Adaptation: the main reasons for its violation and ways to eliminate them

This pathology is characterized by the emergence of a certain set of reactions to a traumatic event, stress, and social difficulties.

In people with adaptation disorders, the adaptive capabilities of the psyche are reduced, i.e. they cannot “enter” new life circumstances or they need a longer time to master the changes that have arisen (6 months-1 year).

Types

1. Social adjustment disorder. It occurs when a person encounters situations that require a radical change in his lifestyle. Such stress can be caused by moving to a new place of residence, transferring to another position, the unexpected prospect of becoming parents, the departure or death of a spouse, orphanhood, etc.

   In women, psychogenic adaptive mechanisms are most often disrupted when they lose support in life, when a man abandons them or their parents die. In such cases, their usual way of life collapses, changes, and mental balance is disturbed, and the fear of the future so traumatizes the psyche that the patients seem to close themselves off from the need to change themselves and their lives and go into pseudo-reality, which they model in their minds from negative experiences. Military adjustment disorder is common among young men . If a guy does not have an internal readiness for the upcoming difficulties, he literally “breaks down” and in the first months of service his behavior looks inadequate to others. The young man withdraws into himself, withdraws, reacts poorly to calls to him, experiences serious sleep disturbances, sometimes refuses to eat, looks tense and anxious. Mature men may lose their adaptive capabilities due to troubles at work, loss of social status, and potency disorders.

2. Prolonged depressive reaction caused by adaptation disorder. This is a temporary (short-term) dysfunction of mental activity, accompanied by a depressed mood, excessive tearfulness, and an uncertain outlook on the future. Its duration is no more than 1-2 years. This disorder also occurs against the background of changes in the life circumstances of patients.

ICD-10

Disorder of the adaptive capabilities of the human psyche belongs to the group of reactions to severe stress and objective circumstances - F43 .

It includes mental and behavioral disorders associated with the influence of severe emotional experiences or significant changes in people's lives. Doctors believe that these reasons are the trigger that provokes the development of the disease.

Disorder of adaptive reactions (adaptation) is classified with code F43.2 .

Experts characterize it as the impossibility of adequately responding to environmental conditions, a disturbance in the emotional background and the appearance of actions inappropriate to the situation, a narrowing of an individual’s social contacts, and a change in his social activity.

Causes

The development of this pathology is based on a deep-seated fear of the newness of life; this separation from usual circumstances can negatively affect the psyche and health of people.

The occurrence of adaptation disorder occurs under the influence of many factors:

• these are individual characteristics of the psyche: its vulnerability and sensitivity, a person’s character and temperament, infantilism (immaturity) of adaptive mental functions, lack of formation of life motivation, prospects for the future;
• this is the presence in the past of violent emotional experiences about changes in fate;
• this is a lack of skills and abilities to independently resolve life’s difficulties (provoked by overprotection in childhood or, on the contrary, complete ignoring of the child);
• this is the presence of chronic and somatic diseases;
• This is the presence of a history of phobic disorders.

What events can cause disruption of adaptation mechanisms?

1. Divorce or death of parents.
2. Protracted conflicts in the family.
3. The beginning of the school period.
4. Separation from loved ones.
5. Examination period.
6. Admission to the University.
7. Military service.

8. Breaking up with a partner.
9. Finding and changing jobs.
10. Birth of children.
11. Dismissal from the institution.
12. Unemployment.
13. Retirement, resignation.
14. Disasters.
15. Natural disasters.
16. Fires.

Symptoms

Patients with adaptation disorder look confused and uncollected, they feel high anxiety and suspiciousness about the next day, they are bothered by obsessive thoughts about the meaninglessness of life, death, illness, injustice in the world.

The main characteristic signs of adaptation disorder are the inability to plan and fear of the future.

Diagnostics

It is possible to identify the disease and make a correct diagnosis taking into account the following criteria:

• detecting a clear connection between the occurrence of a disorder and a change in the life circumstances of patients (the pathology may be a consequence of long-standing events that occurred months or years ago);
• observation of violations in professional activities (absenteeism, reluctance to get a job, lack of interest in work) and in the social sphere (narrowing of social circles, ignoring loved ones, isolation, avoidance of public events);
• the presence of inadequate emotional (anger, crying, withdrawal) and behavioral (ignoring the words of the interlocutor, failure to fulfill duties at home and at work) reactions;
• identification of depressive, apathetic states, insomnia, somatic disorders;
• the duration of such reactions is at least three months.

Treatment

Since adaptation disorders can get worse, it is better not to wait until you “pull yourself together”, but to contact a qualified specialist (psychologist or psychiatrist).

Practice shows that the main difficulty in treating impaired adaptive reactions lies in identifying the root cause of the disease.

Consultations and conversations with doctors who know the technique of detecting a traumatic situation in the minds of patients can help with this, i.e. psychotherapeutic sessions are structured in such a way that they help patients understand their problems and change their attitude towards them. When such a turning point occurs, the patients’ emotional background and behavior change.

For severe depression, anxiety and fear, various medications are used: from simple sedatives to antipsychotics and antidepressants.

Video

Source: https://psihbolezni.ru/rasstrojstva/rasstrojstvo-adaptatsii-mkb-10-simptomy-prichiny-lechenie/

Adjustment disorder

What is adjustment disorder?

Adjustment disorder (also adjustment disorder) is a stress-related condition. You experience more stress than you normally expect in response to a stressful or unexpected event, and the stress causes serious problems in your relationships, work, or school.

Job problems, illness, the death of a loved one, or any number of life changes can cause stress. In most cases, people adapt to such changes within a few months. But if adjustment disorder is present, people still have emotional or behavioral reactions that can lead to feelings of anxiety or depression.

The victim should not cope with this condition on their own. Treatment can be brief and will help restore emotional well-being.

Symptoms and signs

Signs and symptoms depend on the type of adjustment disorder and may vary from person to person. The person experiences more stress than they normally expect in response to a stressful event, and the stress causes significant problems in their life.

Adjustment disorder affects the way a person feels and thinks about himself and the world, and it can also affect the actions or behavior of the affected person. Here are some examples:

• Feelings of sadness, hopelessness, or not being able to enjoy things you are usually used to enjoying;
• frequent crying;
• restlessness or anxiety, nervousness;
• sleep problems;
• lack of appetite;
• difficulty concentrating;
• feelings of being overwhelmed;
• difficulty functioning in daily activities;
• withdrawal from social support and withdrawal;
• avoiding important things such as going to work or paying bills;
• suicidal thoughts or behavior.

Symptoms of adjustment disorder begin within 3 months of the stressful event and last no more than 6 months after the end of the stressful event. However, persistent or chronic adjustment disorders may continue for more than 6 months, especially if the stressful situation continues, such as unemployment.

  Conduct disorder in children and adolescents

When to see a doctor

Stressors are usually temporary and we learn to cope with them over time. Symptoms of adjustment disorder improve because stress is lessened. But sometimes a stressful event becomes part of life. Or a new stressful situation arises and we are faced with the same emotional struggle again.

Talk to your doctor if you continue to have difficulties. A person may receive treatment to help them cope better with stressful events and feel better again.

If you have concerns about your child's adjustments or behavior, talk to your child's pediatrician.

If you have thoughts of harming yourself or someone else, immediately call the emergency number 112, go to the emergency department, or confide in a trusted relative or friend.

Causes and risk factors

Adjustment disorders are caused by significant changes or stressors in life. Genetics, life experiences, and temperament can increase your likelihood of developing adjustment disorder.

Risk factors

Certain things can make a person more prone to adjustment disorder.

Stressful events

Stressful life events—both positive and negative—can put you at risk for developing adjustment disorder. For example:

• divorce or family problems;
• relationship or interpersonal problems;
• life changes such as retirement, birth of a child;
• adverse situations such as job loss, loss of a loved one or financial problems;
• problems at school or at work;
• life-threatening events such as physical attack, combat, or natural disaster;
• ongoing stressors, such as medical illness or living in a crime-ridden area.

Your life experience

Life experiences can influence how you cope with stress. For example, the risk of developing an adjustment disorder may be increased if:

• the person experienced significant stress in childhood;
• have other mental health problems;
• there are many difficult life circumstances happening at the same time.

  Obsessive-compulsive disorder (OCD)

Complications

If adjustment disorder is not treated, it can eventually lead to more serious mental health problems such as anxiety disorder, depression, or substance abuse.

Diagnostics

Diagnosing adjustment disorders is based on identifying major life stressors, symptoms, and how they affect the ability to function.

The doctor will ask about your medical, mental health and social history.

It may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.

To diagnose adjustment disorders, the DSM-5 lists the following criteria:

• The presence of emotional or behavioral symptoms for three months from a specific life stressor.
• Experiencing more stress than would normally be expected in response to a stressful life event and/or situation that causes serious problems in relationships, work, or school.
• The symptoms are not the result of another mental disorder or part of normal grief.

Types of adjustment disorders

The DSM-5 lists 6 different types of adjustment disorders. Although they are all related, each type has unique signs and symptoms. Adaptation disorders can occur with:

• Depressed mood. Symptoms generally include feelings of sadness, crying and hopelessness, as well as a lack of enjoyment from things you used to enjoy.
• Anxiety. Signs generally include nervousness, restlessness, difficulty concentrating or remembering things, and feeling depressed. Children with adjustment disorder with anxiety may have a strong fear of being separated from their parents and loved ones.
• Mixed anxiety and depressed mood. Symptoms include a combination of depression and anxiety.
• Violation of behavior. Signs are mostly associated with behavioral problems such as fighting or reckless driving. Youth may miss school or damage property.
• Mixed disorder of emotions and behavior. Symptoms include a combination of depression and anxiety, as well as behavioral problems.
• Uncertain. Symptoms do not correspond to other types of adjustment disorders, but often include physical problems, problems with family or friends, and problems at work or school.

Length of symptoms

How long the signs and symptoms of adjustment disorder will last also varies. Adaptation disorder may be:

• Spicy. Signs last 6 months or less. They should weaken after the stress factors are removed.
• Constant (chronic). Signs last for more than 6 months. They continue to bother and ruin lives.

Treatment of adjustment disorders

Many people with adjustment disorders find treatment helpful and often only require short-term therapy. Others, including those with persistent adjustment disorders or persistent stressors, may benefit from longer-term treatment. Treatment for adjustment disorder includes psychotherapy, medication, or both.

Psychotherapy

Psychotherapy, also called talk therapy, is the main treatment for adjustment disorder. It can be provided as individual, group or family therapy. Therapy may:

• Provide emotional support.
• Help you get back to your normal routine.
• To help understand why a stressful event had such a profound impact.
• Help you learn to cope with stressful events.

Medications

Medications such as antidepressants and anti-anxiety medications may be prescribed to relieve symptoms of depression and anxiety.

As with therapy, medications may only be needed for a few months, but do not stop taking medications without first consulting your doctor. When you stop taking it suddenly, some medications, such as certain antidepressants, can cause withdrawal-like symptoms (aka withdrawal).

Prevention

There are no guaranteed ways to prevent adjustment disorders. But developing healthy coping skills and learning resilience can help during times of high stress.

If you know a stressful situation is coming—like moving or retiring—call on your inner strength, strengthen healthy habits, and gather social support in advance.

Remind yourself that this is usually a short-term condition and that you can get through it.

Source: https://tvojajbolit.ru/psihiatriya/rasstroystvo_adaptatsii/

Adjustment disorder symptoms and causes

Adaptation disorder is a specific diagnosis, the symptoms of which manifest themselves primarily in the form of a persistent negative reaction to a sudden and, as a rule, stressful change in the usual situation, an unfavorable event, etc.

Most often, such a diagnosis as adaptation disorder occurs against the background of stress or the complex influence of stress factors and internal problems.

A person whose psyche is affected by such a diagnosis as adaptation disorder exhibits extremely unfavorable symptoms that significantly worsen the quality of life in general and its professional and social state in particular.

Understanding Adjustment Disorder

The symptoms that accompany this diagnosis manifest themselves as a maladaptive reaction to stressful circumstances. Let's look at the example of the army.

A man lived in his usual surroundings, and suddenly - a summons. Upon arrival in the army, the life of a citizen undergoes many changes with its own characteristics and limitations.

Life typical of the army, of course, becomes familiar over time.

But at the beginning (usually during the first 3-4 months of being in the army), the consciousness resists what happened, which causes stress.

Such a diagnosis as adaptation disorder recedes when the stress factor ceases. If the provoking factors and accompanying symptoms remain, the body, as a rule, gets used to it and moves to a new level of stress resistance. No special treatment is used in such conditions.

If the patient has to experience events that go beyond normal reality, causing significant damage to his professional or social activities, a diagnosis such as adaptation disorder is highly likely to develop. If the stress is long-term, the diagnosis may persist throughout life. There are no age, gender or any other restrictions.

Key symptoms and signs of the pathological condition

Manifestations of such deviation can take on a wide variety of forms. As a rule, the main symptoms are anxious and depressive, often mixed.

In most cases, maladjustment is accompanied by symptoms such as a feeling of weakness and inability to cope with the events that have occurred.

Often the manifestations are reinforced by a feeling of some kind of external threat, excessive irritability, suspiciousness, and a feeling of internal tension.

Physical and mental exhaustion occurs, it becomes difficult to concentrate and remember something new, difficulties arise in various issues that require quick and balanced decision-making, analysis and responsibility for the consequences.
Thus, the symptoms include the following:

• depressed mood;
• persistent anxiety;
• depression and inner feelings;
• disturbances of normal behavior;
• anxiety;
• internal discomfort.

Causes of maladjustment

The problem arises against the background of a citizen’s overly emotional, close and personal reaction to stressful circumstances and very serious life changes.

The most common causes of stressful situations include:

• difficulties in relationships;
• financial difficulties;
• conflicts in the family;
• problems at the place of study/work;
• sudden changes in the traditional way of life;
• detection of serious health problems;
• serious illness and/or death of a loved one;
• intimate failures.

In the presence of certain circumstances (for example, in the case of forced living in a disadvantaged and unsafe area), maladjustment can take a long course.

Possible risk factors

Under certain circumstances, the propensity for the occurrence of the disorder in question may increase significantly. Thus, the list of key risk factors includes the following provisions:

• genetic predisposition;
• features of individual adaptability;
• characteristic social skills;
• lack of opportunities to eliminate disturbing circumstances;
• gender identity.

There are suggestions that women, due to their psycho-emotional characteristics, are more at risk of developing the problem in question.

People with serious illnesses, as well as people living in unfavorable, difficult conditions are traditionally at increased risk. According to average statistical data, about half of the representatives of the listed groups show a tendency to maladjustment

Certain factors experienced by the patient in early childhood can lead to the occurrence of the disorder under study. Examples include the following:

• frequent moving;
• features of the family’s social status (for example, too poor or too rich);
• various kinds of extreme influences, for example, living in a military combat zone;
• injuries that can lead to the development of problems with adaptation to life.

People who are predisposed to developing problems such as maladjustment are at risk for other common psycho-emotional disorders, for example, depression, anxiety, bipolar disorder, etc.

Features of manifestation and diagnosis of deviations

Most often, the disorder in question completely ceases to cause discomfort and anxiety to the patient on average six months after the end of the adverse events. If the disorder becomes chronic, its manifestations may persist for 6 months or more - this usually happens if the source of stress does not disappear.

The presence of a problem is indicated, first of all, when a person experiences difficulties in social and other areas of life. Among the characteristic manifestations are:

• painful and uncomfortable sensations in the chest area;
• restless and anxious state;
• lack of strength to solve current problems, plan the future, achieve important goals;
• difficulties in everyday life;
• parallel development of behavioral disturbances and psycho-emotional background.

During the diagnostic process, the treating specialist studies the nature of the impact of stressors and draws conclusions regarding the intensity of their severity.

Additionally, examinations are prescribed to confirm or refute the presence of problems such as post-traumatic stress, anxiety, depression, etc. To clarify the diagnosis, the patient may be referred to a psychiatrist for consultation.

Treatment methods

When selecting the appropriate treatment, the specialist assesses the individual characteristics of the patient’s condition and draws up a program that can effectively neutralize the manifestations that prevent a person from leading a full life. Additionally, treatment is aimed at eliminating the likelihood of developing a depressive state.

Remember: treatment can only be prepared by a specialist and it must be comprehensive

Key methods are listed below.

1. Psychotherapy. It is considered as the main therapeutic method that allows you to effectively cope with the problem of maladjustment. It is used, first of all, to search for provoking moments and the subsequent development of mechanisms of resistance to newly emerging stress. As a rule, it is short-term and can be carried out in different forms: family, individual, behavioral, group.
2. Drug treatment. Usually used in combination with psychotherapy methods to alleviate general characteristic symptoms. The patient may be recommended medications that have a sedative and antidepressant effect. Medicines are used to relieve associated symptoms.

Source: https://prodepressiju.ru/psihicheskie-rasstrojstva/stress/rasstroystvo-adaptacii-simptomy.html

Adjustment disorder - causes, symptoms and treatment

08.05.2019

Adjustment disorder is a pathological condition characterized by emotional disorders, impaired social adaptation, decreased performance and the inability to adapt to significant life changes. Adaptation disorder is registered in 2–8% of the population, regardless of age and gender.

Causes

Adjustment disorder is caused by emotional and stress factors. These factors do not threaten the physical and mental health of a person, but cause a negative emotional pathological state that disrupts the adaptation response.

Causes:

• emotional and psychological: lack of sleep, divorce, sudden change in social status, prolonged neuropsychic stress, death of a loved one;
• physiological: malnutrition, injuries, somatic diseases, disorders of the central nervous system.

Most often, students, military personnel, police officers, medical personnel, migrants, lonely elderly people, and journalists are susceptible to adaptation disorder.

Symptoms

The clinical picture is varied and nonspecific: each person has different symptoms and signs. The prevalence of specific symptoms depends on its “vulnerabilities”: people prone to anxiety will suffer from anxiety.

There are two types based on duration:

1. Short-term adjustment disorder. Lasts up to 1 month. It is mild and often goes away without treatment.
2. Prolonged adjustment disorder. Lasts from 1 month to 2-3 years. It occurs in different clinical types, most often with a predominance of anxiety-depressive symptoms and behavioral disorders.

The clinical picture includes the following syndromes and symptoms:

• Asthenic. It manifests itself as rapid fatigue, exhaustion, irritability and anger, impaired concentration, and sleep disturbance.
• Anxious. It manifests itself as a feeling of internal discomfort, psychomotor agitation, anxiety, and sleep disturbance. Accompanied by autonomic reactions: nausea, loss of appetite, diarrhea or constipation, sweating, shortness of breath or dizziness.
• Depressive. It manifests itself as decreased mood, slowed thinking and attention, low motor activity, apathy, and anhedonia. Depressive syndrome is often combined with anxiety.
• Inappropriate emotional reactions: aggressiveness, outbursts of rage and anger, emotional coldness, excitement, gloomy and melancholy mood with a tendency to an angry outburst.
• Behavioral reactions: withdrawal from alcoholism, gambling, drug addiction, smoking, dismissal from work.
• Cognitive: decreased intellectual productivity, absent-mindedness, decreased short- and long-term memory, flattened imagination and fantasies.
• Vegetative syndrome: dizziness, flushing of the face, frequent urination, trembling, rapid heartbeat, shortness of breath, excessive sweating, muscle twitching.

Severe adjustment disorder is accompanied by suicidal behavior and suicidal thoughts. People harm themselves: most often, scars from cuts can be found on the hands.

Diagnosis and treatment

Diagnostic criteria for adjustment disorder according to the International Classification of Diseases, 10th revision (disease code – F43.2):

1. excessive preoccupation with a problematic situation;
2. constant and obsessive thoughts about the stress factor;
3. inability to adapt to changes;
4. symptoms interfere with daily activities;
5. difficulty concentrating or sleeping;
6. loss of interest in work, hobbies, social life;
7. reduction of professional duties: a person performs job duties less and worse, wants to leave work as quickly as possible, and often asks for time off.

Diagnosis and treatment are carried out by a medical psychologist and psychiatrist. They conduct a clinical interview and psychometric study. With the help of psychological tests, emotional and adaptation disorders are established.

Treatment objectives:

• increasing stress resistance;
• elimination of symptoms of adaptation disorder;
• activation of the body's compensatory capabilities.

Adaptation disorder is treated with biological methods and psychotherapy. Biological methods include the pharmacological approach - taking medications. The most commonly prescribed groups of drugs are:

1. Anxiolytics. They reduce anxiety, calm you down and improve sleep. Representatives: Diazepam, Phenazepam, Gidazepam. May cause addiction and side effects such as depression. Prescribed if the clinical picture includes symptoms of psychomotor agitation, severe anxiety and restlessness.
2. Antidepressants. Normalizes mood and motor activity. Representatives: Fluoxetine, Sertraline, Paroxetine. Heavy antidepressants (Amitriptyline, Nortriptyline) are not prescribed.

Adaptation disorder is often treated with the common drug Adaptol. It is not recommended to buy or take it: Adaptol does not have an evidence base and proven clinical effectiveness.

Psychotherapy – cognitive behavioral approach, autogenic training, hypnotherapy.

Didn't find a suitable answer? Find a doctor and ask him a question!

Source: https://sortmozg.com/psihicheskie-rasstrojstva/adaptatsi

Stress...adjustment disorders

laesus_de_liro

... the prevalence of mental disorders caused by adaptation disorders among adults is 25 - 30%.

The very concept of “adjustment disorder” has become widespread in psychiatry in recent decades. This diagnostic category was first introduced in the third edition of the Diagnostic and Statistical Manual of Mental Disorders III (DSM-III), but was developed in more detail in subsequent classifications of diseases. In the International Classification of Diseases, 10th revision (ICD-10), adjustment disorders are classified under the rubric of stress-related disorders. In DSM-IV they are classified as a separate category, but are described as mental disorders in the pathogenesis of which emotional stress plays an important role.

In modern common understanding, an “adjustment disorder” is a psychologically understandable response to a specific stressor or stressors that results in clinically significant emotional or behavioral symptoms (adjustment disorders occur in any age group).

In accordance with the International Classification of Diseases, 10th revision, the diagnostic criteria for adjustment disorder are as follows:

A . The disorder is observed during the period of adaptation to a significant change in social status (loss of loved ones or long-term separation from them, refugee status, etc.

) or a stressful life event (including a serious physical illness).

B. _ Individual predisposition (vulnerability), but combined with evidence that the disorder would not have occurred without the stressor.

C.

Presence of symptoms: - depressive mood, anxiety, restlessness; - a feeling of inability to cope with the situation, to adapt to it; - some decrease in productivity in everyday activities;

  - tendency to dramatic behavior, outbursts of aggression.

Most often, maladjustment is characterized by an anxious mood, a feeling of inability to cope with the situation, and even a decrease in the ability to function in everyday life. Anxiety is manifested by a diffuse, extremely unpleasant, often vague feeling of fear of something, a feeling of threat, a feeling of tension, increased irritability, and tearfulness. The patient experiences “anticipation anxiety,” a future-oriented preoccupation that reflects a readiness to cope with upcoming negative events. Sometimes the patient expresses fears regarding real and/or perceived unpleasant events. For example, to those around him, such a patient may express various catastrophic thoughts related to the global economic crisis: “... and by spring in our country everyone will eat exclusively black bread and water. And there will be no cars on the street - there will be no money to refuel. Can you imagine – empty streets...” If the listener is also prone to anxiety, then the patient’s words have fallen on fertile soil, anxiety begins to cover (“infect”) the patient’s environment. This spread of anxiety is especially typical during periods of social disadvantage. At the same time, anxiety in this category of patients can manifest itself as specific fears, primarily concerns about their own health. Patients are afraid of the possible development of stroke, heart attack, cancer and other serious diseases. This category of patients is characterized by frequent visits to the doctor, numerous repeated instrumental studies, and a thorough study of the medical literature. Adaptation disorder with depressive mood is characterized by a low background mood, sometimes reaching the level of melancholy, and a limitation of usual interests and desires. Patients express pessimistic thoughts regarding current events, uniformly negatively interpret any events, blame themselves and/or others for their inability to influence events. The future seems to them exclusively in black colors. This category of patients is characterized by mental and physical exhaustion, decreased concentration, memory impairment, and loss of interests. Patients note that it is difficult for them to gather their thoughts, any undertaking seems impossible, and a strong-willed effort is required to maintain everyday activities. They note difficulty concentrating on one issue, difficulty in making decisions, and then in putting it into practice. Patients, as a rule, are aware of their failure, but try to hide it, citing various reasons to justify their inaction. The main symptom of depression, low mood (sadness), is often actively denied by the patient or considered by him as an insignificant secondary symptom associated with somatic pathology. In some cases, depressive affect may be hidden behind additional mental symptoms: irritability, hypochondriacal ideas, anxiety, phobic symptoms. More than half of patients with adjustment disorders do not realize that they suffer from a mental disorder and present only somatic complaints. When a doctor tries to discuss the patient’s emotional experiences, the latter almost always shows a negative reaction. A narrowing of interests and loss of pleasure (the second most important symptom of depression) may also be ignored by the patient; or certain life limitations are considered by him as an inevitable consequence of a somatic illness. In such cases, to understand the reasons for the patient’s maladjustment, objective information from close relatives is necessary.

D. _ The proven temporary connection between the stressor and the resulting disorder is no more than three months.

In addition to the fact that symptoms of adjustment disorder begin within 3 months after the onset of the stressor, they should not last more than 6 months after its cessation.

If the stressor is acute (for example, sudden dismissal from work), the onset of the disorder is usually immediate (or within a few days) and its duration is relatively short (no more than a few months). If the traumatic impact or its consequences are prolonged, the adaptation disorder may become protracted.

Persistence of adjustment disorders or progression to a more serious disorder (eg, depressive episode) is more likely in children and adolescents. It is believed that adjustment disorder should resolve within 6 months after the end of the stressor (or its consequences).

It is also indicated that symptoms may persist for an extended period (ie, longer than 6 months) if they occur in response to a chronic stressor or a stressor that has lasting consequences (eg, financial and emotional difficulties due to divorce).

Researchers indicate that the stressor can be one-time (for example, the end of a romantic relationship) or repeated (severe professional difficulties or family problems), as well as current (associated with seasonal professional crises) or continuous (living in a neighborhood with criminal elements or drug addicts).

Stressors can affect an individual, a microsocial group (for example, a family, a military unit) or an entire community or communities (in the event of a natural or man-made disaster).

Some stressors may accompany events associated with normal human development (for example, starting school, marriage, having children, failure to achieve professional goals, retirement). A number of authors emphasize (CT Kaelber, DSRae, 1998; Yu.V. Popov, V.D. Vid, 2006; etc.

) that "adjustment disorder" is a residual category used to describe clinical manifestations in response to any identifiable stressor, but that these manifestations "do not have to meet criteria for other, more specific disorders" (eg, anxiety or mood disorder) and should not be simply an intensification of pre-existing mental pathology. However, adjustment disorder may be diagnosed in the presence of other forms of disorder if they do not explain the clinical picture of symptoms that arose in response to a stressor, for example, a patient may develop a short-term depressive reaction after losing a job, and at the same time he has an previously diagnosed with obsessive-compulsive disorder. Modern researchers emphasize that when diagnosing adaptation disorder, it is necessary to take into account the specific cultural, age and gender characteristics of patients. A person’s cultural attitudes must be taken into account when making a clinical judgment about the degree of adequacy of a person’s response to a specific stressor. The basic, pathogenetically oriented component of the treatment of adaptation disorders is psychotherapy, since psychogenics play a leading role in the development of these disorders. For short-term (up to 3 months) adaptation disorders, the clinical picture of which is mainly determined by mild and/or moderate anxiety, psycho-vegetative and asthenic symptoms, it is quite sufficient to supplement psychotherapy with the use of anxiolytic (tranquilizer) drugs. In this case, it is advisable to follow the principle of dynamic monitoring of the patient’s condition with the addition of an antidepressant in the event of the appearance or intensification of depressive symptoms. A number of clinical signs make it possible to clarify the indications for prescribing antidepressants: prolonged course of adaptation disorder with depressive symptoms; deepening of depressive symptoms with the appearance in the clinical picture of autochthonous hypothymia, phenomena of somatization of affect, increased motivational-volitional and affectogenic cognitive impairments. At the same time, the principles of treatment of depressive episodes and adaptation disorders are largely similar. Additional information : 1 . [ read ] article “Adjustment disorders: modern approaches to diagnosis and therapy” by O.S. Antipova, Federal State Budgetary Institution "Moscow Research Institute of Psychiatry" of the Ministry of Health and Social Development of Russia, department of affective spectrum disorders with a depression research group; 2013;

2 . [ read ] article “Adjustment disorders: the state of affairs” Patricia Casey, Susan Bailey; 2011.

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Treatment of adaptation disorders. Symptoms of adjustment disorder

Adaptation disorder is an intermediate state between a person’s normal reaction to adversity and a mental illness. The complexity of the pathology lies in its intermediateness, since the person himself and those around him often cannot determine it. The prognosis depends on the timeliness of diagnosis and timely provision of assistance.

Causes

Adaptation disorder is most often observed , which is explained by the instability of their psyche. But, with prolonged experience of stressful situations, it is diagnosed in people of working age and elderly patients. The pathological condition appears when:

• Stress;
• Neuroses;
• Psychosis.

With these diseases, patients complain of insomnia and deterioration of the person’s general condition, which leads to adaptation disorder. Personality adjustment disorder has varying degrees of severity, depending on the severity of the stress.

The onset of the disease can be observed during a serious single stress, for example, the loss of a prestigious job, the death of a loved one, etc. Pathology develops with periodic stress that occurs against the background of poverty or chronic diseases.

People with a genetic predisposition are at risk of developing pathology. If a person has problems with intimacy or conflicts in the family, this leads to maladjustment. It appears when there are material difficulties or difficulties in relationships with others. If the traditional way of life changes dramatically, this leads to a pathological process.

Signs of pathology

Symptoms of adjustment disorder are not always pronounced and may differ in each individual case, which complicates the diagnosis process. The main symptoms are of an anxious and depressive nature.

Maladjustment is accompanied by a feeling of inability to cope with the troubles that appear in life. With pathology, the patient becomes suspicious and irritable. Most people note the appearance of a feeling of internal tension.

Psychiatry of adaptation disorder has information that it is accompanied by:

• Anxiety;
• Persistent anxiety;
• Internal discomfort;
• Violations in normal behavior.

In patients with pathology, the mood worsens. In especially severe cases, a sad state appears. A person becomes uninterested in his usual activities. A person becomes physically and mentally exhausted, so he cannot make informed decisions. He does not analyze the situation and is not responsible for the decisions made.

Disadaptation has a vague clinical picture, so when the first suspicious symptoms appear, it is recommended to seek help from a specialist who will correctly diagnose and prescribe effective treatment.

Types of pathology

In accordance with the causes and characteristics of its course, maladjustment is divided into several types:

• Social adjustment disorder. With pathology, the patient cannot communicate with his usual circle of friends and acquaintances. He gradually moves away from them and retires. If the pathology is severe, the patient cannot be in society at all. He may not leave the apartment for months.
• Depressive adjustment disorder. The disease develops against the background of depression. A person is constantly depressed. They have no desire to communicate and gradually lose their usual interests.
• Mental adjustment disorder. A pathological process occurs in the form of an acute reaction to stress, which develops in the form of psychological shock. It is accompanied by various mental disorders.
• Prolonged adjustment disorder. The pathological process is characterized by a long course. The situation is aggravated when a stressful situation of varying severity appears.
• Anxious adjustment disorder. With this type of pathology, patients experience alarming symptoms under any circumstances.
• Mixed adjustment disorder. This form of pathology combines several of the above.

There are several types of pathology that are recommended to be determined in order to make the correct diagnosis of adaptation disorder .

Diagnostic measures

Only a qualified specialist can determine maladjustment. It determines the development of somatic symptoms in children and adolescents and alarming signs in older people, which indicate the progression of pathology. The diagnosis is made in accordance with the diagnostic criteria of DSM-III-R:

• Reactions to overt psychosocial stresses that occur within three months.
• The nature of maladjustment. At this stage of diagnosis, the presence of impairments in school or work and symptoms that should not be present during stress are determined.
• The duration of the maladjustment reaction is more than 6 months.

In case of maladaptation, differential diagnosis is recommended. Pathology must be distinguished from conditions such as disorders that appear due to the use of psychoactive drugs, post-traumatic disorders that occur due to stress, and aromatization.

Treatment of the disease

Treatment of adjustment disorders requires the use of psychotherapy. It is recommended to conduct group therapy for patients who experience the same stress, for example, retirees or people with the same chronic illness.

Individual psychotherapy is aimed at ensuring that a person begins to understand that the onset of the disease is observed under stress. This is the main cause of the pathology.

If treatment methods are selected correctly, the patient gains strength and endurance with which to combat stress.

To avoid secondary gain, proper implementation of psychiatric decision is recommended. Treatment of the disease will be successful if the doctor has an attentive and caring attitude towards the patient. When symptoms of secondary gain appear, the treatment process becomes more complicated.

With maladjustment, the patient may become overly aggressive, which leads to conflicts at work or school, committing crimes, etc.

Doctors should not justify these actions of patients and try to justify them to law enforcement agencies. With this line of behavior of the doctor, the person’s emotional state does not improve.

In addition, he does not criticize himself, and such socially unacceptable behavior becomes the norm for him.

Disadaptation is a dangerous pathological process that has a blurred clinical picture. That is why pathology is often diagnosed untimely. The choice of treatment method should be made by a doctor, which will ensure its effectiveness.

Source: https://chastnaya-psihiatricheskaya-klinika.ru/rasstrojstvo-adaptatsii-adaptatsionnoe-rasstrojstvo-lechenie