Mixed Adjustment Disorder: Symptoms, Causes, and Treatments

Throughout our lives we have to deal with all kinds of events, situations or experiences that can leave a mark on our psychological health. In some people, the impact of these vital moments is so strong that it can trigger a psychological condition.

This type of condition is known as mixed adjustment disorder.. The purpose of this article is to analyze this type of disorder, its symptoms, causes and treatment; as well as to point out which are the main differences with the rest of the adaptive disorders.

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What is Mixed Adjustment Disorder?

Mixed adjustment disorder refers to a group of conditions that appear as a reaction to a vital stressor. Specifically, the person experiences a series of difficulties when trying to cope with a stressful or emotionally charged life event, feeling marked by strong feelings of depression and anxiety.

These events or situations can include from the death of a loved one, relationship problems or a job termination. Although any of these experiences can be distressing and stressful, some people have difficulties when managing certain stressors, which usually lead to the appearance of this type of disorder psychological.

In the case of mixed adjustment disorder, the person's reaction is much more severe than usual and it can end up causing a very significant deterioration of social, work and / or academic functioning. Also, for it to be diagnosed as such, symptoms must appear within three months after the onset of the stressor and should not last more than six months after the stressor has missing.

This reaction can appear in response to a single event, such as a serious traffic accident or the death of a relative, or after experiencing a stressful period of time such as marital or work problems serious.

Usually mixed adjustment disorder has been associated with a high risk of suicide or suicidal behavior and with substance abuse. In addition, a mixed adjustment disorder that persists can develop into a much more serious mental disorder such as a major depressive disorder.

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What symptoms does it present?

Although the symptoms can vary widely among people with mixed adjustment disorder, the clinical picture of this condition includes:

• Depressed mood.
• Crying
• Low self-esteem.
• Withdrawn attitude.
• Suicidal ideations.
• Anxiety, worry, stress and tension.
• Agitation.
• Lack of concentration.
• Social, work or school deterioration.
• Insomnia.
• Continuous tired feeling.
• Tremors and / or spasms.
• Palpitations.
• Physical discomfort such as general pain, stomach pain, or chest pain.

How is it different from other adjustment disorders?

In addition to mixed adjustment disorder, there are six other types of adjustment disorders that appear in response to a stressful experience. As mentioned above, mixed adjustment disorder is characterized by both feelings of depression and anxiety. However, the rest of the disorders have other specific qualities:

1. Adjustment disorder with depressed mood

In this case the patient tends to experience only feelings of sadness and hopelessness, as well as constant crying and anhedonia.

2. Adaptive disorder with anxious mood

The person feels pathologically overwhelmed, anxious, and over-worried; being able to reach the point of presenting concentration problems and memory failures.

3. Adaptive disorder with behavioral disturbance

The symptoms of this subtype are associated with an altered pattern of behavior, which usually involves problematic, risky and reckless behaviors.

4. With mixed disturbance of emotions and behavior

Collect all the types named above. Feelings of depression, anxiety, and behavior problems.

5. Adjustment disorder, unspecified

People with this diagnosis have symptoms not associated with the previous disorders. They usually include physical symptoms and / or problems with friends, family, work and / or school.

Which can be the causes?

As we mentioned at the beginning of the article, the cause or trigger of a mixed adjustment disorder is found in the appearance or experience of a highly stressful factor.

In adults, this factor is usually related to economic, work or relationship problems, while in children and adolescents these experiences include school problems, family problems or separations. On the other hand, there are other experiences that can affect people of any age What The death of a loved one, vital changes, accidents, catastrophes or medical conditions such as cancer.

However, these experiences are characterized by negatively affecting anyone. Therefore, there are a series of conditioning factors that modify the way in which a person faces a stressful situation and that favor the appearance of mixed adjustment disorder. These include:

• Existing coping strategies.
• Economic conditions.
• Availability of social support.
• Occupational and recreational opportunities.

What is the treatment based on?

Depending on the state of the person diagnosed with mixed adjustment disorder, they may need to a short-term treatment, or a treatment over a slightly longer period of time dragged on. In the same way, depending on the severity of the disorder, the intervention protocol in this diagnosis may include psychological therapy, medication, or both.

1. Psychological therapy

Psychological therapy is usually the treatment of choice in a mixed adjustment disorder, since this allows the patient to recover their normal levels of functioning. The main objective of any type of psychological therapy is to help the person understand their situation and develop skills to deal with stressful situations.

The main types of therapy used in this disorder include:

• Family and group therapies.
• Specific support groups.
• Cognitive Behavioral Therapy.
• Brief strategic therapy.

2. Drug therapy

The mission of drug therapy is to decrease some of the symptoms of this disorder such as insomnia and the physical symptoms of depression and anxiety. Commonly used medications include:

• Benzodiazepines such as lorazepam and alprazolam.
• Non-benzodiazepine anxiolytics such as gabapentin.
• Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) such as sertraline or venlafaxine.