Stress and adjustment disorders are reactions to severe stress and trauma. A distinction is made between acute stress reaction, adjustment disorder and post-traumatic stress disorder. Persistent personality changes can also occur after extreme stress.
Below you will find further information and selected specialists for the treatment of stress and adjustment disorders.
Stress disorders are directly caused by a one-off severe stress event (trauma) such as
or by prolonged severe stress (e.g. prolonged sexual abuse). The symptoms of such excessive reactions to stress can vary greatly.
In principle, it is normal for trauma or bad life events to cause sadness, fear, anxiety, sleep disorders etc. Such reactions are only described as a mental disorder when
An acute stress reaction is a symptom that occurs in the hours immediately after a stressful event. It subsides after a maximum of 48 hours ("nervous breakdown", psychological shock).
Feelings of inner emptiness, despair and fear, and possibly also suicidal thoughts, occur. It is important not to leave those affected alone and to support them in their stabilization ("crisis intervention").
Adjustment disorders are characterized by various symptoms such as anxiety, worry and tension. They cause the person affected great suffering. Adjustment disorders begin within a month of the triggering event and last for a maximum of several months.
Triggering events can be acute events such as the death or serious illness of a relative. However, they can also be longer-lasting stresses, e.g. marital problems or difficulties at work.
Adjustment disorders are mainly treated with outpatient psychotherapy. In addition to necessary crisis intervention, support in processing the triggering event can also be useful. A calming medication may also be prescribed in the short term.
Case study: Adjustment disorder
A 34-year-old married mother of two small children presents to a psychotherapist on the advice of her family doctor. She had actually been doing quite well in recent years until her husband told her three weeks ago that he had met another partner over the internet and wanted to separate from her. They were still living in the same apartment in separate rooms and he was looking for an apartment.
Since this event, she feels desperate, is often irritable, has strong fears about the future, has trouble sleeping and often has to cry. She is still able to do her part-time job. This even gives her some variety and distracts her, as do meetings with friends. However, as soon as she is at home, all the symptoms return and she doesn't know what to do next.
Post-traumatic stress disorder (PTSD ) occurs after severe, catastrophic stressful situations such as assault, rape or torture. Symptoms include
Many sufferers are ashamed of the experience and the disorder. This is why they often seek psychiatric or psychotherapeutic treatment late or never. They also frequently abuse alcohol or tranquillizers in order to get the symptoms under control on their own. This can lead to a complicated addiction problem.
Around 60 percent of all people suffer a trauma in the course of their lives. However, only 5 to 10 percent suffer from PTSD. Women are affected about twice as often as men. The likelihood of developing post-traumatic stress disorder varies greatly depending on the type of trauma:
The treatment of PTSD should primarily be psychotherapeutic. Initially, however, stabilization is necessary, e.g. through
is important.
Afterwards, it often makes sense to deal with the traumatic situation instead of constantly avoiding it. This can be done by reliving the experience in your mind, but also by visiting the site of the traumatic event. Psychotherapy can be supplemented by drug therapy with antidepressants if necessary.
Case study: Post-traumatic stress disorder (PTSD)
A 24-year-old female student consults the outpatient clinic of a specialist psychosomatic clinic due to severe anxiety, sleep disorders, irritability and low mood. These symptoms had been present since she had been attacked by a stranger in front of her apartment four months ago when coming home at night. While locking her bicycle, she was hit hard on the head. After that, she could not remember anything until 25 minutes later when she regained consciousness. Her purse was gone. She had suffered considerable injuries as a result of the blow and the subsequent fall.
Since then, she had not touched her bike, could no longer go out alone after dusk and had constant nightmares. Even during the day, the event kept replaying like a movie.
After particularly severe, long-lasting and repeated traumas, permanent personality changes can also occur. Such events include
Even after the danger has passed, those affected fear that the events could happen again. They are extremely distrustful of their environment. Chronic sleep disorders and other physical complaints are common. Some of those affected fall completely out of their previous social framework as a result.
