Not everyone manages to adapt to new life situations immediately after a crisis. An adaptation disorder can be alleviated by targeted therapy. When a treatment is necessary and with which mental illness the disorder is often confused.
- Feelings of sadness and overwhelming are typical of an adjustment disorder – sufferers often withdraw.
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If anxiety, depressive moods or problems with the fulfillment of everyday obligations occur after a stressful life change, this is called an adjustment disorder. This is not always in need of therapy and is usually limited in time. Here the adaptation disorder differs from other mental disorders.
Overview of article content:
What causes stress in women
Therapy: How is an adaptation disorder treated?
Although by definition adaptation disorders disappear after some time, it is often necessary to take therapy in order to shorten the duration of the adaptation disorder or to alleviate the symptoms.
If the adjustment disorder takes a slight course, support from family and friends can be sufficient to survive the life crisis. In more severe cases with a high level of suffering, therapy is essential. The specialist in psychiatry or a psychotherapist develops an individual treatment plan. With the help of these methods, those affected can be helped:
behavior therapy
psychotherapy
Talk therapy
Medications: Benzodiazepine tranquilizers (sedatives) in the lowest dosage; time-limited sleeping pills; St. John's wort for mild depressive moods, mild antidepressants for more severe symptoms
The aim of the treatment is to release mental, physical and psychosocial reserves for coping with problems, to relieve guilt and fears, to reduce emotional pressure, to motivate those affected, to strengthen their own strength and to regain self-control. For this, it is important to include the patient's environment in the therapy in addition to the supportive and uplifting support from the therapist.
What is an adjustment disorder?
All people are confronted with very stressful events or life circumstances in the course of life. It is very different how the individual deals with it and how easy or difficult it is to manage these phases of life. Whether and to what degree the disease develops does not depend on an objective severity of the event. What is decisive is the subjective feeling of the stress, the amount of previous serious experiences as well as the individual resilience (resilience) and coping ability.
Difficulties at work, financial losses, problems in family or partnership, health restrictions, but also a positive or negative life-changing event such as the birth of a child or the loss of a partner can cause considerable stress and overwhelm those affected. There may be various physical and psychological symptoms that are more pronounced than a normal reaction to stress and that are known as adaptive disorders.
An adjustment disorder can last for days, weeks or a maximum of six months and can also be triggered by less severe events. According to the World Health Organization (WHO) classification, adaption disorders also include hospitalism in children, culture shock and the grief reaction.
Frequency: How often do adjustment disorders occur?
It is difficult to distinguish an adaptation disorder from other mental disorders, which is why a high number of undiagnosed adaptation disorders can be assumed.
According to these estimates, about 0.6 percent of all women and 0.3 percent of men suffer from an adjustment disorder. From outpatient psychiatric or psychotherapeutic people, five to 20 percent should show signs of an adjustment disorder. It can occur at any age. The fact that the number of women affected is higher than that of men can be due to the fact that women trust their doctor more quickly and the adjustment disorder is diagnosed more often. Whether the family situation or marital status is reflected in the number of illnesses is as unexplored as the question of whether social status has an impact.
Symptoms of adjustment disorder
The possible symptoms of the adjustment disorder are very diverse and can occur in the most varied combinations among those affected. It is important for the diagnosis that a clear temporal connection can be established with a triggering event. Typical symptoms are:
Psychological signs that last for a long time and significantly affect the life of those affected: Fear and worry, depression, anger, resentment, despair, and emotional confusion are most common. Feelings of isolation, distress and sadness are also typical. Those affected have the feeling that they are no longer able to cope with everyday life tasks. In some cases, "dark thoughts" may arise, sometimes with concrete suicide ideas or suicide preparations.
Physical signs with no demonstrable physical cause: Abdominal pain, concentration problems, muscle tension, cardiovascular problems
Social signs: Slumps in mood, lack of interest, difficulty concentrating and a loss of friends can severely impair the social behavior of those affected and limit performance. There may be social withdrawal, aggressiveness or dissocial behavior (no ability to compassion).
In addition, the following symptoms are characteristic of an adjustment disorder for different age groups:
Baby: In infants, adjustment problems can manifest themselves through excessive crying, sleep disorders and drinking problems. The adjustment disorder can be caused by birth or by a disturbance in the parent-child relationship.
Children: Children often show regressive states in the event of adjustment disorders, i.e. relapses to previous behavior that seemed to have long since been overcome in development. Bedwetting, baby talk and thumb sucking are typical.
Youth: In adolescents, an adjustment disorder can manifest itself in disturbed social behavior. Reactions to a stressful situation can be aggression, lies, tails, stealing or ruthless and anti-social behavior in the circle of friends, at school or at work. Drug abuse or excessive drinking is not uncommon.
Causes and risk factors for an adjustment disorder
Triggers for an adaptation disorder are not catastrophic extreme situations or the most severe traumatic experiences, but stressful changes in living conditions, which can also be called crises. How bad you feel about such a life crisis is a very subjective feeling. Equal events can trigger an adjustment disorder in one person, while others develop strategies and deal with the situation without problems.
There are a number of influences that can promote the development of an adaptation disorder. In most cases, several of these factors come together and trigger the symptoms together:
long duration and high intensity of the triggering event
several consecutive events
Vulnerability (vulnerability, psychological instability, poor resilience) of those affected
Weakness in the individual coping strategy: Those affected cannot deal with frustrations, insults, humiliations and excessive demands.
pre-existing mental disorder (s)
lack of support from friends and family
Lack of understanding of the wider environment (neighbors, work colleagues, teachers and sometimes doctors)
an influence of genetic factors is assumed, but has not been proven
Diagnostics: How can you diagnose an adaptation disorder?
The adjustment disorder is diagnosed in most cases by a psychotherapist or psychiatrist. The first route for those affected generally leads to a family doctor.
Based on the first description of the symptoms, the patient may develop suspicion of an adjustment disorder. In the next step, the doctor will examine existing physical symptoms to rule out organic causes for the symptoms.
If this confirms the suspicion that it could be a mental disorder, specific questions are asked, such as:
- Did an experience put you under a lot of strain?
- Is there joylessness, lack of interest or lack of drive?
- Do you feel sad?
- Do you feel overworked?
- Are there difficulty concentrating?
If a potentially triggering cause is found that is no more than one month ago, the suspected diagnosis is confirmed. Now the family doctor will refer the person concerned to a psychiatrist or psychotherapist so that a correct diagnosis can be made.
It is also important to have other mental disorders excluded by the specialist. In particular, the suspected adjustment disorder must be differentiated from depression, anxiety disorders, beginning schizophrenic psychoses and personality disorders. Acute or medium to long-term post-traumatic stress disorders can also have similar symptoms.
In some cases, for example, the diagnosis can also be "normal grief response" if it is understandable and does not exceed the usual level of grief.
Course and prognosis of an adjustment disorder
An adjustment disorder does not last longer than half a year, in most cases it takes much less time to heal. As a rule, the disorder can be overcome within a few weeks, especially in older age, the symptoms persist for a few months. In rare cases, long-term and persistent stress can lead to longer courses, especially if depressive symptoms have already occurred.
If left untreated, adjustment disorders due to withdrawal and social isolation can have serious consequences and lead to loss of job or serious relationship problems. In some cases, alcohol and drug use are increased. The disorder has large individual differences.
The number of diseases seems to be increasing. This could be due to the fact that mental disorders are better recognized today, but above all they are more recognized. The willingness to reveal itself to family and friends and to consult a doctor has increased significantly and leads to more diagnosed and successfully treated cases of adjustment disorders.
Can you prevent an adjustment disorder?
The risk of adaptation disorders decreases if there is a stable social network through family, friends and acquaintances.
In order to avoid recurrence, those affected can learn psychoanalytic methods and thus train their own skills in coping with the crisis. Communication and fear management training are particularly helpful.
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