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Stress and Adjustment Disorder

When a person’s capacity to adapt is overwhelmed by events, stress results. The event may be insignificant, if considered objectively. Even favourable changes like promotion (stress of coping with increased responsibility) and transfer (stress of adjusting in new environment) may cause stress. Response to stress, for each individual, depends on his/ her personality.

WHAT COMMONLY CAUSES STRESS?

The causes are different at different ages.

  1. Adolescents may get stressed due to physical changes (perceived as not proper) and career prospects.
  2. Young adults may get stressed due to employment relationship, adjustment in marriage with spouse/ in-laws, tiff with parents or relationship with their own children and a struggle to achieve financial stability.
  3. In middle age it could be changing spousal relationships, problems with aging parents and problems of having young adult children who do not see eye to eye or may be having their own stressors.
  4. In old age, the main concern is retirement and survival, loss of physical capacity, major personal losses, menopause and thought of death with increasing number of deaths in close friends and relations.

HOW DO PEOPLE REACT TO STRESS?

Like the causes, even reaction to stress may differ. One may be either anxious, depressed or develop a physical symptom. Some may resort to drinking or drugs; others may start an affair. Common psychological symptoms are fear (of facing the stressor again); anger (frustration); guilt or shame (over helplessness)

Reactions to acute stress may be lack of sleep, inability to concentrate, bad dreams etc

POST-TRAUMATIC STRESS DISORDER:

This is a disorder that is characterized by re-experiencing a traumatic event, eg molestation, rape, severe burns, riots (cases kept coming in for as long as 1 year after the communal riots in Mumbai in ‘92), experiencing natural calamities (after Jan 2001 quake in India). This result in decreased responsiveness and avoidance of events connected with original stress.

WHAT EXACTLY DO PATIENTS FEEL?

They are generally "hyper" – startle at the slightest stimulus, thoughts intruding the activity going on, sleep problems, nightmares, dreams about the event and hyper alertness (mom! The building is shaking – in the aftermath of an earthquake). The symptoms are aggravated by events reminding one of the stressor event. Sometime the symptoms arise after a long time like child sexual abuse manifesting after marriage.

HOW IS IT TREATED?

Treatment is mainly Psychotherapy. Family support matters a lot. In some instance medicines (sedatives etc) may be used.

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