Adjustment Disorder

ADJUSTMENT DISORDER

1. Definition

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), adjustment disorder is recognised as a stress response syndrome, which is defined as a maladaptive reaction to an identifiable stressor. The ICD-11 classifies it as a stress-related disorder. The stress is either an expected or unexpected event that causes confusion or disorientation to one’s life. For example, COVID-19 social distancing for students, the introduction of online learning, break up of a relationship, loss of income, re-entering parents’ home after being away (such as having been at university).

 

2. Symptoms

  • Feeling of hopelessness/not enjoying things you use to enjoy
  • Sadness
  • Frequent crying
  • Anxiety (nervousness)
  • Headaches or stomach aches
  • Trouble sleeping
  • Lack of appetite
  • Difficulty functioning in daily activities
  • Withdrawing from social support
  • Suicidal thoughts/behaviour
  • Avoiding important activities/responsibilities such as school work

Symptoms normally present themselves within three months of the stressful event and do not last longer than six months. However, if the stressor is ongoing, chronic adjustment disorder can continue for more than six months.

 

3. Why me? Why Now?

Usually one starts noticing a change in functioning after a stressful event has occurred which alters or changes one’s way of life. For instance, COVID-19 could be a stressor that forces a sudden change in your life as a student. With all the new rules and regulations being implemented, adapting to the new normal could be stressful. Therefore, a change in behaviour (unexpected) or functioning is required outside of the norm and that could potentially cause distress. Consequently, forcing one to begin adopting and adhering to the new normal could cause adjustment difficulties.

 

4. What now?

During lockdown with strict rules and regulations, and the government encouraging social distancing, students could use resilience as a healthy coping mechanism.

What is resilience? It is the ability to adapt well to stress, trauma or tragedy. It is the ability to cope and function normally after experiencing a difficult event. Of course building resilience varies from person to person, but please consider these tips:

  • Stay connected with healthy relationships (family or friends)
  • Do something every day that gives you a sense of meaning or enjoyment
  • Live a healthy lifestyle (good diet and sleep, regular physical activity)
  • Use past experiences to help you improve your coping skills
  • Be hopeful for the future and strive for a positive attitude
  • Develop and recognise your personal strength(s)
  • Confront your fears and accept challenges
  • Address problems when they occur, instead of avoiding them

Crucial to note: If you suspect that you, or someone you know, may be suffering from adjustment disorder and not just normal adjustment challenges, it is imperative to consult with a professional for further investigation or exploration of symptoms.

 

5. Videos on adjustment disorders

Adjustment Disorder | DSM-5 Diagnosis and Treatment: https://www.youtube.com/watch?v=B9_HVnTRflc

Andreas Maercker: Introduction to Adjustment disorder (ICD-11): https://www.youtube.com/watch?v=wj0IKOVm0Ss

 

References

American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Washington, DC: American Psychiatric Association.

Carta, M.G., Murru, A., Balestrieri, M., Hardboy, M.C. 2009. Adjustment Disorder: Epidemiology, diagnosis and treatment. Research Gate, 5(15). DOI: 10.1186/1745-0179-5-15.

Zelviene, P., & Kazlauskas, E. 2018. Neuropsychiatric Disease and Treatment. Adjustment disorders: current perspectives. Dove press journals, 14, 375-381.

 

Compiled by Masilo Mafokoane (Student Counsellor at Student Counselling and Development, Mahikeng Campus).

July 2020