Adjustment disorder

We know that stress can be bad for you. It increases your risk of developing heart disease and several stress-related physical conditions, as well as this debilitating psychiatric condition.

Adjustment disorder can develop in response to a stressor like a single event (for instance, the termination of a relationship), or multiple stressors (such as business difficulties or marital problems). Stressors may be recurrent or continuous (like living in a crime-ridden neighbourhood).

Emotional and/or behavioural symptoms develop within three months of the onset of the stressor. Once the stressor has been removed, symptoms usually disappear after six months.

Symptoms

Depression and anxiety are the most common symptoms, along with impairment in social and/or occupational functioning.

Diagnosis

The disorder is diagnosed according to criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The following criteria apply:

1. The development of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within three months of the onset of the stressor(s).

2. These symptoms or behaviours are clinically significant as evidenced by either of the following:

• marked distress that is in excess of what would be expected from exposure to the stressor, or
• significant impairment in social or occupational (academic) functioning.

1. The stress-related disturbance is not due to another psychiatric disorder, such as major depression or an anxiety disorder.
2. The symptoms do not represent bereavement.
3. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional six months.

Treatment

Psychotherapy
The aim of individual therapy is to provide emotional support and to assist the person to return to previous functioning. The focus is to help the patient understand the significance of the stressor, to teach the patient how to develop healthier coping mechanisms, and to strengthen his or her support base.

Medication
If symptoms of depression and/or anxiety are present, antidepressants and anti-anxiety medications may be prescribed.

Prognosis

By nature, this condition is short-lived, with a good prognosis.

When to call your doctor

If you experience an abnormally high level of distress in reaction to exposure from a stressor, ask your general practitioner for a referral to a psychologist or psychiatrist for an assessment.

How can the condition be prevented?

There are no known preventative measures. However, a good support structure and healthy coping mechanisms gave been shown to be helpful in dealing with stressful events.