can we feel if we struggle with them,
and what are our treatment options?
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But, let's jump in to what adjustment disorders are.
I'm gonna read to you a little bit of the criteria
from the DSM so we can better understand
how adjustment disorders are diagnosed.
And there are five main criteria
that fall under the adjustment disorders diagnosis.
And the first is, "The development of emotional
"or behavioral symptoms in response
"to an identifiable stressor occurring
"within three months of the onset of the stressor."
And I think that this is important,
because the development of an adjustment disorder
has to occur within three months of the stressor happening.
And that stressor could be something like,
I have to move, or I lost my job,
or I'm going through a tough divorce or breakup.
So we have that three month period,
and I think that's kind of important for us to note
because most diagnoses have some kind of time frame
that we're looking for to make sure that we're
getting the proper diagnosis.
The second criteria is, "These symptoms or behaviors
"are clinically significant, as evidenced
"by one or both of the following."
So, I have to have at least one, or both of these.
The first is, "Marked distress that is out of proportion
"to the severity or intensity of the stressor,
"taking into account the external context
"and the cultural factors that might influence
"symptom severity and presentation."
And I really like this, because talking about the fact
that our response to it is a little bit more
than the actual situation warrants.
That's when it becomes an issue, right?
If we're having something that's really shitty happening
to us, we can feel bad and that's part of
a normal human response, but if our response
to that is so much greater, that's when
it's a diagnosable mental illness.
And you see, I think that that's important to note,
because we're all human.
We all have different responses, but when it gets kind of
out of hand is when we really need to get help.
And the second thing is, we have to have,
"Significant impairment in social, occupational,
"or other important areas of functioning."
And that is always part of a DSM diagnosis,
and that's frankly just because if we're unable
to do things in our regular life,
that means we're being impaired by this mental health issue
and that mental health issue becomes
a diagnosable mental illness.
And the third criteria is that, "The stress-related
"disturbance does not meet the criteria
"for another mental disorder and is not
"merely an exacerbation of a preexisting mental disorder."
And they always say that because let's say we're already
diagnosed with PTSD, and the symptoms are kind of just
an exacerbation of that, then that means
that it's not an adjustment disorder,
because it doesn't fit this, so it's always important
to note what other issues we have going on,
so we make sure if we are given this diagnosis
that it's the right one, and that it's not
just an exacerbation of something
that we already had going on.
And the final two criteria are,
number one, "The symptoms do not represent
normal bereavement."
If we've lost someone in our lives that we loved,
and we miss them, that's okay.
We can grieve, that's normal.
The second is, "Once the stressor or its consequences
"have terminated, the symptoms do not persist
"for more than an additional six months."
That's why this is called an adjustment disorder.
I want you to keep that in mind,
because when we're struggling to adjust
that's when this would be diagnosed.
But, if the stressor, or its consequences have ceased,
they've been terminated, then if it goes on
for an additional six months past that,
it's not an adjustment disorder.
It's probably something else.
And I think that it's important to note
that attachment disorders fall under the same category
as PTSD or reactive attachment disorders.
They call this whole chapter trauma and or stress related
disorders, and I think that's kind of important to note,
and it gives you an idea of what adjustment disorders
really are, and other things that kind of
fall into the same type of category.
Now, when we're diagnosing someone
with an adjustment disorder, the reason that it's called
adjustment disorders and it's not just adjustment disorder,
is because we need to specify whether it comes along
with a depressed mood, anxiety,
mixed anxiety and depressed mood,
disturbance of conduct, there's a lot of different ways
that this can present itself.
And that's why it's called adjustment disorders.
It's kind of an umbrella term, for any of the things
that we can feel and struggles we can have
when we're trying to manage an intense life stressor.
And when we're talking about the stressors
that can lead to an adjustment disorder,
these so called stressors can be single events,
meaning we had a really nasty breakup.
That just happens once, obviously it can span
over a chunk of time, but it's just a one event thing.
Or, it can be recurrent, meaning maybe we're having
continued business problems, or struggles at school,
or marital issues that are happening at different times
like every few months, or every few weeks,
we're having another issue.
Either way, that can still lead to an adjustment disorder.
It doesn't have to be a one single event,
or multiple, it can be either or.
And it's also important to remember that these stressors
can happen to individuals, meaning like,
I went through a breakup, therefore it's happened to me,
and potentially my ex-partner.
Or it could happen to entire groups,
like, let's say we have some kind of environmental issue,
a flood, a earthquake, that can cause
an adjustment disorder in everyone that's affected.
So, it can happen to individuals as well as larger groups.
And the reason I think this is so important
to talk about is because adjustment disorders themselves
are linked to an increased risk of suicide.
They find people who struggle with adjustment disorders,
if left untreated, have a higher risk
of having a suicide attempt,
or even just thoughts of suicide.
So, it's important that we talk about it
and we get treatment sooner rather than later.
The way that we differentiate adjustment disorders
from PTSD, is when it comes to adjustment disorders
it doesn't matter the severity of the stressor.
If you remember, the first criteria when it comes to PTSD
being diagnosed is that we have to be traumatized,
we have to fear for our life, or the life of someone else.
The severity has to be very high.
When it comes to adjustment disorders
it doesn't really matter.
And the last thing in the DSM that I wanna touch on
is that an adjustment disorder is not
a normal stress reaction.
In the DSM, they call these normative stress reactions,
and it states, "When bad things happen,
"most people get upset."
Duh, right, we're human, that's how we react.
"This is not an adjustment disorder.
"The diagnosis should only be made
"when the magnitude of distress."
For example, the anxiety, changes in mood, or conduct.
"Exceeds what would normally be expected
"which may vary in different cultures."
So, taking into account where you live
and kind of what's quote unquote normal
in your society and in your culture,
if our reaction to the distress is way more than expected,
or than what's normal, that's when
it's an adjustment disorder, otherwise,
it's just a normal reaction to shitty things happening.
Now, everyone is going to experience an adjustment disorder
differently, like I told you at the beginning,
there are a bunch of different ways
that it can be experienced, with depressed mood,
or anxiety, but some of the most common symptoms are,
and I'm reading from my notes.
Insomnia or fatigue, so being super tired,
but then when you lay down you're just not able
to go to sleep.
Crying easily, having a lot of anxiety,
or anxious feelings in our body, like heart palpitations,
sweating hands, having suicidal thoughts,
body aches or soreness, maybe thinking that we're sick.
An lot of people, when I was reading about this,
reported going to the doctor first, thinking that
they had the flu or something,
come to find out it was because or that divorce
they're going through, or that really terrible thing
that was happening at work.
And the final symptom that they talk about the most
is impulsivity, they might act rashly,
make decisions that would normally take us months,
in a matter of seconds.
And all of these symptoms, it's important to note
that once that stressor is gone,
and it isn't in our life anymore,
what we're feeling doesn't last more than six months.
If it does, then again, adjustment disorders
that's not the right diagnosis for you.
And the most important thing, treatment options.
And as always, adjustment disorders are managed best
when we get treatment quickly.
And the first option for treatment is therapy.
Since the situation and stress
are what causes adjustment disorders,
having someone you can go to, that you trust,
where you can vent about what's going on
and talk it through, get time to process it
and then be given some tools and techniques
to try out on your own, can be really beneficial.
And the best types of therapy for adjustment disorders
are number one, CBT, the second is family
or group therapy, as well as support groups,
because if it's happening to a bunch of you,
let's say, as a family you got evicted from your home,
all of you could benefit from seeing someone,
and in a group setting it could help you
all better understand how each of you are feeling,
and validate your experience.
And the final one that they mention is just talk therapy.
Like I said, being able to vent about it,
talk about it, get some tools and techniques,
can be all that we really need
in order to process through what's going on,
and help us feel better.
And if therapy isn't enough, as always,
medication is there to help as well.
Since adjustment disorders can come along
with feelings of anxiety or depression,
they find SNRIS and SSRIS, otherwise known
as antidepressants, to be super beneficial.
So, if you feel like you're drowning in your symptoms
and things aren't getting better,
make sure you talk to your doctor and see if medication
is an appropriate choice for you.
Since adjustment disorders are caused by stress
and bad things happening in our life,
it's important for us to know
how to prevent it from happening again.
And no, unfortunately, I'm not God.
We can't control the world around us,
I can't stop stressful things from happening to me,
or to you, but there are things that we can do
to help us feel better, be more supported,
so that when bad things happen,
we're able to rebound more quickly,
and it doesn't follow us and bother us for three months,
four months, five months, where we just feel terrible.
And so obviously the first way to prevent
adjustment disorders from happening,
is to build up your support system.
These can be people in your real life.
That's why support groups can be amazing.
These could be family, friends,
these can be groups that you join.
Finding people who enjoy the same things that you do,
and having a group of people to support you
and uplift you when you're having a hard time,
can keep us out of the depths,
and keep us out of struggling with an adjustment disorder.
And the second way to prevent adjustment disorders
from happening to us is to do self-care regularly.
This can look different from person to person,
but we have to make sure that we're giving to ourselves
as much as we're putting out to other people
and so that may mean that you take time
reading that book you've been putting off,
or journaling, taking a hot bath,
going for a walk, petting some animals,
whatever it is for you that helps fill you up,
and make you feel better, we need to make sure
we're doing that regularly.
This isn't just a, oh, crap I haven't taken care
of myself, I'm gonna do it all today.
These are things we should do every few days.
Maybe, every day, do at least one thing
that's really good for you, makes you feel better
because having a support system around us
that lifts us up when we need it most
and is there when we're having a really shit time,
as well as doing some self-care and making sure
that we're taking care of ourselves regularly,
can really decrease the likelihood of us getting
an adjustment disorder in the first place.
So, make sure you give those things a try.
Try to boost those up in your life,
so that you are more well equipped
to fight against stresses that can come up without
any warning at all.
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As always, leave in the comments
what are some things that you do
to help build up your armor against adjustment disorders,
or feelings of depression, or anxiety.
Let us know, because together you and me
we're working towards a healthy mind and a healthy body.
And I will see you next time, bye.