Is Adjustment Disorder a Copout Diagnosis?

None of us live perfect lives—we make mistakes, we lose our way, and sometimes we’re total victims of unfortunate circumstances. However, life’s blows hit some of us a little harder than others. For example, someone somewhere in the world has just gotten fired. Let’s call him Tom. While it might be easy for someone on the outside looking in to say, ‘Hey it’ll be okay, keep your head up,’ it’s not that easy for Tom. Instead of adapting an optimistic view of his future, he becomes disoriented and has trouble going on with life as normal.

Tom develops adjustment disorder, which is a mental illness characterized by the presence of emotional and/or behavioral symptoms in response to an identifiable stressor; in this case, Tom losing his job is the stressor. Let’s delve deeper into the nature of other possible stressors:

1. Adjustment disorder may be caused by…

• …a single event, such as the aforementioned example of being fired from a job. A break-up, death of a loved one, or sexual assault can also be triggers for adjustment disorder.
• …or multiple stressors, such as continuous marital issues or a combination of the above.

2. The stressors can be…

• …recurrent, in that the premise keeps coming back up, such as failed relationships or one’s consistent efforts to find a job.
• …or continuous, whereas an unfortunate circumstance or event persists, such as an incurable disease that slowly diminishes one’s wellbeing.

Even though adjustment disorder is a real illness and listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), some individuals have a hard time believing it’s real and, instead, think of it as a “copout diagnosis.” This may be due to their own stressors or history with traumatic experiences, which did not result in a mental illness. For example, someone who lost their job just like Tom may not have experienced the distress that Tom did, but rather saw the firing as an opportunity and thrived because of it. And if he could do that, why couldn’t Tom? Again, we’re all different—we process major life events differently and some of us develop mental illnesses while others don’t.

Criteria for An Adjustment Disorder Diagnosis

With that being said, traumatic events and difficult stressors don’t always lead to an adjustment disorder. In order for a diagnosis of this illness to be made, the following criteria as set forth by the DSM-5 must be met:

• At least one of the following…
• Symptoms are clinically significant and may cause severe distress and functional impairment.
• Distress that’s disproportionate with how one is expected to react to the given stressor.
• All of the following…
• The distress and/or functional impairment cannot be attributed to an existing mental health disorders.
• When the stressor is removed or the individual has learned to cope, the symptoms subside within 6 months.
• The response isn’t characteristic of normal bereavement.

5 Types of Adjustment Disorder

In addition to the criteria above, individuals with adjustment disorder can experience anxiety, difficulty concentrating, feelings of isolation and low self-esteem, insomnia, worry, sadness, and hopelessness—which further support diagnosis and help signify specifications for the adjustment disorder. These specifications are as follows:

1. Adjustment disorder with depressed mood, which is characterized by individuals experiencing feelings of sadness and hopelessness. They also tend to cry often and may even stop enjoying previously loved activities.
2. Adjustment disorder with anxiety, whereas individuals often feel overwhelmed, anxious, and worried. One may also have trouble with his or her concentration and memory.
3. Adjustment disorder with disturbance of conduct, in which individuals display behavioral issues like starting fights or acting recklessly. Kids with this type may start missing school and even breaking the law.
4. Adjustment disorder with mixed disturbance of emotions and conduct, whereas the individual experiences symptoms like depression, anxiety, AND behavioral issues.
5. Adjustment disorder unspecified, which isn’t characterized by any of the aforementioned symptoms. Instead, symptoms are typically physical or issues with peers and/or work or school.

Believing and Supporting One Another

Our society is often hesitant to have a conversation about mental illness. Many of us shy away from topics of depression, claims of anxiety, and discussions about mental health in general—but we shouldn’t. Instead, we should believe and support one another because dealing with mental illness—whether it be depression, anxiety, a personality disorder, eating disorder, or adjustment disorder—is a long and bumpy road; long and bumpy enough without the stigma, judgment, and disbelief.

So the next time someone says that they have a mental illness try simply being there for them. Don’t skeptically ask questions or ask for proof—believe them and help them through the difficulties that come with mental health disorders.

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