Adjustment Disorder


Just after being fired from the job, Aryan started to feel hopeless, lost interest in daily activities and chores, became withdrawn and would not want to interact with anyone. Additionally, he started drinking and smoking more than usual. Despite being tired at night when he would go to bed, he couldn’t sleep and would feel like crying. He would end up overthinking and felt overwhelmed and stressed out.What Aryan was experiencing is known as Adjustment disorder, also known as Situational Depression which occurs in response to a significant life event, losing the job in his case. Other situations which can be stressful for an individual and can cause dysfunction in personal, social and occupational functioning can include (to list a few):Death of a loved oneRelationship issues/ breakup/ divorceLosing a petFinancial challengesRetiringHealth related issuesSpecific important stages in life like marriage/ retirement/ change of school etc.As the name suggests adjustment disorder refers to when a person faces difficulty in dealing with a stressful or traumatic situation resulting in exaggerated and unmanaged emotional distress/ reaction. People from both the genders (males and females) of all age groups can experience adjustment disorder including children and adolescents.Direct impact on an individual’s physical and emotional health, interpersonal relationships, education, and occupation, essentially every aspect of a person’s life.The phenomena of adjustment disorder can have a different clinical picture for different people. While in the example above Aryan displayed symptoms of depression, for another person it may look like anxiety, rebellious behaviour or even behavioural issues like breaking the law, drinking and driving, over-speeding, etc.The symptoms at psychological level can include:rebellious or impulsive actionsanxiousnessfeelings of sadness, hopelessness, or being trappedcryingwithdrawn attitudelack of concentrationpoor self-esteemsuicidal thoughtsThe physical symptoms can include:sleep disturbances/ insomniamuscle twitches or tremblingtirednessnausea/ vomitingbody pain or sorenessindigestionAn adjustment disorder is diagnosed when a person reports the psychological and physical symptoms within three months of a clearly identifiable stressor with exaggerated levels of stress and these symptoms resolve within six months after the stressor is removed. An individual’s personality make up, his/ her coping mechanisms and social skills generally determine the likelihood of adjustment disorder.While adjustment disorders are known to resolve however therapy is helpful and if needed, medication can be introduced to help the individual in case of severe symptoms. Interpersonal psychotherapy, crisis intervention along with cognitive behaviour therapy and mindfulness based relaxation can be helpful and a trained mental health professional can provide them.