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Adjustment Disorder: Drugs and Treatment

Tuesday, 12 Oct 2010 04:22 PM

Nearly everyone finds it difficult to adjust to new situations in their life. It takes a little time and patience, but we learn to adapt and adjust. Adjustment disorder is when an individual finds it difficult to deal with a particular situation in life. Stressful situations may include messy divorces, layoffs, financial stress, or deaths in the family. The individual often experiences anxiety and depression, and sometimes goes into complete withdrawal from society and family members.
 
Adjustment Disorder diagnosis:
 Patients who are suffering from adjustment disorder, or AD, exhibit symptoms within three months of a stressful situation.

The DSM-IV-TR lists the following symptoms that form a part of adjustment disorder (AD), and an individual is confirmed as suffering from AD if they exhibit three or more of these symptoms:
  1. Persistent distress that is greater than what is expected in a particular situation.
  2. The patient experiences significant difficulty in dealing with relatives and neighbors. He or she can sometimes become depressed and increasingly anxious about simple situations.
  3. The patient may experience mixed anxious and depressed moods.
  4. Disturbed behavior that may result in aggression, depression, anger, and even sexual promiscuity.
A detailed medical history of the patient is recorded by the psychiatrist along with interviews of  family and friends. Adjustment disorder diagnosis is only confirmed if the symptoms do not fit into the category of major depression or other anxiety disorders. It also becomes very difficult to distinguish the same disorder from post-traumatic stress disorder, personality disorder, or acute stress disorder. There are six different subtypes of adjustment behavior that can be differentiated only by a physician to get an adjustment disorder diagnosis.
 
Adjustment Disorder treatment
Psychotherapy forms the basis of adjustment disorder treatment. Effective treatments include:
  1. Stress reduction therapies like psychodynamic psychotherapy will teach patients to deal with stressors and stressful situations. It also helps them understand the situation better and how to deal with it. Group therapy is another route by which patients can be taught to express their feelings and to deal with them.
  2. Medication is very rarely given to adjustment disorder patients. This is because the symptoms usually resolve with psychotherapy and support. But there are a few cases where the patient has severe underlying anxiety and depression that must be controlled with medication. As a result, the physician will prescribe short-term medications including anti-anxiety medications like lorazepam or clonazepam to reduce anxiety and stress, and stimulants for those suffering from severe depression.
It must be noted that doctors will not advise the use of long-term medications to treat adjustment disorder. If the stressor or stressful situation can be identified and controlled, the patient can usually deal with future problems through self-care and awareness. It’s always better to consult a trained psychiatrist before taking any medication.

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