Seeking help for adjustment disorder

Recognising and seeking support for a relatively unknown disorder can be hard, however, this article provides an insight and some helpful tips for moving forward with adjustment disorder

What is adjustment disorder?

Adjustment disorder is a diagnosable psychological condition that occurs because of a major life stressor. It encompasses emotional and behavioural symptoms that occur within three months of the life stressor. Symptoms include depressed mood, anxious features, mixed anxiety and depression, and behavioural problems.

The signs and symptoms are similar to a range of other conditions, however when they have been triggered by a specific event or stressor, it is diagnosed as adjustment disorder. The symptoms can be divided into:

• Depressive symptoms: low mood, anhedonia (loss of joy or pleasure), tearfulness, hopelessness
• Anxiety: excessive worry, nervousness, difficulty concentrating, poor sleep onset
• Behavioural symptoms: changes in conduct such as reckless driving, aggression, etc.

Adjustment disorder in veterans

In the veteran community, adjustment disorder is frequently diagnosed upon discharge with the major life stressor being the change in identity when leaving the Defence Force and entering civilian life.

Additionally, when military personnel experience severe injuries and subsequent loss of function or career, this can also trigger adjustment disorder, as they struggle to adjust to their new physical limitations or career identity changes.

The sticking point for veterans is that being in the Defence Force merges with their core identity and their values. So, when that is altered without their choice, it can cause significant impairment resulting in the inability to adjust to their new life.

Adjustment disorder vs. PTSD

It’s important to note that adjustment disorder is not the same as post-traumatic stress disorder (PTSD).

PTSD has similar symptoms but in response to a life-threatening event or witnessing something that could potentially be life threatening. There needs to be a traumatic event, with symptoms then arising within one month of that event.

Adjustment disorder can be triggered by a wider range of events that constitute a dramatic change in the functioning of a person’s day to day life, like severe injury, change in jobs, divorce, etc.

Treating an adjustment disorder

The treatment of adjustment disorder can be done with a range of psychological interventions including:

• Acceptance and Commitment Therapy which is about learning about one’s values, mindfulness, learning to sit with discomfort, etc.
• Cognitive Behavioural Therapy which involves learning to examine one’s beliefs and automatic thoughts to test their accuracy, i.e. “I am broken” is a distorted negative belief that many experience after injury, which is not accurate and can be challenged and modified into a more helpful and accurate belief.
• Schema therapy which is designed to address one’s unmet needs and to help them break these patterns of thinking, feeling, and behaving.

If you’re reading this article and believe you may have an adjustment disorder, or know of a veteran who matches the above signs and symptoms, here are some helpful tips:

• Take inventory of your current functioning. Has it changed significantly since a life stressor? In what ways?
• Examine your values. What are the things that are most important in your life? Such as being honest, resilient, caring, etc. Once you know what your values are, how can you continue to behave in line with those values, even with the changes you might face as a result of the life stressor.
• Get support. That can be from a psychologist or a friend or loved one. Sharing what you’re experiencing can be challenging, however, it is one of the most helpful things you can do.
• Ask yourself, “what is currently in your control?” What can you do today that will help move you in the direction you want to go in? It might be adjusting your diet or sleep patterns, re-engaging with a hobby, etc.

If you believe you may have an adjustment disorder or need support, please call 1300 462 837 (1300 4 MATES) to book an appointment with a Mates4Mates psychologist.

Written by Jonathan Moscrop, Mates4Mates Clinical Lead – Psychological Services