Adjustment Disorders
What is an adjustment disorder? In the DSM-V (the manual that contains criteria for all sorts of psychiatric problems), it is defined as an emotional or behavior reaction to a stressful event or changes. When the reaction occurs within 3 months after the event, is out of proportion for what would be expected in that situation, and is causing symptoms which can significantly interfere with your child's functioning (at home, school, socially, etc), it is a good idea to have your child evaluated by a pediatric mental health provider.
Changes happen in our children's or adolescents' lives all the time. They may be fairly minor such as a new teacher or they may be fairly major such as parental divorce, family move, new baby in the house, or a serious illness (in the child or a family member). How your child responds may be related to several factors- their age, their usual temperament (how easily do they adjust to most changes), past experiences (have they had other trauma or loss), their support systems (family, friends, teachers, etc), and their overall coping skills. Even the same experience (such as a family move to a new house) can cause different reactions in different children.
Although adults also can have Adjustment Disorders, the symptoms in children may look different. When a child is having trouble adjusting to a change, it can show up with more frequent crying, fear of separation (beyond the usual age for developmental separation anxiety), nervousness, sleep problems, appetite changes, anger and aggressive behavior, and school problems (difficulty with focus, difficulty with controlling behavior, difficulty with peers).
There are different types of Adjustment Disorders based on the main types of symptoms your child or teen may be having.
1) Adjustment Disorder with Depression
2) Adjustment Disorder with Anxiety
3) Adjustment Disorder with Anxiety and Depression
4) Adjustment Disorder with Disturbance of Conduct
5) Adjustment Disorder with Mixed Disturbance of Emotions and Conduct
6) Adjustment Disorder Unspecified (which can be social withdrawal or problems with normally expected activities, like school or other activities)
Sometimes, it can be difficult to tell if your child's behavior is due to an Adjustment Disorder or some other problem. Children with ADHD may have trouble with focus and attention, but a child with an Adjustment Disorder may also not be able to focus well or finish their work. Some children with conduct disorders may be thought to have an Oppositional Defiant Disorder, because they are acting out or breaking rules, but the underlying problem may be very different. Substance abuse problems can cause teens to isolate themselves or appear depressed.
If your child or teen is showing signs of an Adjustment Disorder, a good Psychotherapist may be helpful. They can help your child develop better coping skills to adapt to change, as well as helping reduce the stress. A Family Therapist can help your family handle the change as well, improving communication skills and support among family members. Seeing your child's Pediatrician can help identify whether the symptoms are due to an Adjustment Disorder or some other problem. Most adjustment disorders improve within 6 months after the stressor is removed or reduced. Problems that continue may be attributed to Post-Traumatic Stress Disorder or an Anxiety Disorder or other diagnoses.
Dr. Cheryl Coldwater is a pediatrician with experience evaluating and treating children and adolescents with pediatric mental health issues. You can schedule an appointment on SimplePractice.com for an office visit, virtual appointment, or a meeting in the park where we can safely distance as needed.