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Adjustment Disorder

Adjustment disorder is an unusually strong or long-lasting reaction to an upsetting event. It is a group of symptoms, such as stress, feeling sad or hopeless and physical symptoms that can occur after a stressful life event. It can occur in young children, adjustment disorder graphicadolescents, and even adults. A child with the disorder will have a hard time coping with everyday activities. There might be symptoms of depression, anxiety or hostility.

Many different events may trigger symptoms of an adjustment disorder.

Stressors for people of any age include:

  • Death of a loved one
  • Divorce or problems with a relationship
  • General life changes
  • Illness or other health issues in yourself or a loved one
  • Moving to a different home or a different city
  • Unexpected catastrophes
  • Worries about money

Triggers of stress in teenagers and young adults may include:

  • Family problems or conflict
  • School problems
  • Sexuality issues

There is no way to predict which people who are affected by the same stress are likely to develop adjustment disorder. The social skills developed before the event, and ways learned to deal with stress (in the past) may play roles.

Symptoms

Symptoms of adjustment disorder are often severe enough to affect school, work or social life. Symptoms include:

  • Acting defiant or showing impulsive behavior
  • Acting nervous or tense
  • Crying, feeling sad or hopeless, and possibly withdrawing from other people
  • Skipped heartbeats and other physical complaints
  • Trembling or twitching

To have adjustment disorder, you must have the following:

  • The symptoms clearly come after a stressor, most often within 3 months
  • The symptoms are more severe than would be expected
  • There do not appear to be other disorders involved
  • The symptoms are not part of normal grieving for the death of a loved one

Sometimes, symptoms can be severe and you may have thoughts of suicide or make a suicide attempt.

Exams and Tests

A health care provider will do a mental health assessment to find out about your behavior and symptoms. You may be referred to a psychiatrist to confirm the diagnosis.

Treatment

Most mental health professionals recommend some type of talk therapy. This type of therapy can help you identify or change your responses to the stressors in your life.

Cognitive behavioral therapy (CBT) is a type of talk therapy. It can help you deal with your feelings:

  • First, the therapist helps you recognize the negative feelings and thoughts that occur.
  • Then the therapist teaches you how to change these into helpful thoughts and healthy actions.

Other types of therapy may include:

  • Long-term therapy, where you will explore your thoughts and feelings over many months or more
  • Family therapy, where you will meet with a therapist along with your family
  • Self-help groups, where the support of others may help you get better

Medicines may be used, but only along with talk therapy. These medicines may help if you are:

  • Nervous or anxious most of the time
  • Not sleeping very well
  • Very sad or depressed

Note: Psychotherapy is the treatment of choice for any adjustment disorder since the disorder is seen as usually a quite normal reaction to a specific situational event. The main goal of treatment is to relieve symptoms and help the patient return to a similar level of functioning as before the stressful event occurred.

Solutions

With the right help and support, you should get better quickly. The problem usually does not last longer than 6 months, unless the stressor continues to be present.

If you or a loved one suffer from Adjustment Disorder, please call for help.

Learning to React Well

Managing emotional reactions means choosing how and when to express the emotions we feel.

People who do a good job of managing emotions know that it’s healthy to express their feelings — but that it matters how (and when) they express them. Because of this, they’re able to react to situations in productive ways:

They know they can choose the way they react instead of letting emotions influence them to do or say things they later regret.

They have a sense of when it’s best to speak out — and when it’s better to wait before acting on, or reacting to, what they feel.

They know that their reaction influences what happens next — including how other people respond to them and the way they feel about themselves.

You’ve probably been in a situation where someone reacted in a way that was too emotional, making you cringe or feel embarrassed for the person. You also might have been in a situation where your own emotions felt so strong that it took all your self-control not to go down that path yourself.

Maybe you can think of a time when you didn’t manage your reaction. Perhaps anxiety, anger, or frustration got the better of you, It happens. When it does, forgive yourself and focus on what you could have done better. Think about what you might do next time.

Emotions 101

The skills we use to manage our emotions and react well are part of a bigger group of emotional skills called emotional intelligence (EQ). Developing all the skills that make up emotional intelligence takes time and practice.

People who react well are already good at some basic EQ skills. But these are skills anyone can practice:

  • Emotional awareness. This skill is all about being able to notice and identify the emotions we feel at any given moment. It is the most basic of the EQ skills. Sometimes, just naming the emotion we feel can help us feel more in charge of our emotions.
  • Understanding and accepting emotions. Understanding emotions means knowing why we feel the way we do. For example, we might say to ourselves, “I feel left out and a little insecure because I didn’t get invited to the prom yet, and two of my friends already did.”
  • It helps to view our emotions as understandable, given the situation. We might think to ourselves: “No wonder I feel left out — it’s natural to feel that way in this situation.” It’s like giving ourselves a little kindness and understanding for the way we feel. This helps us accept our emotions. We know they’re reasonable, and that it’s OK to feel whatever way we feel.
  • Accepting emotions means noticing, identifying, and understanding our emotions without blaming others or judging ourselves for how we feel. It’s not helpful to tell ourselves that how we feel is someone else’s fault. It is also not good to judge our emotions and think, “I shouldn’t feel this way” or “It’s awful that I feel this way!” The goal is to acknowledge your feelings without letting them run away with you.

Once these basic skills feel natural, you’re more able to manage what you actually do when you feel strong emotions. Practicing the basic skills also will help you get past difficult emotions faster.

We always have a choice about how to react to situations. Once we realize that it’s easier to make choices that work out well.

Learning to react well takes practice. But we all can get better at taking emotional situations in stride and expressing emotions in healthy ways. And that’s something to feel good about!

5 Ways to Be More Aware of Your Emotions

As we grow up, we get better at knowing what we are feeling and why. This skill is called emotional awareness. Understanding our emotions can help us relate to other people, know what we want, and make choices. Even emotions we consider “negative” (like anger or sadness) can give us insight into ourselves and others.

Emotional awareness comes more easily to some people than others. The good news is, it’s a skill that anyone can practice. Here are a few ways to become more in touch with your emotions:

Notice and name your emotions. Start by just noticing different emotions as you feel them. Name them to yourself. For example, you might say, “I feel proud” when a class presentation goes well, “I feel disappointed” at not doing well on a test, or “I feel friendly” when sitting with a group at lunch.

Track one emotion. Pick a familiar emotion — like joy — and track it throughout the day. Notice how often you feel it and when. Whenever that emotion shows up, you can simply make a mental note to yourself or jot it down in a journal. Notice where you are, who you’re with, and what you’re doing when that emotion is present. Note whether the emotion is mild, medium, or strong and if it has different intensities at different times.

Build your emotional vocabulary. How many emotions can you name? Try going through the alphabet and thinking of one emotion for each letter.

Think of related emotions that vary in intensity. For example, you might be irritated, annoyed, mad, angry, irate, or fuming. See how many of these “emotion families” you can come up with.

Keep a feelings journal. Take a few minutes each day to write about how you feel and why. Journaling about your experiences and feelings builds emotional awareness. You also can express an emotion creatively. Make art, write poetry, or compose music that captures a specific emotion you’re feeling.

There’re lots more you can try, of course. For example, you can try identifying the emotions an artist is trying to convey as you read poetry or listen to music, then recognize how you feel in response.

The more you’re aware of your emotions, the more they’ll help you to know yourself and understand the people around you.

Reviewed by: D’Arcy Lyness, PhD