#JamesDonaldson On #MentalHealth – What Are #AdjustmentDisorders? – James Donaldson's

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When #kids have big reactions to stressful events

Hannah Sheldon-Dean

What You’ll Learn

What are the different kinds of #adjustmentdisorders?
What is the difference between an #adjustmentdisorder and #PTSD?
What helps #kids who have #adjustmentdisorders?

It’s normal for #kids to get upset when they go through a big change like a move or a divorce. But sometimes #kids under #stress have unusually strong reactions to events like these. These kinds of responses are called #adjustmentdisorders and they’re some of the most common #mentalhealthchallenges in #kids of all ages.

#Children who have an #adjustmentdisorder act or feel very different than they did before the stressful event. Their symptoms get in the way of daily life. The symptoms themselves vary a lot and depend on what kind of #adjustmentdisorder the #child has. It might look like #anxiety, #depression, #behaviorproblems, or some combination. The symptoms usually start right after the stressful event and stop within six months of the #stress going away.

The events that might lead to an #adjustmentdisorder can be very different for different #kids. Some common ones include moving, changing #schools, and family changes like divorce or a new sibling.

#Adjustmentdisorders are related to #PTSD, but the symptoms are not as severe as #PTSD. Additionally, kids with #PTSD have gone through very dangerous or life-threatening events, while #kids with #adjustmentdisorder are reacting to less extreme events.

Treatment can be very helpful for kids with #adjustmentdisorders. The best kind of treatment depends on the child’s symptoms, but #CBT (#cognitivebehavioraltherapy) is often appropriate. Families can also help by taking the child’s concerns seriously and talking openly about feelings at home. For example, you could say: “I see how hard this change is for you. It’s okay to be upset, and we’re going to get through this together.”

It’s normal for #kids to get upset when they go through a big change. A move, a divorce, a new sibling — any stressful event in a child’s life can affect their mood or #behavior.

But sometimes #kids under #stress have very strong emotional or #behavioral reactions that seem to be out of proportion to the events they’re experiencing. When the distress begins to interfere with the child’s daily life, they may have an #adjustmentdisorder. #Adjustmentdisorders are some of the more common #mentalhealthdisorders in #children.

What do #adjustmentdisorders look like?

#Adjustmentdisorders always occur in response to a stressful event of some kind, followed by an unusually strong reaction to the event. #Children who have an #adjustmentdisorder will act or feel noticeably different than they did before, and their symptoms cause them serious problems in their day-to-day lives.

The symptoms themselves can vary a lot from #child to #child. “It can skew in the direction of more #anxiety-related symptoms, or toward depressive symptoms, or centered around disruptive #behavior and conduct problems, or some combination of the three,” says Erika Rooney, PsyD, a clinical #psychologist at the #ChildMindInstitute.

Because of the variety of reactions that #kids might have, there are six distinct subtypes of #adjustmentdisorder to help better guide diagnosis and treatment:

With depressed mood: Feeling extremely sad or hopeless, low energy, crying frequently.
With #anxiety: Feeling very worried or jittery, #separationanxiety, physical symptoms like stomachaches.
With mixed depressed mood and #anxiety: Some symptoms of both #depression and #anxiety.
With disturbance of conduct: Disruptive #behavior, anger, getting into fights.
With mixed disturbance of emotions and conduct: Some emotional symptoms (like #depression or #anxiety) as well as some #behavioral ones.
Unspecified: Reactions that don’t quite fit the other subtypes but that nonetheless interfere significantly with the child’s life.

These symptoms start within the first three months of the stressful event, and they usually don’t last for more than six months afterward.

#Kids with previous #mentalhealthdiagnoses can also be diagnosed with an #adjustmentdisorder, but only when the symptoms that show up after the event are much different than the symptoms they experienced before. For example, a #child with #ADHD who has previously had #behavior problems might be diagnosed with an #adjustmentdisorder if they develop #anxiety after moving to a new town.

#Adjustmentdisorders can be diagnosed at any age (including in #adults), and they are common in both #children and #adolescents. #Boys and #girls are diagnosed with #adjustmentdisorders at about equal rates.

What kinds of events can lead to #adjustmentdisorders?

Any event that a #child experiences as particularly stressful or upsetting can be a cause of #adjustmentdisorder. These events are not generally dangerous or life-threatening. Common examples include:

Moving
Changing #schools
#Parents divorcing or remarrying
A new sibling or other change in family composition
Being diagnosed with a health condition or having a family member be diagnosed
Social stresses (like falling out with a friend or a breakup)
#School or extracurricular struggles (like failing a class or being cut from a sports team)

Different #kids find different events stressful, and individual differences and cultural norms also play a role in shaping kids’ experiences of life changes. “It’s not a prescribed set of circumstances that can cause an #adjustmentdisorder,” says Dr. Rooney. “Sometimes it might not be something that’s obvious to the #parent.” The key factor is that a #child with #adjustmentdisorder is more upset about what they’ve experienced than would normally be expected for a #child of their age and circumstances.

Regardless of the specific #stress the #child is dealing with, it usually makes sense to reevaluate #kids with an #adjustmentdisorder whose symptoms last longer than six months. A clinician can determine whether the child’s symptoms are still mainly a reaction to a stressor or if a different diagnosis, like an #anxietydisorder or a mood disorder, would make more sense.

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#Adjustmentdisorders vs. #posttraumaticstressdisorder (#PTSD)

#Adjustmentdisorders are related to #posttraumaticstressdisorder (#PTSD), but there are a few key differences between the two. Timing, type of event, and severity of symptoms are key factors in determining the diagnosis.

One big distinguishing feature is the kind of event that the #child is reacting to. #PTSD develops in response to a real or perceived threat of harm or death to oneself, or by seeing or hearing about a loved one going through that kind of event. Examples include violence, abuse, natural disasters, #sexualassault, abrupt separation from a caregiver, serious accident or illness, or the unexpected or violent death of someone the #child is close to. The same is true of acute #stressdisorder, which may be a precursor to #PTSD if left untreated

#Adjustmentdisorders, on the other hand, are unusually strong reactions to non-threatening, relatively normal life stressors and circumstances.

The symptoms are also different between the two disorders. “#Adjustmentdisorder shares some of the symptoms you might see with #PTSD, but not all and they might be less severe,” says Dr. Rooney. For example, a #child with #PTSD or acute #stressdisorder might experience flashbacks or intrusive thoughts about the traumatic event and be completely overwhelmed with fear, while a #child with #adjustmentdisorder might be more preoccupied with worry or sadness.

Additionally, the child’s symptoms need to continue for at least a month before being diagnosed with #PTSD, because it’s normal to be very upset right after a life-threatening event. Adjustment disorders can be diagnosed sooner, but they don’t continue for as long after the event.

“If a clinician is unable to collect enough information about the child’s symptoms or life history, or if they don’t have time to do a full evaluation, for example in an emergency room, it may be unclear whether or not the #child is experiencing #PTSD,” Dr. Rooney notes. In those cases, #adjustmentdisorders are sometimes used as temporary diagnoses that might be updated once the clinician has more information.

How are #adjustmentdisorders treated?

Even though #adjustmentdisorders don’t usually last for long, professional support can be very helpful for #kids who are experiencing them. In treatment, #kids can learn to handle difficult feelings and manage life #stress, which makes it less likely that they’ll continue to experience #mentalhealthchallenges going forward. Treatment for #adjustmentsdisorders is often brief, lasting only a few weeks or months.

Because the symptoms of #adjustmentdisorders vary so much, treatment also looks different for the different subtypes. “Treatment is tailored to the primary symptoms that the #child is presenting with,” says Dr. Rooney. “If it’s more of a disruptive #behavior problem, for example, then it would be geared toward collaborating with #parents on effective limit-setting, and helping the #child with perspective-taking or impulse control, those kinds of things. If it’s #anxiety, then you’d focus it differently. It’s really specific to how they present.”

In many cases, the appropriate treatment is #cognitivebehavioral therapy (#CBT), which helps #kids understand the connections between their thoughts, feelings, and #behavior. “Most #kids with #adjustmentdisorders respond well to the core components of #CBT, which involves building up a set of effective coping skills, such as managing intense emotions, reframing unhelpful thoughts, and learning relaxation skills” Dr. Rooney says.

If a #child with #adjustmentdisorder is experiencing especially intense #anxiety or #depression, a #doctor might prescribe them a low dose of an antidepressant medication. The medication can help ease the child’s symptoms enough for them to engage in therapy and get through the most challenging phase of coping with the stressful event.

How can #parents support #kids with #adjustmentdisorders?

If your #child has been diagnosed with an #adjustmentdisorder, it’s important to take their symptoms seriously, even though they’re reacting to what might seem like ordinary life #stress.

“The diagnosis is telling you that their symptoms are impairing enough to impede their functioning and quality of life, and as such, worth clinical attention,” says Dr. Rooney. “Moreover, the symptoms could get more intense if the #child doesn’t get therapeutic support.” At the same time, it can help keep things in perspective to remember that their condition is likely to be temporary and may not be related to any longer-term diagnosis. “If someone says your #child has #adjustmentdisorder with depressed mood, for example, it doesn’t mean that they actually have major depressive disorder,” she adds.

Validation often goes a long way in helping #kids through challenging times, whether or not their symptoms reach the level of a clinical diagnosis. Even if your child’s reaction seems out of proportion to you, knowing that you see their pain and are there to help them navigate it can help #kids cope more effectively. For instance, you might say: “I see how hard this change is for you. It’s okay to be upset, and we’re going to get through this together.”

Dr. Rooney also notes that #parents who use effective coping skills themselves give #kids a model for how to do the same. A lot of the events that might cause #adjustmentdisorder for #kids are hard for the whole family — if you’ve recently moved, lost a job, or had a new baby, for instance, chances are that you’re dealing with plenty of #stress of your own. By finding ways to relax as a family and talking openly about feelings at home, you can let #kids know that it’s normal to feel overwhelmed sometimes and that there are things they can do to feel better.

“It’s always good to make it a family activity, if one can,” says Dr. Rooney. “You can have regular check-ins to see how everyone is coping, to model open communication and reinforce the skills that your #child is learning in treatment, which will ultimately help them and the family.”

Topic: Trauma & Grief, Supporting Healthy Development

Hannah Sheldon-Dean

Hannah Sheldon-Dean, MSW, is a staff editor and writer at the #ChildMindInstitute.

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James Donaldson is a Washington State University graduate (’79). After an outstanding basketball career with WSU, he went on to play professional basketball in the NBA with the Seattle Supersonics, San Diego/L.A. Clippers, Dallas Mavericks, New York Knicks, and Utah Jazz. He also played for several teams in the European Leagues in Spain, Italy, and Greece, and he toured with The Harlem Globetrotters to wrap up his career. James was an NBA All-Star in 1988 while playing center for the Dallas Mavericks. In 2006, James was inducted into the Pac-10 Sports Hall of Fame and also the Washington State University Athletic Hall of Fame. In 2010, James was elected as a board member for the NBA Retired Players Association.

James frequently conducts speaking engagements (motivational, inspirational, educational) for organizations, schools, and youth groups.

In 2010, James was the recipient of the NBA Legends of Basketball ABC Award, awarded for outstanding contributions in Athletics–Business–Community.

He believes in being a role model for success and professionalism to the scores of young people to whom he devotes so much of his time. He currently serves on several boards and committees and is a member of many organizations.

James believes in developing relationships that create a “Win-Win” environment for everyone involved, and in being the best he can be!

For more information about James Donaldson or to request he speak at your event, contact him at:

www.StandingAboveTheCrowd.com
JamesD@StandingAboveTheCrowd.com
1-800-745-3161 (voicemail & fax)

James Donaldson is the author of “Standing Above The Crowd” and “Celebrating Your Gift of Life” and founder of the Your Gift of Life Foundation which focuses on mental health awareness and suicide prevention, especially pertaining to our school aged children and men.

If you’re interested in having James come and speak to your group of young adults, business entrepreneurs, aspiring political and community leaders, and athletic teams, please contact him at jamesd@yourgiftoflife.org and or leave a personal message for him at 1-800-745-3161. Keep up with him and read about how he is reaching out and making a difference in the lives of so many around the world at www.yourgiftoflife.org