Adaptive Disorder: Why Don’t I Adapt To Changes?

He adjustment disorder It is an emotional state that can be depressive, anxious or behavioral (with alteration in behavior), produced by a situation that changes the person’s balance and that is a stressful factor for them. Very often, throughout life, people encounter stressful events, changes and unexpected events, however, some people do not adapt to them, generating intense discomfort and affecting their daily life.

These certain identifiable stressors at work, routines, relationships, etc. are the causes of adjustment disorder (TA) that involves emotional symptoms such as anxiety or depression or symptoms that cause changes in ways of acting.

What is adjustment disorder? Meaning

To better understand the definition of adjustment disorder It should be noted that it is included within the disorders related to trauma and stress factors of the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders edited by the American Psychiatric Association (APA), which serves to classify mental disorders and offer clear diagnostic criteria.

This guide describes the adaptive disorders as a psychological response to one or more stressors that involves emotional discomfort such as anxiety or depression and that can also have consequences on behavior in social, school or work environments. These reactions are considered to be excessive than expected in the face of that particular source of stress. For its correct identification, the manual adds that the symptoms of adjustment disorder and its duration usually range between 3 months after the stressful event and that they must be resolved in the following 6 months.

How many people are affected by adjustment disorders?

The epidemiology of this adaptive syndrome It varies according to the population studied and the evaluation methods, although studies in the general population are quite scarce. According to some sources such as those collected by ASAPME , this disorder in children, adolescents and the elderly, ranges between 2% and 8%, while up to 12% are diagnosed in patients who are hospitalized. Finally, in people who have recently suffered a stressful life episode, the prevalence is up to 50%.

Another study on the profile of people with adjustment disorder in adults carried out by the Spanish Society of Community Pharmacy with a sample of more than 1,500 patients reflects that this alteration in adaptation affects more women than men and a higher percentage of people who are actively working.

Adaptive disorder and sick leave

Another curious fact is what we find in the relationship of tadaptive disorder and sick leave In the article Reducing long term sickness absence by an activating intervention in adjustment disorders According to several Dutch authors, it is stated that adjustment disorders are the most relevant cause of sick leave in the Netherlands, where more than 50% of sick leave are due to stress-related problems.

Symptoms of adjustment disorder

Sometimes you can confuse the adjustment disorder with other common responses to stress. For this reason, it is sometimes difficult to diagnose. The DSM-5 establishes clear criteria that rule out other disorders for identification:

1. The presence of emotional or behavioral symptoms as a consequence of a perfectly identifiable stressor. These symptoms appear within 3 months after the event that causes them.
2. Discomfort greater than “normal” in proportion to the source of stress and notable worsening of daily activities at work or socially.
3. Rule out other possible disorders or the aggravation of pre-existing disorders.
4. The symptoms do not respond to a reaction duel
5. Persistence of 6 months in symptoms, for longer or chronic disorders, it is necessary to seek other diagnoses.

Additionally, people who suffer from adjustment disorder often present the following symptoms.

• Impulsiveness
• Anxiety
• Feelings of sadness, hopelessness, or feeling trapped
• Sadness
• withdrawn attitude
• Lack of concentration
• Loss of self-esteem
• Suicidal thoughts
• Physical symptoms: insomnia, tremors, fatigue, body pain or discomfort.

If you identify with many of these symptoms, perhaps you are suffering from adjustment disorder In these cases, it is highly recommended to go to a mental health professional.

Examples of cases of adjustment disorder in adults

Once established what the adjustment disorder is and what its characteristics are and the criteria that lead the professional to diagnose it, let’s look at some practical examples of adjustment disorder cases to serve a much more graphic representation.

For example, a patient came to therapy because she had recently changed jobs. In principle the change was for the better; She had a better salary, better hours and everything seemed good. However, she missed her previous coworkers with whom she had made great friends, and she felt sad because the work was more individual (previously she had to work more in a team).

In this case, the person did not know what was happening to him but he did not feel like doing anything, when he left work he went home to lie on the couch and let the hours pass by. The situation began to spread even on weekends until she decided to take the step of coming to therapy. This girl’s example is a case of adjustment disorder Although the change has apparently been for the better, he has not assimilated the differences and is overwhelmed by what he does not like about his current job.

This example of adjustment disorder in adults shows that, sometimes, changes can be a stressful factor that ends up overcoming us and entering into emotional situations for which we must seek a remedy.

Causes of adjustment disorder

The stressors that lead to suffering from an adjustment disorder can be of various kinds: change of home or city of residence, a new job, the breakup of a romantic relationship, a chronic illness, the birth of a child, changes in stability economic, go live with your partner or with a friend, etc.

The common factor in all these cases is the change in situation to which the person responds in an exaggerated or dramatic way, that is, exaggerates or overstates the negative effects of change, even when you rationally know that what has happened is, in some certain cases, to improve your situation.

Sometimes it is only necessary for one change to occur to emotionally destabilize the person, but on other occasions the disorder occurs as a result of several alterations that alone would not produce such an effect. In this second case, the person feels out of place, since they are not able to relate the change to their discomfort.

People more prone to adjustment disorder

It is possible that there are certain factors that make some people more prone to maladjustment than others. Genetic predisposition, the experiences we have lived, a greater resistance to change or a notable personal vulnerability cause adjustment disorder to appear. The stressful experience and the moment in which it appears is also decisive in having a greater chance of suffering from the adjustment disorder or not. After all, we all live moments of stress and complicated situations throughout our lives and not all people are affected in the same way

Types of adjustment disorder

Some of the symptoms of adjustment disorder They are demotivation, apathy, low energy even for daily tasks, alterations in sleep, eating or sexual desire, mood disorders such as anxiety or depression, low mood, irritability or feelings of uselessness and frustration. These stress factors cause increase in conflicts in the person’s social network and even in the workplace, decreased quality of life and associated disorders such as depression or Binge eating disorder

Furthermore, depending on the symptoms shown by the affected person, adjustment disorder is divided into several subtypes as are the following:

1. Depressive adjustment disorder: In this case, depressive symptoms such as discouragement, hopelessness, crying and sadness stand out.
2. Adjustment disorder with anxiety: Nervous states, worries, restlessness and fear predominate.
3. Mixed adjustment disorder or anxious and depressive disorder: In this case, the mixture of typical symptoms of both previous states stands out.
4. Disorder with behavior modification: Changes in the way of behaving and habits. Establish discussions or new attitudes towards others such as breaking the rules or irresponsibility or rebellion.
5. Mixed with alterations of both emotions and behavior: Furthermore, it is difficult to fit all patients into one label because each person may show one or more symptoms or all of them at the same time.

What can I do if I suffer from adjustment disorder?

For overcome adjustment disorder Some strategies can be practiced to help in certain cases.

1. Investigate the origin: Just as to treat fever you have to see where the infection comes from, to treat mood problems associated with adaptive disorders You have to find out what caused them. If what has happened can be changed, get to work, but if it cannot, in that case you have to accept and assimilate what has happened in the best way possible.
2. Relativize the difficulties: Normally we tend to focus on the negative and think about it a lot, this is what is called ruminating (the same thing cows do with food). This type of behavior such as ruminative thoughts causes insomnia, eating problems, irritability, lack of desire to do things, and most of the symptoms associated with adjustment disorder Detect when you are thinking too much about something and focus on what you are doing. After stopping this whirlwind, it is important not to dramatize, that is, we have to accept the bad things that happen to us, but perhaps it is not as bad as we are making it out to be.
3. Appreciate the positive of the change : After dramatizing the next step to overcome adjustment disorder It is putting things on a scale. It is possible that even the most negative change has a positive side. For example, if your partner has left you, value the time you will now have to dedicate to yourself and your hobbies, think about the things you didn’t like about the relationship and the relationship you would have in the future if you stayed with someone who is not in love. . Take advantage of that change or that stressful situation that distresses you to reinvent yourself. Promotes the resilience , or the ability to adapt, from other perspectives. If you have changed jobs and you consider that you have made a mistake, appreciate that at least you have left your comfort zone, you have taken risks and you have been brave.
4. Get active : The final step to begin to overcome adjustment disorder It is facing the situation and doing things. Sitting around staring at shrews won’t get you over the TA. Don’t let yourself be carried away by lack of energy or apathy, even if you don’t feel like going out, do it, cook and do housework, DIY, listen to happy music and dance, play sports, meet friends, etc. It will also help you to practice relaxation techniques for sleeping, yoga or mindfulness