The 6 types of adjustment disorders

Stress is a basic emotion for our survival. Activate fight or flight responses when necessary, especially in the face of events that are dangerous to our physical and psychological integrity.

However, sometimes stress becomes a maladaptive response, exaggerating potential risks. of a certain event and behaving in a way that is very detrimental to the correct development and functioning vital.

Adjustment disorder refers to a diagnosis in which the person manifests problems in adapting to the demands of their environment. Here we will take a closer look at this concept and we will address the types of adjustment disorders that exist.

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Adjustment disorders, what are they?

According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), adjustment or adjustment disorders are defined as mental disorders that have a strong relationship with stress and the ability to adapt successfully to life events and inconveniences.

The main activating factor of these disorders is the experience of stressful situations, or the high frequency of their appearance. That is to say, adjustment disorders do not develop without first appearing a condition that activates them, being fundamentally stress.

In more concrete terms, these disorders are understood as maladaptive responses to continuous and/or severe stress, the which negatively affect effective coping mechanisms to be able to carry out a correct functioning social.

Generally, it causes significant and prolonged discomfort, in addition to changing the person's way of being, making you lose interest in things you used to enjoy, feel sadness and anxiety, combined with a deep and continuous helplessness.

One of the explanations that have been given to understand the appearance of this type of disorder has to do with the natural mechanism of some people when they experience a situation especially stressful. After having suffered a particularly worrisome event, these individuals learn to pay more attention to the state of their body, interpreting all unpleasant physiological sensation as an indicator that something is terribly wrong, which, in turn, generates higher levels of anxiety and depression.

symptomatology

Although we are going to see the types of adjustment disorders and their main symptoms, it is worth mentioning their common symptoms first. These symptoms appear when the person is in a particularly difficult situation. These situations require the person to initiate a whole series of processes whose ultimate goal is to overcome them. Some examples of stressful life situations can be the loss of a loved one, the breakup of a love relationship, the stress of studieschange city...

Among the main symptoms of adjustment disorders are having a low mood, with depressive symptoms, in addition to having ruminating and negative thoughts, such as excessive concern about how events will unfold and the problem that has triggered the manifestation of the disorder.

You can also feel physical discomfort, which enhances stress, acting as a cycle that feeds back.. Some of these are chest tightness and trouble breathing. The person may have trouble falling asleep, insomnia, and trouble concentrating.

Among dysfunctional thoughts we can find having low self-esteem, having a biased image of one's own image, feelings of hopelessness, fear, feeling that there is no possible way out of the situation in which you find yourself or difficulties planning daily activities and carrying them out, in addition to feeling only.

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Diagnosis

The diagnosis of adjustment disorders is based on the identification of important factors of life that cause serious stress to the person, in addition to unleashing the aforementioned symptoms.

In the DSM-5 it is considered that an adjustment disorder can be diagnosed if the person reports having manifested emotional or behavioral symptoms within three months immediately after experiencing a stressor in your life.

Another key point in the diagnosis is that more stress is being suffered than would be expected in a person without psychopathology for the same unpleasant event, in addition to having too serious an impact on relationships, work, studies or other aspects of the life of the person.

adjustment disorder will be diagnosed if the symptoms manifested, such as sadness or anxiety, are not due to any other mental disorder, such as clinical depression or an anxiety disorder, nor is it due to normal grief.

Types of adjustment disorders

The DSM-5 lists six different types of adjustment disorders, depending on which symptoms take center stage. There are six types of adjustment disorders that can be found:

1. In a depressed mood

Low mood predominates, wanting to cry or feeling hopeless, characteristic symptoms of a clinical depression.

People who are diagnosed with this variety of adjustment disorder often experience feelings of sadness and hopelessness, as well as a lack of interest or loss of motivation in carrying out activities that were previously considered pleasurable.

2. Anxiously

Nervousness, anguish, worry, agitation predominate or separation anxiety.

A fairly characteristic symptom of this particular subtype is that the person can very easily feel overwhelmed by events. There are concentration and memory problems.

In the case of children, it is common to find symptoms of separation anxiety, which are shown when you have to get away from your parents or loved ones, such as having to go to school, being in a medical procedure...

3. With mixed anxiety and depressed mood

A combination of features typical of depression and anxiety predominates.

4. With behavioral disturbance

The alteration of behavior predominates, that is, the person engages in behaviors that are risky such as reckless driving or fighting.

In adolescents it is common that if there is an adjustment disorder with altered behavior, the youngster carries out acts of vandalism, in addition to being absent from school.

5. With mixed disturbance of emotions or behavior

Emotional symptoms predominate, such as those of depression and anxiety, combined with the presence of behavioral disorders.

6. Unspecified

This subtype refers to the maladaptive reactions that cannot be fully classified into one of the specific subtypes of the same disorder.

Problems occur in different spheres of the person that he considers important, such as his closest circle of friends, family, workplace or studies.

Types depending on their duration

The duration of symptoms of adjustment disorders is variable. This may be due to the patient's own personality characteristics, his family support, or the fact that he is already attending therapy.

1. Sharp

Symptoms last less than 6 months. The problems that the person reports living are alleviated at the moment in which the stressor that triggered them is eliminated.

2. Persistent or chronic

The symptoms last for more than six months, continuing for a long time and even becoming chronic. This type of adjustment disorder are especially worrying given that the degree of vital disturbance is very high, given that the more time the person spends suffering from the problems they complain about, the more damage they will do.

Treatment

In the psychotherapeutic approach, the most frequently used current is cognitive-behavioral therapy, which is the treatment that has offered the best results and the one with the most scientific foundation. The objectives in cognitive-behavioral therapy in adjustment disorders are:

• Identify stressors and see if they can be reduced or eliminated.
• Rephrase the meaning of the stressor for the patient.
• Prepare a list of negative consequences experienced by the patient.
• Provide the patient with coping skills, especially emotional.
• Provide the patient with techniques to reduce tension, such as meditation or exercises.