Adjustment disorder with anxiety occurs when a stressful event causes anxious symptoms, which are considered more severe than what would ordinarily be expected. Alternately, an event could create enough anxiety to interfere with a person's functioning in the world, like working, attending school, or maintaining relationships. There are other adjustment disorder types including those that feature depression or a combination of depression and anxiety. Any of the types should be diagnosed only when an event can be identified, and when the symptoms are not better accounted for by another condition.
The term adjustment disorder with anxiety implies the basic elements of this condition. A patient has difficulty adjusting to a recent event, which is shown by increased anxiety. An event can refer to many stressful life circumstances like losing a job, moving, retiring, or getting a divorce. Deaths of family members and friends are excluded. Symptoms of anxiety after a death are usually classified as bereavement.
Symptoms that accompany adjustment disorder with anxiety are varied. Patients may report feeling jittery, having difficulty sleeping, or being irritable. Excessive worrying or nervousness could occur. Children may have slightly different symptoms like irritability, separation anxiety, sudden hyperactivity, and poor concentration in school. In either adults or children, anxious symptoms interspersed with depressive symptoms usually change the diagnosis to adjustment disorder with depression and anxiety.
The duration of illness in adjustment disorder with anxiety varies. Some patients recover within six months, in which case, the illness is considered acute. Chronic courses lasting six months or longer are not unusual. Treatment may help shorten a course.
Therapy is the standard treatment for this condition. Some preferred models include cognitive behavioral therapy or psychodynamic work. Brief therapy is often appropriate for acute cases. More than one family member suffering from adjustment disorder due to the same event might call for family therapy. Prescription drugs may also be appropriate to reduce anxiety or address sleeplessness.
Though adjustment disorder with anxiety is often considered a minor condition, it can be associated with serious consequences. Some youths will have anxiety and conduct issues, which might cause legal problems or jeopardize school standing. In addition, adjustment disorders have been associated with elevated suicide rates. This condition requires careful observation, and early intervention with therapy and medications, as needed.
Many clinicians have trouble diagnosing adjustment disorders. They may feel that features like personality, temperament, family background, and culture all combine to influence “normal” adjustment. If this is so, it may seem presumptive to diagnose a longer period of adjustment as a disorder.
Others seize on this diagnosis first when they are uncertain if clients will go on to manifest more serious conditions like generalized anxiety disorder, post-traumatic stress syndrome, or acute stress disorder. This is a less serious diagnosis and is unlikely to follow people through life. Hesitancy in diagnosing a more serious illness has its own problems, as failure to render an accurate diagnosis could lead to inadequate initial treatment.
