Adjustment Disorders in Women

Posted on February 14th, 2013
Posted in Depression

Adjustment disorder is a general term used to describe several related forms of mental illness that can occur when people don’t recover from the effects of traumatic or stressful events within a certain amount of time. The specific symptoms of these conditions vary according to the severity of a person’s adjustment difficulties and the particular type of maladjusted reaction that appears. Boys and girls develop adjustment disorder with roughly equal frequency. However, women apparently develop the condition much more frequently than men. In part, this gap between women and men may stem from women’s higher risks for several psychiatric conditions that can increase the likelihood of an adjustment disorder.

Adjustment Disorder Basics

Adjustment disorders are sometimes referred to collectively as situational depression. According to standard guidelines set forth by the American Psychiatric Association, people with these disorders have unhealthy or “maladaptive” reactions to significant trauma or stress that appear within a three-month period following the traumatic or stressful event. Beyond this basic description, adjustment disorders are not particularly well-defined; in part due to this lack of clear definition, adjustment disorders belong to a group of conditions known as subthreshold conditions, which typically don’t produce symptoms as severe as the symptoms associated with most fully defined mental disorders.

Despite its relative vagueness, the standard definition for adjustment disorders does include six different subtypes of the condition, each of which produces a certain range of symptoms. For example, some people develop a form of adjustment disorder that features relatively mild versions of sadness, hopelessness, suicidal thinking, and other symptoms found in people with clinical depression. Others develop a form of the disorder that features relatively mild versions of restlessness, irritability, panic, and other symptoms found in people with clinical anxiety. Another subtype of adjustment disorder manifests as disturbed or abnormal conduct on the part of the affected individual. In some cases, people with adjustment problems develop mixed symptoms of depression and anxiety, or develop depression or anxiety in combination with disturbed or abnormal conduct. In addition, some people develop anxiety disorder not otherwise specified (ADNOS), a condition that includes any maladaptive reactions not found in the other disorder subtypes.

Virtually everyone goes through a period of adjustment in the aftermath of stressful or traumatic situations. People with an adjustment disorder have reactions to these situations that last longer or grow stronger than the reactions found in the average individual. Traumatic or stressful events that can trigger the appearance of an adjustment disorder include serious accidents, natural disasters, childbirth, major physical illnesses, marriage, divorce, death of family or friends, losing a job, changing jobs, financial problems, relationship difficulties, and any other major life change. Underlying factors that can contribute to a prolonged or intensified reaction to stress or trauma include genetic predisposition, poor development of coping skills or social skills, a person’s natural temperament, exposure to an abusive or overly protective household environment, and altered levels of certain key chemicals found in the brain and bloodstream.

Frequency in Women

Roughly 12 percent of Americans develop an adjustment disorder at some point in their lifetime. Some studies indicate that men who seek treatment for a mental disorder show symptoms of an adjustment disorder somewhat more frequently than women who seek similar treatment. Additional studies indicate that adjustment disorder probably affects men and women more equally than major depression, mild depression, or a form of depression called dysthymia. However, despite these counterexamples, the American Psychiatric Association reports that women receive a diagnosis for some form of adjustment disorder roughly twice as frequently as men.

Specific Risk Factors in Women

Women have significantly higher risks than men for certain psychiatric problems, including the eating disorders anorexia and bulimia, various types of anxiety disorder, and various types of clinical depression. In turn, people who have an eating disorder, anxiety disorder, or depression often have personal histories that include at least some of the factors that can contribute to an adjustment disorder, such as a history of physical or sexual abuse during childhood. In combination, these facts probably help explain the greater frequency of adjustment disorder found in women.

Considerations

As stated previously, adjustment disorders typically produce symptoms that are not as severe as the symptoms associated with clinical depression, clinical anxiety or other well-defined psychiatric disorders. However, this doesn’t mean that adjustment disorders are harmless. Statistically speaking, people with these disorders have unusually high risks for serious problems that include non-fatal self-harm, suicide, and substance abuse.

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