Treating Adjustment Disorder

General consensus is, our lives comprise three core spheres: relationships, work and health. If any one of these key aspects is changing or failing, we are on alert. But if two or more of them are in transition, we may have trouble coping.

Take, for example, a young man who changes his job and living situation in a short span of time. The job is really a career move with a new environment, new protocol, etc. His home is in a different city, away from the friendly neighbors he used to spend time with. Since he had stopped using substances some time before this, the coping mechanisms he once used are no longer available. He finds himself experiencing increasing anxiety to the point at which he decides to seek help.

The therapist may diagnose this man’s condition as adjustment disorder. Tending to be short-term, this state is characterized by finite periods of depression and/or anxiety brought on by major life changes or loss. Once an individual adapts to his new circumstances, the disorder ends for him.

But in the meantime, the feelings associated with the affliction can be excruciating, leading many to pursue counseling. Symptoms can include (abbreviated from the WebMD website):

• Hopelessness
• Sadness
• Crying
• Anxiety
• Worry
• Headaches or stomachaches
• Palpitations
• Isolation
• Absence from work or school
• Dangerous or destructive behavior
• Changes in appetite
• Insomnia
• Low energy or tiredness
• Substance abuse

A mode of treatment useful for numerous psychological conditions can also be successfully applied to adjustment disorder. That is, cognitive therapy. This model, developed by Aaron Beck in the 1960s, argues that individuals’ own thoughts and perceptions  about events directly affect their emotional responses, as opposed to the actual events. Counselors attempt to discover their clients’ distorted beliefs about themselves or provocative situations, through questioning and teaching them to examine their own thinking.

Because the cycle of therapy for adjustment disorder is relatively short (often from three to six months), and the individual sessions can be as little as 45 minutes, homework is key. Therapists guide clients to track or log negative thoughts, then ask questions for each thought: “Is this true?” “If part of it is true, what isn’t true?” Keeping a schedule to track how one feels at different times is also useful for pinpointing triggers. Finally, the individual is encouraged to devise his own replacement behaviors for less healthy activities. For instance, connecting with loved ones is a good substitute for isolation. Turning to old, favorite hobbies trumps drinking or overeating.

Generally, the scrutiny of one’s beliefs coupled with the new, healthy behaviors will empower an individual, ending the disorder and achieving his adjustment within a few months. If not, perhaps client and therapist need to consider other possible conditions, such as long-term depression or generalized anxiety disorder.