Adjustment Disorder with Depressed Mood

What is adjustment disorder with depressed mood?

An adjustment disorders is a way of reacting to stress. An adjustment disorder with depressed mood means that you are more depressed than would be expected after a stressful event.

You may wonder why something is getting to you so much. Or your symptoms may seem unrelated to the event that caused them. It is normal to feel depressed, to cry, or to sulk during times of stress. But if you have an adjustment disorder, you are also less able to socialize or function on the job or at school.

How does it occur?

In an adjustment disorder, symptoms occur within about 3 months of something that stresses you. Examples may include moving, changing schools or jobs, the loss of a relationship, or illness in yourself or someone close to you. A happy event like marriage or the birth of a child can also be stressful.

What are the symptoms?

Symptoms of an adjustment disorder with depressed mood include:

• being more upset than would normally be expected
• being unable to deal with things at work, at school, or socially
• feeling sad or hopeless
• not feeling pleasure in things that used to interest you
• developing symptoms within 3 months of a stressful event that don't last longer than 6 months after the end of the stressor or its consequences.

Grief after someone dies is not considered a symptom of an adjustment disorder. Depressed symptoms and a short-term decrease in pleasure and the ability to work or socialize are to be expected at such a time.

Depressed feelings on the anniversary of someone's death, a divorce, or other type of major loss can be symptoms of an adjustment disorder. Some people also have this reaction when they reach the same age as someone close to them who died.

How is it diagnosed?

Your healthcare provider or a mental health therapist can tell you if you have symptoms of an adjustment disorder. He or she will ask about your symptoms, any other medical problems and any drug or alcohol use. You may have some lab tests to rule out medical problems such as hormone imbalances and heart problems.

You may be suffering depression, a more serious disorder, if your symptoms include:

• changes in weight or appetite
• sleep disturbances (being unable to sleep or sleeping too much)
• loss of energy
• decreased sex drive
• guilt or feelings of worthlessness
• difficulty concentrating
• agitation
• thoughts of hurting yourself or someone else.

How is it treated?

Adjustment disorders may be treated with psychotherapy, medicine, or both. Some medicines that may be prescribed are:

• antidepressants such as citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), escitalopram (Lexapro), mirtazapine (Remeron), and phenelzine (Nardil)
• mood stabilizers (primarily for bipolar and cyclothymic disorders) such as lithium (Eskalith, Lithobid, Lithonate, Lithotabs), carbamazepine (Tegretol), and valproic acid (Depakene).

You must take these medicines daily as prescribed for them to work properly.

There are no nonprescription medicines available to treat depression.

Psychotherapy

Seeing a therapist can help. Support groups are very helpful.

Natural and Alternative Treatments

Claims have been made that certain herbal and dietary products help depression. St. John's wort is the only one that research shows is effective for mild depression.

Many types of alternative treatments are said to help depression. Some of them are:

• Biofeedback. You learn to control body functions such as muscle tension or brain wave patterns. Biofeedback can help with tension, anxiety, and concentration, but it does not help depression.
• Acupuncture. Acupuncture may be helpful in treating some types of depression.
• Massage Therapy. Massage therapy may help lower stress, but it does not cure depression.
• Relaxation Therapies. Learning special relaxation methods can help with depression. Yoga and meditation may also be helpful.
• Art and Music Therapies. Some people find art and music therapy are helpful in treating depression.

What can I do for myself?

• Try to understand what made you start to feel this way. Understanding how stress has affected you is one of the most important things you can do for yourself.
• It can help to talk to others who have gone through the same type of event that is bothering you.
• Stay healthy by eating right, exercising, getting enough sleep, and avoiding drugs, alcohol, and coffee.
• Maintain a positive attitude that you will soon feel better.
• Ask your friends and family for support. Don't isolate yourself.

When should I seek help?

Seek professional help for yourself or a loved one if the symptoms don't go away after a few weeks, if the symptoms get worse, or if the symptoms keep you from being able to function as usual.

Get emergency care if you or a loved one has serious thoughts of suicide, violence, or harming others.

For more information, contact the National Mental Health Association (NMHA). NMHA's toll-free Information Center number is 1-800-969-NMHA. Its Web site address is http://www.NMHA.org.