Death of a loved one! Being the victim of a crime! A natural disaster such as a fire or flood. The loss of a job! The end of a relationship! The death of a pet! Divorce! Being abused or molested! Witness to a horrific accident! A serious illness!
Has just the description of these events elicited an emotional or physical reaction somewhere deep inside of you? If you as an adult experience a visceral reaction to not only the concept of these horrific events but in fact, in experiencing them, imagine how they may impact a teenager with a brain still in development and potentially insufficient coping skills! While these scenarios may sound extreme, surprisingly and unfortunately, many teens around the world experience incidents like this on a regular basis.
Can teens appropriately handle a stressful life event?
Of course, they can!
Many teens have experienced life-threatening or traumatic events and do not experience any adverse reactions. However, in some teens, a major life change, stress, loss or event can prompt a short-term mental illness known as Adjustment Disorder.
Again, it is important to note that not all teens who experience a traumatic event will also experience Adjustment Disorder. In other words, just because a teen loses a close friend does not automatically mean that they will begin displaying symptoms. Also, there is no indication that siblings even within the same family who experience the same stressful situation will each show signs of it.
The stress and pressure from a sudden and unexpected event can cause some teens to experience symptoms similar to depression such as hopelessness, difficulty coping or adjusting to new environments or situations, and a loss of interest in activities and friends. However, Adjustment Disorder symptoms do not incorporate many of the emotional and physical symptoms that clinical depression brings.
In some cases, teens who are exposed to a stressful situation may demonstrate signs and symptoms of a more severe disorder known as PTSD. Although both Post Traumatic Stress Disorder and Adjustment Disorder are triggered by a traumatic or life-threatening event, the effects of an Adjustment Disorder are relatively short-term, typically lasting less than six months.
Symptoms may often begin within three months of the incident and may be expressed as an unexpected or atypical reaction to the event. Because children and teens may have a more difficult time expressing their feelings, many signs of Adjustment Disorder manifest as behavioral in nature. For example, skipping school, acting out, fighting, reckless driving, vandalism or other destructive behavior. Symptoms may develop slowly beginning with an occasional stomachache or a slight change in attitude about school or friends.
Other symptoms of Adjustment Disorder in teens may include:
- Heart palpitations
- Regular stomach or headaches
- Frequent and uncharacteristic crying
- Feelings of hopelessness or extreme sadness
- Changes in appetite
- Aggressive (unexplained) outbursts
- Engaging in risky behavior
- Lack of energy and lethargy
- Nervousness and frequent worry
Do these symptoms look like any other mental health challenges that teens could possibly experience? Of course they do . . . depression, anxiety, behavioral disorders. While many mental health issues present themselves in similar ways, the difference in Adjustment Disorder is that it is clearly marked by a stressor, a stressful or traumatic event that can be directly connected to the manifestation of these signs and symptoms. It is highly likely that if your teen were to never experience the stressor, they would never experience other symptoms of a mental health issue.
According to recent studies, the diagnosis of Adjustment Disorder in teens is relatively common. However, those who are diagnosed are only just a portion of those who suffer in silence not sharing their feelings or hiding their symptoms of situational avoidance, irritability, sleeplessness. While these symptoms may also correspond with several other mental health issues faced by teens, an Adjustment Disorder is triggered by a stressful event that for some is just too much to handle.
There are in fact six subtypes of Adjustment Disorder, each with symptoms similar to other mental health issues:
- Adjustment Disorder with Depressed Mood: Teen demonstrates symptoms similar to depression including a loss of interest in once-loved activities, feelings of hopelessness, sadness and unexplained bouts of crying.
- Adjustment Disorder with Anxiety: Teen appears worried and anxious and depending upon the stressor which led up to the symptoms, may even experience separation anxiety.
- Adjustment Disorder with Mixed Anxiety and Depressed Mood: Teen experiences symptoms associated with both anxiety and depressed mood.
- Adjustment Disorder with Disturbance of Conduct: Teen will demonstrate behavior that is not only out of character but possibly defiant, violent, recklessly violating other people’s rights, and being disrespectful of social norms. Typically, a teen’s mood remains the same.
- Mixed Disturbance of Emotions and Conduct: Teen demonstrates both a change in behavior as well as changes in mood. The symptoms of the other subtypes will also be present.
- Adjustment Disorder Unspecified: Teen displays having difficulty in dealing with the situation or event yet does not necessarily demonstrate symptoms of any of these subtypes. They appear to be “off” and displaying behavior which is simply out of character.
Let’s look at an example of what Adjustment Disorder may look like. Brady, a high school junior, just lost his best friend suddenly when a car accident took his life. Brady and Tyler spent every day together. They both played baseball and hung out with the same group of friends. Brady’s life suddenly changed from hanging out with his friend every day after school to a huge hole where his friendship used to be. He cannot sleep and is overwhelmed by sadness. Brady finds himself breaking down into tears at the oddest moments and begins to withdraw from his friend group, preferring to be alone than to socialize.
At school, Brady is having difficulty concentrating and is beginning to develop a rebellious and disruptive attitude. Brady’s parents at first believe that his behavior is simply grief taking hold of him, not realizing that he is slipping into an Adjustment Disorder. While his feelings of loss and pain are normal with the passing of a dear friend, Brady is having more difficulty coping with the loss than is typical and it is beginning to impact his ability to function in everyday life.
Three months after the accident, when Brady is showing signs of depression, anxiety and no longer seems to be himself, his parents decide that it is time to seek help for him. After discussing their concerns with his pediatrician, Brady’s parents believe that in the best interest of their son and his mental health, they must seek the professional assistance of the trained therapists and counselors at a treatment center like those at Beachside Treatment Center.
After being admitted to the mental health facility and undergoing counseling, Brady has learned new coping mechanisms to the stress which caused his mental health issue. He now understands how the loss of his friend was the stressor that caused his Adjustment Disorder and that with the appropriate support, he has gained full control over his life and challenges. Although he still deeply misses his friend, Tyler, he manages his sadness and grief and can now cope with these feelings in a more appropriate manner.
While there is no prevention for the onset of Adjustment Disorder, it is proven that with strong family and group support, and the assistance of trained professionals like those at Beachside Treatment Center, teens can appropriately work through the incident or situation which triggered their emotional and possibly physical symptoms.
If you suspect that your teen may be experiencing Adjustment Disorder, speak to their doctor immediately to conduct an examination and further evaluation of their symptoms. Early detection can help to reduce the severity and duration of the symptoms themselves. Unfortunately, Adjustment Disorder may easily turn into other types of disorders or mental health issues if your teen is predisposed or at risk in this area and if not promptly treated. For example, episodes of hopelessness and sadness may morph into clinical depression, leaving your teen vulnerable to thoughts of self-harm and suicide. As teens try to manage their own methods of coping with the traumatic event or incident, they may turn to drugs or alcohol as a means of numbing their feelings of loss and pain. Of course, this type of behavior could lead to substance abuse, poor decisions, and additional stress and anxiety.
Unlike many other mental health challenges that teens may face, Adjustment Disorder is completely recoverable. In fact, a teen who is treated after a stressor pushes them into this depressive state often emerges having learned new coping skills and mechanisms that can be used in other areas throughout their life. Adjustment Disorder is commonly also known as stress response syndrome, alleviating some of the stigma associated with mental health issues. It is their response to stress which will dictate how they recover from their current situation as well as how they manage stress in others that may arise in the future.
What is involved with the treatment of Adjustment Disorder?
We have discussed how it is triggered as well as the outcome of recovery but what is the path that a teen must take to get there? While a physician may prescribe low doses of anxiety medication to help a teen with their behavior or anxiety, it is typically a short-term remedy. Psychotherapy is the preferred means of treatment for Adjustment Disorder and in reality, the only thing that guarantees a teen’s full recovery and freedom from their symptoms.
A trained therapist may encourage your teen to share their feelings and emotions in a supportive environment, providing guidance and constructive feedback where necessary. Typically group therapy is conducted with other teens who have experienced similar traumatic or stressful situations to encourage empathy and to dispel feelings of being alone or isolated.
Your teen may also participate in individual therapy in which they will learn impulse control, anger management, problem-solving, stress management, and communication skills. Parents and caregivers may also engage with healthcare professionals in order to learn new skills to address behavior problems, to create an environment in which open dialogue is encouraged, and effective ways to establish boundaries.
Watching your teen struggle with a stressful situation or incident is difficult enough let alone when they are having difficulty coping with it. It is imperative that you do whatever is necessary to get your teen the support and help that they need to appropriately cope with their feelings and emotions. While Adjustment Disorder is one of the most often diagnosed mental health disorders, it is also one of the most under-researched. As our children are exposed to more and more events and situations, the rate at which children are diagnosed increases.
Just because your teen may be struggling to cope with a loss, separation, or an incident, does not mean that they cannot fully recover and lead a successful, productive life in the future. It also does not mean that they necessarily are experiencing a diagnosed mental health condition.
As we have discussed, the effects of Adjustment Disorder are typically short-term and recoverable through the caring support of the medical professionals at Beachside Treatment Center. Rather than sit back and panic as you witness your teen struggle with their loss, stress, or grief, get them the help that they need today.