Definition

WHO defines health as a state in which a person has overall physical, mental and social health, not just the absence of disease or the absence of weakness. However, mental health often goes unnoticed.

In carrying out your daily life, factors often arise that cause you to feel stressed. Stress is defined as emotional or physical pressure. This situation requires adjustments so that life can continue to run well.

When someone cannot adjust well to the stress they feel, this can cause adjustment disorders. Adjustment disorder is defined as a short-term condition that occurs when a person experiences difficulty in managing or adapting to certain sources of stress.

This situation can arise because a person feels stress that is higher than before, such as a major change in life, or the loss of a loved one. If not handled properly, this situation can cause significant problems in various areas of life, including in the work environment, school, or with a partner.

Adjustment disorders can occur in anyone regardless of age, gender, race, or lifestyle. Although adjustment disorders can occur at any age, they are more likely to occur during transitional periods, such as adolescence and middle age.

Causes

This situation is related to stress in life. The cause of stress is usually a significant change in life. Apart from that, the presence of a family with a similar history (genetics), life experiences, and a person's temperament can also be a cause of adjustment disorders.

Risk factor

Several things are risk factors for adjustment disorders, namely;

Stressful event.

• Divorce or problems in the household
• Relationship or interpersonal problems
• Change of situation; such as retirement, new parents having a baby, or children entering school for the first time.
• Adverse circumstances; such as being laid off, losing a loved one, having financial problems,
• There are problems at school or at work
• Frightening and threatening life experiences; such as natural disasters, combat, or physical attacks,
• Ongoing stress; such as having a medical illness or living in a neighborhood with a high crime rate.

Life experience

The life experiences you have experienced can also have an impact on how you deal with stress that arises, such as:

• If you have experienced significant stressful events in childhood,
• Have you ever had mental problems before?
• You are experiencing quite difficult life circumstances simultaneously with your current situation.

Symptoms

Adjustment disorders can change how you feel and think about the environment and the world. A person with adjustment disorder will have emotional symptoms with or accompanied by behavioral symptoms as a reaction to the perceived stressor.

Generally, these symptoms begin to be felt within 3 months after the incident and rarely last more than six months. The symptoms caused can interfere for a person to function properly in their environment. Some of the symptoms felt include: 

• Difficulty sleeping, working, or studying
• Feeling hopeless or hopeless
• Feeling sad
• Often cries
• Anxiety or nervousness
• Worry
• Headache or stomach ache
• Feeling a strong, irregular heartbeat (palpitations)
• Withdrawing or isolating yourself from people around you and social activities,
• Being absent from work or school more often,
• Having new and destructive bad behavior, such as fighting, reckless driving, and vandalism.
• There is a change in appetite, which can be in the form of loss of appetite or excessive appetite,
• Having problems sleeping (either sleeping too much or having trouble falling asleep),
• Feeling tired or having no energy

Symptoms in children and teenagers tend to be frequent truancy from school or a tendency to fight. In adults, symptoms of adjustment disorder tend to be more emotional, such as sadness and anxiety.

Diagnosis

If your doctor suspects you have an adjustment disorder and finds you have symptoms, the doctor will take an anamnesis and ask about your mental health history. Then your doctor will refer you to a psychiatric specialist (psychiatrist) or psychologist.

Psychologists and psychologists will help you to understand, diagnose and overcome the situation you are experiencing. Psychologists and psychologists will also look for other mental disorders, such as PTSD (posttraumatic stress disorder), major depression and anxiety disorders.

The doctor will diagnose you with adjustment disorder based on guidelines from the DSM-5 or Diagnostic and Statistical Manual of Mental Disorder-5. In Indonesia, a psychiatric diagnosis guide in the form of PPDGJ 3 is also used. Based on DSM-5, you will be diagnosed with an adjustment disorder if you meet the following criteria;

• Symptoms of emotional changes or habits that occur within 3 months of the stressful event you experienced,
• Shows feelings of sadness that are more intense than usual,
• Having significant problems in personal life or at work or school,
• The symptoms that appear are not related to other diseases or other mental health disorders.

These symptoms appear within three months of the stressful event and usually less than six months after the incident.

Management

Treatments undertaken to treat adjustment disorders can include;

• Psychotherapy or talk therapy
• Pharmacological treatment using drugs, including antidepressants or anti-anxiety drugs. This type of medicine must be under the supervision of a doctor because it can cause serious side effects if misused.
• Join a support group. This group was formed to do the same thing; it could have similar feelings or experiences. This group was founded to achieve the same goal.
• Maintain good communication with your closest friends or family, do interesting activities or hobbies that you enjoy, change your lifestyle to be healthier, sleep regularly, learn and develop coping mechanisms, and become more positive in responding to life events. These things can help you to deal with stress or adjustment disorders well.

Complications

Adjustment disorders can sometimes turn into major depressive episodes in people at risk of developing mood disorders (for example, people who are genetically predisposed to mood disorders).

Adjustment disorders can heal completely without causing complications. However, if adjustment disorders are not treated properly, this situation can cause more serious mental problems such as anxiety disorders, depression, and substance abuse.

Prevention

There is no single thing that can guarantee you will be free from adjustment disorders. However, you are advised to learn skills in the form of healthy ways to deal with stress and learn to become a resilient person. This can help you if you experience a high-stress event one day.

You can also change your lifestyle to be healthier as a coping mechanism, including regular exercise, getting enough sleep, and building good communication and relationships with the people around you. Communicate with loved ones to get social support and ease your emotional burden.

When to see a doctor?

Immediately seek treatment if you feel the above symptoms or if these symptoms make you feel uncomfortable. Going to a psychiatrist or psychologist is not something to be ashamed of and does not mean you are 'crazy'. Seeking professional help for what you feel is important. Because the integrity of health is seen not only physically and socially, but also mentally, when these factors influence each other, if you are mentally disturbed, your physical and social health can also be affected.