Treatment of adaptation disorders. Symptoms of adjustment disorder

Causes

Adaptation disorder is most often observed , which is explained by the instability of their psyche. But, with prolonged experience of stressful situations, it is diagnosed in people of working age and elderly patients. The pathological condition appears when:

• Stress;
• Neuroses;
• Psychosis.

With these diseases, patients complain of insomnia and deterioration of the person’s general condition, which leads to adaptation disorder. Personality adjustment disorder has varying degrees of severity, depending on the severity of the stress.

The onset of the disease can be observed during a serious single stress, for example, the loss of a prestigious job, the death of a loved one, etc. Pathology develops with periodic stress that occurs against the background of poverty or chronic diseases.

People with a genetic predisposition are at risk of developing pathology. If a person has problems with intimacy or conflicts in the family, this leads to maladjustment. It appears when there are material difficulties or difficulties in relationships with others. If the traditional way of life changes dramatically, this leads to a pathological process.

Why does adjustment disorder occur?

The likelihood of an adaptation disorder increases with the number of stressful situations, but their significance for the patient is no less important. What can quickly upset the emotional and mental balance of one person will have no effect on another, or will cause a minor and short-term reaction. Most often, the patient develops the disease in the following cases:

• personal characteristics (low resistance to stress, anxiety, communication difficulties);
• individual and hereditary predisposition
• weakness of defense mechanisms and inability to withstand life's difficulties;
• lack of support from friends, colleagues or relatives;
• a pronounced negative assessment of events that are difficult for the psyche, a tendency to exaggerate the danger.

The mechanism of adaptation disorder has already been studied. Normally, any stressful situation causes stimulation of the pituitary gland, and the ACTH produced by it increases the production of adrenaline in the adrenal glands. At the same time, the sympathetic nervous system is activated with increased blood pressure, increased heart rate and respiration. Such processes were required by people at the dawn of humanity, when they needed to quickly escape from an enemy or catch up with prey. According to the feedback principle, after reducing the influence of the stress factor, the pituitary-adrenal system reduces its activity and returns to normal.

But constant shocks that arise against the background of the patient’s high mental vulnerability end with the appearance of an imbalance and prolongation of the mechanism for the production of stress hormones. Long-term stimulation of the endocrine organs leads to autonomic disorders, mental problems and depletion of the adrenal cortex.

Numerous studies indicate that maladaptation at the mental level is caused by both a single stress factor and a multiple one. The trigger mechanism is:

• loss of a loved one;
• the end of a close relationship;
• problems at work;
• negative attitude of loved ones.

Stressors can relate to an individual or to entire groups of people and communities. This could be a family, a military unit, a community. Sometimes the events that cause adjustment disorder are related to normal stages of development (schooling, marriage, having a child, retirement).

Our clinic’s specialists carefully identify the triggers that lead a person to maladjustment. To do this, the best psychotherapists work with him against the background of drug therapy.

Signs of pathology

Symptoms of adjustment disorder are not always pronounced and may differ in each individual case, which complicates the diagnosis process. The main symptoms are of an anxious and depressive nature. Maladjustment is accompanied by a feeling of inability to cope with the troubles that appear in life. With pathology, the patient becomes suspicious and irritable. Most people note the appearance of a feeling of internal tension. Psychiatry of adaptation disorder has information that it is accompanied by:

• Anxiety;
• Persistent anxiety;
• Internal discomfort;
• Violations in normal behavior.

In patients with pathology, the mood worsens. In especially severe cases, a sad state appears. A person becomes uninterested in his usual activities. A person becomes physically and mentally exhausted, so he cannot make informed decisions. He does not analyze the situation and is not responsible for the decisions made.

Disadaptation has a vague clinical picture, so when the first suspicious symptoms appear, it is recommended to seek help from a specialist who will correctly diagnose and prescribe effective treatment.

Psychotherapy for adjustment disorder

Psychotherapy techniques play a leading role in the treatment of many borderline mental disorders, and violation of adaptive mechanisms is no exception. The most effective ways to help with this deviation are:

• behavioral therapy;
• connitive-behavioral;
• existential;
• relaxation techniques;
• group therapy;
• family psychotherapy.

Experienced specialists at our clinic help you choose the best treatment option for each person individually. This takes into account the characteristics of the symptoms of his disease, the causes of disruption of adaptation processes and the main characteristics of the individual.

Behavioral psychotherapy helps the patient identify in what period of childhood he developed a maladaptive pattern of behavior. At that time it was necessary as a condition for survival in certain circumstances, but later it began to play a negative role. A person recalls his fears and experiences associated with significant people, conducts a mental dialogue with them, and begins to understand his aspirations and desires in relation to loved ones. In the end, the patient realizes that situations existing in the present time cause similar emotions. Understanding this process allows one to correct behavioral stereotypes and create more effective ways of responding that do not lead to adaptation disorder.

Cognitive behavioral therapy helps resolve the problem well. While working with a psychotherapist, the patient discovers destructive attitudes and negative thoughts, and then they are corrected or completely replaced with constructive ones. Which generally changes the attitude towards stressful situations and allows you to find ways to overcome them without harm to the nervous system.

Many patients benefit from existential psychotherapy, which is aimed at helping a person understand his life, values ​​and path, and accept responsibility for his actions and actions. Using this method, internal conflicts are considered as necessary moments of rethinking existence, and ways of discovering new human capabilities. Depression, according to this type of psychotherapy, is considered a symptom of the loss of old values, but at the same time providing an opportunity to find new ones. Anxiety is a sign of the need to make a choice, and it will pass as soon as a person makes it. The psychotherapist at our psychiatric clinic helps not to get stuck on negative experiences and pushes the patient to action. A positive result of such work is possible only if a trusting and friendly atmosphere is created between the patient and the specialist.

Teaching the patient relaxation methods is of great benefit for restoring mental adaptation. They help relieve muscle spasms and eliminate chronic stress. And this, in turn, allows you to remove nervous tension and give your body a supply of energy to withstand present and future stress. These practices also help in the treatment of somatic diseases that arise during a period of long-term maladaptation - arrhythmia, hypertension, asthenia, headache, sleep disturbance. Various methods are used for relaxation - breathing exercises, repetition of a certain sequence of calming phrases, autogenic training, meditation. If you carry them out regularly and combine them with each other, you can effectively eliminate tension, improve your mood, and increase the body’s adaptive and immune forces.

Family psychotherapy is used to treat adaptation disorders. A negative environment and destructive relationships between close people are a strong and chronic mental burden that aggravates the patient’s situation. The work of a psychotherapist allows you to change a tense atmosphere into a favorable one, direct communication between relatives in a positive direction, and relieve everyone from overstrain and the possible development of neurotic deviations.

The specialists of Dr. Isaev’s clinic provide an individual approach to each patient and select methods taking into account the characteristics of his personality traits, level of intelligence and other characteristics.

To improve a person’s condition, group exercises also help; all those gathered actively participate in it under the guidance of a specialist. At the same time, he uses a personality-oriented, cognitive, psychodynamic methodology. Such therapy has a beneficial effect on the cognitive, behavioral and affective aspects of each patient’s personality, helps to work off negativity and establish new patterns of behavior within the microsociety.

After proper treatment, a person experiences:

• complete restoration of social status;
• improving family relationships;
• return to previous plans and tasks;
• normalization of general condition;
• no complaints;
• consistently good mood;
• lack of affective lability;
• high work capacity.

An individual approach to each patient in Dr. Isaev’s clinic and the correct choice of complex treatment allows a person to return to normal life and not experience difficulties.

Types of pathology

In accordance with the causes and characteristics of its course, maladjustment is divided into several types:

• Social adjustment disorder. With pathology, the patient cannot communicate with his usual circle of friends and acquaintances. He gradually moves away from them and retires. If the pathology is severe, the patient cannot be in society at all. He may not leave the apartment for months.
• Depressive adjustment disorder. The disease develops against the background of depression. A person is constantly depressed. They have no desire to communicate and gradually lose their usual interests.
• Mental adjustment disorder. A pathological process occurs in the form of an acute reaction to stress, which develops in the form of psychological shock. It is accompanied by various mental disorders.
• Prolonged adjustment disorder. The pathological process is characterized by a long course. The situation is aggravated when a stressful situation of varying severity appears.
• Anxious adjustment disorder. With this type of pathology, patients experience alarming symptoms under any circumstances.
• Mixed adjustment disorder. This form of pathology combines several of the above.

There are several types of pathology that are recommended to be determined in order to make the correct diagnosis of adaptation disorder .

Diagnostic measures

Only a qualified specialist can determine maladjustment. It determines the development of somatic symptoms in children and adolescents and alarming signs in older people, which indicate the progression of pathology. The diagnosis is made in accordance with the diagnostic criteria of DSM-III-R:

• Reactions to overt psychosocial stresses that occur within three months.
• The nature of maladjustment. At this stage of diagnosis, the presence of impairments in school or work and symptoms that should not be present during stress are determined.
• The duration of the maladjustment reaction is more than 6 months.

In case of maladaptation, differential diagnosis is recommended. Pathology must be distinguished from conditions such as disorders that appear due to the use of psychoactive drugs, post-traumatic disorders that occur due to stress, and aromatization.

Diagnosis of adjustment disorder

The criteria for determining the disease are:

• identification of psychological trauma preceding the onset of disorders;
• symptoms typical of an anxiety or affective disorder, but of lesser severity;
• onset within 1-3 months, duration no more than six months after psychotrauma.

Differential diagnosis is carried out with the following disorders:

• depressive disorder;
• anxiety disorder;
• personality disorder.

To obtain an accurate diagnosis, consultation with a psychiatrist or psychotherapist is required. If necessary, consultations with other specialists are carried out.

Treatment of the disease

Treatment of adjustment disorders requires the use of psychotherapy. It is recommended to conduct group therapy for patients who experience the same stress, for example, retirees or people with the same chronic illness. Individual psychotherapy is aimed at ensuring that a person begins to understand that the onset of the disease is observed under stress. This is the main cause of the pathology. If treatment methods are selected correctly, the patient gains strength and endurance with which to combat stress.

To avoid secondary gain, proper implementation of psychiatric decision is recommended. Treatment of the disease will be successful if the doctor has an attentive and caring attitude towards the patient. When symptoms of secondary gain appear, the treatment process becomes more complicated.

If anxiety-depressive disorders , then this requires drug therapy. Patients are recommended to take anti-anxiety medications and tricyclic agents, which help relieve depression.

With maladjustment, the patient may become overly aggressive, which leads to conflicts at work or school, committing crimes, etc. Doctors should not justify these actions of patients and try to justify them to law enforcement agencies. With this line of behavior of the doctor, the person’s emotional state does not improve. In addition, he does not criticize himself, and such socially unacceptable behavior becomes the norm for him.

Disadaptation is a dangerous pathological process that has a blurred clinical picture. That is why pathology is often diagnosed untimely. The choice of treatment method should be made by a doctor, which will ensure its effectiveness.

Mental adaptation disorder and vegetative deviations

Manifestations of adaptation disorder can occur with affective disorders, depression and anxiety, volitional and emotional inhibition, insomnia or drowsiness. Deviations in behavior in the form of hyperactivity, aggressiveness, and antisocial actions are often observed.

All psychopathological maladjustment syndromes are associated with symptoms of dysfunction of the autonomic nervous system. It is to them that the patient pays most attention; it is with them that he first comes for help. After stress, the following disorders may occur:

• feeling cold or hot;
• heavy sweating;
• stomach ache;
• diarrhea or constipation;
• increased heart rate and pressure surges.

Without understanding the true cause of suffering, a person with adaptation disorder usually complains about heart function, hypertension, and less often about other possible diseases. And only an experienced doctor can determine the psychological nature of the appearance of deviations.