What is an adjustment disorder with anxiety?

Adjustment disorder with anxiety is a condition in which you continue to feel nervous, worried, or afraid after a stressful event. These symptoms can last from 3 to 6 months after the event.

We all have times in life when we get anxious. Financial problems, ending a relationship, being in a car accident, or losing a job are some of the things that can make anyone nervous or fearful for a while. A happy event like marriage or the birth of a child can also be stressful. Feeling some stress, worry, and fear is normal. However, if your symptoms continue for months, or are more severe than what most people usually have, then it is called an adjustment disorder.

How does it occur?

An adjustment disorders is a way of reacting to stress. Symptoms usually begin shortly after the stressful event.

If you have had problems with anxiety before, then you are more likely to have an adjustment disorder. Adjustment disorders are as common in men as women, and can develop at any age.

There are different types of adjustment disorders. For example, you might have problems with depression, or with both anxiety and depressed mood.

What are the symptoms?

The most common symptoms are:

• feeling tense, jittery, and nervous
• worrying more
• being more emotional
• wanting to run away or escape
• feeling overwhelmed
• having trouble sleeping
• having a change in appetite
• having trouble concentrating or remembering things.

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.

How is it treated?

Anxiety can be successfully treated with psychotherapy, medicine, or both. Psychotherapy or short-term use of medicine can be very helpful with an adjustment disorder.

Medicines

Several types of medicines can help treat anxiety. Your healthcare provider will work with you to carefully select the best one for you. Some medicines are:

• antianxiety medicines such as lorazepam (Ativan), diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and buspirone (BuSpar)
• newer antidepressant medicines such as mirtazapine (Remeron) and venlafaxine (Effexor)
• selective serotonin reuptake inhibitor (SSRI) antidepressant medicines such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and fluvoxamine (Luvox)
• tricyclic antidepressants such as imipramine (Tofranil), desipramine (Norpramin), and clomipramine (Anafranil).

Psychotherapy

Seeing a therapist can help. There are several kinds of therapy that can help a person with anxiety. Support groups are also very helpful.

Natural and Alternative Treatments

• Herbs and Supplements. Claims have been made that certain herbal and dietary products (kava root, chamomile, and valerian) help anxiety. No herb or dietary supplement has strong research support to prove that it helps anxiety. Some herbal products can interact with prescription medicines. Be sure to tell your healthcare provider about any herbal products you are taking.
• Biofeedback. With biofeedback you learn to control body functions such as heart rate, blood pressure, muscle tension, or brain wave patterns. Biofeedback can help reduce tension and anxiety. Biofeedback techniques use special machines to help you learn how to control certain nervous system responses.
• Massage Therapy. Massage therapy may help lower stress and muscle tension.
• Relaxation Therapies. Learning to relax can help with anxiety. Yoga and meditation may also be helpful.
• Hypnotherapy. Self-hypnosis can help you learn to control anxiety symptoms and things that trigger your anxiety.
• Art and Music Therapies. Some people find art, music, or movement therapy helpful in controlling anxiety.

How long will the effects last?

Once the stressful event is gone, the symptoms of anxiety usually go away in a few weeks or months. Symptoms may last longer than 6 months. If symptoms go on longer than 6 months, you may want to see a therapist for evaluation.

What can I do to help myself or my loved one?

Maintaining a healthy lifestyle is important. To help manage anxiety:

• Exercise for at least 20 minutes every day, for example a brisk walk.
• Learn which activities make you feel better and do them often.
• Talk to your family and friends.
• Stay socially active.
• Eat a healthy diet.
• Avoid caffeine, alcohol, and nicotine.
• Do not abuse drugs.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.

Many towns and cities have support groups that may help you. Some groups help with specific stress events like divorce, sexual assault, or financial problems. Look in the telephone book under Support Groups or ask your therapist or your local community mental health center.

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. Seek immediate help if you have severe chest pain or trouble breathing.

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.

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