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| Adjustment Disorder Signs and Symptoms The development of emotional or behavioral
symptoms in response to an identifiable stressor(s) occurring within 3
months of the onset of the stressor(s).
Once the stressor (or its consequences) has
terminated, the symptoms do not persist for more than an additional 6
months. Stages can be Adjustment Disorders subtypes are selected according to the predominant symptoms:
Treatment: Therapists usually do not treat Adjustment
Disorder with medication. Sometimes a few days or weeks of anti
-anxiety medication, is prescribed to control anxiety and insomnia. Usually antidepressant or antipsychotic
medications are not used for Adjustment Disorders. If
antidepressant or antipsychotic medication is indicated, it is more likely
that the diagnosis is a more serious Mood or Psychotic disorder, rather
than just Adjustment Disorder. Adjustment Disorder (by definition) lasts
less than 6 months, thus supportive psychotherapy is usually all that is
necessary. This supportive psychotherapy should
emphasize that full recovery usually occurs within a few months, and that
this natural recovery is hastened by a psychotherapy which focuses on
stress-reduction. Thus the problem triggering the Adjustment Disorder
should be clarified, and alternative solutions explored. Finally, some
plan for stress-reduction should be agreed upon. It is important that the
therapist not dictate what changes the patient must make. Brief environmental change may be helpful;
however, simplistic advice such as "take a few days of vacation"
is usually insufficient. Psychotherapy should fight against the patient's attempts to withdraw and "just give up". The patient should be encouraged, perhaps by "prescription," to increase contact with others. Other, more serious mental disorders are
frequently misdiagnosed as "Adjustment Disorders". Thus, if
long-term therapy is needed, the patient probably has something else
(e.g., Major Depressive Disorder, or Generalized Anxiety Disorder). The therapy of an adolescent with an
Adjustment Disorder should usually involve the family. Adolescents in
conflict are actively asking for help, although their pleas may be
misunderstood because of their aggressive behavior. Formal psychotherapy is seldom necessary in
the isolated stress response or Adjustment Disorder. Supportive
psychotherapy, with an emphasis on the here and now, is usually
sufficient. Usually all that is required is crisis intervention, brief
counseling, and education. While much of treatment usually is individual psychotherapy, family members can benefit from a family session after the start of individual psychotherapy. Behavior therapy usually focuses on having
the patient to keep a daily log of what triggers the stress, how the
patient responds to the stress, and what helps reduce the stress.
Techniques for general tension reduction are also helpful in reducing the
reaction to stressful events. Many patients with Adjustment Disorder (e.g., following a diagnosis of cancer or AIDS, or breakup of a relationship) often benefit from attending support groups with others who have also experienced the same stressor. Within the group, members exchange advice, share coping strategies, and provide support and encouragement. Some support groups also provide new social networks to replace those lost through events such as death or divorce. |