The 6 types of adaptive disorders

A classification of the different adaptive disorders, described and summarized.

Stress is a basic emotion for our survival. It triggers fight or flight responses when these are necessary, especially in the face of events that are dangerous to our physical and psychological integrity.

However, sometimes stress becomes an unadaptive response, exaggerating the potential risks of a given event and behaving in a way that is very detrimental to the correct development and functioning of life.

Adaptive disorder refers to a diagnosis in which the person manifests problems in adapting to the demands of his or her environment. Here we will take a closer look at this concept and we will approach the types of adaptive disorders that there are.

Adaptive disorders, what are they?

According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), adaptive or adjustment disorders are defined as mental disorders that have a strong relationship to stress and the ability to adapt successfully to life events and inconveniences. a strong relationship with stress and the ability to successfully adapt to life's events and inconveniences..

The main activating factor of these disorders is the experience of stressful situations, or the high frequency of their occurrence. In other words, adaptive disorders do not develop without the appearance of a conditioning factor that activates them, mainly stress.

In more concrete terms, these disorders are understood as maladaptive responses to stress, continuous and/or severe, which negatively affect effective coping mechanisms to be able to carry out a correct social functioning.

Generally, it causes significant and prolonged discomfort, in addition to changing the person's way of being, making him/her lose interest in aspects he/she used to enjoy.It generally causes significant and prolonged discomfort, in addition to changing the person's way of being, making him/her lose interest in aspects he/she used to enjoy, feel sadness and anxiety, combined with a deep and continuous helplessness.

One of the explanations that have been given to understand the appearance of this type of disorders has to do with the natural mechanism of some people when they live a particularly stressful situation. After having suffered a particularly disturbing event, these individuals learn to pay more attention to the state of their body, interpreting any unpleasant physiological sensation as an indicator that something is terribly wrong, which, in turn, generates higher levels of anxiety and depression.

Symptomatology

Although we are going to look at the types of adaptive disorders and their main symptoms, it is worth mentioning their common symptomatology first. These symptoms appear when the person is in a particularly difficult situation. These situations require the person to initiate a whole series of processes that have, as an ultimate goal, to overcome them. Some examples of stressful life situations can be the loss of a loved one, the breakup of a love relationship, the stress of studies, changing city..., etc.changing city...

Among the main symptoms of adaptive disorders are having a low mood, with depressive symptoms, as well as having ruminative and negative thoughts, such as excessive concern about how events will develop and the problem that has triggered the manifestation of the disorder.

Physical discomfort may also be felt, which enhances the stress, acting as a feedback loop.. Some of these are tightness in the chest and breathing problems. The person may have problems falling asleep, insomnia and concentration problems.

Among dysfunctional thoughts we can find having low self-esteem, having a biased self-image, feelings of hopelessness, fear, feeling that there is no possible way out of the situation in which he/she finds himself/herself or difficulties in planning daily activities and carrying them out, as well as feeling alone.

Diagnosis

The diagnosis of adjustment disorders is based on the identification of major life factors that cause serious stress to 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 reports to have manifested emotional or behavioral symptoms within three months of having experienced a life stressor.

Another key point in the diagnosis is that more stress is being experienced than would be expected in a person without psychopathology for the same unpleasant event, as well as having an unduly severe impact on relationships, work, school or other aspects of the person's life.

The adaptive disorder will be diagnosed in case the manifested symptoms, such as sadness or anxiety, are not due to any other mental disorder, such as clinical depression or anxiety.such as clinical depression or an anxiety disorder, nor are they due to normal bereavement.

Types of adaptive disorders

The DSM-5 lists six different types of adjustment disorders, depending on which symptoms take center stage. There are six types of adaptive disorders that can be found:

1. With depressed mood

Predominantly low mood, with a desire to cry or feeling of hopelessness.symptoms characteristic of clinical depression.

People who receive a diagnosis for this variety of adjustment disorder often experience feelings of sadness and hopelessness, as well as a lack of interest or loss of motivation in activities that were once considered pleasurable.

2. With anxiety

Nervousness, anguish, worry, agitation, or separation anxiety. or separation anxiety.

A fairly characteristic symptom of this particular subtype is that the person may feel very easily overwhelmed by events. There are problems with concentration and memory.

In the case of children, it is common to find symptoms characteristic of separation anxietyThe most common symptoms, which are shown when you have to be away from your parents or loved ones, such as having to go to school, being in a medical procedure...

3. With mixed anxiety and depressed mood

A combination of features of depression and anxiety predominates.

4. With behavioral disturbance

Behavioral disturbance predominates, i.e., the person carries out behaviors that are risky such as reckless driving or fighting..

In adolescents it is common that if there is an adaptive disorder with behavioral alteration, the young person carries out vandalism acts, in addition to being absent from school.

5. With mixed emotional or behavioral disturbance

Emotional symptoms predominate, such as depression and anxiety, combined with the presence of behavioral disturbances.

6. Unspecified

This subtype refers to the maladaptive reactions that cannot be completely classified in one of the specific subtypes of the same disorder..

Problems occur in different spheres of the person that he/she considers important, such as his/her closest circle of friends, family, workplace or studies.

Types according to their duration

The duration of the symptoms of the adaptive disorders is variable. This may be due to the patient's own personality characteristics, family support or the fact that he/she is already attending therapy.

1. Acute

Symptoms last less than 6 months. The problems reported by the person are relieved as soon as the stressor that triggered them is eliminated.

2. Persistent or chronic

The symptoms last more than six months, continuing for a long time and even becoming chronic. This type of adaptive disorders are especially worrisome because the degree of vital disturbance is very high, since the longer the person suffers the more damage they will do.The longer the person suffers from the problems complained of, the more damage they will do.

Treatment

In the psychotherapeutic approach, the most recurrent current is the cognitive-behavioral therapy, which is the treatment that has offered the best results.which is the treatment that has offered the best results and has the most scientific basis. The objectives in cognitive-behavioral therapy in adaptive disorders are:

• Identify the stressors and see if they can be reduced or eliminated.
• To reformulate the meaning of the stressor for the patient.
• Elaborate a list of negative consequences experienced by the patient.
• Provide the patient with coping skills, especially emotional coping skills.
• Provide the patient with stress reduction techniques, such as meditation or exercises.