Stress is a fundamental emotion for our survival. It activates fight or flight responses when these are necessary, in particular in the face of events that are dangerous for our physical and psychological integrity.
However, stress sometimes becomes an inappropriate response, exaggerating the potential risks of a given event and behaving in a way that is very detrimental to the proper development and functioning of life.
Adaptive disorder refers to a diagnosis in which the person exhibits problems adapting to the demands of their environment. Here we will take a closer look at this concept and we will discuss the types of adaptive disorders that exist.
What are adaptive disorders?
According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), adaptive or adaptive disorders are defined as mental disorders a strong relationship with stress and the ability to adapt satisfactorily to life’s events and inconveniences.
The main factor that activates these disorders is the experience of stressful situations or the high frequency of their occurrence. In other words, adaptive disorders do not develop without first appearing a condition that activates them, fundamentally being stress.
More precisely, these disorders are understood as maladaptive responses to stress, continuous and / or severe, which negatively affect the effective coping mechanisms to be able to carry out correct social functioning.
It usually causes significant and prolonged discomfort, in addition to changing the way the person is, Causing him to lose interest in aspects he previously enjoyed, feeling sadness and anxiety, combined with a deep and continuing helplessness.
One of the explanations given to understand the occurrence of this type of disorder concerns the natural mechanism of some people when they live in a particularly stressful situation. After experiencing a particularly disturbing event, these people learn to pay more attention to the state of their body, interpreting any unpleasant physiological sensations as an indicator that something is wrong at all, which in turn leads to higher levels of anxiety and depression.
We will see again the types of adaptive disorders and their main symptoms, it is necessary to mention before their common symptomatology. These symptoms appear when the person is in a particularly difficult situation. These situations require the person to initiate a series of processes which have the ultimate goal of overcoming them. Some examples of stressful life situations can be the loss of a loved one, the breakdown of a romantic relationship, the stress of studying., Change city …
Some of the main symptoms of adaptive disorders include low mood, depressive symptoms, as well as ruminant and negative thoughts, excessive worry about how events will unfold and the problem that triggered the disorder to manifest.
You may also experience physical discomfort, which increases stress, acting as a feedback cycle.. Some of them are chest tightness and difficulty in breathing. The person may have trouble falling asleep, insomnia and problems concentrating.
Among the dysfunctional thoughts we can find low self-esteem, a distorted self-image, feelings of hopelessness, fear, the feeling that there is no way out of the situation we find ourselves in. or difficulty in planning daily activities and – on, in addition to feeling lonely.
The diagnosis of adjustment disorder is based on identifying important life factors that cause serious stress in the person, in addition to triggering the above symptoms.
In the DSM-5, it is considered that an adaptive disorder can be diagnosed if the person declares to have manifested emotional or behavioral symptoms within three months immediately after experiencing a stressor in your life.
Another key point of diagnosis is that you are suffering more stress than you would expect in a person without psychopathology for the same unpleasant event, in addition to having too severe an impact on relationships, work, studies or other aspects of the person’s life. .
Adaptive disorder will be diagnosed if the symptoms shown, such as sadness or anxiety, are not due to any other mental disorderLike clinical depression or an anxiety disorder, it is also not due to normal grief.
Types of adaptive disorders
The DSM-5 lists six different types of adjustment disorder, based on which symptoms are central. There are six types of adaptive disorders that can be found:
1. In a bad mood
Bad mood prevails, with an urge to cry or a feeling of hopelessness, Symptoms characteristic of clinical depression.
People who are diagnosed with this variety of adaptive disorders often experience feelings of sadness and hopelessness, as well as a lack of interest or loss of motivation when performing activities that were previously considered enjoyable.
2. With anxiety
Nervousness, anxiety, worry and restlessness predominate or separation anxiety.
A fairly characteristic symptom of this particular subtype is that the person can very easily feel overwhelmed by events. There are problems with concentration and memory.
In the case of children, it is common to find symptoms of separation anxiety, Which appear when you have to move away from your parents or loved ones, for example having to go to school, undergo a medical procedure …
3. With mixed anxiety and depressed mood
A combination of depression and anxiety characteristics predominate.
4. With modified behavior
Behavior modification predominates, i.e. the person engages in risky behaviors, such as reckless driving or fighting..
It is common among adolescents for adaptive behavior modification disorder that the young person commits acts of vandalism in addition to being absent from school.
5. With mixed alteration of emotions or behavior
Emotional symptoms, such as depression and anxiety, predominate, combined with the presence of behavioral disturbances.
6. Not specified
This subtype refers to maladaptive reactions which cannot be fully classified into one of the specific subtypes of the disorder itself.
Problems arise in different areas of the person that you consider important, such as your closest circle of friends, your family, your workplace or your studies.
Type according to its duration
The duration of symptoms of adaptive disorders is variable. This may be due to the patient’s personality traits, family support, or the fact that they are already in therapy.
Symptoms last less than 6 months. The problems that the person experiences are alleviated by the time the stressor that triggered them is removed.
2. Persistent or chronic
Symptoms last more than six months, last a long time, and even become chronic. This type of adaptive disorder they are particularly worrying because the degree of vital disturbance is very high, Since the more time the person spends suffering from the problems, the more harm they will do.
In the psychotherapeutic approach, the most common current is cognitive behavioral therapy., Which treatment has offered the best results and which has the most scientific basis. The goals of cognitive behavioral therapy for adaptive disorders are:
- Identify the stressors and see if they can be reduced or eliminated.
- Rephrase the meaning of the stressor for the patient.
- List the negative consequences suffered by the patient.
- Provide the patient with coping skills, especially emotional ones.
- Equip the patient with techniques to reduce stress, such as meditation or exercise.
- Ayuso-Mateos, JL, Vazquez-Barquero, JL, Dowrick, C., Lehtinen, V., Dalgard, OS, Casey, P., … Odin Group (2001). Depressive disorders in Europe: prevalence figures from the ODIN study. British Journal of Psychiatry, 179, 308-316.
- Kocalevent, RD, Mierke, A., Danzer, G. and Burghard, FK (2014). Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations Between Stress, Resources, and Mental Health. PLoS One, 9 (5).
- Rapee, RM, Litwin, EM and Barlow, DH (1990). Impact of Vital Events on Subjects with Panic Disorder and Comparison Subjects American Journal of Psychiatry, 147, 640-644.