Online Therapy for People with Adjustment Disorder.

As a mental health online therapist, I have seen many clients struggling with adjustment disorder, also known as situational depression. This condition involves a prolonged, negative reaction to a specific life stressor, which is more severe than what would be considered typical, and can cause significant impairment in social, occupational, or academic functioning. Adjustment disorder can result in depression, anxiety, difficulty moving past the stressful event, and reckless behavior. If left untreated, it can even lead to suicidal behavior, substance abuse, or the worsening of existing medical conditions.

Adjustment disorder can be linked to a single event, such as a natural disaster, losing a job, starting a new job, or marital problems, or multiple events happening simultaneously, such as witnessing parental conflict repeatedly or living in a high-crime neighborhood. Stressors can be continuous or recurrent. The symptoms of adjustment disorder are similar to those of depression and anxiety, such as lack of appetite, difficulty concentrating, physical complaints, and social isolation or withdrawal.

One of the most significant challenges in diagnosing adjustment disorder is that the person experiencing the symptoms may not be aware of the specific stressor that brought on the disturbance. A clinical interview that encompasses recent stressors, a history of mental health or medical issues, and the individual's current ability to function in day-to-day life is usually required for diagnosis.

According to the DSM-5, between 5 and 20 percent of those in outpatient mental health treatment can be diagnosed with adjustment disorder. In in-hospital psychiatric settings, it is an even more common diagnosis, sometimes approaching 50 percent. Adjustment disorder appears to be equally prevalent in both males and females.

Adjustment disorder can affect people of all ages, genders, and socioeconomic backgrounds. However, individuals from disadvantaged circumstances tend to experience higher rates of stressors and may be at a higher risk for adjustment disorders.

Treatment for adjustment disorder typically involves psychotherapy, such as individual, family, behavior, or group therapy, as well as self-help groups. The primary goal of treatment is to relieve symptoms and to help the individual achieve a level of functioning comparable to what they demonstrated prior to the stressful event.

Short-term goals should be established at the start of therapy, as the course of adjustment disorder tends to be short-term in nature. These goals will often center around recognizing and taking advantage of the social supports available to an individual in the form of family, friends, and community. The individual's coping and problem-solving skills will be explored and developed. Relaxation techniques might be explored to deal with feelings of stress.

Treatment will also include eliciting the patient's concern and helping the individual understand his or her role in the stressors, reviewing and reinforcing any positive steps the patient may have already taken to deal with the stressors, teaching additional ways to cope with or avoid future stressors, helping the individual put stressors in perspective to their life overall, helping the person better understand his or her reaction to the stressors, and helping the patient come to perceive stressors as an opportunity for positive change or improvement. Family therapy, as well as effective communication and coping skills, may be recommended when the patient is a child or adolescent.

It's important to note that most people recover from adjustment disorder without any remaining symptoms if they have no previous history of mental illness and have access to stable social support. Individuals suffering from adjustment disorder should work to develop and maintain a healthy diet and sleep pattern, as well as a strong social support system. With the help of a mental health professional, individuals can learn effective coping mechanisms and find ways to move past their specific stressors.