Situational Depression or Reactive Depression (Adjustment Disorder)

What is Adjustment Disorder?

An adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor (or stressors) occurring within 3 months of the onset of the stressor. A stressor is anything that causes a great deal of stress in the person's life. It could be a positive event, like a wedding or purchasing a new home, or a negative event, like a family member's death, the breakup of an important relationship, or loss of a job.

These symptoms or behaviors are clinically significant as evidenced by either of the following:
  • Marked distress that is in excess of what would be expected from exposure to the stressor
  • Significant impairment in social, occupational or educational functioning
The stress-related disturbance does not meet the criteria for another specific mental disorder. Once the stressor (or its consequences) has ended, the symptoms do not persist for more than an additional 6 months. By definition, if your feelings related to the event last longer than 6 months, it will no longer qualify for an adjustment disorder diagnosis.

An adjustment disorder can occur at any time during a person's life and there is no difference in the frequency of this disorder between males and females. An adjustment disorder is diagnosed by a mental health professional through a simple clinical interview.

Adjustment disorders are often diagnosed when it's not clear the person meets the criteria for a more severe disorder, or the actual diagnosis is uncertain. This diagnosis often gives the clinician time to further evaluate the client during additional therapy sessions.

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Adjustment Disorder Types

Adjustment disorders are further categorized by the specific symptoms experienced:
  • Adjustment disorder with depressed mood
  • Adjustment disorder with anxiety
  • Adjustment disorder with mixed anxiety and depressed mood
  • Adjustment disorder with disturbance of conduct
  • Adjustment disorder with mixed disturbance of emotions and conduct
  • Adjustment disorder, Unspecified
Possible Triggers

Situational depression differs from major depression in that it is triggered by external events. The symptoms tend to disappear once the sufferer has learned to adapt to the new situation. A variety of stressors have been linked to the development of adjustment disorder. In large measure, what triggers the disorder depends on the individual, but the following types of events have a known association to situational depression:

*Ending a relationship
*Serious illness (yourself or in someone you love)
*Death of a family member or someone you love
*Becoming a victim of a crime
*Going through an accident
*Major life changes such as marriage, birth, or retirement.
*Surviving natural or manmade disasters

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Symptoms

The emotional or behavioral symptoms begin to develop in response to a stressful event. The symptoms come on within a few months of the event and it is rare for the symptoms to last beyond six months of the stressful occurrence that prompted them. In this type of depression, the reaction to the stressful event seems out of proportion to what one would expect in relation to what has occurred. The symptoms may interfere with the sufferer's daily functioning. He may find it difficult to sleep, study, or work.

The symptoms of adjustment disorder can include any of the following:
*Anxiety
*Nervousness
*Tearfulness
*Sadness
*Hopelessness
*Worry
*Lethargy
*Fatigue
*Sleep Difficulties
*Heart palpitations
*Stomachache
*Headache
*Missing work or school
*Withdrawal from friends and activities
*Destructive behavior
*Loss of appetite
*Binge eating
*Abuse of recreational drugs or alcohol

Behavioral Issues

In children and teenagers, the disorder is more likely to be characterized by behavioral issues, for instance playing hooky, fighting with peers, or acting out. Adults tend to have symptoms that are emotional in nature, for instance anxiety and sadness. The disorder is very common and can affect people of every age, race, sex, or lifestyle. There is, however, a greater tendency to this condition during times of major life transitions, for instance, with the onset of adolescence, middle-age, or with the arrival of the golden years.

Adjustment disorder and clinical depression

Situational and clinical depression can certainly feel and appear to be the same thing, but there are significant differences that people should be aware of. On the whole, clinical depression can be much more serious and certainly requires the assistance of trained mental health professionals for treatment.

Unlike clinical depression, situational depression (SD) is triggered by an external stress and usually goes away once the person learns how to cope or adapt to whatever happened. Situations that cause it can include the death of a loved one, the end of a relationship, being fired from a job, being the victim of a crime, physical trauma/disease/illness, an accident, having a baby, economic hardship, living through a natural disaster, and loneliness.

Adjustment disorder and post-traumatic stress disorder

Adjustment disorder is not the same as post-traumatic stress disorder (PTSD). PTSD generally occurs as a reaction to a life-threatening event and tends to last longer. Adjustment disorder, on the other hand, is short-term, rarely lasting longer than six months.

Asking for Help

A person who is in the early stages of depression will not find much solace in hearing that they just need to get over it. What they need initially is emotional support, someone who will listen and understand without judgment, so that they have a trusted confidant to share their feelings with. Dismissing their worries and concerns as trivial will only prolong the condition because they’re likely to turn more inward and suppress the very things that need to be brought out and dealt with.

Everyone reacts differently to what life throws at them, and dictating the way another should feel is almost never a good idea. The person will feel alone. Although it is said that time heals all wounds, it is the positive and helpful things that you do in that time that bring about healing and mental homeostasis quickest.

A five-year career plan is a worthless scrap of paper unless you have being a good friend/sibling/father/mother/husband/wife/citizen prominently displayed on the list. Being there when someone close to you is down is the true test for that. Fair-weather friends bail out of the fox hole at the first sign of trouble. In a sense you are helping to liberate a mind from the tyranny of depression.

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Treatment

A treatment plan for adjustment disorder involves talking to a trained mental health professional who is capable of managing the patient's symptoms through therapy and providing them with effective coping mechanisms. Once the patient learns to deal with the issue that brought about the disorder in a healthy (and sometimes slightly detached) manner, they will most often be fully recovered from the grim effects of it in three to six months.

Asking for help may be the hardest hurdle to overcome for some folks who have situational depression. But it’s essential to do so; and to try as many different solutions or a combination of treatment techniques until the suffering is alleviated and finally terminated. They will need the help of a trained therapist, psychologist, or psychotherapist who knows the most effective way to handle grief, loss, or the disabling upheaval of what brought about the condition. Trained mental health professionals will also be able to determine that this is indeed what the patient is suffering from and not a more serious mental disorder.

In many cases, adjustment disorder is the result of some sort of loss which results in Dr Elisabeth K├╝bler-Ross's widely accepted five stages of grief that include denial, anger, bargaining, depression, and acceptance.

So the goal is to get that person over the bridge to acceptance. As the Buddhists believe, non-acceptance is largely the root of all humanity’s troubles and there is a lot to be said for that ancient wisdom. While we’re on that topic, along with all the positive effects of regular and sustained exercise for attaining mental wellness, the ancient practice of Yoga is also ideal for healing a troubled mind. You can learn a whole lot more about that by reading Yoga has Far-Reaching Benefits on your Mental and Physical Well-Being. If it helps heal combat veterans who witnessed the horrifically depressing attributes of war, it can work for anyone else too.

Psychotherapy is the most common and trusted treatment plan for an adjustment disorder because the patient will begin to come to terms with how the external stressor affected them. A patient will learn to unravel the discouraging and bleak reoccurring thoughts until they gain a more healthy perspective.

Anti-depressants, medications to help with sleeping problems, and/or anxiety might be needed in some cases to bring a patient around. A psychotherapist will point out valuable insights that the patient is unable or incapable of seeing and understanding. Plus, they know effective coping mechanisms to employ such as cognitive therapy.

In many ways a person with situational disorder is his or her worst enemy. But the new skills learned to cope with this condition will actually improve their lives when they do overcome it. Some of our greatest lessons are learned after coming out of dismal anguish and when you realize that you can help someone who is going through the same thing. You are plugged into what Abraham Lincoln deemed "the better angels of our nature."


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