Adjustment Disorders in Health Problems

Adjustment difficulties are common in many different health problems. People may struggle to adjust in connection with stress, anxiety, depression, post-traumatic stress disorder, eating disorders, sleep disorders, bipolar disorder and many other conditions. With appropriate treatment, the symptoms of adjustment disorder can be resolved, so anyone experiencing adjustment problems should consult a psychiatrist and discuss suitable treatment.

In the context of health problems, adjustment disorder is a psychological disorder that develops when an illness is chronic or recurring and affects the person physically, emotionally and behaviourally. It includes the difficulties of the treatment process, the psychological consequences of illness in daily life and the changes it brings to quality of life.

Stress-related adjustment problems

These arise after a stressful event, when the person cannot adapt and return to normal functioning. Symptoms include worry, restlessness, sleep problems and emotional instability. Treatment options include cognitive behavioural therapy, medication and relaxation techniques.

Anxiety-related adjustment problems

These generally last longer and are more severe. The person may feel anxiety strong enough to prevent normal daily functioning. Treatment options include antidepressants, anti-anxiety medicines and cognitive behavioural therapy.

Depression-related adjustment problems

Depression is a mood disorder that affects functioning and quality of life. When it is involved, symptoms may include worry, weakness, fatigue, sleep problems and loss of appetite. It is treated with antidepressants, psychotherapy and other medication.

Trauma-related adjustment problems

These can develop when a person cannot adjust to the symptoms of post-traumatic stress disorder after a traumatic event. Symptoms include nightmares, panic attacks, sleeplessness, restlessness and other signs of anxiety. Treatment includes therapy, medication and behavioural techniques.

Adjustment problems related to eating disorders

These can arise from the eating disorder itself or from the other health problems it causes. Symptoms include dieting, overeating, vomiting and other eating disorder behaviours. Treatment includes nutritional therapy, psychotherapy, family therapy and medication.

Sleep-related adjustment problems

These can result from disrupted sleep patterns, insomnia, sleep apnoea and other sleep disorders. Treatment includes sleep hygiene, cognitive behavioural therapy, medication and other approaches.

Adjustment problems related to bipolar disorder

In bipolar disorder, adjustment problems can arise from mood episodes alternating between mania and depression. Symptoms include changes in energy, sleeplessness, anxiety and depression.

Signs of adjustment disorder

The most common signs are emotional, such as sleeplessness, anxiety, worry, low mood, depression, anger and restlessness, and behavioural, such as feeling unable to cope, angry reactions, tension and behaviour problems. Difficulty concentrating, loss of self-confidence, low self-esteem, social anxiety and fear can also occur. The main contributing factors are stress related to health problems, the persistence of chronic illness, serious health events, adapting to the social environment, family problems, financial problems and personal characteristics.

Treatment

Treatment depends on the person’s characteristics and situation. In general, psychological counselling, psychotherapy, behaviour therapy, medical treatment and dietary follow-up are used. Psychological treatment is designed individually, taking into account personality, health status, age, gender and social environment. It aims to help the person understand their health condition, learn techniques to reduce stress and feel supported.

Psychological effects

The psychological effects vary with the person’s health, age, gender and social environment. They can include depression, anxiety, loss of self-confidence, anger problems, social anxiety, sleep problems and distress.

What can help

• keeping chronic illnesses under control and attending regular medical check-ups
• eating a balanced diet, getting enough sleep and exercising
• using techniques to reduce stress
• seeking social support
• taking part in social activities and nurturing friendships
• getting professional and, where necessary, medical help

The role of the family

The family clearly plays an active role in the treatment of adjustment problems related to health conditions. Family work is very important for both treatment and prevention. Its main aim is to create an environment that supports the person, understands them and helps them recover, through a healthy home atmosphere, better communication, practical support and professional help when needed.

Effects on children

In children, adjustment problems often show up as changes in behaviour, lower self-confidence, difficulty joining social activities and a drop in school performance. Anxiety, depression, sleep problems, learning difficulties and social withdrawal may also occur. If a child shows signs of adjustment disorder, it is important to seek professional help.

The psychology of illness

Illness is a new process of adjustment full of distress, worry and tension. It affects not only the person but also those around them. The sense of control is shaken, and problems with control and trust arise. Waiting and uncertainty create stress. Worry, anger, resentment, hopelessness and pessimism are common during illness. The need for attention and support grows, and sensitivity, being easily hurt, sadness and a fragile mood often take over. In chronic illness, the long course of treatment can bring mental and physical fatigue, burnout, pessimism, hopelessness, anxiety and anger. In chronic and life-threatening illness, fear of death, fear of being alone, becoming bedbound and isolation are common psychological difficulties.

The psychology of illness approaches illness holistically. It does not define the patient by the illness but considers them as an individual, together with their environment, following the principle that it is the person, not the illness, who is treated. It offers a patient-centred approach. Psychological counselling and professional support are needed for the adjustment problems, distress, tension, anxiety and psychological difficulties that arise during illness. Psychological support is especially important in chronic illness: helping the person cope with stress, anxiety and depression, accept the situation, become more flexible and increase positive emotions, and so improve quality of life. American Psychological Association