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Chronic Adjustment Disorder

Chronic adjustment disorder is a mental health condition characterized by an inability to adjust to or recover from a traumatic or stressful life event. Many military members experience these events and thus have a high risk of developing chronic adjustment disorder. They may be able to apply for VA disability benefits for this condition.

The link between military veterans and post-traumatic stress disorder (PTSD) is well-known, but PTSD isn’t the only stress-related condition that affects combat veterans. 

Chronic adjustment disorder is similar to PTSD: It is a stress-related mental health condition that affects the individual’s ability to form or maintain relationships or complete the tasks of everyday life, such as personal care, working, going to school, or caring for their family.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists chronic adjustment disorder as a mental illness. Military veterans who have chronic adjustment disorder may make a disability claim with the U.S. Department of Veterans Affairs if their condition impacts their daily life and their ability to support themselves.

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    Why do veterans have chronic adjustment disorder?

    There are several kinds of adjustment disorders. These disorders share certain characteristics, such as the individual’s inability to adjust to a significant life change or change in circumstances. 

    Adjustment disorders aren’t limited to military veterans. For example, they can arise from difficulty adjusting to life after the loss of a loved one or a divorce. They are common when someone moves from living in a stressful environment, such as deployment, to a much less stressful one, such as demobilizing and moving back home.

    Many veterans develop chronic adjustment disorder in response to stressful events or life changes. During combat, or even in a deployed non-combat role, military members are subject to stressful living conditions and may be under constant threat or perceived threat. 

    Adjustment disorders typically develop in response to an identifiable incident or incidents, although in some cases, there may not be a single direct cause of the disorder.

    A service member’s temperament and vulnerability to adjustment disorders, personal history of trauma, pre-existing mental health conditions, support system, and coping skills influence the severity of the adjustment disorder and how long the condition lasts.

    How is chronic adjustment disorder diagnosed?

    Diagnosing chronic adjustment disorder for military veterans is often completed by a licensed psychiatrist or other licensed mental health professional. They will note the veteran’s symptoms and ask questions about incidents or circumstances that could have triggered the condition. 

    Not every person will exhibit all symptoms of chronic adjustment disorder, and some may express their symptoms to a greater or lesser degree. In addition, the symptoms may wane over time or may suddenly present more strongly if a particular life event triggers an association with the initial event.

    Common physical symptoms of chronic adjustment disorder include:

    • Insomnia
    • Body aches, headaches, or stomachaches
    • Sweating hands
    • Heat palpitations

    Some emotional and behavioral symptoms of chronic adjustment disorder include:

    • Impulsive or reckless behavior
    • Agitation and anxiety
    • Withdrawing from others and feeling isolated
    • Crying or feelings of hopelessness
    • Difficulty concentrating
    • Changes in eating habits; rapid weight gain or loss
    • Increased abuse of drugs or alcohol
    • Suicide ideation or attempts

    Many symptoms of chronic adjustment disorder are the same as clinical depression or situational depression; veterans who suffer from one condition may also suffer from the other. A mental health professional should consider whether both disorders are present when making a diagnosis.

    The DSM-5 states that a diagnosis of chronic adjustment disorder requires the following five criteria:

    • Symptoms developed within three months of the trigger event
    • Distress exceeds normal levels and causes substantial problems in the person’s life
    • Symptoms do not meet the criteria for another mental disorder and are not a flare-up of an existing mental health condition
    • Symptoms are not part of the normal process of grief
    • Symptoms last more than six months after the initial event ended

    The difference between an acute adjustment disorder and a chronic adjustment disorder is the length of time that the symptoms last. Acute adjustment disorder symptoms last less than six months. Chronic adjustment disorder symptoms last longer than six months and can continue indefinitely.

    How is chronic adjustment disorder treated?

    Chronic adjustment disorder treatment has the best results when diagnosed early. Intensive treatment can effectively alleviate symptoms and improve the quality of life for those with the disorder. Psychotherapy, or “talk therapy,” is the most common treatment for this disorder

    The situation itself and resulting stressors trigger the onset of chronic adjustment disorder. Many people respond well to talking through the event with a qualified therapist or counselor. These therapists can give the individual tools to cope with stress and intrusive thoughts. 

    Talk therapy can include individual therapy sessions and group support sessions. Some people may also benefit from family therapy if the disorder has affected familial relationships.

    Medication may also be an option to help reduce the symptoms of chronic adjustment disorder. Anti-anxiety medicines, such as benzodiazepines, are the most commonly prescribed. 

    Some people may also require antidepressants or sleep aids. Other medications may include selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

    Is chronic adjustment disorder eligible for VA disability?

    Chronic adjustment disorder is a reaction to a traumatic or stressful event. These events often happen to people who serve in the military. 

    The VA recognizes the connection between a triggering event and the onset of chronic adjustment disorder. Therefore, it will offer disability benefits to veterans whose experiences while serving triggered the onset of the disorder.

    Chronic adjustment disorder, like all types of military disabilities, is evaluated on a scale of 1-100 by the VA. A 100% disability rating is completely debilitating. This rating is more common for veterans who suffer from more than one diagnosed disability. 

    If your chronic adjustment disorder is severe, but you don’t have any other recognized disabilities, then it’s unlikely that you’ll receive 100% disability benefits from the VA.

    If you do qualify for disability benefits for chronic adjustment disorder, the VA may opt to reevaluate your condition over time. If your symptoms last less than five years, your disability rating is “unprotected” and subject to change.

    With proper therapy and treatment, chronic adjustment disorder symptoms may lessen and eventually cease; therefore, your disability compensation may decrease accordingly. 

    A disability rating that remains the same for more than five years receives a “stabilized” rating. This makes it harder for the VA to modify or decrease your benefits. However, the likelihood of chronic adjustment disorder symptoms remaining static for five years is lower than that of many other qualifying disorders. 

    In order to maintain your initial disability rating, you must prove to the VA that you are still experiencing chronic adjustment disorder symptoms at the same level of severity as they were at your initial diagnosis and that the symptoms have a significant impact on your life. You must also prove that you are still receiving treatment for the disorder.

    Appealing a Denial

    Military veterans may develop chronic adjustment disorder as a result of their experiences while on active duty or deployed. Chronic adjustment disorder is a recognized disability that is eligible for VA disability benefits. 

    If the VA has denied your disability claim, you have options to appeal.

    Page Last Updated
    September 9, 2022
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