Mother’s Experiencing Adjustment Disorders

A Mothers’ Mental Health Toolkit Project Learning Video

with Dr. Joanne MacDonald Reproductive Mental Health Service

IWK Health Centre Halifax, NS

Adjustment Disorders

• Adjustment Disorders are a mental and emotional disturbance that can occur for any person at any time of life.

• An Adjustment Disorder is a time-limited change in emotion, thinking and function related to one or more specific identifiable triggers or stressors.

Adjustment Disorders

• Adjustment generally follows change.

• Adjustment responses are greatest when the changes involve more stress or demand, increased conflict, new roles, or loss of supports, both a person’s own resources inside themselves, or the practical support of others.

• Mothering challenges can involve all these aspects of adjustment. Risk for an Adjustment Disorder then becomes higher.

Adjustment Disorders

Adjustment Disorders

Features of Adjustment Disorders include: • Stressors or changes one can see and understand• Difficulty using usual coping strategies• Emotions can include depression, irritability, anxiety,

agitation or a reduced reactivity called apathy• Often impacts the woman’s relationships• Can see disturbance of emotions, thinking patterns,

behaviours• Addiction relapse can be a risk• ‘Understandable’ responses but excessive and not helpful

Adjustment Disorders

• Key Concepts:• We pay attention to Adjustment Disorders

because they can set a woman up for a chronic mood disorder and/or unhelpful coping responses.

• While time frame is shorter, the effect on the woman’s life and mothering can still be high.

Adjustment Disorders

What are some typical triggers or stressors?

1. Sleep deprivation2. Increased work load (eg. new baby)3. Financial strain4. Moving house5. Rapidly changing roles6. Conflicts in important relationships7. Illness for woman or other family member8. Losses – pregnancy-related, physical or emotional9. Trauma

Adjustment Disorders

• Can you think of a mother who has some of these triggers?

Adjustment Disorders

• For example • A 26 y/o mother with 4 m/o old infant with reflux/colic and 3

y/o toddler, moves to rural town where partner can find promising work. She leaves her job as a waitress in a small city where she grew up. She has no maternity benefits, has the loss of all her social and practical supports. Her mother is diagnosed with cancer just after the couple moves and can’t come to visit as planned. Her sister is angry that she moved away when mother is ill and feels left with all the responsibility. Partner’s job involves long hours and the one car. She used to go to a gym with childcare but is afraid to walk on the busy highway near their home which is a ‘fixer upper’.

Adjustment Disorders

What happens?

• She feels overwhelmed, can’t use her previous coping strategies around exercise and visiting friends. Getting out to the few activities in new town seems like too much work with two small children. She was independent and very organized in past so ‘hates to ask for help’.

• She finds herself just staring at times, unable to make a plan, feels down, has begun watching more TV than she likes, feeling playing with toddler a chore, is tearful ‘for no reason’ and daydreams about old times at home or worries about her mother.

• Symptoms would be low energy and initiative, mixed anxious and depressed mood, tension with partner, social isolation.

• Her response is not helping her cope better.

Adjustment Disorders

Treatments?– “Oh you’ll get over this eventually” not helpful

1.Support and education 2.Enhanced self-care, possibly new activities3.Talk therapies4.Relationship skill building5.Meet change with changed behaviors and strategies6.Sometimes medications for a short time to support

sleep, lower anxiety, prevent more serious depression

Adjustment Disorders

• Outcome?

• Typically full recovery• Can build skills & resilience• Critical to learn for ‘next time’• Can happen to anyone• Stressors can be high and many

Adjustment Disorders

• Learning Points:

• Triggers must be present for this diagnosis• Doesn’t come ‘out of the blue’• Not a chronic or long lasting mood or mental disorder• But intervention is important to limit effects on mother

and her family• Common disorder – 25 +% of people in their lifetime• Very treatable problem• Can happen to any of us

Adjustment Disorders

Thank You!