Transcript Anxiety and Mothers

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 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 deprivation
2. Increased work load (eg. new baby)
3. Financial strain
4. Moving house
5. Rapidly changing roles
6. Conflicts in important relationships
7. Illness for woman or other family member
8. Losses – pregnancy-related, physical or emotional
9. 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 activities
3.Talk therapies
4.Relationship skill building
5.Meet change with changed behaviors and strategies
6.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
Thank You!