By David Joel Miller.
When is an adjustment disorder not an adjustment disorder?
Sometimes people have symptoms as a result of experiencing trauma or stress. These difficulties are sufficiently severe that we think this person needs treatment but the exact group of symptoms they have doesn’t quite fit a listed disorder. The new DSM – 5 solves this problem by creating another name for adjustment like disorders.
Other Specified Trauma- and Stressor Related Disorders (F43.9)
This designation gives us five more ways to categorize problems of everyday living which were caused by stressors or trauma but do not quite neatly fit the defined adjustment disorders. Below are the five reasons you might get an adjustment like disorder diagnosis.
1. You had a stressor but your problems did not begin until more than three months after the stressor.
2. There problems continue for more than six months even though the stressor has ended but your symptoms have not turned into another diagnosis.
3. You were having an “ataque de nervious.” This particular condition is listed in the back of the DSM – 5 under cultural concepts of distress. While not recognized in the United States as a mental disorder, this particular group of symptoms is widely recognized in Spanish-speaking countries.
4. Another cultural syndrome. There are a number of cultural syndromes that are recognized in a particular geographic or ethnic area. The cultural syndromes are understood as an inability to cope with a particular stressor.
5. Persistent Complex Bereavement Disorder. This condition is listed in an appendix to the DSM under conditions for further study. Since it didn’t make the list of official diagnoses, researchers needed a way to code it. The result is this condition ended up here under adjustment like disorders.
I don’t think I’ve ever seen an adjustment like disorder listed in the person’s chart nor have I ever use this particular diagnoses myself. But when I saw it was right there in the DSM-5 I just couldn’t resist letting you all know about this. Maybe this illustrates how learning to diagnose mental illnesses is both an imprecise science and an area for continuing learning.
As with the other things we are calling a mental illness this adjustment like disorder 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 causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem this issue needs to be more severe 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.
For more on this topic see Adjustment Disorders in the Trauma- and Stressor Related Disorders category.
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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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books