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What is Adjustment Disorder?An adjustment disorder is a severe reaction to a stressful event or life experience and is a common diagnosis. Many people don’t realize this is a mental health disorder which can lead to serious and unhealthy emotions and behaviors that can affect your life. According to the Diagnostic and Statistical Manual of Mental Disorders- 5th Edition (DSM- 5), adjustment disorders are also associated with an increase of suicide attempts and completions. Knowing how to spot an adjustment disorder and how to treat it is essential in preventing more serious complications down the line. What Causes Adjustment Disorders?Adjustment disorders are triggered by stress. Stress can be anything that affects you directly or it can be something that happened to your family, your community or a group of people you are associated with in some way. Stressors can fall into any of the following categories:
Adjustment Disorder SymptomsSymptoms vary depending on the type of adjustment disorder you are experiencing and can sometimes resemble other mental health disorders or health issues. Some common symptoms of adjustment disorders are:
Adjustment Disorder DSM 5/ ICD 10: What Does it Mean for Everyday Life?An adjustment disorder can affect your relationships, your performance at work or school and/or your health. Is there an Adjustment Disorder Test: How is it Diagnosed?There is currently no reliable test designated to help licensed mental health providers (LMHP) accurately diagnose adjustment disorders. To diagnose, your LMHP will complete a thorough evaluation by gathering information about your symptoms, life experiences and mental health history. Mental health providers use the Diagnostic and Statistical Manual of Mental Disorders- 5th Edition (DSM- 5) and the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) as tools to help them assess and diagnose mental health disorders.
Adjustment Disorder Diagnostic CriteriaAdjustment disorders are part of the Trauma-and stressor-related disorders found in the DSM-5 and part of the Reaction to severe stress, adjustment disorders in the ICD-10. There are slight differences between the DSM-5 and the ICD-10 criteria for adjustment disorder, but overall, your therapist will look for the following:
Types of DSM-5 and ICD-10 Adjustment DisordersAdjustment disorders are diagnosed under specific categories called specifiers(DSM-5) or subtypes(ICD-10). These are based on the symptoms that are most prevalent and help guide treatment. Below are some of the most common adjustment disorder categories with possible symptoms: DSM-5 Adjustment disorders specifiers: DSM-5 Adjustment Disorder with Depressed Mood
DSM-5 Adjustment Disorder with Anxiety
DSM-5 Adjustment Disorder with Mixed Anxiety and Depressed Mood
DSM-5 Adjustment Disorder with Mixed Disturbance of Emotions and Conduct
DSM-5 Adjustment Disorder with Disturbance of Conduct
ICD-10 Adjustment Disorders Subtypes:
Who is at Risk for This Disorder?Adjustment disorders can affect anyone! At this time, there is no significant research indicating that a certain race, class or gender is at greater risk for an adjustment disorder. However, it is believed that people who are exposed to high levels of stress could be at increased risk. This could include people of lower socioeconomic status, or those living in areas with high community violence. Adolescents, middle-aged and late-aged adults may also be at greater risk as they are experiencing major life changes. DSM-5/ICD-10 Adjustment Disorder Case ExampleNancy’s mother had a stroke and needed her as her full-time caretaker. Nancy had to move across country to help her mother and initially had difficulties sleeping, would randomly burst into tears and experienced heart palpitations when she thought of all that had changed. Additionally, she was constantly worried about her mother’s health and felt angry and resentful most of the time. Nancy felt embarrassed to admit that she was having such a hard time, but followed her doctor’s advice and found a therapist. Her therapist provided her with information to a caretakers support group, helped her create a plan to meet new people and take more breaks for self-care. With time, Nancy was able to adapt to her new situation and make new friends. She was able to understand that being a caretaker is hard and that it is okay to feel overwhelmed at times. Nancy’s case is an example of adjustment disorder with mixed anxiety and depressed mood. DSM-5/ICD-10 Adjustment Disorder in Adults and Children: How does it differ between age groups?Adults tend to “internalize.” Their symptoms may be more emotional and harder to spot.
Children and adolescents tend to “externalize.” Their symptoms may be more behavioral and obvious to others.
Adjustment Disorder TreatmentTherapy is effective for adjustment disorders and various approaches can be considered:
A person is usually able to recover completely from an adjustment disorder once they are able to either adapt to the new situation or the stressor has ended. Possible Medications for Adjustment DisorderYour medical provider may be able to prescribe antidepressants or anti-anxiety medication to help alleviate symptoms such as insomnia, anxiety, and/or suicidal thoughts. Medicine alone has not been proven effective for adjustment disorders, therefore therapy will still be important. Cost of medication may vary depending on the insurance provider. Insurance Coverage for Adjustment DisorderAdjustment disorders are a billable diagnosis and are usually covered by most insurance providers. Call your insurance provider to get information on preferred providers, number of sessions allowed and other coverage information. Some therapists do not take insurance so you may have to pay out of pocket and request a reimbursement from your insurance. How to Find a Therapist
What should I be looking for in an LMHP?Titles for licensed mental health professionals (LMHP) may vary depending on their field of study or where they practice. Some examples are:
When looking for an LMHP it is important to consider several factors:
Questions to Ask a Potential Therapist
Coping With Adjustment DisorderHere are some coping skills for some of the most common forms of adjustment disorders:
Look out for These ComplicationsTalk to your mental health provider right away if you notice:
4 Tips for Improving Your Stress ToleranceHere are some tips to help strengthen your ability tolerate stressful situations. These will help reduce your vulnerability to future episodes of adjustment disorder and other mental health conditions.
Adjustment Disorder Leave PoliciesAccording to the Americans with Disabilities Act (ADA), “a reasonable accommodation may be obtained for any condition that would, if left untreated, “substantially limit” one or more major life activities.” Adjustment disorders typically do not last more than six months, however, depending on the severity of your symptoms and your treatment needs, you may be eligible to request reasonable accommodations from your employer. Accommodations can vary depending on the employer and the type of work you do. Your therapist may need to provide documentation verifying that your symptoms are limiting your job performance and provide an explanation of how an accommodation could help you. Adjustment Disorder Support HelplinesNational Alliance on Mental Illness (NAMI) Helpline: Provides information on mental health disorders and referrals to local providers. Live person available M-F from 10am-6pm EST. 1-800-950-NAMI National Suicide Prevention Lifeline: 24 hour toll-free crisis hotline to help connect you to a local crisis center that can help you seek help in your area. 1-800-273-TALK SAMHSA Treatment Referral Helpline: Provides general information on mental health and helps you locate treatment services in your area. Speak to a live person M-F 8am-8pm EST 1‑877‑SAMHSA7 Teen Line: Provides teen-to-teen counseling services from 9pm to 10pm. 1-310-855-HOPE
Remember that you are human and stressful things are tough! Remind yourself to take a break and don’t be afraid to ask for help if life feels overwhelming. Reach out to your family, friends, or therapist for support. Be kind to yourself! Don’t let mental disorders prevent you from living your best life! About the Author: Celia Viveros is a Licensed Clinical Social Worker in Washington State. The majority of her work has been with adolescents and families dealing with traumatic stress due to immigration, sexual abuse, and community violence. A great deal of her work has also been focused on helping adolescents with sexual behavior problems. Celia was inspired to write in order to provide an accessible way for people to get information on mental health issues. She hopes to provide helpful coping skills and most of all, normalize, the many issues people face but are too ashamed to talk about. Her goal is to provide people with tools that will help them find a healthy and joyful life. Dogs are a common staple in U.S. households. In fact, as of 2020, there
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What is F43 23 adjustment disorder with mixed anxiety and depressed mood?Code F43. 23 is the diagnosis code used for Adjustment Disorder (AD) with Mixed Anxiety and Depressed Mood. It is sometimes known as situational depression. It occurs when an individual is unable to adjust to or cope with a particular stress or a major life event.
What is the DSMDSM-5 Criteria for Adjustment Disorder
The DSM-5 defines adjustment disorder as “the presence of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)” (American Psychiatric Association, 2013).
Can you have both depression and adjustment disorder?Adjustment disorder can be present with anxiety, depressed mood, disturbance of emotions and conduct, or combinations of these conditions. A child and adolescent psychiatrist or qualified mental health professional can diagnose adjustment disorder.
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