By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
You don’t have to be “crazy” to have a mental illness.
Sometimes bad things happen, and those difficulties in life can overwhelm you. When these things happen, often people get right back up, but if something bad has happened to you and you find that you can’t get back on track you might well have an Adjustment Disorder. Adjustment Disorders are the result of bad things happening to you.
Professionals need to be careful not to turn everything that could possibly happen to someone into some sort of mental disorder. Beginning professionals are cautioned to avoid pathologizing their clients by being so sure everyone who comes to their office must have some kind of extreme mental disorder.
Stress affects everyone differently.
A particular stress, divorce, for example, can have a very different meaning for different people. One person may become very depressed. Another might become quite angry. Some people may even be happy and throw a party.
We know that stress can be quite difficult to handle. But if someone’s response is far beyond what we expect, then that excessive response gets diagnosed as an adjustment disorder. To be diagnosed with an adjustment disorder your distress as a result of what happened has to be in excess of what we would normally expect.
Because of the large number of possible ways stress might affect someone there are six specifiers or some types of adjustment disorder.
This inability to adjust can result in suicide.
Adjustment disorders have come to be recognized as serious mental health issues because of the high rate of suicide, homicide or other negative behavior that can occur in the aftermath of the stressor. Things like divorce, loss of the job, business failure or other negative events can overwhelm a person and exceed their ability to cope.
Adjustment disorder requires an identifiable trauma or stressor.
Just any difficulty coping with life does not get diagnosed as an adjustment disorder. In this condition, we know clearly that something specific happened in your life. We call this the identified stressor. We expect to see the results of that experience start happening within three months of the original incident. We also believe that adjustment disorder normally stops all by itself within six months of the time it began.
If you have a strong reaction to a stressor in the first month after the incident, we call that Acute Stress Disorder, a condition that usually resolves very shortly.
An Adjustment Disorder results in a change in your feelings or behavior.
As a result of this stressor, people find their feelings overwhelming them. That may become depressed, anxious or angry. Not only are these feelings negative but they’re far beyond what would be useful.
People with Adjustment Disorders may begin behaving in ways that are just not normal for them. That may be constantly angry, become violent or begin abusing drugs and alcohol. Some develop other addictions.
People with an adjustment disorder are at high risk to become violent towards those they blame for their misfortune.
Bereavement is not the same as Adjustment Disorder.
Having someone close to you die is something everyone experiences sooner or later. Mental health professionals see this loss of a loved one as quite different from Adjustment Disorder. While everyone needs to grieve in their own way, most people eventually get past the loss of a loved one.
In an Adjustment Disorder not being able to adjust damages your life.
As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is not interfering with your everyday life. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem this adjustment difficulty needs to be more than your situation would warrant. These other issues may need treating first, then if you still have symptoms you could get this diagnosis.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
Staying connected with David Joel Miller
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Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.