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Difference Between Adjustment Disorder and PTSD
Adjustment disorder (AD) and post-traumatic stress disorder (PTSD) are two mental health conditions that have similar symptoms but differ in their causes, severity, and duration. AD is a short-term condition caused by a stressful life event, whereas PTSD is a chronic condition caused by exposure to a traumatic event. In this essay, we will explore the differences between these two disorders in terms of their symptoms, causes, treatment, and prognosis.
What is Adjustment Disorder?
AD is sometimes called as situational depression, reactive depression, or exogenous depression. This disorder is due to the inability of the individual to cope with a new life situation such as unemployment, marriage, change of community, and others. As compared to the other diagnoses, this is most probably the least stigmatizing of them all. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM 5) specifies the following criteria for AD −
The emotional or behavioral symptoms manifested within three months of the onset of the stressor.
The experienced distress is out of proportion to the severity of the source of stress.
There is a significant impairment in various areas of functioning such as work and family.
The symptoms do not last longer for more than an additional six months.
AD may be specified as: with depressed mood, with anxiety, with mixed anxiety and depressed mood, with disturbance of conduct, with mixed disturbance of emotions and conduct, or unspecified.
What is Post-traumatic Stress Disorder (PTSD)?
PTSD is triggered by experiencing or witnessing a traumatic event such as war, calamity, and abuse. It was first specified in 1980 in DSM III. The DSM 5 specifies the following criteria −
Exposure to a threatening situation, injury, or violence through direct experience, as a witness, by knowing that the event happened to a close family member or friend, and through repeated exposure to emergency situations as in the case of first responders, firefighters, and policemen.
Presence of intrusive memories, recurrent nightmares, dissociative reactions like flashbacks of the traumatic experience, intense psychological distress at the presence of triggering stimuli, significant physiological reactions such as panic attacks, dizziness, and palpitations in response to triggering stimuli.
Persistent avoidance of reminders which cause distressing memories, thoughts, or feelings.
Pessimistic changes in thinking and feelings as characterized by forgetting certain aspects of the traumatic event, negative self-concept, irrational guilt, persistent negative feelings such as anger and shame, lack of interest in social relationships, and feelings of detachment.
Significant changes in arousal and reactivity as evidenced by irritability, aggression, hypervigilance, inability to concentrate, and sleep disturbance.
The disturbance lasts for at least one month.
The distress, which is not caused by any kind of substance, impairs important areas of functioning.
PTSD may be specified as with dissociated symptoms or with delayed expression.
Differences: AD and PTSD
Symptoms − Both AD and PTSD share some common symptoms, such as anxiety, depression, and insomnia. However, the duration and intensity of these symptoms differ significantly. AD symptoms usually start within three months of a stressful event and last for no more than six months. In contrast, PTSD symptoms can start months or even years after the traumatic event and can last for years or even a lifetime.
The symptoms of AD are usually milder than those of PTSD, and they don't involve flashbacks, nightmares, or intrusive thoughts. Instead, people with AD may experience emotional distress, social withdrawal, physical complaints, and difficulties adjusting to changes in their lives.
PTSD symptoms, on the other hand, can be severe and debilitating, affecting all aspects of a person's life. The hallmark symptoms of PTSD include re-experiencing the traumatic event through flashbacks, nightmares, or intrusive thoughts, avoidance of triggers associated with the trauma, hyperarousal, and negative mood and cognitions.
Causes − AD is caused by a stressful life event that disrupts a person's ability to cope with everyday challenges. Some examples of such events include divorce, job loss, financial difficulties, illness, or a natural disaster. AD can affect anyone, regardless of age, gender, or background, and it doesn't require exposure to a traumatic event.
PTSD, on the other hand, is caused by exposure to a traumatic event that poses a threat to a person's physical or psychological well-being. Such events can include military combat, sexual assault, natural disasters, terrorist attacks, or witnessing a violent crime. Not everyone who experiences a traumatic event develops PTSD, but some factors, such as pre-existing mental health conditions, lack of social support, or genetic predisposition, can increase the risk of developing the disorder.
Treatment − The treatment for AD and PTSD differs depending on the severity and duration of the symptoms and the underlying causes. AD is usually treated with supportive therapy, such as cognitive-behavioral therapy (CBT), psychoeducation, and stress management techniques. The goal of treatment is to help the person adjust to the stressful event, regain their confidence, and resume their normal activities. In some cases, medication, such as antidepressants or anti-anxiety drugs, may be prescribed to alleviate the symptoms.
PTSD, on the other hand, requires a more intensive and long-term treatment approach, as the symptoms can be persistent and resistant to conventional therapy. The gold standard treatment for PTSD is trauma-focused CBT, which includes exposure therapy, cognitive restructuring, and relaxation techniques. In some cases, medication, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to reduce the symptoms of anxiety and depression.
Prognosis − The prognosis for AD is generally good, as most people recover within a few months without any long-term consequences. However, if left untreated, AD can lead to chronic stress, depression, or other mental health problems.
The prognosis for PTSD, on the other hand, is variable, as some people may experience a full recovery, while others may struggle with the symptoms for years. The outcome depends on factors such as the severity of the trauma, the duration of the symptoms, the availability of social support, and the effectiveness of the treatment.
The following table highlights the major differences between Adjustment Disorder and PTSD −
The common stressors in AD are significant changes in life situations such as unemployment, moving to another area, and sickness.
The usual triggers for PTSD are more serious events such as sexual violence, serious injury, and threatened death.
The DSM 5 indicates that AD symptoms should manifest within three months of the onset of the stressor and that they should not last for more than 6 months.
PTSD symptoms should last for more than one month and delayed expression may occur (at least six months after the event).
AD may be specified as with depressed mood, with anxiety, with mixed anxiety and depressed mood, with disturbance of conduct, with mixed disturbance of emotions and conduct, or unspecified.
As for PTSD, it may be specified as with dissociative symptoms or delayed expression.
The symptoms of AD are less intense as well as less numerous such as marked distress and significant impairment in functioning.
The symptoms of PTSD are more intense such as intrusive and distressing memories, recurrent nightmares, dissociative reactions, persistent avoidance of stimuli, negative changes in mood and cognition, and marked changes in arousal and reactivity.
AD is often the most common diagnosis in a hospital psychiatric consultation in the United States as the percentage usually reaches 50%. This may also be due to the fact that it is probably the least stigmatizing diagnosis.
As for PTSD, the projected life-time risk for Americans is estimated to be at 8.7%. The individuals who are at most risk are the survivors of sexual assault, military combat, and captivity.
In conclusion, AD and PTSD are two distinct mental health conditions that share some common symptoms but differ in their causes.
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