Adjustment Disorder with Anxiety

________________________________________________________________________

KEY POINTS

• An adjustment disorder is a way of reacting to stress.
• Adjustment disorder with anxiety means feeling nervous, worried, or afraid for 3 to 6 months after a stressful event.
• Treatment may include medicines, therapy, and learning ways to manage stress.

________________________________________________________________________

What is an adjustment disorder with anxiety?

Adjustment disorder with anxiety is a condition in which you feel nervous, worried, or afraid for a long time after a stressful event. Symptoms usually start shortly after the stressful event and last from 3 to 6 months.

An adjustment disorder is a way of reacting to stress. Financial problems, ending a relationship, being in a car accident, or losing a job are some of the things that can make you nervous or fearful for a while. A happy event like marriage or the birth of a child can also be stressful. Feeling some stress, worry, or fear is normal. However, if your symptoms continue for months, or are more severe than what most people have, then it is called an adjustment disorder.

What is the cause?

The exact cause of this disorder is not known. The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with anxiety may have too little or too much of some of these chemicals.

Anxiety problems tend to run in families. Anxiety can be brought on by alcohol or some drugs. Medical conditions such as heart problems, breathing problems, lack of vitamins, thyroid problems, and others can cause anxiety symptoms. If you have had problems with anxiety before, then you are more likely to have an adjustment disorder.

Adjustment disorders are as common in men as women, and can start at any age.

What are the symptoms?

Symptoms may include:

• Feeling tense, jittery, nervous, and worrying more than usual
• Feeling overwhelmed and wanting to run away or escape
• Having trouble sleeping
• Having a change in appetite
• Having trouble concentrating or remembering things
• Having sudden emotional reactions such as panic, guilt, or anger

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms, medical and family history, and any medicines you are taking. He will make sure that you do not have a medical illness or drug or alcohol problem that could cause the symptoms. You may have tests or scans to help make a diagnosis.

How is it treated?

Anxiety can be successfully treated with therapy, medicine, or both.

Medicines

Short-term use of medicine can be very helpful with an adjustment disorder. Several types of medicines can help. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Therapy

Seeing a therapist can help. Cognitive behavioral therapy (CBT) is very helpful for adjustment disorders. CBT is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new ways to think and act.

Support groups can help you understand that you are not alone. Groups also provide a safe place to share feelings.

Other treatments

Claims have been made that certain herbal and dietary products help control anxiety symptoms. No herb or dietary supplement has been proven to consistently or completely relieve anxiety. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe. Before you take any supplement, talk with your healthcare provider.

Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and therapy.

If symptoms worsen or last longer than 3 months, you should see a therapist.

How can I take care of myself?

• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs, because they can make your symptoms worse. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take all medicines as directed by your provider or therapist. It is very important to take your medicine even when you are feeling and thinking well. Without the medicine, your symptoms may not improve or may get worse. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide, violence, or harming others. Seek immediate help if you have severe chest pain or trouble breathing.

For more information, contact:

• National Alliance on Mental Illness (NAMI)
  800-950-6264
  http://www.nami.org
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/