My 5 year old son and I moved out of an abusive home over a year ago now. He was 4 at the time, and because withholding of basic needs was the form that the abuse took, I gave him some time to get used to life in a world with running water, and toilets, and washing machines, and most importantly, life experiences. We began to do things that we had not be able to do, such as going to playgrounds, and out for ice cream. He had to learn to use a real toilet, and experience a shower. He thrived in many areas, but, on the other hand, some things just did not fall into place.
By Fall, we had a lovely and stable living situation, but things that I could once chalk up to his age, I could no longer. Something was amiss, and I suspected Asperger’s Syndrome, and I began to get my son assessed. At the same time, anxiety, an intense fear of separation, and behavioral issues began to pop up, and grow. He had persistent nightmares, had meltdowns of epic proportions, and his behavior was down right hideous at times. We began seeing a social worker, and a behavioral therapist while we awaited his big, diagnostic assessment. The assessment took place a week before we moved from Maine to Montana, and the results took 4-6 weeks to get. When they finally arrived, I learned that not only did Aidan have Asperger’s Syndrome, but an Adjustment Disorder with mixed emotional and conduct issues.
So, what is an adjustment disorder, and who gets it, and why? An adjustment disorder is defined as a maladaptive, or unhealthy response to psychologically stressful events. It can have depressive components, or anxiety, or mixed emotional and conduct components, such as with my son. A stressful event can be living in an abusive setting, being bullied, changing schools, or for adults, the loss of a job, or a relationship. It can look different depending on the person, and all age groups can suffer from adjustment disorders. Some 70% of children being seen in a psych setting are diagnosed with an adjustment disorder. Sometimes this is done to avoid labeling a child with something bigger, such as oppositional defiant disorder, or a major mental illness.
An adjustment disorder may cause anxiety in a child, as it did with my son, behavioral issues, truancy, sexual promiscuity, substance abuse, and depression. While an adjustment disorder may sound rather tame, people with adjustment disorders are at risk for suicide, and so treatment should be sought as soon as a problem is realized. In adults, women are twice as likely to be diagnosed with an adjustment disorder, and in the adult population, it is estimated that 5% to 20% of people who seek out counseling fit into one of the adjustment disorder subtypes.
Adjustment disorders are generally treated with therapy, whether it be group, or individual. Cognitive-behavioral therapy is especially helpful, and for most adults, the prognosis is good. Medication may be used if depression is present. In children, those who are diagnosed with an adjustment disorder prior to the age of 13 tend to fair well with treatment, with the adjustment disorder generally not associated with a future psychiatric disorder. For kids who have an adjustment disorder and are over the age of 13, things often do not turn out as well. After 5 years, 43% of the kid go on to be diagnosed with a mental illness of far more severity than the adjustment disorder.
For my son, our move has made all of the difference. He is away from his father, and does not have to be subjected to visits to the house where the abuse took place. His behavioral problems have all but disappeared, and what behavioral problems we do have I can easily chalk up to him being 5 years old. His anxiety has lessened greatly, and he is toying with the idea of sleeping in his own room. He is far more confident, outgoing, and separates from me with relative ease now. I am rather amazed by his progress, and certainly thrilled for him. He is now flourishing.
He still has Asperger’s and always will, but he is a smart and funny child who draws people to him. He still has nightmares every night, but he is learning to trust again. Because of the progress that he has made in two short months, I feel very encouraged that he will fully recover from his adjustment disorder. If your child has recently been through a stressful time and is not behaving like himself, seek help for him, and do it as soon as possible. There is much help for kids with adjustment disorder, and much hope if treatment is begun early. We all need a little help every now and then, and oftentimes, out of that help comes a gift, such as learning new, effective ways to cope with stressful events when they happen in the future