Reaction to severe stress, and adjustment disorders, depression

The reaction to severe stress and adjustment disorders are identified not only on the basis of symptoms and the nature of the course of the disease, but also on the basis of the evidence of the influence of possible causes: an adverse event in life that caused an acute stress reaction, or a significant change in life leading to prolonged unpleasant circumstances and adaptation disorders.

Depending on the timing of occurrence, the following types of disorders are distinguished.

Acute stress response

Occurs immediately after an injury. Symptoms are kaleidoscopic, can change and disappear on their own without the intervention of a doctor. Lethargy, confusion, anxiety or depression, euphoria, or anger are possible, patients may complain of palpitations, nausea, difficulty breathing. It usually resolves within 3 days or may progress to post-traumatic stress disorder.

Post-traumatic stress disorder

Prolonged or delayed stress response. It is characterized by depression, flashbacks, nightmares, irritability and aggressiveness, alienation, panic attacks, and sometimes addiction to alcohol or drugs. It can last for years.

Adjustment disorders

They occur during a period of significant life changes and can manifest themselves as a short-term or prolonged depressive or anxiety-depressive reaction.

Grief reaction

It occurs in response to the death of a loved one. It is manifested by obsessing over the deceased, talking about him, detachment, depression. The grief reaction is characterized by five stages (stages of acceptance) – denial, anger, bargaining, depression, humility. Getting stuck on one of them can lead to prolongation of mourning and the development of other disorders.

Depression or depressive syndrome

Pathopsychological syndrome, which is characterized by a short-term or chronic decrease in unmotivated depressive mood (hypothymia). Also, the loss of the ability to experience joy (anhedonia), positive interests, enjoyment, decrease (inhibition) of intellectual mental activity (bradypsychia), psychomotor retardation (bradykinesia), disturbed sleep rhythm, as well as excessive asthenia and drowsiness.

You can also observe a decrease in instinctive activity (decrease or increase in appetite), a decrease in the instinct for self-sacrifice and self-preservation (suicidal statements and actions), impairment of cognitive processes – attention, memory, thinking.

For example, a pessimistic negative view of the actions taking place around, a loss of interest in the micro- and macroenvironment, and in previously habitual mental and work activities, an inadequate increase or decrease in self-assessment.

In patients with anxiety, emotional experiences are more often directed towards the future, in people with a depressive symptom complex, on the contrary, experiences in the past: conflicts, failures that occurred at an early age, both in the micro- and in the macro-environment, are more relevant. Even insignificant, long-forgotten events acquire such significance that patients can blame the closest people and interpersonal relationships can become unbearable.

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