Treatment plan for adjustment disorder with depressed mood

June 4, 2019, Bridges to Recovery

Adjustment disorder, a reaction to stress or trauma, often stirs up negative emotions that may include depression. If you are living with both types of mental illness, your ability to function is likely to be significantly impaired.

This complicated interaction is difficult to treat. One of the most effective ways to learn to move on from trauma and to manage depression is to commit to long-term, residential treatment. Less intensive care, such as outpatient therapy, may not be adequate to address all the complicated, interrelated symptoms of these two conditions.

What Is Adjustment Disorder?

Psychiatrists and other mental health professionals categorize adjustment disorder as a trauma- and stressor-related disorder. What this means is that the underlying cause of the condition is a stressful life event or traumatic experience. The cause may be a single event, like the death of a loved one, or an ongoing stressor, such as living with a chronic or terminal illness.

Adjustment disorder is often referred to as a group of disorders or symptoms, because each individual’s experience is unique. What they all have in common, though, is an inability to cope with a stressor or trauma in a healthy, productive way. Someone with an adjustment disorder struggles to adjust to life after a bad experience. Possible symptoms include:

• Feelings of sadness and hopelessness, being overwhelmed
• Loss of interest in normal activities
• Crying frequently
• Loss of appetite
• Insomnia
• Difficulty focusing on and completing normal tasks
• Social withdrawal and isolation
• Anxiety or nervousness, stress
• Avoiding responsibilities
• Suicidal thoughts

To be diagnosed with an adjustment disorder, there must be behavioral or emotional symptoms that begin within three months of a stress or trauma. You also must have distress and reactions to that situation that are much more severe then it warrants. Or, you have to display significant impairment in your life because of your reaction. There are also subtypes of adjustment disorder:

• With an anxious mood
• With a depressed mood
• With both anxiety and depression
• With disturbed conduct (behavioral changes)
• With disturbed conduct and emotions

Adjustment Disorder and Depression

These two conditions have overlapping symptoms. Misdiagnosis of one for the other is not uncommon. There is also the possibility that you can be diagnosed with the depressive subtype of adjustment disorder or with both adjustment disorder and major depression. To be diagnosed with depression, you must meet the specific criteria for that condition.

To be diagnosed with depression, you must have a depressed mood, a loss of interest in activities, or both, as well as any other related symptoms. These include fatigue, changes in appetite, changes in sleep, difficulty thinking and concentrating, and thoughts of death or suicide. Having at least some of the signs of depression along with adjustment disorder is common.

The Importance of Treating Adjustment Disorder and Depression Together

Even if you are diagnosed with adjustment disorder and have signs of depression but don’t strictly meet the criteria, you can benefit from a focused treatment plan that addresses both issues. Ignoring depression as one of your symptoms could lead to even worse depression or recurring episodes, and ultimately a diagnosis of major depression.

A tricky aspect of treating both conditions is that adjustment disorders are typically short-term, while depression is a chronic mental illness that often recurs. However, when you manage adjustment disorder and learn healthier ways of coping with stress or a traumatic experience, it can reduce episodes of depression.

On the other hand, treating depression without addressing the adjustment disorder and underlying trauma will most likely cause recurrences. You need to learn to face and process the trauma and life changes that triggered negative emotions and behaviors. Without learning positive ways to cope, depression will likely persist and recur.

How Residential Treatment Can Help

Any treatment for adjustment disorder with depression is better than none, but there are important reasons to consider a residential treatment center. Co-occurring disorders are far more complex than having just one mental illness. The two conditions are intertwined, and one impacts and complicates the other. To get effective treatment, you need experts in not just the two separate conditions but also in managing co-occurring conditions.

Residential treatment centers are more likely to have these experts on staff with experience working with similar patients. These mental health professionals also have experience developing treatment plans that meet the unique needs of each individual patient. Intake to a residential center begins with a thorough evaluation so that the staff knows exactly what you need and what course of treatment is best.

Also important in residential treatment is the fact that you get to focus on your wellness and recovery with limited distractions. A few months in this safe, supportive environment allows you to let go of home life and responsibilities and to spend your time and energy on processing trauma and stress and practicing better ways of coping.

Treatment Types for Depression and Trauma

Because the source of your depression and adjustment disorder is known, treatment can be targeted. Trauma-focused therapies can help you learn to process that bad experience or major life stress and reframe it in a more helpful way. There are several therapy types you can benefit from in a residential setting:

• Trauma-focused cognitive behavioral therapy. CBT is a common type of therapy that is used for all kinds of patients. With a focus on trauma, it can help you face your feelings associated with traumatic experiences, practice healthy coping strategies, and make real, positive changes to problematic behaviors and thought patterns.
• Somatic experiencing therapy. To better cope with stress and trauma, this type of therapy teaches you to focus on physical sensations and to take your energy and thoughts away from traumatic memories.
• Eye movement desensitization and reprocessing. This type of therapy uses guided movements to help you reframe and be less negatively reactive to traumatic memories. This is used with patients with post-traumatic stress disorder and can benefit anyone struggling with difficult memories.

With depression as part of your diagnosis, your therapy will also focus on those symptoms and trying to cope with them. You may also benefit from medical treatment. Some patients respond well to antidepressant medications. A long-term stay in residential care gives you the chance to find the right medication, as this can take several weeks.

Treatment in a residential setting also affords the opportunity to benefit from other services you won’t get in outpatient therapy. Most residential centers will have recreational opportunities, family participation, health and lifestyle education, aftercare programming, and a supportive, therapeutic community.

Adjustment disorder can be effectively treated, but it becomes more complicated with depression. If you are struggling to cope with a big stressor in your life and you also feel really down and hopeless, reach out and get help. Consider staying in residential care to get the best possible treatment.

Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to lasting wellness.