Stress & Adjustment

Stress & Adjustment

Stress is a fact of life in the modern world in which we live. It has many causes and can appear within our work life, during study, as a result of troubled relationships, during life changes such as divorce, starting a family or retiring, when coping with an illness or even when daily tasks mount up.

Some stressors are good for you because they motivate you to take action. However when stress undermines both your mental and physical health, it can cause significant distress and interfere with your everyday life.

CATEGORY: Life & Coping Skills

SOURCES: APS | verywellmind.com | BMD

Number: #2

 

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An Australian Bureau of Statistics’ National Study of Mental Health and Wellbeing released in 2023, of 5,500 people aged 16 to 85 years old during 2020-2021, showed that more than two in five Australians experience a mental health issue in their lifetime and that in 2020–21 more than 3.4 million Australians sought help from a health care professional for their mental health.

The study is published at https://abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/2020-21

Stress is the body’s normal response to change. It can be physical, emotional, or mental. Whether it’s meeting an upcoming deadline or organising a birthday party, stress is part of everyday life.

However, everyone reacts to stress differently. Feeling stressed may be obvious for some but others may not notice until it becomes more severe. Major life changes, such as the death of a loved one or moving to a new city, can cause stress.

Most people adjust to these changes within a few months. For some, however, coping with the stress that comes with these changes can be so overwhelming that it disrupts their lives.

When these feelings persist longer than usual, it may be a sign of an adjustment disorder and a lack of effective stress management skills.

Experts have not identified a specific cause for why a person might struggle with adjustment disorder, but there are certain factors that can increase your risk for developing this condition.

We all face challenges at different stages of our life.

Even people who generally manage whatever life throws at them can find themselves struggling to respond in healthy and effective ways to major life events, and people who do not have well developed coping skills will find dealing with major life events challenging.

Adjustment disorders can happen at any age, but they are especially common in children. Any stressful event or series of situations can trigger this condition.

Major life events can be both positive and problematic and difficult. Both types can create stress.

Common stressors for adults include:

  • Death of a loved one
  • Divorce or relationship problems
  • Financial difficulties
  • Getting married
  • Having a baby
  • Illness or other health issues in yourself or a loved one
  • Living in a high crime neighbourhood
  • Loss of employment
  • Moving to a new place
  • Natural disaster
  • Retirement

 

Some stressors that may lead to adjustment disorder in children and teens include:

  • A new brother or sister
  • Death of a pet
  • Parental divorce or separation
  • Entering a new school or leaving school
  • Leaving home for the first time
  • Sexuality issues (such as uncertainties related to sexual orientation)

 

A stressor can be a single event (termination of a relationship) or multiple events (relationship problems), that can be continuous (living in an unsafe community) or recurrent (seeing your ex during the holidays).

Symptoms

 

Signs that your stress may be unhealthy include:

 

 

  • Feelings of anxiety
  • Feelings or depression
  • Feelings of irritability or quick to anger
  • Difficulty concentrating
  • Sleep patterns are off
  • An increase or decrease in your appetite
  • Physical reactions such as headaches, chest pains or an upset stomach
  • Your blood pressure has increased
  • Racing heart
  • Other major health problems
  • Increased acne
  • Getting sick more often
  • Feeling achy
  • Reduced libido

 

When your stress is disproportionate to the stressor and is impairing your functioning, an adjustment disorder may be diagnosed. There are six subtypes of adjustment disorders listed in the DSM-5. Each is based on the type of major symptoms experienced.

Adjustment disorder with depressed mood: Low mood, tearfulness, and feelings of hopelessness.

Adjustment disorder with anxiety: Nervousness, worry, jitteriness, and fear of separation from caregivers.

Adjustment disorder with mixed anxiety and depressed mood: A combination of the above symptoms.

Adjustment disorder with disturbance of conduct: Violating the rights of others, violating societal norms and rules.

Adjustment disorder with mixed disturbance of emotions and conduct: A combination of symptoms from all of the above subtypes are present (depressed mood, anxiety, and conduct).

Adjustment disorder unspecified: Reactions to stressful events don’t fit any of the above subtypes. Reactions may include behaviors like social withdrawal.

Diagnosis

 

The diagnosis of an adjustment disorder is typically made by a mental health professional, (such as a psychologist or psychiatrist) after performing a full psychological evaluation. The evaluation includes a detailed personal history of development, life events, emotions, behaviors, and the identified stressful event.

To be diagnosed with an adjustment disorder, your symptoms must be “clinically significant.” According DSM-5, this means that you must meet one or both of the following criteria:

  • Your distress is out of proportion with the expected reaction
  • Your symptoms must significantly impair your personal life, social functioning, or work/school performance and/or attendance.

 

Additionally, to be diagnosed:

  • Your symptoms must have begun to appear within three months of the stressor occurring.
  • Your distress and impairment don’t meet the criteria for another disorder (such as post-traumatic stress disorder or PTSD) and are not the result of an existing mental health disorder.
  • Your reaction is not part of normal bereavement.
  • When the stressor is removed, your symptoms subside within six months.

 

Adjustment disorder is often difficult to diagnose because it shares symptoms with other mental health disorders

Therapy | Treatment

The main goal of treatment for stress and adjustment disorder is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred.

Therapy

When you see a psychologist for stress, they will guide you through understanding what situations trigger your stress, implementing effective coping strategies and developing life balance. They will teach you techniques such as relaxation methods, problem solving approaches, time management skills and breathing exercises.

 

Adjustment disorder is highly treatable and often responds well to psychotherapy. Regardless of the stressor, therapy will help you understand how and why the stressor has affected your life. Therapy will also help you develop better coping skills and stress management to deal with stressful events.

 

The form of psychotherapy will vary from patient to patient. Because of the brevity of most stressful situations and therefore of adjustment disorders, short-term psychotherapy like cognitive behavioral therapy (CBT), is generally preferred. Brief therapy with a focus on relevant skill acquisition such as stress management, time management, managing competing priorities, communication and assertiveness skills, or interpersonal relationship management can be helpful when life changes are creating too much stress, are impacting on other parts of your life, or when you’re feeling stuck and unable to adjust.

 

Some people may also benefit from family therapy, especially if the situation is family-related or the patient is an adolescent. Couples therapy may be ideal if the disorder is negatively impacting a romantic relationship.

 

Medication

Although psychotherapy is the first-line treatment for adjustment disorder, medications are sometimes prescribed to alleviate troublesome symptoms, such as anxiety, depression, and insomnia.