Adjustment Disorders

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All humans face stressful life events. Sometimes these stressful events are navigated with little difficulty. At other times they cause troubling symptoms. Adjustment Disorder may be diagnosed when a stressful event triggers symptoms. An Adjustment Disorder is a psychological response to stressors that results in clinically significant emotional or behavioral symptoms.

This may include a decrease in performance at school or work, substance use, changes in relationships and somatic complaints. Somatic complaints are complaints about the body including pain, nausea, headaches and body aches, which often have no medical explanation. This reaction to the stressful event is marked by distress that is in excess of what would be expected given the nature of the stressor, or causes a significant impairment in social or occupational functioning.

When these emotional or behavioral symptoms develop within three months from the onset of the stressor it may be an Adjustment Disorder. Symptoms may be present for several weeks and may last up to several months. The Adjustment Disorder may be considered acute when symptoms last less than six months, or chronic when longer than six months. They may occur at any age.

Adjustment Disorders are relatively common and require an identifiable stressful event that can be of any severity. This is different than Post-Traumatic Stress Disorder, which is a more familiar, but less common diagnosis that requires the presence of an extreme stressor.

Examples of the variety of triggering stressors that may lead to Adjustment Disorder include:

• Single events, like a termination of a relationship

• Multiple stressors, like business difficulties or marital problems

• Recurrent stressors, including seasonal problems at work

• Continuous stressors, like living in an area where there is frequent crime

• Developmental events, like getting married, becoming a parent, or going away to school

Adjustment Disorder may include emotional symptoms, like a depressed mood or anxiety, or both. It can also include disturbances of conduct, like angry outbursts or lying. Or, it can include both disturbances of emotions and conduct.

Adjustment Disorder is considered a short-term illness. With time and proper treatment it is likely to resolve and allow the person to return to their normal functioning. The treatment of Adjustment Disorder may include both medication and therapy. Often therapy alone can be effective in helping the person to improve their ability to cope with the stressor. These improved coping skills often include learning to use support systems more effectively, changing negative thinking and changing unhealthy behaviors.

The setting for such therapy may include outpatient therapy with a counselor or psychologist. Or, for more severe cases, it may include an Intensive Outpatient Program (IOP) or a Partial Hospitalization Program (PHP). IOP treatment is generally three hours of therapy three times a week. PHP treatment is six hours of daily therapy five times a week. It is rare that Adjustment Disorder requires inpatient psychiatric treatment. The needed level of care is determined by the severity of the symptoms and the amount of disruption to the person’s functioning. No matter what level of care a person needs there is no reason to feel ashamed for seeking treatment. Part of being human is leaning on other when there are struggles. And all humans struggle at times.

MidMichigan Medical Center – Gratiot has a Psychiatric Partial Hospitalization Program (PHP) for those who need this level of treatment. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth.

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